What Is Polyuria?
If you're asking yourself why you pee so much, you could have a condition called polyuria. That's the medical term for making a larger amount of pee than usual.
Adults usually make no more than 3 liters of urine per day. But with polyuria, you could make up to 15 liters per day. So you pee more often and in bigger amounts than usual. It's a classic sign of diabetes, but it also can come from other medical conditions or drinking too much water and other fluids.
Other problems, such as an overactive bladder, an enlarged prostate, and urinary tract infections, can send you running for the bathroom many times a day, even if there isn’t much urine in your bladder. But polyuria makes you have to go more often because your bladder is full.
Polyuria Symptoms
If you have polyuria, you might have symptoms such as:
- Peeing more than the average seven or eight times a day
- Peeing large amounts each time, which might not happen with other causes of frequent urination
- Feeling thirstier than usual, because of the cause of your polyuria
- Waking up often at night, because of the need to pee
- Pale, diluted urine, if your polyuria is linked to excess fluid consumption
Polyuria Causes
Polyuria can have many causes. Here are some of the most common.
Type 1 and type 2 diabetes
Polyuria is often an early sign of diabetes, and diabetes is the most common cause of polyuria, in children and adults.
Here's how diabetes can cause polyuria: First, diabetes makes sugar build up in your bloodstream. That makes your kidneys work harder to filter the sugar out. If the kidneys can't keep up, they produce extra urine to get the sugar out. When the extra sugar and fluids get to your bladder, you have to pee more.
Plus, the more you go, the thirstier you feel, and the more you drink, leading to more peeing.
Drinking too much fluid
Some physical health conditions can make you extra thirsty, so that you drink and pee more. But drinking too much, which doctors call polydipsia, also can be linked to mental health problems, including schizophrenia and bipolar disorder.
Also, some otherwise healthy people drink more water and other fluids than they should in a misguided attempt to improve their health, potentially leading to polyuria and other problems.
Drinks with alcohol or caffeine are especially likely to increase urine levels.
Medications
Different drugs can lead to polyuria. The most common culprits are diuretics, also known as water pills, which are medicines that move water and salts out of your body. They are commonly used for blood pressure control.
Other medications that can lead to polyuria include calcium channel blockers, also used for blood pressure control; lithium, used for bipolar disorder; SSRIs (selective serotonin reuptake inhibitors), which are antidepressants; and demeclocycline, an antibiotic.
Diabetes insipidus (arginine vasopressin disorder)
With this rare condition, unrelated to type 1 and type 2 diabetes, your body isn’t able to control its fluid levels. It's caused when you have trouble making or using a hormone called vasopressin or antidiuretic hormone (ADH). When you have this condition, you feel very thirsty no matter how much you drink.
It can happen because of many medical conditions, including kidney problems, certain cancers, autoimmune disorders, and brain issues linked to surgery, tumors, infections, or head injury. Pregnancy can also cause temporary diabetes insipidus. It usually goes away when you're no longer pregnant.
Kidney disease or kidney failure
Damaged kidneys can’t process urine the way they’re supposed to. Polyuria can often be an early sign of kidney trouble. Conditions that affect your kidneys, including liver disease, sickle cell anemia, and high blood calcium levels (hypercalcemia), can contribute to polyuria.
Excessive IV fluids
If you are getting fluid through your veins because of a medical problem, producing too much urine is a sign you are getting too much.
Diagnosing Polyuria
Your doctor looks at many things to confirm polyuria and diagnose the cause.
Symptoms. They’ll ask about how much and how often you pee, how thirsty you are, and whether any changes in thirst happened suddenly or gradually. They'll also look for symptoms linked to possible causes.
History. Your doctor will ask you when your symptoms started and check on any recent medical treatments that could cause them, like getting IV fluids or tube feeding, or having brain surgery. They'll ask how much water and other fluids you drink.
Physical exam. They’ll check for signs that you might have diabetes or other conditions linked to polyuria.
Urine tests. Along with a standard urine test, your doctor might order an 8-, 12-, or 24-hour test. For a typical extended test, you’ll get a special container and pee into it over a 24-hour period. When the 24 hours are up, you'll take the container back to the lab. Be sure to follow instructions, such as keeping the urine cool until you can return it. The test looks for the same things as a one-time urine test, but gathering all your pee over a longer period gives the doctor a better sample of what’s in it.
Water deprivation test. This is a test for diabetes insipidus. Because it can cause dehydration, it's usually done in a hospital, under medical supervision. Different doctors do the test in different ways. But you might, for example, have no fluids for 8 hours or until you’ve lost 5% of your body weight. Your weight and urine concentration will be tested at regular intervals. You may also get doses of manufactured ADH to see how your kidneys respond.
Blood tests. These will check levels of calcium, sodium, potassium, and other substances that might cause or be affected by excess urination.
Glucose test. Your doctor will check your blood sugar to see if you have diabetes.
Pituitary function test. The pituitary gland, found at the base of your brain, makes ADH. If something is wrong with it, your production could be off.
Polyuria Treatment
How you stop polyuria depends on what’s causing it. So it's important for you and your doctor to figure out the cause before you try any treatments or lifestyle changes.
Once you know the cause, the treatment might include:
- Getting your type 1 or type 2 diabetes under better control
- Switching medications or doses of drugs that add to your polyuria
- Treating conditions that affect your kidney function
- Taking a medication called desmopressin, for some forms of diabetes insipidus
- Reducing salt in your diet, for some other forms of diabetes insipidus
- Drinking less fluid – but only if excess fluid consumption is the cause
- Treating any mental illness that causes you to drink too much fluid
When to See a Doctor for Excessive Urination
If you find yourself needing to pee more than eight times a day or think you're peeing out more liquid than is normal for you, check with your doctor.
Call the doctor right away if your increased urination comes with any of these other symptoms:
- Fever
- Vomiting
- Pain in your lower back or side
- Blood in your urine (hematuria)
- Discharge from your penis or vagina
Takeaways
Polyuria means your body is making too much urine. If you have it, you may notice that you're not only peeing more often, but peeing out larger amounts. It could mean that you're just drinking too much water and other fluids. Or it could be a sign of a medical condition, such as diabetes or kidney trouble. Your doctor can help you sort it out.
Polyuria FAQs
How much peeing is considered polyuria?
The usual medical definition is peeing out more than 3 liters of urine a day. You can't tell exactly how much you're peeing without measuring it. So, to confirm polyuria, your doctor might ask you to collect all your urine for a day.
What deficiency causes polyuria?
One possible cause of polyuria is arginine vasopressin deficiency – a shortage of the hormone vasopressin, also known as antidiuretic hormone (ADH). The hormone is made in a part of your brain called the hypothalamus and stored in the pituitary gland, found at the base of the brain. Your body needs this hormone to move fluid filtered by the kidneys back into the bloodstream. When you don't have enough of the hormone or your kidneys don't respond to it in the right way, you make too much urine. This condition is also known as diabetes insipidus.
Can you reverse polyuria?
Yes, polyuria is either a symptom of another condition or a result of drinking too much fluid. So treating the condition behind it or drinking less fluid can reverse it.
