Many people believe that drinking huge amounts of water and passing large amounts of urine is a sign of “super healthy kidneys.” After all, if the body is flushing everything out smoothly, it must be working perfectly… right?
Not necessarily.
A viral post by doctor and medical educator Dr. Priyam Bordoloi explains why excessive thirst and excessive urination can sometimes point toward an underlying medical issue rather than peak health.
According to the doctor, one of the biggest misconceptions about kidney health is the idea that producing massive amounts of urine automatically means the kidneys are functioning exceptionally well.
In reality, one of the kidney’s most important functions is actually water conservation.
How the body normally controls water balance
In the post on X, Dr. Priyam explained that the human body relies on a hormone called ADH (antidiuretic hormone), also known as vasopressin, to regulate water levels.
Its job is simple: tell the kidneys to hold on to water when the body needs it.
Under normal conditions, the kidneys concentrate urine efficiently, preventing excessive water loss.
But in certain medical conditions, this mechanism breaks down.
What happens in Diabetes Insipidus?
According to Dr. Priyam, in conditions like Diabetes Insipidus (DI): • either the brain does not produce enough ADH or the kidneys stop responding properly to it.
As a result, "the kidneys lose the ability to concentrate urine. So the body starts producing enormous amounts of very dilute urine...sometimes 5, 8, even 10+ liters/day", the doctor expalined.
When that happens, the kidneys lose their ability to concentrate urine properly.
"Now because water is constantly being lost, the brain triggers intense thirst to prevent dangerous dehydration. So the excessive thirst is not the cause of the urination. It’s actually the body’s survival response to the water loss. Because the body is losing so much water, the brain triggers intense thirst as a survival response to prevent dehydration," said the doctor.
Other possible causes doctors consider
However, Dr. Priyam pointed out that not every person with excessive urination has Diabetes Insipidus.
Other possible causes include:
- uncontrolled diabetes mellitus,
- psychogenic polydipsia,
- electrolyte imbalances such as hypercalcemia,
- kidney-related disorders,
- and certain medications.
