GP Cover Letter: New Thirst and Urination Symptoms, Hand-Skin Review, and Separate Appointment Requests
Date: Friday 10 July 2026
Type: Cover Letter
Current concerns
The order below reflects the matters I currently wish to raise.
The main matter for assessment during this consultation is item 1.
Item 2 may also be reviewed if there is still enough visible or palpable abnormality at the time of the appointment. Otherwise, the photographs and supporting record provide the clearest evidence, and a further appointment may be needed when the condition recurs.
Items 3 and 4 are limited requests concerning the suspected medicine reaction record and the reissue of two questionnaires.
Items 5 and 6 are included as wider clinical background that may be relevant to assessment, prescribing decisions, referrals, or future care. I am not requesting detailed assessment of either matter during this consultation.
- New excessive thirst, increased urination, profound fatigue, and salt craving.
- Recurrent dorsal-hand skin changes.
- Review and appropriate documentation of the previous suspected naproxen-related itchy rash.
- Reissue of the ADHD questionnaire and AQ-10.
- Possible dyslexia or another specific learning difficulty, included as background only; no GP or NHS action is currently requested.
- DSD-related matters, included as background before a future referral request.
Details
1. New excessive thirst, increased urination, fatigue, and salt craving
Since around 6 July 2026, I have experienced:
- markedly increased thirst;
- estimated tap-water intake, including salted tap water, of approximately 2 litres per day, around 1 litre more than usual;
- a marked increase in urine output;
- profound fatigue;
- difficulty drinking water without added salt;
- a strong urge to drink salted water.
On 10 July 2026, after waking at approximately 5:00 am, I had already consumed five cups of salted water by the time the supporting record was prepared and still felt thirsty.
I have also recorded some intermittent unusual sensations affecting an area of the right knee, an area below the left knee, and the top of the right foot. I will demonstrate the exact locations during the consultation because they are easier to show than to describe accurately.
Related document(s):
- Excessive Thirst, Increased Urination and Salt Craving Record
- Long-Term Health Timeline
- Lift Movement and Pain Synchronisation Record
2. Recurrent dorsal-hand skin changes
The recurrent skin changes on the back of my hand became more noticeable again before this consultation.
Because the appointment had already been arranged, I applied Elocon 0.1% w/w ointment on only one occasion and only to part of the affected area. The intention was to preserve part of the untreated skin for clinical examination.
The current appearance therefore differs from the earlier untreated photographs.
I would appreciate review of the recurrent skin changes and advice on the appropriate future use of Elocon.
Related document(s):
- Recurrent Hand Skin Changes and Suspected Naproxen Medicine Reaction Record
3. Previous suspected naproxen medicine reaction
During the February 2026 acute episode, I developed numerous itchy red spots extending from the wrist towards the elbow while taking naproxen and flucloxacillin concurrently.
The rash improved markedly after naproxen was discontinued while flucloxacillin continued.
I am raising this during the present consultation because the suspected reaction may be relevant to prescribing decisions.
I would appreciate advice on whether the suspected reaction should be recorded in my medical record and whether future NSAID use requires any precautions.
Related document(s):
- Recurrent Hand Skin Changes and Suspected Naproxen Medicine Reaction Record
4. ADHD questionnaire and AQ-10
- Please could the ADHD questionnaire be reissued, as I was unable to complete it within seven days.
- Please could the AQ-10 questionnaire also be reissued.
5. Possible dyslexia or another specific learning difficulty
I may have dyslexia or another specific learning difficulty, although this has not been formally assessed and I cannot be certain.
I have noticed similar difficulties when studying English, French, and Japanese. The most significant current impact is on compulsory English-language study, while the difficulties in other areas are less severe.
I am not requesting assessment or other action through the GP or NHS at present. As any formal assessment would mainly be used for educational support, I intend to raise this directly with my future university.
I am including this so that clinicians are aware of this background.
6. DSD-related matters
I also have DSD-related matters that I would like to discuss separately when I have more capacity.
This is a substantial topic and is not expected to be addressed fully during this consultation.
I am including it as wider clinical background because it may be relevant to assessment, prescribing decisions, referrals, or future care.
After my usual GP returns from leave and I have completed the supporting documents, I intend to request an appropriate referral.
Notes
Plain-text versions of the supporting documents are available at:
The website contains patient-prepared plain-text documents only. Original NHS records, prescription labels, photographs, and other clinical records remain the primary supporting evidence where applicable.
These documents record the observations that appeared relevant at the time of writing. They may not contain every detail that would be clinically useful.
Please ask me about any additional history or information that may assist the assessment.
Please feel free to copy, adapt, or retain any relevant information for clinical documentation or referral writing.
As I am not a healthcare professional, please verify any clinical information before relying on it.
Thank you for reviewing this information.