The average adult drinks around 1.5 liters of water or other beverages on an average day, at average temperatures and with average physical activity. Athletes will sometimes drink around three liters of water on hot days. However, anyone who easily drinks well over three liters of water a day, experiences an increased feeling of thirst and therefore has to visit the toilet frequently could be suffering from diabetes insipitus.
A clinical picture with constant thirst
Most people are familiar with diabetes mellitus griech. diabeinein, hindurch passieren (für vermehrte Harnausscheidung), lat. mellitus, honigsüß. Diabetes mellitus ist ..., but not with diabetes insipitus. While in type 1 and type 2 diabetes mellitus the sugar metabolism is disturbed, diabetes insipitus is a disorder of the hydrogen metabolism. This clinical picture is therefore also known as urinary retention. People who suffer from diabetes insipitus constantly have the frightening feeling of drying out. And this despite the fact that they easily drink 10 bottles of water a day, even in moderate temperatures and without extreme physical exertion. A healthy person would not be able to metabolize this amount. Most people would be at risk of acute water intoxication if they consumed less than half this amount of liquid. In the worst case, water intoxication can lead to fatal brain swelling.
Just thirsty or seriously ill?
Under physical stress, at work or during sport, it is normal for healthy people to feel thirsty. And this is a good thing, as the body loses more water and needs to balance its water intake. However, anyone who is constantly thirsty and has to go to the toilet countless times a day should definitely have a medical examination. The kidneys play the main role in hydrogen metabolism, which could possibly be disturbed. Excess fluid is filtered out of the blood in the kidneys. This is then passed on to the bladder in the form of urine. The smallest measuring cells, which are also located in the brain, register how much excess fluid the organism needs to get rid of or whether additional water is required. If this mechanism is disturbed, it can lead to pathological thirst, for example. Fortunately, diabetes insipidus is not life-threatening as long as enough fluid is consumed.
Diabetes insipidus centralis and renalis
There are two different forms of diabetes insipidus, centralis and renalis. Diabetes insipidus centralis is caused by damage to the brain. The hypothalamus may have been damaged by a head injury, meningitis or a tumor, for example. As a result, not enough of the hormones necessary for hydrogen metabolism can be produced, released or stored. In a small percentage of people with diabetes insipidus centralis, the disease can also be hereditary. In diabetes insipidus renalis, the kidneys do not react to the hormones released. There is no damage to the brain. Kidney damage can be inherited or acquired. This is usually due to chronic kidney disease or strong medication that has impaired health.
Caution in the case of disorders of the water balance: If you feel very thirsty for no good reason or have a constant strong urge to urinate, it is advisable to consult an endocrinologist. This is because it is highly likely that a hormonal problem is behind the disruption of the hydrogen metabolism.
