Vasopressin; arginine vasopressin; AVP; ADH
What is anti-diuretic hormone?
Anti-diuretic hormone is made by special nerve cells found in an area at the base of the brain known as the hypothalamus. The nerve cells transport the hormone down their nerve fibres (axons) to the posterior pituitary gland where the hormone is released into the bloodstream. Anti-diuretic hormone helps to control blood pressure by acting on the kidneys and the blood vessels. Its most important role is to conserve the fluid volume of your body by reducing the amount of water passed out in the urine. It does this by allowing water in the urine to be taken back into the body in a specific area of the kidney. Thus, more water returns to the bloodstream, urine concentration rises and water loss is reduced. Higher concentrations of anti-diuretic hormone cause blood vessels to constrict (become narrower) and this increases blood pressure. A deficiency of body fluid (dehydration) can only be finally restored by increasing water intake.
How is anti-diuretic hormone controlled?
The release of anti-diuretic hormone from the pituitary gland into the bloodstream is controlled by a number of factors. A decrease in blood volume or low blood pressure, which occurs during dehydration or a haemorrhage, is detected by sensors (baroreceptors) in the heart and large blood vessels. These stimulate anti-diuretic hormone release. Secretion of anti-diuretic hormone also occurs if the concentration of salts in the bloodstream increases, for example as a result of not drinking enough water on a hot day. This is detected by special nerve cells in the hypothalamus (osmoreceptors) which simulate anti-diuretic hormone release from the pituitary. . Anti-diuretic hormone is also released by thirst, nausea, vomiting and pain, and acts to keep up the volume of fluid in the bloodstream at times of stress or injury. Alcohol prevents anti-diuretic hormone release, which causes an increase in urine production and dehydration.
What happens if I have too much anti-diuretic hormone?
High levels of anti-diuretic hormone cause the kidneys to retain water in the body. There is a condition called Syndrome of Inappropriate Anti-Diuretic Hormone secretion (SIADH; a type of hyponatraemia) where excess anti-diuretic hormone is released when it is not needed (see the article on hyponatraemia for more information). With this condition, excessive water retention dilutes the blood, giving a characteristically low salt concentration. Excessive levels of anti-diuretic hormone might be caused by drug side-effects and diseases of the lungs, chest wall, hypothalamus or pituitary. Some tumours (particularly lung cancer), can produce anti-diuretic hormone.
What happens if I have too little anti-diuretic hormone?
Low levels of anti-diuretic hormone will cause the kidneys to excrete too much water. Urine volume will increase leading to dehydration and a fall in blood pressure. Low levels of anti-diuretic hormone may indicate damage to the hypothalamus or pituitary gland, or primary polydipsia (compulsive or excessive water drinking). In primary polydipsia, the low level of anti-diuretic hormone represents an effort by the body to get rid of excess water to stop the blood becoming too dilute. Diabetes insipidus is a condition where you either make too little anti-diuretic hormone (usually due to a tumour, trauma or inflammation of the pituitary or hypothalamus), or where the kidneys are insensitive to it. Diabetes insipidus is associated with increased thirst and the production of large amounts to pale urine which can lead to rapid dehydration if untreated.
Last reviewed: Jul 2021
What is an antidiuretic hormone (ADH) test?
Antidiuretic hormone (ADH) is a hormone that helps your kidneys manage the amount of water in your body. The ADH test measures how much ADH is in your blood. This test is often combined with other tests to find out what is causing too much or too little of this hormone to be present in the blood.
ADH is also called arginine vasopressin. It’s a hormone made by the hypothalamus in the brain and stored in the posterior pituitary gland. It tells your kidneys how much water to conserve.
ADH constantly regulates and balances the amount of water in your blood. Higher water concentration increases the volume and pressure of your blood. Osmotic sensors and baroreceptors work with ADH to maintain water metabolism.
Osmotic sensors in the hypothalamus react to the concentration of particles in your blood. These particles include molecules of sodium, potassium, chloride, and carbon dioxide. When particle concentration isn’t balanced, or blood pressure is too low, these sensors and baroreceptors tell your kidneys to store or release water to maintain a healthy range of these substances. They also regulate your body’s sense of thirst.
The normal range for ADH is 1-5 picograms per milliliter (pg/mL). Normal ranges can vary slightly among different laboratories. ADH levels that are too low or too high can be caused by a number of different problems.
ADH deficiency
Too little ADH in your blood may be caused by compulsive water drinking or low blood serum osmolality, which is the concentration of particles in your blood.
A rare water metabolism disorder called central diabetes insipidus is sometimes the cause of ADH deficiency. Central diabetes insipidus is marked by a decrease in either the production of ADH by your hypothalamus or the release of ADH from your pituitary gland.
Common symptoms include excessive urination, which is called polyuria, followed by extreme thirst, which is called polydipsia.
People with central diabetes insipidus are often extremely tired because their sleep is frequently interrupted by the need to urinate. Their urine is clear, odorless, and has an abnormally low concentration of particles.
Central diabetes insipidus can lead to severe dehydration if it’s left untreated. Your body won’t have enough water to function.
This disorder is not related to the more common diabetes, which affects the level of the hormone insulin in your blood.
Excess ADH
When there’s too much ADH in your blood, syndrome of inappropriate ADH (SIADH) may be the cause. If the condition is acute, you may have a headache, nausea, or vomiting. In severe cases, coma and convulsions can occur.
Increased ADH is associated with:
Dehydration, brain trauma, and surgery can also cause excess ADH.
Nephrogenic diabetes insipidus is another very rare disorder that may affect ADH levels. If you have this condition, there’s enough ADH in your blood, but your kidney can’t respond to it, resulting in very dilute urine. The signs and symptoms are similar to central diabetes insipidus. They include excessive urination, which is called polyuria, followed by extreme thirst, which is called polydipsia. Testing for this disorder will likely reveal normal or high ADH levels, which will help distinguish it from central diabetes insipidus.
Nephrogenic diabetes insipidus is not related to the more common diabetes mellitus, which affects the level of insulin hormone in the blood.
A healthcare provider will draw blood from your vein, usually on the underside of the elbow. During this process, the following occurs:
- The site is first cleaned with an antiseptic to kill germs.
- An elastic band is wrapped around your arm above the potential area of the vein where the blood will be drawn. This causes the vein to swell with blood.
- Your healthcare provider gently inserts a needle syringe into your vein. Blood collects in the syringe tube. When the tube is full, the needle is then removed.
- The elastic band is then released, and the needle puncture site is covered with sterile gauze to stop the bleeding.
Many medications and other substances can affect the levels of ADH in your blood. Before the test, your doctor may ask you to avoid:
- alcohol
- clonidine, which is a blood pressure medication
- diuretics
- haloperidol, which is a medication used to treat psychotic and behavioral disorders
- insulin
- lithium
- morphine
- nicotine
- steroids
The uncommon risks of blood tests are:
Abnormally high levels of ADH may mean you have:
Abnormally low levels of ADH may mean:
- pituitary damage
- primary polydipsia
- central diabetes insipidus, which is rare
An ADH test alone is usually not enough to make a diagnosis. Your doctor will probably need to perform a combination of tests. Some tests that may be performed with an ADH test include the following:
- Anosmolality test is a blood or urine test that measures the concentration of dissolved particles in your blood serum and urine.
- An electrolyte screening is a blood test that’s used to measure the amount of electrolytes, usually sodium or potassium, in your body.
- A water deprivation testexamines how frequently you urinate if you stop drinking water for several hours.
Written by Puya Yazdi, MD | Last updated: October 12, 2020
Vasopressin, otherwise known as Antidiuretic Hormone (ADH), has roles in water balance and blood pressure, but it’s also sought after as a smart drug. This post reveals the roles of vasopressin, health implications of high/low levels, and factors that impact secretion.
What is Vasopressin?
Role in the Body
Why is it so important? Vasopressin plays a major role in keeping the body hydrated, the mind sharp, and the mood bright.
- For athletes: too high vasopressin levels may result in difficulty holding onto salt, a key electrolyte.
- For those concerned about mental sharpness: vasopressin is considered a “smart drug” by many and is being studied as a treatment for dementia.
- For those struggling with frequent urination or bedwetting: low vasopressin may play a role.
- For those who feel nauseated after drinking a lot of water or get headaches after intense exercise: high vasopressin may be involved.
- For those feeling constantly thirsty and always running to the bathroom, low vasopressin may play a role [1].
- It may also play a role in stress and/or chronic inflammation [2].
Although it’s seldom discussed, even in health circles, vasopressin clearly plays a major role in our everyday health and well-being. This post discusses how it can manifest in different health conditions.
Overview
Vasopressin is otherwise known as Arginine-Vasopressin (AVP) because in most species it contains arginine. It is produced by the hypothalamus and released by the pituitary gland in the brain.
It’s also called Antidiuretic Hormone (ADH) because it reduces urination (diuresis).
Vasopressin is especially active at night, eliminating the need to go to the bathroom every couple of hours, and allowing you to sleep straight through until morning [3, 4].
Besides helping the body to retain water, is also constricts blood vessels, which increases blood pressure. You can think of it as inhibiting flow – of water and of blood. That’s where the name “vasopressin” comes from – causing a restriction in blood vessels.
How Vasopressin Affects the Brain
It all starts in the brain.
When the brain gets the signal that the body is getting dehydrated (blood pressure is low, blood is highly concentrated), vasopressin is released and the kidneys are given the message to conserve water and prevent the loss of water in the urine. Instead, the urine is more concentrated and water is reabsorbed into the body, diluting the blood, and restoring balance to the body.
Vasopressin does much more than just regulate our water and salt concentrations. It also has a role in memory, regulating blood pressure and body temperature, CRH release, socio-sexual behavior, and even our circadian rhythm [5].
It can act as a neurotransmitter, and it can stimulate the production of other needed neurotransmitters [6].
Vasopressin is also considered to be a stress hormone like cortisol or CRH [7].
Health Effects of Vasopressin
Keep in mind that health effects of vasopressin as a hormone in the body may not translate to the effects of vasopressin administration.
Nootropic Effects
The effects described below are not researched well enough. They stem from low-quality clinical or animal trials.
- Vasopressin is used as a nootropic/smart drug by some people. It can influence mental clarity, attention to detail, short-term memory [8, 9] and long-term memory [9, 10].
- It enhances learning in mice [11].
- It is also being studied for the treatment of memory problems associated with aging, dementia, drug toxicity, and amnesia [8].
- High Vasopressin can make you more cooperative [12].
Low Vasopressin
Vasopressin levels are a marker of urine and blood flow. Low or high levels don’t necessarily indicate a problem if there are no symptoms or if your doctor tells you not to worry about it.
The following conditions have been linked with low vasopressin:
- Bed wetting [13].
- Diabetes Insipidus [14].
- Insomnia in the elderly [15, 16].
- Slow gut flow (motility) in the digestive tract (in rabbits) [17]. Vasopressin has also been found in the human digestive tract with implications for involvement there [18].
Factors That May Increase Vasopressin (AVP Promoters)
Addressing your vasopressin levels won’t necessarily cause improvement in blood and urine flow. The following is a list of factors that impact water balance and that may also increase low vasopressin. Though studies suggest various dietary and lifestyle factors may increase vasopressin, additional large-scale clinical trials are needed.
- Restricting water
- Dietary Sodium [19]
- Standing [20]
- Exercise [21]
- Sauna [22]
- Forskolin/cAMP [23]
- Glycine [24, 25]
- Rhodiola – Lowers endopeptidase activity, leading to higher vasopressin. Rhodiola sacra [26] and Rhodiola sachalinensis [27].
- Ginkgo – Lowers endopeptidase activity, leading to higher vasopressin [28]
- Baicalein – Inhibits endopeptidase, raising vasopressin [29]
- Berberine – Inhibits endopeptidase, raising vasopressin [30]
- Acetylcholine – Increases vasopressin (in rat studies) [31]
- Increased IL-1beta [32]
- Increased Interleukin-6 [33]
- Increased CRH [34]
- Inhibited IGF-1 [35]
- Increased BMAL1, which is needed for the production of vasopressin [36]
- Stimulated 5-HT2C receptors, which leads to an increase in vasopressin [37]. Some 5-HT2C activators include Serotonin [37], Ginseng [38], and Bacopa (rats) [39].
- Nicotine (rabbits, cats, men) [40, 41, 42].
- Racetams – Raise Acetylcholine, raising vasopressin
- Pramiracetam – Inhibits endopeptidase, raising vasopressin [43].
- Desmopressin – Synthetic vasopressin that has 10 times the antidiuretic effects of vasopressin, but 1500 times less of the constricting effect on blood vessels [44].
- Other Drugs that increase vasopressin: morphine, amitriptyline, barbiturates, desipramine, and carbamazepine (45).
High Vasopressin
Vasopressin levels are a marker of urine and blood flow. Low or high levels don’t necessarily indicate a problem if there are no symptoms or if your doctor tells you not to worry about it.
Associated Conditions
- Stress – in humans [46, 47] and in rats [48] and mice [49]
- Pain – in humans [50]
- High blood pressure [51]
- Major depression [46]
- Diabetes (Type 2)
- Low Cortisol [52]
- Low sodium/Hyponatremia/Syndrome of Inappropriate Diuretic Hormone (SIADH) secretion
- Unsteady gait [53]
- impaired memory [54]
- Low Thyroid [55]
- Post Viral Fatigue Syndrome [56]
- Kidney Stones – Vasopressin causes our urine to be less dilute.
- High Blood Sugar – Insulin can cause the release of vasopressin [57]. Vasopressin causes insulin release in mice [1].
- Low BUN (Blood Urea Nitrogen) levels [58]
- Low Uric Acid levels particularly in SIADH [59]
- High CRH – Vasopressin releases CRH [34]
- Anorexia – vasopressin suppresses appetite [60, 61]
Factors That May Lower Vasopressin (AVP Inhibitors)
Addressing your vasopressin levels won’t necessarily cause improvement in blood and urine flow. The following is a list of factors that impact water balance and that may also reduce high vasopressin. Though studies suggest various dietary and lifestyle factors may increase vasopressin, additional large-scale clinical trials are needed.
- Cold (humans and rats) [62, 63]
- Lying down – Inhibits vasopressin [64].
- California Poppy – Has 2 compounds that inhibit the V1 receptor [65, 66].
- Lithium – In human studies [67].
- Decrease Interleukin-6 [33].
- Decrease IL-1beta [32].
- Decrease CRH – CRH increases Vasopressin [34].
- Increase MSH – MSH decreases ADH/Vasopressin in rat studies [68].
- Increase IGF-1, which inhibits vasopressin [35].
Hormones:
- Increased Progesterone – Progesterone therapy caused a decrease in blood levels of vasopressin [69].
- Combined Estrogen with Progesterone – There was no change in blood levels of vasopressin with estrogen treatment alone, but following a combined administration of estrogen and progesterone [70].
- Increased Testosterone [70].
Other:
- Danggui-Shaoyao-San (Chinese herb formula) (rat and mouse models) [71].
- Alisma plantago-aquatica – (cell studies) [72].
- Alcohol – Inhibits vasopressin [73].
- Decreased BMAL1, which is needed for the production of vasopressin [36].
(25 votes, average: 4.68 out of 5)
The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. We do not aim to diagnose, treat, cure or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition.