What is the recommended hydration method and management for frequent urination, anxiety, and decreased appetite, potentially exacerbated by a multivitamin?

Hydration Management for Frequent Urination with Anxiety and Decreased Appetite

Yes, you can drink Pedialyte or use oral rehydration solutions, aiming for at least 1,600 mL (approximately 6-7 cups) per day, and your frequent urination may indeed be worsened by the multivitamin—consider stopping it temporarily to assess if symptoms improve. 1, 2

Recommended Hydration Approach

Oral rehydration solutions like Pedialyte are appropriate and effective for maintaining hydration status, particularly when dealing with decreased appetite and anxiety that may impair normal fluid intake 1, 3. The evidence supports several hydration options:

Primary Hydration Options

• Carbohydrate-electrolyte solutions (3-8% concentration) such as Pedialyte show superior fluid retention compared to plain water, with decreased urine output and improved rehydration indices 1
• Plain water remains acceptable if oral rehydration solutions are not available or not tolerated, though it provides less optimal fluid retention 1, 3
• Alternative beverages including 2% milk, coconut water, or diluted sports drinks can be used if preferred 1

Specific Fluid Volume Recommendations

Target a minimum of 1,600 mL (approximately 54 ounces) of fluid per 24 hours to maintain adequate hydration status in adults 2. For women over 50 with frequent urination concerns, this baseline should be maintained unless medically contraindicated 2, 4.

• Distribute fluid intake throughout the day rather than consuming large volumes at once 5, 4
• Aim for 0.4-0.8 L per hour during waking hours until well-hydrated 5
• Avoid excessive plain water consumption without electrolytes, as this can paradoxically worsen electrolyte balance 3

Addressing the Multivitamin Concern

Your observation about worsening urination with the multivitamin is clinically plausible. Many multivitamins for women over 50 contain B-vitamins and other water-soluble nutrients that increase urinary output as excess amounts are excreted 6.

Recommended Action

• Temporarily discontinue the multivitamin for 3-5 days to assess whether urinary frequency improves
• If symptoms improve, consider switching to a lower-dose formulation or taking it with food and adequate fluids
• Resume only if nutritional deficiencies are documented, rather than for general supplementation 3

Managing Anxiety and Decreased Appetite

Anxiety itself can increase urinary frequency through autonomic nervous system activation, creating a cycle where worry about urination worsens the symptom 6. The decreased appetite compounds this by reducing natural fluid and electrolyte intake from food.

Practical Management Strategy

• Choose sodium-containing fluids (20-30 mEq/L sodium) such as Pedialyte, broth, or sports drinks rather than plain water 5, 3
• Consume small, frequent sips throughout the day rather than large volumes, which may feel overwhelming with anxiety and can trigger more frequent urination 1, 5
• Pair fluids with salty snacks if appetite allows, as this improves sodium balance and fluid retention 5, 3
• Avoid caffeine-containing beverages (coffee, tea, energy drinks) which can worsen both anxiety and urinary frequency 1

When to Seek Medical Evaluation

Seek medical attention if you experience any of the following:

• Urinary frequency persists beyond 72 hours despite adequate hydration and stopping the multivitamin 5
• Development of pain with urination, blood in urine, or fever 5
• Signs of dehydration including dizziness, decreased urine output (less than 800 mL/day), or dark concentrated urine 1
• Worsening anxiety that impairs daily function or prevents adequate fluid intake 6

Common Pitfalls to Avoid

Do not restrict fluids thinking this will reduce urinary frequency—this can lead to dehydration and concentrated urine that irritates the bladder, potentially worsening symptoms 1, 6, 4.

Do not rely solely on thirst as a hydration guide, especially with anxiety, as stress can blunt normal thirst mechanisms 6, 2. Instead, monitor urine color (should be pale yellow) and volume as practical indicators of hydration status 1, 7.

Avoid consuming large volumes of hypotonic fluids (plain water, juice, tea) without electrolytes, as this can cause sodium loss and paradoxically increase urinary output 1, 3.