ADH stands for antidiuretic hormone also known as vasopressin. ADH primarily acts in the kidney to resorb water. Vasopressin can also be administered to raise blood pressure. ADH is produced by the hypothalamus and released into the bloodstream by the pituitary gland. ADH levels increase in response to low blood volume. Thus in times of dehydration or hemorrhage, ADH works to increase the amount of water in the bloodstream by decreasing water loss and kidney. This increased water retention will also dilute the amount of sodium in the blood, causing sodium levels to decrease. On the other hand, the pituitary stops releasing ADH in response to decreased sodium levels in the blood, acting as a feedback mechanism.
Normal Ranges for ADH:
1 to 5 pg/mL
Sources:
https://medlineplus.gov/ency/article/003702.htm
https://emedicine.medscape.com/article/246650-clinical
https://www.uptodate.com/contents/diagnosis-of-polyuria-and-diabetes-insipidus
Low levels of ADH may not be detectable on laboratory tests. In fact, some labs do not list a lower level of normal on their results. That said, people without the ability to produce ADH have a condition called central diabetes insipidus. In this condition, people cannot resorb water in the kidneys so they drink and urinate almost constantly. It is treated by administering ADH.
Some specific causes of low ADH are:
- Central diabetes insipidus
- Brain tumor
- Brain hemorrhage
- Primary polydipsia
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The causes of high ADH levels are collectively known as syndrome of inappropriate antidiuretic hormone secretion or SIADH. In SIADH, the body cannot excrete sufficient amounts of water because ADH levels are chronically too high. As a result, sodium levels drop resulting in hyponatremia. If sodium levels drop slowly, there may be no or only subtle symptoms. If sodium levels drop rapidly, severe symptoms may occur, even death. Gradual hyponatremia causes slowed reaction times, cognitive slowness, and problems with balance and walking. Early symptoms of quickly dropping sodium include a lack of appetite, nausea, and malaise. This is followed by headache, muscle cramps, irritability, drowsiness, confusion, weakness, seizures, and coma. There are several causes of SIADH ranging from mental and neurological disorders, cancer, lung disease, genetic disorders and many medications.
Some specific causes of high ADH are:
- Stroke
- Psychosis
- Head trauma
- Brain tumor
- Surgery
- Lung tumor
- Porphyria
- Hereditary SIADH
- Old age
- Medications
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