Hormones

By Ananya and Anhad

 ADH

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.
 Case study
A 19 yr old undergraduate nursing student who is working part-time as a CNA. Lately she realizes
that she has to go to the bathroom very frequently - almost every hour- and that she is drinking more
than 5 L of water a day. She goes to see her NP, who finds her physical exam to be normal, with a BP
of 105/70 and a HR of 85 bpm. Labs revealed an elevated sodium of 147 mEq/L [N=140 mEq/L] and
osmolarity 301 mOsm/L [N=290 mOsm/l] but a normal fasting glucose level of 90 mg/dL [N= 70-100
mg/dL]. As a consequence of the results her NP performs a 2-hr water deprivation test. At the end of
this time her urine osmolarity remained at 70 mOsm/L, but her plasma osmolarity increased to 325
mEq/L. Treatment with dDAVP [an ADH agonist] resulted in an increase in urine osmolarity to 500
mOsm/L and a decrease in her plasma osmolarity to 290 mOsm/L. She is treated with dDAVP nasal
spray, which she reports as "amazing", returning her back to normal urine output and thirst levels.
Treatment