Why am I peeing like this?
May 17, 2009 7:53 PM   Subscribe

YANMD: Liver, Diabetes, or too much Caffeine?

I realize you are not my doctor. I also realize that I should go to a doctor. So please, don't let your only answer be: you should go to a doctor.

Background info: I am a 25 year old overweight and hypertensive (Although, I don't 100% agree with the diagnosis of being hypertensive, but that's another story) female. I take Lisinopril/Prinivil for the hypertension. I also take a OTC acid reducer for reflux.

For, quite a long time now (several months if not a year) - I have had urges to pee that come out of no where, and more often then not when I am standing. They are not, what I would describe, as a full bladder urge and as a matter of fact seem to be a small amount. When I fight them off/hold it, they go away. But sometimes I have to rush to the bathroom and almost wet myself. the only other consistent symptom I seem to be having is that my temp is 99.2 in the evenings.

Being aware that my eating habits, weight and family history contribute to a diagnosis of diabetes.. i have checked myself for symptoms. I do not have any extreme thirst or irritability. I even did a ten hour fasting test and used my mother's glucose monitor to test my blood sugar - it was in the mid 90's.

I wondered if it was a bladder infection - but I do not have any burning sensations so often described as a symptom. Also, my urine does not smell or look any different then it has the rest of my life.

I am concerned it's my liver that's causing this sensation. I do have intermittent lower back pain - but this is only in the mornings, which i contribute to my bed/poor sleeping habits.

Could this just be a result of my weight or age or too much caffeine? Or do you think that sudden urges to pee and so low a fever that doctors don't even consider it a fever enough of a worry that I seek medical help?

and, if it's relevant - i cannot be pregnant.
posted by anonymous to Health & Fitness (16 answers total)
Do you snore? Apnea can cause some of your symptoms.
posted by Joe in Australia at 7:58 PM on May 17, 2009

Have you done kegels on a regular basis? That can really help with the random pee urges.

But I'd hate to suggest Kegel exercises when it's something bigger.

Just out of curiosity, have you talked with the doctor about your diabetes worries? Have you had your thyroid functions checked? Why do you think it's your liver, and have you had its levels/functions tested?
posted by barnone at 8:15 PM on May 17, 2009

You could test the caffeine hypothesis by cutting out caffeine for a while. Should only take a few days.
posted by winston at 8:18 PM on May 17, 2009

Maybe you have an ulcer contributing to the fever/reflux? Or an allergy/intolerance?
posted by barnone at 8:22 PM on May 17, 2009

if you at all think it could be a uti (and you can have one even if it doesn't burn), you should absolutely definitely go to your doctor because it could move to your kidneys, blah blah blah.

how overweight are you, and where do you you carry your weight. extremely overweight women who carry their weight mostly in their stomach (an "apple" shape) are at risk for incontinence issues. you know how pregnant women complain that the baby is sitting on their bladder? it's kind of like that, but with fat; there's more fat in your abdominal area, fighting for space with your bladder and all your other organs.

that's really an over-simplification (by a lot) but it gives you an idea. so, your weight could certainly be contributing to the pee urge.
posted by misanthropicsarah at 9:01 PM on May 17, 2009

You can have a hard time losing weight if you're hypothyroid. Thyroid and diabetes are both endocrinological issues so they can be genetic. On the other end, hyperthyroid contributes to feeling hot and indigestion and elimination issues (diarhea and/or gas).

List of things I'd start if I was in your position: 1) Go to GP and ask for full blood sugar and thyroid tests, and UTI and full STI check and explain your worries; 2) reference to an endocrinologist if needed; 3) Kegels (google for explanation); 4) walk briskly and/or swim and/or cardio to keep losing weight; 5) food diary to see if your reflux is at all related to food allergy or intolerance.
posted by barnone at 9:11 PM on May 17, 2009

I don't know if any of the symptoms you mention can be caused by a thyroid problem, but have your doctor re-check your thyroid at your next visit. If there was some concern a year ago, you may have moved into hypothyroid territory by now. A few years ago, my doctor tested my thyroid and it was right on the borderline. Two and a half years later, I was retested, and it was much worse. Hypothyroidism can cause symptoms like fatigue, dry skin, brittle fingernails and hair, and all sorts of other fun things. My current doctor mentioned that there have been some studies that indicate that hypothyroidism and hypertension are linked and/or that the former contributes to the latter, but I can't point you to any documentation on that.

As for your symptoms, are you on the regular Lisinopril or the combo Lisinopril-HCTZ? I'm on the latter and it has a diuretic in it, which causes me to have to pee often, even if there's not a ton of volume. I also have a friend who was diagnosed with interstitial cystitis after having similar frequent-urination symptoms, so you may want to have your doctor look into that.

Why do you question the hypertension diagnosis? Do you self-test? I have a bit of white-coat hypertension (my blood pressure is a little higher when it is taken at a doctor's office), but when I am at home it's lower. Have you experienced something similar that leads you to question the diagnosis?
posted by bedhead at 9:12 PM on May 17, 2009

You don't have to have smelly urine or discomfort to have a bladder or urinary tract infection. Inded - you might just have an irritation rather than an infection (although your temp makes infection seem likely).

You might try giving up caffeine and sugar for while and taking something like Ureez, Ural (similar things) or large quantities of cranberry juice (or capsules) and plenty of water and seeing if the urges die back down to more normal levels over the course of a week or so.
posted by ninazer0 at 10:27 PM on May 17, 2009

I had pee urges and my doctor told me to give up caffeine for unrelated digestive problems. The pee urges have gotten a lot less horrible since then. Giving up caffeine was wicked hard (I still drink black tea, but not coffee or soda), but it's been at least three months and I really have had a much better life in general.

Cutting out coffee sounds like it'll be total hell, but it really helps to have a doctor tell you that you should :) Give it a try and see if you get better.
posted by crinklebat at 10:42 PM on May 17, 2009

Obviously you should see a doctor if these things bother you. Nevertheless, you can check your blood sugar at home with a meter. The store brands are about $20. The name brands, such as Lifescan, tend to be more accurate and often there are coupons or other offers which drops the price to less than the store brands. Strips are a little pricey though. It is not as accurate as the blood test from your doctor, but you can check yourself multiple time and at various times during the day to see if something is going on that your last test missed. Also, if you are hypertensive you should have a bp monitor.
posted by caddis at 5:12 AM on May 18, 2009

I think you may have a chronic bladder infection, especially since you have low back pain.

People can have chronic bladder infections without the smelly urine, burning, irritation and other classic UTI symptoms.

(Do you ever have a sore throat that comes and goes? That can be an indicator of a UTI as well. Strange but true.)

You can check your urine with a drugstore strip, but that is not as accurate as a culture from the lab. I would urge you to check with the doctor about that.
posted by FergieBelle at 6:14 AM on May 18, 2009

Caffeine can exacerbate diabetes/blood sugar issues. I can't find a proper cite at the moment, but my father in law had improved blood sugar levels after cutting out caffeinated diet sodas.
posted by electroboy at 7:02 AM on May 18, 2009

It sounds like you're describing a case of overactive bladder. Caffeine's one of the possible causes of overactive bladder. I can't imagine any connection to liver trouble, but if you're concerned about your liver all you need is a blood test of your liver enzymes.

A temperature of 99.2°F is perfectly normal in the evening. Body temperature is commonly below 98.6 in the morning, and above 98.6 in the evening or after exercise. 98.6 is just supposed to be an average, so anything below 100.0°F is normal.

There's a possible connection between thyroid issues and a sudden urgent need to pee. One test that is sometimes used to diagnose people whose TSH levels are not high enough to make a hypothyroidism diagnosiseasy is the TRH stimulation test. TRH is normally released by your hypothalamus to prod your pituitary into producing more TSH. During the TRH stimulation test, TRH is injected to see how far TSH levels go up as a result. The interesting point is that the sudden surge of TRH causes the patient to momentarily experience a strong urge to urinate. Perhaps natural surges of TRH in the body cause the same feeling.

By the way, you don't have to snore in order to have sleep apnea. If you have signs of sleep apnea, get a sleep test done, even if you do not snore.
posted by Ery at 7:55 AM on May 18, 2009

Just to reassure you; the definition of hypertension is an elevated systolic OR diastolic BP (ranges vary per Dr >120->140/>80->90) OR a patient taking an antihypertensive med; which explains why now that you are on Lisinopril your BPs are normal; it means its working. If you didn't need it, your BP would be dangerously low, and you would be having symptoms of hypotension.
posted by kgreerRN at 8:23 AM on May 18, 2009

You're on meds for BP. Isn't one of the side effects of those frequent urination? You could probably ask your doc or nurse that on the phone, and/or your pharmacist.
posted by Marie Mon Dieu at 8:25 AM on May 18, 2009

Prinivil has one side effect of either urinating a lot more, or a lot less than normal (I know, oddball side effect.) With having family with diabetes though, I would definitely see a doctor for testing.,
posted by SuzySmith at 3:29 PM on May 18, 2009

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