Ask a doctor on the topic of General medicine

Additional question for Dr. med. Ralf Berg

August 9, 2012 | 25,00 EUR | answered by Dr. med. Ralf Berg

Dear Dr. Berg,

Thank you very much for your helpful explanations last time regarding exhaustion in Thailand.

1) Introduction
During my last visit to Thailand, I tried the following:
- Only Japanese food, very hygienic - no diarrhea.
- Preventive intake of 2-3 packets of Elotrans daily.
- Daily consumption of 2-3 bottles of Gatorade (a sports drink).

The success was remarkable! Not only did I not experience exhaustion after a week, but I felt as fit and lively as ever despite the extreme heat. However, I am surprised that my fluid and/or salt balance is so easily disrupted. Hence, my question.

2) Question
Even when observing myself in everyday life in Switzerland at moderate temperatures, I notice that I am almost always thirsty, which I can hardly quench with water alone. I either have to mix salt and sugar into the water and drink liters of it, or resort to Gatorade or even Elotrans again.

Do you have any thoughts on this? Is it normal to always be thirsty, or could there be some underlying condition such as diabetes? Should I see a doctor? I also read on the internet that many people are chronically dehydrated.

The only known condition I have is called Tremor Palatinus, which is a constantly contracting muscle in the soft palate. But I can hardly imagine that this would have an impact on my water and salt balance.

Best regards,

Dr. med. Ralf Berg

Hello,

nice that you could enjoy your stay in Thailand better now. Now to your question: First, you should have your fasting blood sugar tested and undergo a glucose tolerance test. (Blood sugar determination twice after drinking a certain amount of glucose solution, measurement after 2 hours. No physical activity in between, of course also do not eat or drink anything. This can detect whether there is diabetes behind it.
2. You should keep an eye on the electrolytes.
There are some indications that your aldosterone system could be out of balance. In addition to the salts in the blood, the salts in the 24-hour urine collection are measured and the size of the adrenal glands is determined by ultrasound. The connection between the two possible diseases would be a so-called bronzed diabetes (Addison's disease).
Do you have a dark complexion or have you "darkened"?
So go to an internist, describe everything and point out that a doctor has advised you to rule out 1. diabetes and 2. Addison's disease.
I am curious about the result myself. Report back to me? Ps The palatal tremor of course has no influence on the electrolyte balance, but a displaced electrolyte balance with decreased K+ or Ca++ has an influence on the occurrence of the tremor. Best regards R. Berg