| Antidiuretic hormone (ADH) deficiency | 4090.00000000000 | Antidiuretic hormone (ADH) deficiency | Antidiuretic hormone (ADH) deficiency | A | English | Endocrinology | Child (0-12 years) | Kidneys | Endocrine system | Conditions and diseases | Adult (19+)
Caregivers | NA | | 2022-11-28T05:00:00Z | | | | | | 9.80000000000000 | 54.3000000000000 | 815.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>ADH deficiency is a type of hypopituitarism hormone deficiency that affects the kidneys. Learn about what happens to the body in ADH deficiency, how it is diagnosed and treated.</p> | <h2>What is hypopituitarism?</h2><p>Hormones are chemicals produced in the body. They act as messengers that travel to other parts of the body where they affect how organs work. <a href="/article?contentid=4085&language=english">Hypopituitarism</a> is a condition where the pituitary gland does not produce one or more pituitary hormones, or it does not produce enough hormones. "Hypo" means less than usual. The term "panhypopituitarism" means many or all of these hormones are deficient ("pan" means all). </p><p>The pituitary gland is a pea-sized gland located in the middle of the skull. It is part of the body’s endocrine system, which includes all of the glands that produce and regulate hormones. The pituitary gland acts as the control centre for other glands. Hormones produced in the pituitary gland impact many other parts of the body. The pituitary gland releases various hormones in response to chemical messages it receives from the part of the brain called the hypothalamus.</p>
<figure class="asset-c-80"><img src="https://assets.aboutkidshealth.ca/AKHAssets/Pituitary_gland.jpg" alt="brain showing location of hypothalamus and pituitary gland with close up of anterior and posterior lobes" /><figcaption class="asset-image-caption">Hormones are produced in the pituitary gland and carried to other parts of the body.</figcaption> </figure>
<h2>What is antidiuretic hormone deficiency?</h2><p>The back (or "posterior") part of the pituitary stores an important hormone called antidiuretic hormone (ADH). ADH helps the body to retain the water that it needs to function properly.</p>
<figure class="asset-c-80"><img src="https://assets.aboutkidshealth.ca/AKHAssets/ADH_deficiency.jpg" alt="Posterior pituitary lobe produces ADH which signals kidneys to concentrate urine" /><figcaption class="asset-image-caption">ADH is produced in the posterior pituitary lobe, which signals the kidneys to concentrate urine.</figcaption> </figure>
<p>When there is not enough ADH, the kidneys are unable to concentrate urine. The two most obvious warning signals are:</p><ul><li>Excessive thirst</li><li>Frequent urination, often very dilute, pale-coloured urine</li></ul><p>This can lead to severe dehydration if not enough fluids are taken to keep up with the amount of fluid being lost as urine. Infants and young children with ADH deficiency cannot easily satisfy their thirst and are especially at risk of dehydration. Children with this condition must always be allowed to drink enough water to satisfy their thirst. The child’s school, daycare, and/or babysitter needs to be aware of this. Severe dehydration requires immediate medical treatment. ADH deficiency is also called diabetes insipidus or "DI" for short. This condition has no relation to the more common condition of diabetes mellitus or "sugar diabetes".<br></p> | | <h2>Key points</h2><ul><li>Hypopituitarism is a condition where the pituitary gland does not produce one or more pituitary hormones, or it does not produce enough hormones. </li><li>When not enough antidiuretic hormone is produced the kidneys cannot concentrate urine, which can lead severe dehydration.</li><li>ADH deficiency can be treated with medication.</li><li>It is important to know the signs of over or under treatment so that the medication can be adjusted.</li></ul> | | | | | <h2>How is ADH deficiency diagnosed?</h2><p>Several ways your doctor determines that your child lacks ADH are:</p><ul><li>evaluating symptoms, such as increased urination and thirst, bed wetting, and weight loss</li><li>laboratory tests of both blood and urine
</li></ul> | <h2>How is ADH deficiency treated?</h2><p>When the pituitary is unable to release ADH, one way to replace it in the body is with a medication called <a href="/article?contentid=122&language=english">desmopressin</a>. Desmopressin can be given as a nasal (nose) spray medication (called desmopressin spray), in pill form (called desmopressin or DDAVP), in a pill that dissolves under the tongue without the need for water (called DDAVP Melt), or as a subcutaneous (under the skin) injection. Desmopressin helps the body in the same way that ADH does, by holding in the fluid that the body needs.</p><p>The pill form of the medication can be stored at room temperature. However, the nasal spray and injections must be stored in the refrigerator. There are special instructions for how to open the DDAVP Melt pills. Your health-care team or pharmacist will teach you how to do this properly. Generally, desmopressin needs to be given at least once, and often several times, per day for your child’s entire life.</p><p>For infants who are diagnosed with ADH deficiency, a different oral medication called hydrochlorothiazide might be used instead of DDAVP for the first 6-9 months of life. This is because the dosing of DDAVP in infants can be very tricky. Babies also cannot tell you when they are thirsty. For this reason, your health-care provider may ask you to accurately record any fluids the baby drinks (such as milk, water, food, juice) and the amount of fluids the baby puts out (e.g., weighing diapers on a scale). More consistent feeding and diaper changing schedules (such as every 3 to 4 hours) may also be needed. This, in combination with blood levels of sodium, can help your health-care provider find the right dose of medication. Occasionally, older children may also lack a sense of thirst. You may have to monitor urine output and give your child a fixed fluid amount every day as prescribed by your health-care provider.</p><p>It is important to know the signs of too little or too much ADH in both infants and children:</p><table class="akh-table"><thead><tr><th>Too little ADH (not enough desmopressin-DDAVP</th><th>Too much ADH (too much desmopressin-DDAVP)</th></tr></thead><tbody><tr><td><ul><li>frequent and increased urination of pale-coloured urine </li><li>heavy wet diapers, or bedwetting</li><li>increased thirst</li><li>digns of dehydration, if fluid intake is not adequate (dry tongue, sunken look to eyes, tearless cry)</li><li>irritability</li><li>eeight loss/poor weight gain</li><li>fever</li><li>vomiting</li><li>constipation</li><li>difficulty sleeping</li><li>elevated sodium levels on bloodwork</li></ul></td><td><ul><li>Decreased urination of concentrated, very yellow urine</li><li>Decreased thirst</li><li>Less urine output than intake of fluids</li><li>Weight gain (puffiness)</li><li>Nausea</li><li>Headaches</li><li>Disorientation, confusion</li><li>Lethargy</li><li>Low sodium levels on bloodwork</li><li>In severe cases seizures may occur</li></ul></td></tr></tbody></table><p>If any of the above are noted, changes in the dose of medication may be needed to avoid complications. If your child has too little ADH and does not receive treatment, it can lead to excessive urination, dehydration, increased sleepiness and eventually coma. If your child has received too much ADH and does not receive treatment, it can lead to decreased urine output, confusion, increased sleepiness, and possibly seizures.</p><p>Occasionally, it may appear that the usual dose is not as effective when a cold, allergy, or other cause of nasal congestion exists. It is important to clear the nose of mucus before medication is given through the nose. Adults and older children should blow their nose well; infants and young children may need to have the mucus cleared by using a bulb syringe. </p><p>Learning to manage ADH deficiency may seem confusing at the beginning. With practice, you will become more comfortable adjusting your child’s medication at home with the assistance of your endocrine team. Remember, your endocrine team is there to answer questions and offer support.</p> | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Antidiuretic hormone (ADH) deficiency | | False | | | | | | | | |
