Excessive Urination: Causes and Concerns Explained

Regarding issues related to urine output?

I often feel that I have a large urine output, with a daily intake of at least 1500 to 2500 cc and a drinking volume of about 2000 cc.
I went to a urologist for a urinalysis, and aside from a urine specific gravity of 1.003, everything else was normal.
I have noticed that if I don't drink water or drink very little, I don't urinate much, about every 3 to 4 hours, nearly 100 cc.
However, why is it that as soon as I drink water, I have a lot of urine? Also, why do I have to urinate before bed, yet still have a large volume of urine upon waking, sometimes up to 500 cc? I didn't drink that much water before sleeping.
The doctor said my urinalysis was normal, so there was no need for blood tests.
Is that correct?

Hehe, 20~29 year old female. Ask Date: 2014/05/14

Dr. Wu Jiyu reply Internal Medicine

1.
According to your description of "at least 1500 to 2500 cc per day" and "not urinating much if drinking little or no water," both are normal phenomena.

2.
The human body has a self-regulating mechanism; more fluid intake leads to more urination, while less fluid intake results in less urination.

3.
If there are symptoms of excessive eating, drinking, and urination, consider the possibility of diabetes.

4.
A urine specific gravity of 1.003 is slightly low, indicating that the urine is more diluted at that time.
It may be beneficial to retest the first morning urine after fasting to confirm that the urine concentration function is normal.
Thank you for your inquiry; the Nephrology Department at Changhua Hospital is concerned about your health.

Reply Date: 2014/05/14

More Info

Excessive urination, or polyuria, can be a concerning symptom for many individuals. In your case, you mentioned that your daily urine output ranges from 1500 to 2500 cc, which is indeed on the higher side, especially considering your fluid intake of around 2000 cc. It's important to understand the underlying mechanisms and potential causes of this condition.

Firstly, the kidneys play a crucial role in regulating fluid balance in the body. They filter blood to create urine, and various factors can influence how much urine is produced. When you consume a large amount of fluids, your kidneys respond by excreting more urine to maintain homeostasis. This is a normal physiological response. However, if you find that you are producing excessive urine even with a moderate intake of fluids, it may indicate an underlying issue.

One common cause of excessive urination is diabetes mellitus, particularly diabetes insipidus, which is characterized by an inability of the kidneys to concentrate urine. This condition leads to the excretion of large volumes of dilute urine. However, since your urine specific gravity is 1.003, which indicates dilute urine, it might be worth considering further evaluation for diabetes insipidus or other forms of diabetes.

Another potential cause could be a condition known as nocturia, which is the need to wake up during the night to urinate. You mentioned that you experience significant urine output upon waking, even after urinating before bed. This could be due to several factors, including fluid retention during the day that is released at night, or it could be related to bladder overactivity.

In your case, the fact that your urine tests came back normal is reassuring, but it does not completely rule out all potential issues. While your doctor may have deemed further blood tests unnecessary at this point, it might be prudent to seek a second opinion or further evaluation if your symptoms persist or worsen. Blood tests can help assess kidney function, blood glucose levels, and other metabolic factors that could contribute to your symptoms.

Additionally, lifestyle factors such as caffeine and alcohol consumption can also lead to increased urine production. Both substances have diuretic effects, which can exacerbate the feeling of needing to urinate frequently. If you consume these substances, it may be worth monitoring their impact on your urinary habits.

In summary, while your current urine tests are normal, the symptoms you describe warrant further investigation. It is essential to consider all potential causes, including diabetes, bladder overactivity, and lifestyle factors. If your symptoms continue to be bothersome, I recommend discussing the possibility of further testing with your healthcare provider or seeking a referral to a specialist, such as a nephrologist or urologist, who can provide a more comprehensive evaluation of your urinary health.

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