Dry Mouth and Crazy Thirst: What Does it Mean?

Welcome to the symptom guide regarding dry mouth and/or excessive thirst. We’re sorry to hear you’re having this problem!

This symptom guide is designed for persons who have noticed dryness of the mouth and/or unexplained thirst and would like to find out more about this condition. Please keep in mind that this guide cannot replace a face-to-face evaluation with your own doctor. It is meant to provide helpful information while you are awaiting further evaluation or to supplement what you may have already learned after evaluation with your doctor.

This guide will focus on dry mouth that has been persistent over time. Temporary dryness of the mouth may accompany nervousness, anxiety, and breathing through the mouth (as many people do when they sleep). Eating a salty or spicy meal can be a cause of temporary (though intense) thirst.

It’s also worth mentioning that many people drink frequently out of habit. They may feel thirsty if unable to drink as often as they’re used to even though there is no real disease causing the thirst. It can be hard to tell whether this is the cause of a person’s thirst or dry mouth without first ruling out other possibilities.

You’ll be asked a series of questions that will walk you through some of the most common causes that may explain your symptoms. The guide will cover the most common reasons for dry mouth; however, it won’t cover every cause.

Okay, let’s get started

First, a question about your age. We ask because saliva production sometimes decreases with advancing age.

Are You at Least 60 Years Old?

Yes, I’m at least 60 years old.

No, I’m younger than age 60.

Okay, age is less likely to be the reason for your dry mouth or excessive thirst. Sometimes a person who has a dry mouth also has dry eyes.

Do You Also Have Dry Eyes?

Yes, I have dry eyes as well as dry mouth.

No, I don’t have dry eyes.

Your dry mouth could be due to a decrease in saliva production that sometimes accompanies advancing age. However, symptoms are often not solely related to aging. In fact, plenty of older people have perfectly normal saliva production. There are often other factors contributing to dry mouth or excessive thirst, so let’s move on to some additional questions.

Do You Also Have Dry Eyes?

Yes, I have dry eyes as well as dry mouth.

No, I don’t have dry eyes.

Good. That makes Sjogren’s syndrome less likely. Sjogren’s syndrome is a rheumatic disease that affects the entire body. In addition to causing dry eyes and mouth, it commonly causes arthritis, rash, fever, and other symptoms.

Now, on to some questions about some other possible causes of a dry mouth.

Have You Had a Significant Injury to Your Head or Neck? Have You Ever Had Radiation Therapy to Your Head or Neck?

Yes, I’ve had an injury or radiation.

Nope, no injury and no radiation.

If you have dry mouth and also have dry eyes, you could have a disease called Sjogren’s syndrome. The next question asks about features of this disease that could make it more likely in your case.

In Addition to the Dry Eyes and Dry Mouth, Do You Have One or More of the Following?

  • Swelling in the parotid gland(s) — these are salivary glands located on the sides of the face, just below and in front of the ears (we’ll return to this later in the guide).
  • Abnormalities on specialized tests of tear or saliva production performed by your doctors, usually an eye doctor or ear-nose-and-throat doctor. (If you aren’t sure if you’ve had any of these checked, just ask your doctors!). These tests include the Schirmer’s test, Rose-Bengal staining, basal and stimulated salivary flow, or lip biopsy.
  • Positive (abnormal) antibody in the blood, called anti-nuclear antibody (ANA), especially with one type of ANA called anti-Ro. Again, if you aren’t sure whether this has been checked, ask your doctor.

Yes, one or more apply to me.

No, none of those are true for me.

Good, that makes Sjogren’s syndrome (an autoimmune condition that affects the salivary and tear-producing glands) less likely.

Have You Had a Significant Injury to Your Head or Neck? Have You Ever Had Radiation Therapy to Your Head or Neck?

Yes, I’ve had an injury or radiation.

Nope, no injury and no radiation.

You could have Sjogren’s syndrome, an autoimmune condition in which the body’s immune system is thought to attack certain tissues in the body, including the glands that make tears and saliva.

Talk to your doctor about this possibility so that the diagnosis can be ruled in or out. He or she may recommend treatments to improve your symptoms or refer you to a specialist in autoimmune disease.

Have You Had a Significant Injury to Your Head or Neck? Have You Ever Had Radiation Therapy to Your Head or Neck?

Click here to continue with the guide.

Another reason for a dry mouth is prior injury or treatment with radiation therapy.

Have You Had a Significant Injury to Your Head or Neck? Have You Ever Had Radiation Therapy to Your Head or Neck?

Yes, I’ve had an injury or radiation.

Nope, no injury and no radiation.

Good, that makes radiation-induced scarring of the salivary glands and nerve injury unlikely causes of your symptoms. Just a few more questions.

Do You Take Any Medications Regularly?

Yes, I do take medications regularly.

No, I don’t take any medications regularly.

Okay. It’s possible that your dry mouth is due to scarring of the salivary glands from radiation, or from an injury to the nerves that tell these glands to produce saliva. Talk to your doctor about this possibility.

Do You Take Any Medications Regularly?

Yes, I do take medications regularly.

No, I don’t take any medications regularly.

Okay, just checking, because medicines are a common cause of dry mouth. Over-the-counter drugs count, too; certain cold remedies, for example, have a tendency to dry up congested sinuses, but they also commonly cause mouth dryness.

Now, on to a question about another medical problem that may be associated with dry mouth.

Do You Have Diabetes?

Yes, I do have diabetes.

No, I don’t have diabetes.

Well, many medicines can cause dryness of the mouth or thirst as a side effect.

Don’t stop taking medications you were prescribed, even if you think your medication could be causing your symptoms. Check with your doctor and talk about whether an alternative medicine (or even no medicine) is a reasonable option. And keep in mind that over-the-counter medicines, such as cold remedies, can cause dryness of the mouth as well.

Do You Have Diabetes?

Yes, I do have diabetes.

No, I don’t have diabetes.

Good. It’s important to know because, among the many problems associated with diabetes, high blood sugar can lead to increased urination, and excessive urination may lead to dehydration and dry mouth.

Speaking of dehydration from diabetes, other causes of dehydration include diarrhea, vomiting, prolonged fever, and taking diuretics (water pills). Exercise in hot, humid weather is another common cause. Symptoms include thirst, a dizzy feeling when arising, headache, and fatigue.

Do You Think You May Be Dehydrated?

Yes, I think I may be dehydrated.

No, I don’t think I’m dehydrated.

Okay. One relatively common cause of mouth dryness or excessive thirst is poorly controlled diabetes. It’s probably related to the frequent urination and mild dehydration that can develop if blood sugar is high; closer control of your blood sugar could improve the oral dryness you describe. Talk with your doctor about whether tighter blood sugar control would make sense for you.

Speaking of dehydration, now comes a related question.

Dehydration is a term that means “too little water” and is common among persons with diarrhea, vomiting, fever, or poorly controlled diabetes, or those who take diuretics (water pills). Exercise in hot, humid weather is another common cause. In addition to mouth dryness, symptoms of dehydration include thirst, a dizzy feeling when arising, headache, and fatigue.

Based on This Information, Do You Think You May Be Dehydrated?

Yes, I think I may be dehydrated.

No, I don’t think I’m dehydrated.

Okay. This is an important question because dehydration is a relatively common cause of dry mouth.

We’re nearly done. This next question is about the parotid gland. It’s located just below the ear, in front of the jaw, and is one of the major salivary glands.

Have You Ever Had Enlargement of the Parotid Gland?

It may have been called parotitis, or inflammation of the parotid gland.

Yes, but only on one side.

Yes, both salivary glands have been enlarged.

Nope, never had an enlarged salivary gland.

Okay. As a cause of mouth dryness, dehydration is among the most common AND the most reversible. That is, it’s often easy to fix. Drink more fluids (unless you were instructed not to do so by your doctors).

If you have an underlying medical condition that makes you prone to repeated or chronic dehydration — such as diabetes or colitis with chronic diarrhea — treatment of the underlying condition, rather than specific treatment of dry mouth, tends to help the most. Talk to your doctor about how you might better avoid dehydration.

Okay, we’re nearly done. This next question is about the parotid gland. It’s located just below the ear, in front of the jaw, and is one of the major salivary glands.

Have You Ever Had Enlargement of the Parotid Gland?

It may have been called parotitis, or inflammation of the parotid gland.

Yes, but only on one side.

Yes, both salivary glands have been enlarged.

Nope, never had an enlarged salivary gland.

Good! That makes infection, obstruction, or other body-wide conditions that can enlarge the parotid less likely. Just one more question:

Do You Have Heart, Kidney, or Liver Failure?

Yes, I have heart, kidney, or liver failure.

No, I don’t have any of those.

Okay. Dry mouth with parotid swelling on both sides can be seen with:

  • Viral infections, such as mumps
  • Sjogren’s syndrome, an autoimmune condition marked by dry eyes, dry mouth, arthritis, lung problems, and abnormal antibodies in the blood
  • Sarcoidosis, a condition that usually causes enlarged lymph nodes in the chest (which can easily be seen on a chest x-ray) and can sometimes cause parotid enlargement
  • Amyloidosis, in which an abnormal protein deposits in tissues throughout the body
  • High blood triglyceride levels, one of the blood lipids that is part of a full cholesterol panel
  • Alcohol abuse
  • Eating disorders, such as anorexia nervosa and bulimia; recurrent self-induced vomiting can lead to parotid enlargement, though dry mouth is not a common symptom in this situation

Talk to your doctor about the swelling you’ve had in your salivary glands and about these possible causes.

Just one more question:

Do You Have Heart, Kidney, or Liver Failure?

Yes, I have heart, kidney, or liver failure.

No, I don’t have any of those.

Okay. When a person has dry mouth and swelling of one side near the jaw, an obstructed salivary gland is a real possibility. The most common cause of obstruction is a stone (much like a kidney stone, or gallstone), but there are other possibilities. An infection — usually bacterial — can also cause swelling on one side, and bacteria can complicate an obstruction.

Swelling in one parotid gland is a reason to see your doctor sooner than later; understanding the cause is critical so that you can get prompt, appropriate treatment.

Just one more question:

Do You Have Heart, Kidney, or Liver Failure?

Yes, I have heart, kidney, or liver failure.

No, I don’t have any of those.

Okay. We ask because any of those conditions can cause a sensation of excessive thirst.

You’ve reached the end of this decision guide. Please click on this last link to finish.

Let’s finish up!

Okay. We ask because any of those conditions can cause a sensation of excessive thirst. It’s probably because the brain is tricked into thinking the body has too little fluid even though there may actually be too much. Treatment of these conditions may improve your symptoms. Talk to your doctor about this possibility and about treatment options.

You’ve reached the end of this decision guide. Please click on this last link to finish.

Let’s finish up!

Thanks for using this guide — we hope it was helpful and that your mouth dryness or thirst improves soon.

Just Remember:

  • Dryness of the mouth is common, especially among persons as they age; however, age alone is frequently not the only reason and other causes are often quite treatable or reversible.
  • Consider medications as a potential cause of dry mouth or excessive thirst; check with your doctor or pharmacist about this possibility.
  • Treatment for dry mouth usually starts with simple things: searching for a reversible cause (such as certain medications), taking frequent sips of water or ice, using a humidifier where you live or work, and using a fluoride toothpaste and rinse to prevent cavities (which are more common in people with significantly reduced saliva).

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