I'm hoping someone can help me understand what my blood work might be indicating. I'd do the research myself but I've a very limited capacity for reading these days without inciting a sort of PEM. So if anyone can offer something off the top of their head I'd appreciate it very much. The shorter the response the better. Thanks. serum osmolality is 306 (ref. 280-300) albumin is high-normal Sodium is normal ADH (vasopressin) is a whopping 53.5 (ref. 0.5-3.5) My thirst is normal. I drink about 1-1.5 litres of water per day. I've my fair share of subcutaneous water retention. I think nephrogenic diabetes insipidus would be the mainstream interpretation of my labs, but as a ME/CFS sufferer I've to consider other possibilities. Apparently central diabetes insipidus (not the nephrogenic variety) resulting from a deficiency in ADH is common in ME/CFS, though I'm not sure why this is. Is it because most PWME's are low in ADH? I think Shoemaker has indicated that ADH is usually deficient in patients with mold-induced inflammation. What I think is happening in my case is my body is relying more and more on ADH to maintain blood pressure as norepinephrine runs low (I've anecdotal evidence to support this). This would be compatible with Cheney and Peckerman's findings about diastolic dysfunction and low cardiac output. Am I missing anything?