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The last 2 months i have not had normal healthy urination, I

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Hithe last 2 months i...
Hithe last 2 months i have not had normal healthy urination, I hardly go anymore, Occasionally out of the blue i will need to go every 2 hours or so this usually happens around bed time When i do go in the day my urine is dark. Apart from that i hardly go. Im very worried, i drink 3-4 litres per day and have had blood and urine tests all clear. My doctor doesn't know to do.Ihave no visable edema. I am super obese but apart from that healthy.
Submitted: 1 year ago.Category: Urology
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Answered in 7 hours by:
2/3/2016
Urologist: Dr. D. Love, Doctor replied 1 year ago
Dr. D. Love
Dr. D. Love, Doctor
Category: Urology
Satisfied Customers: 19,123
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hello from JustAnswer.

Which blood and urine tests have been done?

If you have the lab report, can you attach it (after blacking out your name)?

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Customer reply replied 1 year ago
Hi i dont have lab test results available to me only the doctor has,they were kidney fuction and check protein in urine
thanks
Urologist: Dr. D. Love, Doctor replied 1 year ago

It certainly is appropriate to check kidney function, but if the only tests that were done were of kidney function, then the next step would be additional blood tests, specifically looking for metabolic conditions that can secondarily affect urine flow.

The first considerations would be the two types of diabetes. The most common type of diabetes, called diabetes mellitus, is due to altered blood sugar metabolism, either because of low levels of insulin or resistance to the effect of insulin. There also can be altered urine flow because of abnormal levels of a different hormone, ADH, which can be high or low, and affect urine flow accordingly. A low ADH causes diabetes insipidus.

I would also usually perform a broader metabolic evaluation, such as for thyroid dysfunction

So, the next step would be additional blood tests including a general chemistry profile, complete blood count, and thyroid profile. It may be necessary to consult with an Endocrinologist, depending upon the initial results, as the evaluation for ADH disorder can be complicated.

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Customer reply replied 1 year ago
Hi diabetes was tested for along with thyroid and complete blood count. I do have low testorone etc due to weight and have seen a endocrinologist to investigate my height weight etc.
Urologist: Dr. D. Love, Doctor replied 1 year ago

Then I would ask the Endocrinologist to assess for ADH abnormalities that could be affecting urine flow.

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Customer reply replied 1 year ago
ok can you have adh abnormalities without diabetes >? thanks
Urologist: Dr. D. Love, Doctor replied 1 year ago

It would depend upon which type of diabetes that you mean. If you mean the common type of diabetes, diabetes mellitus then yes. Most people with ADH abnormalities do not have diabetes mellitus. However, everyone with a low ADH will have diabetes insipidus.

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Customer reply replied 1 year ago
ok but i have been tested for diabetes in blood test? so adh might not be the cause?
thanks
Urologist: Dr. D. Love, Doctor replied 1 year ago

It is not the same test.

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Customer reply replied 1 year ago
oh right i see thankyou for your help, i feel like im getting somewhere thanks
Urologist: Dr. D. Love, Doctor replied 1 year ago

You are very welcome.

Please remember to provide a positive rating so that I am credited for assisting you.

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Customer reply replied 1 year ago
Hi i got a copy of my blood tests
Urologist: Dr. D. Love, Doctor replied 1 year ago

OK

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Customer reply replied 1 year ago
i send them now
Urologist: Dr. D. Love, Doctor replied 1 year ago

OK.

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Customer reply replied 1 year ago
my white cells where high which they usually are, they also protein dipped my urine and it cameback +1 which they weren't concerned about
Urologist: Dr. D. Love, Doctor replied 1 year ago

Other than the white blood count, there is nothing in these labs that is significantly abnormal. The blood sugar is mildly elevated, but not at a level that would be considered to be diabetes mellitus or that would affect urine flow.

However, these tests did not include blood tests of kidney function, such as BUN and creatinine. A general chemistry profile would also usually include liver tests, although liver dysfunction will typically only affect urine flow if there is a secondary effect on kidney function. From the perspective of ADH metabolism, it is good that the blood electrolytes are normal, but a more complete evaluation would be a comparison of blood and urine electrolytes obtained at about the same time.

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Customer reply replied 1 year ago
Creatinine was listed as 73umol/L
Urologist: Dr. D. Love, Doctor replied 1 year ago

This creatinine is normal.

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Customer reply replied 1 year ago
also are adh abnormailites treatable? or is it a case of managing it cheers
Customer reply replied 1 year ago
Also is there anything else that could effect urine apart from kidney and adh abnormalities?
Urologist: Dr. D. Love, Doctor replied 1 year ago

The medicines that are used for diabetes insipidus do not cure the disease, but can help to control the disease process.

Of course, increased urine volume and flow would also be affected by increased oral intake of fluid, but with consistent oral intake, urine flow and volume is only affected by the kidney or systemic conditions that secondarily affect kidney function, such as diabetes mellitus, diabetes insipidus, or thyroid dysfunction, as I discussed above.

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Customer reply replied 1 year ago
just to confirm i have low urine output not high
Urologist: Dr. D. Love, Doctor replied 1 year ago

You said that you hardly go and then need to go every 2 hour out of the blue, which is the usual description of episodic increased urine output.

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Customer reply replied 1 year ago
but that happens very rarley say once a week
Urologist: Dr. D. Love, Doctor replied 1 year ago

If you are drinking 3-4 liters of water per day but only having the increased urine output once a week, then there needs to be more detailed information about fluid dynamics, including measuring the amount of urine output each day and monitoring daily weights. The tests of blood and urine electrolytes can also be done on a regular day and on a day during which there is increased urine output.

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Dr. D. Love
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