Primary polydipsia Alcoholism may cause physiological thirst since ethanol inhibits vasopressin, the hormone primarily responsible for water retention in osmoregulation. The following conditions should also be excluded: DI, cerebral salt wasting, pseudohyponatraemia caused by hyperlipidemia or hyperparaproteinemia, SIADH, mineralcorticoid deficiency, salt-wasting nephropathy, nephrotic syndrome, chronic heart failure and cirrhosis. Tobacco smoking is an often overlooked factor linked to hyponatremia, due to the ADH-releasing effect of nicotine, although this is usually limited to heavy smokers. One study suggested that around 70% of patients with self-induced polydipsia were tobacco smokers. Diagnostic tests for primary polydipsia usually involves the fluid deprivation test to exclude ADH
Minimally disruptive medicine Minimally disruptive medicine Minimally Disruptive Medicine is an approach to patient care in chronic illness proposed by Carl R May, Victor Montori, and Frances Mair. In a 2009 article in the British Medical Journal they argued that the burden of illness (the pathophysiological and psychosocial impact of disease on the sufferer) has its counterpart in the burden of treatment (the workload delegated to the patient by health professionals, which may include self care and self-monitoring, managing therapeutic regimens, organizing doctors’ visits, tests, and insurance). As medical responses to illness have become more sophisticated, the burden of treatment has grown, and