Bathroom stalls with toilets to represent polyuria, excessive urination

What Is Polyuria?

Written on December 21, 2023 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


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Many people may have never heard of polyuria, or excess urination. However, this is a condition that affects many people. Polyuria can be very disruptive to day-to-day functioning and needs to be managed. Read this article for everything that you need to know.

What Is Excessive Urination?

You may be wondering, what is polyuria? Polyuria is defined as a urine output of more than three liters per day.[1] This is different and distinct from simply needing to pee a lot, as polyuria can be very disruptive. Individuals who have polyuria often need to pee many times during the day or night. Typical urine output is considered to be less than two liters per day, so this extra liter of urine can feel extremely significant to those who have polyuria.[2]

Polyuria can be caused by several different factors. If you feel as though your urination patterns have shifted, it is important to not ignore this symptom.

What Causes Polyuria?

Polyuria has several different causes. The amount of water in the body, and thus the amount of urine your body outputs, is determined by the renal system. Water homeostasis is controlled by the renal system and antidiuretic hormone (ADH), which is also regulated by the hypothalamic-pituitary system.[1] Decreased levels of ADH can cause increased levels of urine output. Also, higher levels of solutes in the renal tubules can cause an increase in urine volume.[1] Thus, an impairment in the renal system can cause polyuria.

Polyuria can also be a sign of many other disease states, like type 2 diabetes.[1] When glucose levels are not controlled, the blood will have elevated levels of glucose. This also creates a diuretic effect in which glucose is seen in the urine. Water follows glucose, so when there is more glucose in the blood, more water (or urine) follows the glucose, and that needs to be expelled. If you are living with diabetes, it is important to regularly test blood sugar and hemoglobin A1c (HbA1c) levels. This will give you an idea of your levels and how to manage symptoms, including polyuria.

Additional causes of polyuria can include [3]:

  • Kidney disease
  • Liver failure
  • Medication use (particularly the use of diuretics)
  • Chronic diarrhea
  • Cushing’s syndrome
  • Excessive consumption of water
  • Hypercalcemia
  • Pregnancy

How To Test For Polyuria

If you are wondering if you have polyuria, a healthcare provider will administer testing to screen and diagnose the condition, if applicable. An evaluation for polyuria will typically include a healthcare provider gaining an understanding of your medical history, with a specific focus on the amount of fluid you consume, the age of onset of increased urination, urination patterns, relevant clinical factors, and degree of thirst.[1]

From there, a healthcare provider may physically examine you for any signs of polyuria, such as physical stature, dry eyes, dry mouth, hyperpigmentation of the skin, and/or they may perform a neurological examination to screen for any thought disorders that may be causing increased urination.[1]

A series of urine tests may also be completed, such as a urinalysis, urine osmolality, evaluation of protein content in your urine, and/or urine electrophoresis.[4] There are also blood tests to test for polyuria, such as measuring electrolytes, glucose levels, erythrocyte sedimentation rate (ESR), and lithium.[4] Lastly, a healthcare provider may want to do an imaging test of the renal tract and/or an imaging test of the brain.

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How To Treat Polyuria

Treatment for polyuria will ultimately depend on the cause. In the case of polyuria due to diabetes, polyuria may get better if diabetes is better managed. This may include the use of medications as well as dietary and lifestyle changes to better control glucose levels, which can better optimize urination output.[2]

If the polyuria is not caused by a medical health condition, you can make dietary and lifestyle changes. Some of these include being more mindful of fluid intake, limiting fluids before bedtime, limiting caffeine and/or alcohol intake, and taking inventory of medications that you are on to determine if the polyuria is a side effect of medication.[2]

There is research that shows promise for managing polyuria naturally. Some of the recommended treatments include the use of Chinese herbal blends. Specifically, the use of Gosha-jinki-gan (GJG) has been shown to improve bladder function.[5]

Some research has shown that supplementing with L-arginine can help people with overactive bladders.[6] This is thought to be because L-arginine helps create nitric oxide, and nitric oxide helps keep the urinary tract in good health. L-arginine can also be found in food sources like meat, dairy, walnuts, coconut, cereal, and beans.[6] As always, it is best to contact your healthcare provider before making any adjustments to your medications or supplements.

Additional research has shown promise for pumpkin seed oil in managing overactive bladder symptoms.[7] Pumpkin seed oil is a great source of vitamins, linoleic acid, and oleic acid. While more research is needed in this area to determine the exact mechanism by which pumpkin seed oil can relieve symptoms of polyuria, there is likely no downside to adding this to your diet and/or routine.

Lastly, several mind and body approaches can help people living with polyuria. Some of these include [7]:

  • Biofeedback (a behavior modification technique that helps people to retrain bladder and pelvic floor muscles to help reduce leakage)
  • Acupuncture
  • Behavioral therapies, including hypnotherapy and meditation

When To Contact A Professional

If you or someone you know is experiencing symptoms of overactive bladder, it can be helpful to know when it is appropriate to contact a healthcare provider. Ultimately, if you have been experiencing what feels like excessive urination over several days, and this increase in urination is not caused by an increase in fluids or a change in medications, it may be time to seek the help of a clinician. (Meet with a clinician from the comfort of your home with Everlywell virtual care visits)

If you find yourself going to the bathroom more than eight times per day, or peeing at a rate much higher than your normal rate, it may be wise to contact a healthcare provider.[8] This is especially important if additional symptoms arise along with increased urination, like a fever, vomiting, lower back pain, blood in the urine, or discharge coming from the genitals. While there are many reasons why you could be experiencing an increased need to urinate, it is best to let a healthcare provider screen, test, and examine you for the root cause. While this condition is disruptive, it can be treated and managed in many cases.

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References

  1. Maddukuri G. Polyuria. Merck Manuals Professional Edition. https://www.merckmanuals.com/professional/genitourinary-disorders/symptoms-of-genitourinary-disorders/polyuria. Published December 8, 2023. Accessed December 13, 2023.
  2. Gabbey AE. Excessive urination volume (Polyuria). Healthline. https://www.healthline.com/health/urination-excessive-volume. Published September 17, 2018. Accessed December 13, 2023.
  3. Hardy K. Polyuria - frequent urination symptoms and causes. Diabetes. https://www.diabetes.co.uk/symptoms/polyuria.html. Published October 29, 2023. Accessed December 13, 2023.
  4. Tidy C. Polyuria. https://patient.info/doctor/polyuria. Published December 12, 2022. Accessed December 13, 2023.
  5. Use of herbal supplements for overactive bladder. PubMed. https://pubmed.ncbi.nlm.nih.gov/24223020/ Published 2013. Accessed December 13, 2023.
  6. The Healthline Editorial Team. Alternative treatments for an overactive bladder. Healthline. https://www.healthline.com/health/overactive-bladder-alternative-treatments#supplements. Published October 18, 2022. Accessed December 13, 2023.
  7. Nishimura M, Ohkawara T, Sato H, Takeda H, Nishihira J. Pumpkin Seed Oil Extracted From Cucurbita maxima Improves Urinary Disorder in Human Overactive Bladder. Journal of Traditional and Complementary Medicine. 2014;4(1):72-74. doi:10.4103/2225-4110.124355. https://www.sciencedirect.com/science/article/pii/S2225411016302127?via%3Dihub
  8. Professional CCM. Frequent urination. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/15533-frequent-urination. Last reviewed April 3, 2023. Accessed December 13, 2023.

Jordan Stachel, M.S., RDN, CPT works with a wide variety of individuals, ranging in age from children to the elderly, with an assortment of concerns and clinical conditions. She helps individuals optimize overall health and/or manage disease states using personalized medical nutrition therapy techniques.

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