Depression and antidepressants

[webslave]

I'm starting to question now whether I also have Diabetes Insipidus too.

Note that with diabetes insipidus, you should have excessive urination and extreme thirst and increased fluid intake (especially for cold water and sometimes ice or ice water). The urine does not contain glucose. Extreme urination continues throughout the day and the night, not just night.

[ChgoGuy]

I guess what I am trying to say, is there really a difference between dry mouth and thirst? I would assume that if you have either (or that they are the same) that it indicates some form of dehydration? I can't stress anymore that I know something isn't right, but since I'm not a doctor, I don't know if it's my kidneys, my bladder, prostate or all of the above. Please understand Webslave, and your opinion does matter, in the 3 years I have had this, I have been told I have every urinary issue in the book by 3 urologists incl. CPPS. I have been told I MIGHT have MS, or Parkinsons. I had a very bad accident 20 yrs ago where I was told I was fine, and BTW, "You have CFS and or Fibromyalgia!" I didn't dwell on any of it or obsess over it, but in the end, I've had other doctors tell me - "Maybe not!" to all of the above. So I am left to wonder, what do I really have, and how does it relate to the pelvic pain and urinary issues? There are other things going on too that I nor any doctor can explain. Because it's unrelated to CPPS and urinary frequency, I just haven't discussed it here.

I'm very tired Webslave. I don't sleep, and believe it or not, not ever. I've always been proactive with my health. I never questioned a doctor in my life until this all went down. I'm just looking for answers. I'm not looking to find anything wrong, but there are a lot of things that just aren't right about a lot of things going on. If there is one thing in all this I am obsessed about, it's the medications I've taken, and the ones being offered. Because up to now, nothing has worked. It's just getting me down at the moment. To be honest, I'm more concerned about the effects this is all having on my family because of me.

And you got to believe me when I tell you I am not drinking excessive amounts of water, especially at this time. That is why it is hard for me to understand where all this dilute excess amount of urine produced by my kidneys is coming from. So of course I am questioning why, because the doctors haven't explained why. They are the ones who keep telling me to drink more water, but all that would do is make me urinate more. As I have stated in earlier threads, I was told I may have OAB. I have taken just about every OAB medication also, to no avail. The stuff never took away any urge, it just made me retain urine. I don't take any of it anymore. The urge issues remain at times, but at least I can urinate better than when taking those meds. The only option that is left for the urge, is Botox or an E-Stim. I've voiced my issues with Botox. How can I treat what's going on, when all I have heard from doctors up to now, is that everything I supposedly have is a maybe? The only definite, has been pelvic pain issues related to CPPS. The rest I am not sure, because they are not sure. So I am just confused after 3 years about all of it. I'm worried, not obsessed. But I still totally respect your opinion of it all. I would be f#%ked if I didn't have this forum to get some information. For that I am grateful. I'm just looking for some well deserved peace in my life. The past 3 years have been difficult.

[webslave]

You need to get stats on amount you drink, amount you urinate, level of ADH in blood.

[ChgoGuy]

You need to get stats on amount you drink, amount you urinate, level of ADH in blood.

That's what I am trying to get my primary to do! I'm working on it. I want to rule that out.

I'm just asking your opinion, because I asked my Dr. why, and he couldn't explain why, but I don't urinate much during the day. So if indeed I'm not drinking excess amounts of water during the day, can you think of any reason to explain why during so many nights, I produce 2 liters of urine while I am trying to sleep? To me it looks like my kidneys aren't doing much until I go to sleep. What other kidney problem could point to that, besides Type 2 Diabetes related urinary issues?

[webslave]

ADH suppresses urination at night, but with age, the body makes less ADH, so the kidneys make as much or even more urine during sleep as they do in the day. This means the bladder will need to be emptied more often through the night

[ChgoGuy]

ADH suppresses urination at night, but with age, the body makes less ADH, so the kidneys make as much or even more urine during sleep as they do in the day. This means the bladder will need to be emptied more often through the night

Exactly!

So what I would like to find out, is it possible to take Desmopressin in the evening, to replace **POSSIBLE** low levels of Vassopressin (ADH) while I sleep? I may not have Diabetes Insipidus, but I still could have an ADH issue. I know they used to give Desmopressin to children for bed wetting at night. My thought is that if it could somewhat depress the production of urine at night, It could help me to sleep at night which would help my health overall including stress and anxiety. I have always believed that not sleeping for the past 20 yrs has been somewhat of a curse. Without getting into details, my sleep drastically changed after that accident 20 yrs ago. My head and brain were involved too. Head trauma could lead to damage to the Pituitary Gland, which produces ADH. Could it be that for 20yrs they missed something, or after 20 yrs on top of aging, that I have an ADH problem? If so, could that explain the urinary issues which coincidentally just happened to get worse around the time CPPS hit me? I'm not saying it's the cause, but not sleeping due to urination issues are causing me a lot of stress. So do you understand where I'm going with this? I truly believe Webslave that if I can get my urination issues dealt with, I could sleep. And that would take a huge stress burden off my chest. What I don't know, is will it just shift heavier urination to during the day? And it may not change the fact that I still could be having other issues related to urination for a guy my age? But so far nothing has worked. I just feel it doesn't hurt to rule it out.

I've had other people over the past 3 yrs bring up Diabetes Insipidus to me. I never heard of it before then. When I started up PT again, my therapist had asked me if I have any hormonal issues. She told me she had a female patient she was seeing with the same urinary issues as me. They checked her ADH, saw she had a problem, and put her on Desmopressin. It resolved her urinary issues. I'm not saying I have an ADH problem, but at this stage with all the failures, is it not worth a look at?

[webslave]

Of course it's worth looking at. Report back on the outcome

[ChgoGuy]

Just an observation: I've kind of realized somewhat its difficult to determine dehydration by the color of the urine, because supplements like Quercetin and even the Bladder Smart help keep it pretty yellow for 8-12 hrs of the day. I recently switched over to both.

[webslave]

Just keep drinking. Drink 2-3L per day and you cannot be dehydrated. If you're having trouble getting that much down, sweeten it with an erythritol-type sweetener.

[ChgoGuy]

Just keep drinking. Drink 2-3L per day and you cannot be dehydrated.

That's what I have been doing. I just need to get those kidneys under control after 8pm.

My doctor is off, so I will have to wait until he gets back to check out what's going on. However I did see another Dr. today. She checked some of my blood today to make sure my electrolytes and a few other things were okay after another night of 2 liters of urination (during an 8hr period). When I told her my story and what's been going on, she said there is a very good possibility that indeed it could be Diabetes insipidus, and should definitely get checked and tested for it. She was pretty cool with me today, which is a welcome relief from most doctors. She actually said something that I needed to hear and something I have been thinking for awhile. She said that if it is DI, and I can get the frequent urination under control with Desmopressin, that urinating so less frequently should also help calm down the area, and could help with any pelvic pain issues. That is her/my hope anyway.

[ChgoGuy]

Minor update: Round 1 - I didn't do so well on my urine osmoality test today. After drinking nothing last night thru this morning, my urine showed osmoality of 425. The lowest in the range is 300 out of 1000. After a water fast, osmoality should be 800. The Dr. is on vacation until Monday, I'm sure a water deprivation test is next. The anxiety is causing me minor flare ups of pelvic pain. I hope they stay minor. I guess I'll just have to wait to see which type I have. I feel like I'm drowning from all the water I'm drinking to keep hydrated. As if I didn't have enough on my plate with CPPS.

[ChgoGuy]

Another update:

So my PC Doctor is claiming I don't have Diabetes Insipidus, even though I questioned the results. So his next approach was to check what the issue is with the dry mouth (and eyes) and thirst. So we did a another blood test called an ENA, to check for Sjogrens, Lupus and Scleroderma. That all turned out negative, so I was relieved, but I'm still like "WTF then?" So last Monday I had a follow up with my Urologist. So now he believes their are multiple things going on. Besides the CPPS, he is starting to wonder if I have Nocturnal Polyuria, because I am peeing huge amounts of urine at night, while peeing much less during the day. It only took 3 Urologists and 3 years of me pointing this out. So I must do another voiding diary, and he wants to look at it before presenting it to a Nephrologist. The treatment? Desmopressin - which is the same treatment for some types of Diabetes Insipidus. So there is something to this and ADH as far as the urination is concerned. He thinks that if I can get the urination under control, perhaps it will help settle down the overuse of the pelvic muscles with all the pissing. So going into the New Year, this is the next step we are going to follow. Unfortunately the holidays are going to stand in the way of getting this checked sooner. That's all I got for now. Stay tuned.