Excessive Thirst (Polydipsia): Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Conn’s syndrome (primary hyperaldosteronism, PHA) – involves partial or complete autonomous production of the steroid hormone aldosterone, which is produced in the zona glomerulosa of the adrenal cortex. Symptoms: Hypokalemia (potassium deficiency), hypertension (high blood pressure); however, up to 10% of patients with hypertension have normokalemic (normal potassium) hyperaldosteronism.
  • Cushing’s syndrome – disease in which too much ACTH is produced by the pituitary gland, resulting in increased stimulation of the adrenal cortex and, as a consequence, excessive cortisol production.
  • Dehydration (dehydration)
  • Diabetes insipidus (congenital or acquired disease characterized by increased urine output (polyuria) and increased thirst with polydipsia (increased drinking)):
    • Diabetes insipidus centralis – caused by a deficiency of the antidiuretic hormone (ADH) due to failure of ADH production (partial (partial) or total; permanent or transient (temporary); due to, e.g., hypothalamohypophyseal tumor, traumatic brain injury (TBI), etc.).
    • Diabetes insipidus renalis (synonym: nephrogenic diabetes insipidus; ICD-10 N25.1) – caused by lack of or insufficient response of the kidneys to ADH (ADH concentration is normal or even increased).
  • Diabetes mellitus (diabetes).
  • Electrolyte disorders, unspecified (hypercalcemia/calcium excess).
  • Hypercalcemic crisis – severe increase in blood calcium levels.
  • Thyroid disease, unspecified

Infectious and parasitic diseases (A00-B99).

Liver, gallbladder, and biliary tract-pancreas (pancreas) (K70-K77; K80-K87).

  • Liver disease, unspecified

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

Psyche – nervous system (F00-F99; G00-G99).

  • Psychogenic polydipsia – psychologically induced severe thirst without physical cause.

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99)

  • Fever

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99)

Other

  • Alcohol consumption
  • Dry mouth (see also under “Dry mouth due to medication”).
  • Insufficient fluid intake (eg, by vomiting).

Medication