Brief Answer:
night sweats require assessment

Detailed Answer:
Hi,

Night sweating is a symptom that requires assessment to exclude various disorders like infections, hematologic diseases, etc. The urge to drink cold fluids probably means increased thirst which sounds normal when someone looses too much fluid by sweating. Thirst is usually caused by dehydration which is common in patients who don't get enough fluids, sweat a lot, have high blood sugar (diabetes), high calcium levels (increased urine output) or have an infection (the variations in body temperature cause a cycle of chills and sweating), etc.

I usually advise patients who present with night sweats to do the following:
- make sure that their sweating is not normal (too much heat, not too much sweating). The patient has to be so wet that changing sheets would be inevitable.
- check body weight changes: loosing weight and night sweats (particularly with fever) are called beta symptoms and are associated with advanced hematologic malignancies (but not limited to them) when they've lasted for long enough (6 months or so).
- check the body temperature but not when sweating. The body has to be dry before you check the temperature. Fever may initiate investigation for various causes.
- a basic clinical examination as it may reveal valuable clues for infections or other potential causes.

If everything is normal and the patient does not sweat that much (remember the need to change sheets in order to classify sweating as serious enough) I usually only suggest a follow-up visit after 15-30 days to see how it goes (unless other symptoms occur and the visit has to be rescheduled) and some basic tests like a complete blood count, erythrocyte sedimentation rate, C-reactive protein, urea, creatinine, blood sugar, calcium, phosphorus, albumin, AST, ALT, ALP, serum electrolytes, urinalysis.

If a hematologic malignancy is suspected (swollen lymph nodes, enlarged spleen and/or liver, beta symptoms) then radiological tests may be needed as well.

So in conclusion, I believe that the best course of action right now is to visit your primary care physician. Your doctor can assess your condition and suggest the most appropriate testing strategy in order to avoid unnecessary tests (and anxiety).

I hope you find my comments helpful!
Take care,
Dr. Panagiotis Zografakis

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