# Excessive Thirst, Increased Urination and Salt Craving Record Date: Friday 30 October 2026 Last Updated: Friday 30 October 2026 Type: Letter ## Summary This record describes an episode beginning around Monday 6 July 2026 involving: - markedly increased thirst; - increased water intake; - increased urinary frequency and urine volume; - profound fatigue and sleepiness; - strong resistance to drinking plain water; - a preference or perceived need for water with added salt; - brief episodes of head heaviness or dizziness. From the beginning of the episode, the patient drank very little plain water. Ordinary drinking water was generally consumed with added salt. The patient used oral rehydration solution six times between Friday 10 and Monday 13 July 2026. Before and up to Monday 13 July, daily intake remained approximately eight to nine cups of salted water or oral rehydration solution. From Tuesday 14 to Friday 17 July, daily water intake reduced to approximately five to six cups. The earlier intense thirst became less severe, but dry mouth and the need to add salt to ordinary drinking water continued. Fatigue, sleepiness, head heaviness, and dizziness became more frequent from around Wednesday 15 July. A GP issued a blood-test request on Monday 13 July 2026. Blood was taken at approximately 2:00 pm on Tuesday 14 July 2026. Recent oral rehydration solution use before the blood test is recorded as part of the fluid history. As of 15 September 2026, the patient had not confirmed whether all requested results were available, although the GP can review the available results. On Saturday 18 July 2026, the patient attended the Urgent Treatment Centre because right-hand numbness had become more noticeable than the previous day, together with reduced hand function. The Urgent Treatment Centre arranged a GP assessment for Sunday 19 July 2026. The GP advised on Sunday 19 July that the hand did not require further immediate follow-up at that time. The patient nevertheless continued to feel that the hand was not completely normal and, at that time, intended to raise the symptoms again with the named GP if they continued or recurred. The prescribed seven-day Fucibet course was completed with the final application on the morning of Sunday 19 July 2026. From Sunday 26 to Wednesday 29 July 2026, the patient experienced a short gastrointestinal episode. Mild abdominal discomfort began on 26 July, followed by mild diarrhoea on 27 July and completely watery diarrhoea on 28 and 29 July. The diarrhoea then gradually resolved from 30 July. The patient used the same pharmacy-bought O.R.S Hydration tablet product used earlier in July from Sunday 26 to Friday 31 July, approximately twice daily, for a total of 12 drinks. By Thursday 6 August 2026, the diarrhoea and abdominal discomfort had resolved. However, the preference for water with added salt and resistance to plain tap water had continued. This document records developments up to Thursday 6 August 2026. As of 15 September 2026, the thirst, increased urination, and salt-preference symptoms had remained broadly stable since Thursday 6 August 2026, while the gastrointestinal episode had remained resolved, with no major new changes reported. A separate right upper-limb problem, ongoing as of September 2026, is recorded in **GP456_Right_Upper_Limb_Symptoms_and_History.md**. ## Background On Thursday 2 July 2026, the patient attended a Musculoskeletal Services community appointment and began a revised programme of physical activities. Around Monday 6 July 2026, approximately four days later, a new group of thirst-, urination-, fatigue-, and salt-related symptoms developed. No formal fluid-intake or urine-output record was kept during the first several days because the patient did not initially expect the episode to continue. More detailed records were started on Friday 10 July 2026. ## Details ### Monday 6 to Thursday 9 July 2026 – onset and early observations From around Monday 6 July 2026, the patient experienced: - markedly increased thirst; - increased water intake; - increased urinary frequency and urine volume; - profound fatigue and sleepiness; - strong resistance to drinking plain water; - a preference or perceived need for water with added salt; - brief episodes of mild head heaviness; - a slight increase in appetite. The overall pattern remained broadly similar from day to day, without clear progressive improvement or deterioration. While awake: - thirst usually became noticeably stronger again approximately 60 to 90 minutes after drinking; - it generally returned within no more than approximately 120 minutes; - the main sensation was a need to drink rather than obvious dryness of the lips, tongue, or mouth. From the beginning of the episode: - the patient drank very little plain water; - ordinary drinking water was generally consumed with added salt; - on some occasions, the patient first tried a small amount of plain water; - if it still felt unacceptable, salt was added before drinking continued; - milk, soup, and other drinks did not replace the perceived need for salted water. The resistance to plain water was not described as nausea, difficulty swallowing, or physical obstruction. The patient retrospectively estimated that: - tap-water intake, including salted tap water, increased to approximately 2 litres per day; - this was around 1 litre more than usual; - the estimate did not include milk, soup, or other drinks. No formal urine-output measurements or complete fluid records were kept during this period. All quantities, intervals, and symptom frequencies recorded for this period are approximate. ### Around Thursday 9 July 2026 – more noticeable dizziness and head heaviness - Around Thursday 9 July 2026, the patient experienced mild sudden dizziness and mild head heaviness. - The patient felt that standing might become unsteady. - Because the patient anticipated that the sensation might worsen, the patient lay down as a precaution before losing balance. - The precise duration could not be confirmed from the patient's recollection. - There was no visual darkening, unusual sweating, loss of consciousness, or fall. ### Friday 10 July 2026 – first detailed fluid record - The patient began keeping a more detailed fluid and symptom record. - The patient woke at approximately 5:00 am. - Fluid intake was distributed throughout the day rather than consumed all at once. From waking until close to 2:00 pm: - approximately five cups of salted water were consumed; - the same cup was used throughout the day; - the cup held approximately 330 mL and was usually filled to around 80%; - the estimated usual amount per drinking episode was therefore approximately 260 mL; - some cups were not finished and were later topped up, so the total volume remains approximate. Other fluids included: - approximately half a bowl of soup with noodles at breakfast; - one milkshake close to 2:00 pm; - one milk tea in the evening; - one oral rehydration solution drink at approximately 6:00 pm. The oral rehydration solution was prepared according to the product instructions using two tablets in approximately 200 mL of water. After using oral rehydration solution: - the patient attempted to drink a small amount of plain tap water; - plain water continued to feel unacceptable; - salt was therefore added before ordinary water drinking continued. ### Friday 10 to Monday 13 July 2026 – drinking pattern and oral rehydration solution use - During this period, daily intake remained approximately eight to nine cups of salted water or oral rehydration solution. - Ordinary drinking water continued to be consumed with added salt. - The patient sometimes tried a small amount of plain water before adding salt. - Plain water continued to feel unacceptable. Oral rehydration solution was used six times over four days: - once on Friday 10 July; - twice on Saturday 11 July; - twice on Sunday 12 July; - once on Monday morning, 13 July. The oral rehydration solution replaced some occasions on which salted water would otherwise have been consumed. No further oral rehydration solution was used after the morning of Monday 13 July. The total use remained six drinks. The patient felt that there may have been slight subjective improvement. However, by Monday 13 July: - thirst remained present; - resistance to plain water remained; - ordinary drinking water continued to be consumed with added salt; - the patient still felt unable to drink plain water comfortably; - no clear resolution had occurred. ### Monday 13 July 2026 – GP consultation and blood-test request - The patient attended a GP consultation with a GP who was not the patient's named GP. - The consultation focused on: - thirst; - increased water intake; - increased urination; - fatigue; - difficulty drinking plain water; - the perceived need to add salt to drinking water. - The recurrent right-hand skin condition was also raised, but the patient was advised to arrange a separate appointment for that problem. - The GP issued the blood-test request. - An appointment at the GP practice was not available until approximately two weeks later. - A hospital appointment initially appeared to require a wait of approximately ten days. - On the evening of Monday 13 July, the patient found an available hospital appointment for the following day at 1:50 pm. ### Tuesday 14 July 2026 – blood test following recent ORS use - Blood was taken at approximately 2:00 pm on Tuesday 14 July 2026. - Six oral rehydration solution drinks had been consumed over the preceding four days. - The final recorded oral rehydration solution drink was taken on the morning of Monday 13 July 2026. - This recent intake is recorded as part of the fluid history before testing. - As of 15 September 2026, the patient had not confirmed whether all requested results were available. - The GP can review the available blood-test results. ### Tuesday 14 to Friday 17 July 2026 – reduced intake but continued salted water - From Tuesday 14 to Friday 17 July 2026, daily water intake reduced to approximately five to six cups. - This count referred to water only and did not include milk, soup, tea, or other drinks consumed with meals. - Intake of those other drinks remained broadly similar to usual. - Ordinary drinking water continued to be consumed with added salt. - The patient still found plain water difficult to drink. - On some occasions, a small amount of plain water was tried first. - If it continued to feel unacceptable, salt was added before drinking continued. - The earlier intense thirst became less severe. - Dry-mouth symptoms continued. - The reduced number of cups suggested some improvement in the amount consumed. - However, the need or preference for salted water had not resolved. - Cup volumes were not formally measured, so daily totals remain approximate. ### From around Wednesday 15 July 2026 – increased fatigue, sleepiness, head heaviness, and dizziness - From around Wednesday 15 July 2026, fatigue and sleepiness became more frequent again. - Episodes of head heaviness and dizziness also increased. - The patient did not record a precise number of episodes. - The increase was noticeable compared with the preceding days. - Night-time thirst and urination did not become a prominent feature. - The main change was an increase in daytime fatigue, sleepiness, head heaviness, and dizziness. ### Urination during the initial episode From around Monday 6 July 2026, the patient noticed an increase in: - urinary frequency; - the amount passed during individual episodes; - the paleness of the urine. While awake: - urination generally occurred approximately once every two to three hours; - no formal urine-output measurements were taken. Despite the increased daytime thirst, drinking, and urination: - the patient did not wake during the night because of thirst; - the patient did not wake during the night to urinate. After Monday 13 July, the patient did not monitor urinary frequency or volume closely enough to identify a clear change. ### Fatigue and sleepiness during the initial episode From around Monday 6 July 2026, fatigue and sleepiness were present during much of the day. This felt different from ordinary tiredness following work or normal activity. The pattern included: - occasional periods of approximately one to two hours when the fatigue was milder; - periods of approximately two to three hours when the fatigue became more severe; - no consistent time of day when the more severe periods occurred. During more severe periods, the patient might: - yawn repeatedly; - suddenly feel a strong need to sleep; - become unable to continue normal activity; - fall asleep while sitting. The patient remained able to move independently to bed. Sleep during these episodes commonly lasted approximately two to three hours. After waking, the patient could usually remain active for several hours. ### Brief episodes of head heaviness and dizziness - From around Monday 6 July 2026, the patient experienced brief episodes of mild head heaviness or dizziness. - During the initial period, the episodes: - occurred on most days; - usually occurred approximately once or twice per day; - lasted only a few seconds. - Most noticed episodes during the initial period occurred while the patient was sitting. - Around Thursday 9 July, one episode included a feeling that standing might become unsteady, and the patient lay down as a precaution. The episodes were not accompanied by: - a spinning sensation; - visual darkening; - unusual sweating; - loss of consciousness; - a fall. The frequency or prominence of head heaviness and dizziness increased from around Wednesday 15 July 2026. ### Other observations From around Monday 6 July 2026: - appetite increased slightly; - no clear change in clothing fit was noticed; - body weight was not measured; - there was no obvious change in vision; - there was no nausea, vomiting, or abdominal pain; - there was no noticeable palpitation or rapid heartbeat; - there was no shortness of breath; - there was no new tremor or muscle cramping; - there was no new medicine or supplement; - there was no clear change in coffee, tea, or energy-drink intake. There was one episode of looser stool. - Similar isolated episodes may ordinarily occur approximately once every two to three weeks. Sweating also increased during the same period. - The weather had become substantially hotter than during the previous two to three weeks. The patient: - did not measure body temperature; - did not feel feverish; - did not experience chills. ### Saturday 18 to Sunday 19 July 2026 – Urgent Treatment Centre, GP review, and completion of Fucibet - On Saturday 18 July 2026, the patient attended the Urgent Treatment Centre. - The main reason was that right-hand numbness had become more noticeable than on the previous day, together with reduced hand function. - The Urgent Treatment Centre arranged a GP assessment for Sunday 19 July 2026. - On Sunday 19 July, the GP advised that the hand did not require further immediate follow-up at that time. - The patient nevertheless continued to feel that the hand was not completely normal. - At that time, the patient intended to raise the hand symptoms again with the named GP if they continued or recurred. - The prescribed seven-day Fucibet course was completed on Sunday 19 July. - The final application was used in the morning. - The thirst, increased urination, fatigue, dizziness, and preference for salted water had begun before Fucibet was prescribed. ### Sunday 26 to Friday 31 July 2026 – gastrointestinal episode and further O.R.S use - On Sunday 26 July, mild abdominal discomfort developed during the evening. - The patient began using the same pharmacy-bought O.R.S Hydration tablet product used earlier in July. - The product barcode was 5060135050115. On Monday 27 July: - mild diarrhoea developed; - the patient felt feverish from approximately 7:00 pm to 10:00 pm; - body temperature was not measured; - abdominal pain was not significant. On Tuesday 28 and Wednesday 29 July: - the diarrhoea became completely watery; - bowel movements occurred approximately every two to three hours; - the estimated frequency was approximately four to eight times per day; - there was no visible blood; - there was no black stool; - mucus could not be assessed because the stool and toilet water were very mixed and watery; - there was no vomiting; - appetite was reduced; - there was no marked abdominal pain. The patient regarded this episode as less severe than a previous episode of gastroenteritis during which bowel movements occurred approximately ten times in one day. From Thursday 30 July: - the diarrhoea gradually resolved; - bowel movements slowly returned towards normal; - no significant ongoing abdominal discomfort remained. From Sunday 26 to Friday 31 July: - the same O.R.S product was used approximately twice daily; - 12 O.R.S drinks were used in total over approximately six days; - each drink was prepared according to the product instructions. ### Position on Thursday 6 August 2026 By Thursday 6 August: - the watery diarrhoea had resolved; - there was no significant abdominal discomfort; - bowel movements had gradually returned towards normal; - there was no vomiting; - there was no continuing feverish feeling. However: - the patient continued to prefer tap water with added ordinary salt; - the patient remained reluctant to drink plain tap water; - the preference for salted water had begun before the diarrhoea; - it continued after the diarrhoea resolved; - the patient continued drinking self-prepared salted tap water after stopping O.R.S; - the amount of salt added to the water was not formally measured. ## Notes - This version records the original episode in detail and a brief status update up to 15 September 2026. - As of 15 September 2026, the thirst, increased urination, and salt-preference symptoms had remained broadly stable since Thursday 6 August 2026, while the gastrointestinal episode had remained resolved, with no major new changes reported. - The separate right upper-limb problem, ongoing as of September 2026, is recorded in **GP456_Right_Upper_Limb_Symptoms_and_History.md**. - The short episode of watery diarrhoea resolved gradually after Wednesday 29 July. - The preference for salted water began before the diarrhoea and continued after the bowel symptoms resolved. - The symptoms began around Monday 6 July 2026. - Observations from Monday 6 to Thursday 9 July were reconstructed retrospectively. - More detailed records were kept from Friday 10 July onwards. - From the beginning of the episode, the patient drank very little plain water. - Oral rehydration solution was used six times between Friday 10 and Monday 13 July. - No further oral rehydration solution was used after the morning of Monday 13 July until Sunday 26 July. - The same O.R.S product was then used from Sunday 26 to Friday 31 July, approximately twice daily, for a total of 12 drinks. - Before and up to Monday 13 July, daily intake was approximately eight to nine cups of salted water or oral rehydration solution. - From Tuesday 14 to Friday 17 July, daily water intake reduced to approximately five to six cups. - Ordinary drinking water continued to be consumed with added salt. - The blood-test request was issued on Monday 13 July. - Blood was taken at approximately 2:00 pm on Tuesday 14 July. - As of 15 September 2026, the patient had not confirmed whether all requested results were available. - Fluid quantities, drinking intervals, urine volumes, and symptom changes remain approximate unless otherwise stated. - The patient did not formally measure: - total daily fluid intake; - urine output; - body weight; - body temperature; - blood glucose; - blood pressure; - heart rate; - electrolyte levels. This document reflects the information the patient has been able to identify and organise as relevant. It may not contain every detail that could be clinically useful. ### Please ask me about any additional details that may help with the assessment.