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Antidiuretic-hormone-adh



Why Get Tested

To help detect diagnose and determine the cause of antidiuretic hormone ADH deficiency or excess to investigate low blood sodium levels hyponatremia to distinguish between the two types of diabetes insipidus

When To Get Tested

When you have low blood sodium or have persistent thirst frequent urination and dehydration

Sample Required

A blood sample drawn from a vein in your arm

Test Preparation Needed

None needed for an ADH test however talk to your health care provider about required preparation when the ADH test is performed as part of a water deprivation ADH stimulation test or a water loading ADH suppression test




Common Questions


The antidiuretic hormone ADH test is used to help detect diagnose and determine the cause of antidiuretic hormone deficiencies and excesses However this test is not widely used diagnoses of these conditions are often based on clinical history and other laboratory tests such as blood and urine osmolality as well as electrolytes Antidiuretic hormone also called arginine vasopressin AVP is a hormone produced by the hypothalamus in the brain and stored in the posterior pituitary gland at the base of the brain ADH helps regulate water balance in the body A variety of disorders conditions and medications can affect either the amount of ADH released or the kidneys response to it ADH deficiency is often seen with one of two types of diabetes insipidus Central diabetes insipidus is a decrease in the production of ADH by the hypothalamus or in the release of ADH from the pituitary while nephrogenic diabetes insipidus is characterized by a decrease in the kidney s response to ADH Both types of diabetes insipidus lead to the excretion of large quantities of dilute urine A water deprivation ADH stimulation test is sometimes used to distinguish between these types It involves fluid restriction an ADH test and the administration of ADH vasopressin Several blood and urine osmolality measurements are performed at timed intervals before and after vasopressin is given in order to monitor the body s response to fluid restriction and then to the drug This procedure must be performed under close medical supervision as it can sometimes lead to severe dehydration and can pose a risk to some people with underlying diseases An increased level of ADH is often seen with syndromes of inappropriate ADH secretion SIADH Testing for SIADH may include blood and urine osmolality sodium potassium and chloride tests and sometimes an ADH measurement A water loading ADH suppression test is sometimes performed With this procedure a fasting person is given specific quantities of water and then the amount of urine produced and the changes in urine and blood osmolality are monitored over time An ADH test is also performed This procedure must also be performed under medical supervision as it can be risky in those with kidney disease and can sometimes result in severe low blood sodium hyponatremia Other testing may be performed to help distinguish SIADH from other disorders that can cause edema low blood sodium and or decreased urine production such as congestive heart failure liver disease kidney disease and thyroid disease

An ADH test may be ordered by itself along with other tests or as part of a water deprivation or water loading procedure when excess or deficient ADH production and secretion is suspected It may be ordered when a person has low blood sodium without an identifiable cause and or has symptoms associated with SIADH If SIADH develops gradually there may be no symptoms but if the condition is acute the signs and symptoms are usually those associated with water intoxication and may include Headache Nausea vomiting Confusion In severe cases coma and convulsions An ADH test may be ordered when a person has excessive thirst and frequent urination and the health practitioner suspects diabetes insipidus

ADH test results alone are not diagnostic of a specific condition The results are usually evaluated in conjunction with a person s medical history physical examination and results of other tests Excesses and deficiencies of ADH may be temporary or persistent acute or chronic and may be due to an underlying disease an infection an inherited condition or due to brain surgery or trauma Increased ADH levels are often associated with SIADH which may be due to a variety of cancers including leukemia lymphoma and cancers of the lung pancreas bladder and brain Levels of ADH may be greatly increased with such cancers Moderate increases in ADH may be seen with nervous system disorders such as Guillain-Barr syndrome multiple sclerosis epilepsy and acute intermittent porphyria with pulmonary disorders such as cystic fibrosis emphysema and tuberculosis and in those with HIV AIDS The ADH test may sometimes be ordered to help investigate low blood sodium and its associated symptoms and to identify SIADH but it is not generally ordered to diagnose or monitor any of the diseases or conditions that may cause it A low ADH may be seen with central diabetes insipidus excessive water drinking and with low serum osmolality An increased ADH may be seen with nephrogenic diabetes insipidus with dehydration trauma and surgery With ADH suppression or stimulation tests a health practitioner is looking for appropriate levels of ADH osmolality and kidney water retention responses A water loading ADH suppression test may be used to help diagnose SIADH With this test those with SIADH typically have decreased blood sodium and osmolality They do not produce as much urine as expected urine osmolality is high relative to serum osmolality and the ADH concentration is in excess of what would be appropriate and does not decrease appropriately with water loading A water deprivation ADH stimulation test may be used to differentiate between the two types of diabetes insipidus Central diabetes insipidus is characterized by abnormally low production of ADH and the inability to concentrate urine that is reflected as an increase in urine osmolality after ADH administration but not an increase due to water deprivation alone Nephrogenic diabetes insipidus is the kidney s inability to respond to ADH that is reflected as no change in urine osmolality before or after ADH administration and high blood ADH

In general the ability to concentrate urine decreases with age ADH secretion increases when a person is standing at night and with pain stress and exercise Secretion decreases with hypertension and when someone is lying down Many drugs can affect ADH levels They include Drugs that stimulate ADH release such as barbiturates desipramine morphine nicotine amitriptyline and carbamazepine Drugs that promote ADH action such as acetaminophen metformin tolbutamide aspirin theophylline and non-steroidal anti-inflammatory drugs Drugs that decrease ADH or its effects such as ethanol lithium and phenytoin

No for most people ADH is appropriately produced and utilized by the body to maintain water balance The ADH test is not used as a general screening test and most people will never have one done

Your blood may be collected in the doctor s office but ADH testing requires specialized equipment The test is not offered by every laboratory and may need to be sent to a reference laboratory If you have a water deprivation or water loading test it will be performed under medical supervision

Diabetes mellitus usually referred to as diabetes is related to either decreased insulin production or insulin resistance and causes an increase in blood glucose Diabetes insipidus is not related to insulin or glucose The ancient Greeks in naming the diseases thought that both conditions were similar because persons with them had increased thirst and frequent urination They were different in that in one the urine was sweet diabetes mellitus while in the other is was not diabetes insipidus

Yes a synthetic form of ADH can be given as a replacement to those with central diabetes insipidus Those with nephrogenic diabetes insipidus are encouraged to drink adequate amounts of water to replace what is being lost in their urine and should talk to their health care provider about possible adjustments to their diet