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Meniere's disease and mitral valve prolapse. Might have polydipsia, reduced water intake. Eat sodium and then drink water?

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Nephrologist
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I am 47 years old, weigh 125 pounds and have Meniere's disease and polydipsia, so I reduced my water intake. But I get very thirsty after eating something salty or eating bread. For example, after eating a piece of bread with only 65 mg of sodium I had to drink 52 ounces of water over a four hour period before my thirst was quenched. I was told not to drink more than 5 ounces of water every half hour, so I more or less did that. I find that my thirst is not quenched easily if I wait half an hour or an hour to drink the next cup of water. If I drink 12 ounces of water immediately, and another 6 ounces half an hour or an hour later, I might end up drinking less than if I drink only every half hour. Should I drink about 18 ounces after eating about 200 mg of sodium, and then wait for my blood sodium level to go down before drinking any more?
I also have a question about my kidney function. I have been unable to quench my thirst for two and a half weeks, because I was told I have polydipsia. So I reduced my water intake to 5 and a half or 6 ounces every half hour and then to 5 or 6 ounces every hour. But there have been times where I have drunk 6 ounces every half hour, and then waited till my clear urine became yellow again to drink. This meant that there were periods of time where I drank less water because I was waiting for my urine to become concentrated - but then in the time I was waiting for that I became dehydrated. In one instance there was a period of 14 hours where I drank only 15 ounces of water. Could I have harmed my kidneys? But on the whole I was usually drinking about 100 ounces in a 24 hour period (though sometimes 80 ounces). I also reduced my sodium intake. Today in the morning I was dehydrated so I drank 30 ounces of water over a 3 and a half hour period, from 7:30 AM to 11 AM. I did not start urinating until 11 AM. Does that mean that my kidneys were not functioning properly, or does it simply mean that my body needed the water as I was dehydrated? I noticed that my kidneys were still able to produce 6 ounces of urine every half hour, if that was what I drank. If I drank 6 ounces every hour, they produced 6 ounces every hour. But I have noticed today for the first time that my kidneys seem to be slow to react to changes in my water intake. I want to slowly return to my previous pattern of drinking, which was to eat 2000 mg of sodium and drink maybe 200 ounces of water. Should I first eat 1200 mg of sodium and drink 120 ounces of water and then return to my previous intake of water? Is it safe for me to return to my previous intake of water, will my kidneys be able to deal with the greater amount of water if they are reacting more slowly? But they still are able to produce 6 ounces of urine every half hour.
Posted Fri, 4 May 2012 in Kidney Conditions
 
 
Answered by Dr. Dilip M Babu 24 hours later
Hi,

Thanks for the query.

The amount of water one needs, the amount of urine secreted and the amount of salt needed depend on primarily on kidney functions. Some other factors such as cardiovascular functions, endocrine functions and so on also play a role in affecting salt and water intake.

Though I think your kidneys are ok (as you are producing enough urine), you should check your kidney function tests like urine analysis, blood urea, creatinine and serum electrolytes (sodium, potassium). If kidney function tests are normal you can return to your previous pattern of drinking.

Normal kidneys will able to adjust your body fluid and electrolyte balance by concentrating or diluting urine.

Hope this answers your query. I will be available to answer any further queries which you may have.

Regards
Dr Dilip M Babu
Nephrologist
Above answer was peer-reviewed by
 
Follow-up: Meniere's disease and mitral valve prolapse. Might have polydipsia, reduced water intake. Eat sodium and then drink water? 18 hours later
I also started taking a drug called abilify (a low dose, 2.5 mg every night) while I have reduced my water intake and am thirsty. I later found out that one should not become dehydrated when taking abilify. I took the abilify before going to bed and was extremely dehydrated when I woke up. Could the abilify have damaged my kidneys? My kidneys started hurting after the second day that I took abilify, where I was not drinking enough to quench my thirst. But the first time I had the kidney pain was ten hours after waking up (after the second night that I had taken abilify), when I had drunk a lot of water and was still feeling thirsty. I took the abilify twice and had to temporarily stop taking it because of the kidney pain and am waiting to go back to my normal intake of water to take the abilify again. I am at present drinking about 72 to 90 ounces of water per day and eating about 600 to 1000 mg of sodium, but still feel thirsty after meals.
 
 
Answered by Dr. Dilip M Babu 28 hours later
Hi,

Abilify usually does not damage kidneys or cause kidney pain. You can continue taking Abilify as advised by your psychiatrist. You should monitor your blood sugar, blood lipids, weight gain if you are taking this drug. Consult your psychiatrist about dosage and use of this drug. You can drink 90 to 100 ounces of water per day and try to reduce salt to 600 mg per day.

Hope I answered your query, please accept my answer if you do not have further queries.

Regards,
Dr Dilip M Babu
Above answer was peer-reviewed by
 
Follow-up: Meniere's disease and mitral valve prolapse. Might have polydipsia, reduced water intake. Eat sodium and then drink water? 2 days later
I am not completely sure as to how much sodium is in the food that I am eating. I am combining deli food with food that has no sodium. Deli food tends to be high in sodium. From 8 AM today to 5 PM I probably ate around 575 mg of sodium or more and drank 58 ounces of water (avoirdupois ounces, not fluid ounces, that is less than 58 fluid ounces). I also was hungry and ate a lot. Did I eat too much sodium and not drink enough water? I was thirsty most of the time, because I was limiting my water intake to 5 or 6 ounces every hour, at the most 8 ounces after a meal. I don't want to become hypernatremic. I am limiting how much I drink because of the fact that yesterday and before that when my sodium intake was 300 mg a day, and even when I had increased my sodium intake to 800 mg a day, if I drank 5 or 6 ounces every hour I started to get a bit of a headache and tingling in my feet and hands (due to hyponatremia?). So I am trying to be cautious. But maybe I am overdoing it. I am still thirsty, and perhaps I have too much sodium in my system. I am afraid to drink too much water as I don't want to become hyponatremic. Should I go ahead and quench my thirst - I also want to avoid becoming hypernatremic. If my urine is pale yellow or clear, does that mean that I am not hypernatremic? If my urine is bright yellow, could I be hypernatremic?
 
 
Answered by Dr. Dilip M Babu 10 days later
Hi,
Thanks for reverting.
It is fine if you are consuming this quantity of sodium and water. Further, you should have enough water so that the urine that you are passing is clear.
Hypernatremia, only if caused by severe dehydration, can cause bright yellow urine.
You can have as much water as you want and not worry about hyponatremia. The sodium requirement of an average adult is 1500-2300 mg/day.
The sodium concentration in the body does not directly affect the colour of the urine unless it is related to the hydration status of the patient.
As such the sodium levels are very closely regulated in the body and so is the water content in the body.

I hope I have answered your query. Please accept my answer if you have no further queries.

Regards.
Dr. XXXXXXX M. Babu
Above answer was peer-reviewed by
 
Follow-up: Meniere's disease and mitral valve prolapse. Might have polydipsia, reduced water intake. Eat sodium and then drink water? 17 hours later
I was told to return to my previous pattern of drinking - which was to drink a lot of water (200 ounces per day, while eating a lot of salty food). I am having a lot of difficulties returning to drinking normally. If I simply drink when I am thirsty, I might end up drinking too much, so I drink only 5 to 6 ounces every half hour when I am thirsty (I stay thirsty for many hours this way). When I do this, I might end up drinking more than I used to. I find that I am not urinating a lot during the daytime when I am eating food, but urinate a lot of clear urine at night, and have to wake up many times at night to urinate. Previously, I only had to wake up twice to urinate. Yesterday I drank about 103 ounces of water, and remained thirsty part of the day. At around 10 PM I had to drink 5 to 6 ounces of water every half hour for several hours to quench my thirst. The problem is that when I have drunk a lot of water I feel a pressure in my head and have a tiny bit of edema in my ankles. In the past when I was eating a lot of salty food and drinking a lot I didn't have this problem with pressure in the head. I was told that I can drink 10 to 12 ounces of water to quench my thirst and then 5 to 6 ounces again half an hour later, and can continue doing this until my thirst is quenched. Is it okay for me to do that, or could I become hyponatremic, since I get pressure in my head from drinking 5 or 6 ounces every half hour?
 
 
Answered by Dr. Dilip M Babu 3 hours later
Hi,
Thanks for reverting.
Polydipsia can cause hyponatremia. You can monitor your sodium levels and if it is in the normal range, you can continue your current pattern of drinking until your thirst is quenched. I think you should be closely following up with your treating physician for monitoring sodium levels.

I hope I have answered your query. Please accept my answer if you have no further queries.
Thanks
Above answer was peer-reviewed by
 
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