More urine output when laying down/flat

Hi,

I have few strange urination problems going on for almost a year now. Some days, I urinate less than what I drink and some days more.

Here it goes. Iam 32yrs old and take medication Diovan + Diuretic for high blood pressure in the morning (both). My Blood pressure is in the range of 120-140/80-90 with medication and at seated position (less than 120/80 while in sleeping position). Some days I urinate one full bladder 3-4hrs after taking the diuretic and then the urination is normal throughout the day. Some days, I urinate much less even after 5hrs of taking the diuretic medication. Drinking plenty of water OR no water doesn't make any difference (it can be drinking less water and more urination OR drinking plenty of water and less urination).

Now the problem is, few days (any of the above condition days), when I lay down flat in the evening, within 1hr I produce a full bladder (colorless) urine. And almost everyday, my first urine in the morning is very less and dark (again, irrespective of water intake OR urination on previous day).

I tried to explain to my doctor and he says he can't think of any medical condition causing this. I had many blood tests & urinalysis and everything came out fine. I had a heart echo too, which did not show anything wrong either. I also don't have any edema anywhere. I don't have a weight gain. My weight reduces by around 1pound the day after having lot of urination.

Though the blood test results & urinalysis came out fine, I can't stop worrying about this, as it is not normal for anyone.

Can anyone suggest any other tests that I can ask my doctor to do? I have an appointment with my PCP coming up in a week.

Thanks!

[Chandan Choudhary, M.S., M.Ch]

Dear gholla,

I would like to reassure you that if all the reports are normal, then you have no reason to worry.

Normally, passing more than 1.5 litres of urine per day is normal but there is wide range of variation from person to person.
I would suggest that the following tests be done, to rule out any disease:
•     Kidney function tests (Serum creatinine and blood urea)
•     Urine analysis
•     Ultrasonography of the kidney-ureter-bladder region

If these tests are normal, then you don’t need to worry at all

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Chandan Choudhary

[gholla]

Thanks for the response. I had Kidney function tests & Urine analysis 6 months ago, along with Echo (TTE) and I had the same symptoms then also. Do you think I need one more test of the same? Also, any other heart tests required?

[gholla]

One more question, is the effect of a diuretic pill more when lying down? I always get LOT of urine if I am lying down during the first 4-6hrs of diuretic effect.

[rmprdl1964]

Hi,

I am a 47 y/o person with hypertension who is on three different medications to treat it. Everage resting blood pressure 130/90 to 150/110 at mild activity.
Why are you on diuretics? What is it prescribed for? I had been on some due to fluid retention at one time. It made me go to the bathroom constantly.
I have been told that I'm not drinking enough fluids in a day and have a very difficult time making myself drink more during the day. I have had urological problems (neurogenic bladder) since 1996.

Prior to getting diagnosed I had lost of problems with frequent urination and infections. I had numerous cystoscopies that showed no abnormalities and it was not untill a urodynamics test that I was diagnosed with the neurogenic bladder.

Eventhough I had frequent urination problems at day time, while trying to sleep it was far worse. During normal conditions even with not driking much, I would have a full bladder with in 20 to 30 minutes after laying flat.
I was told that the sensation to urinate while trying to sleep might be due to the fact that one relaxes muscles and sphincters at that time. During the day time or while awake our minds are too busy to have the urge to urinate bother us.

I realize that my condition is far different than yours, but I had a lot of different tests before they came up with the diagnosis of a neurogenic bladder.

I don't want to make your anxiety worse, but it might take several different tests to determine a problem. To be exact it was my second, a more extensive urodynamics test that showed a neurogenic bladder.

Currently I have an indwelling catheter in which can cause problems of it's own, but it is better than having the urination problems. Prior to having the catheter I would need to empty my bladder frequently without the use of diuretics. A period of two hours would be great for me.

I really question your need or use of diuretics, given the fact that you don't report fluid retention. Even now that I'm not on diuretics, my feet swell up if I'm in one postion for an extended period of time, like traveling by car for over an hour.

Is there any possibility of taking the diuretics sooner? I did not take mine after 5pm.

I can see that you still have unanswered questions and I sincerely hope that you will get the help that you need.

God bless

[gholla]

Hi,

Thank you very much for your response. It made me feel little better knowing that there are other causes to this kind of problem.
Regarding taking diuretic, I had mentioned it in the original post. I do take it for hypertension. Earlier I was only on losartan, but the doctor added diuretic 3years ago to control HBP it better. Now I have moved to Diovan+Diuretic to try to improve other side effects of losartan medication (still not better with diovan anyways, I always feel tired). I also take both the medications in the morning itself (before 11am).
My blood pressure readings are better at doc office than home:-) (always better numbers from manual readings[like 130/70-75] compared to digital automated BP machines[like 140/85-90]. Not sure why.)