Deficiency in ADH
Here are two articles (one study and one letter) that speak to abnormal ADH secretion and water metabolism in post-virall fatigue and CFS. There was a lot of interest in ADH and CFS back in the late 90's and then the topic was simply dropped. Why these have never received any real attention is beyond me.
The second article talks about salt loading and fluid intake but why go that route if the real issue is a deficiency in ADH?
Let me know if you'd like a copy. I have these in pdf.
Abnormal arginine-vasopressin secretion and water metabolism in patients with postviral fatigue syndrome.
Bakheit AM,
Behan PO,
Watson WS,
Morton JJ.
Department of Neurology, University of Glasgow, Scotland.
Acta Neurol Scand. 1993 Mar;87(3):234-8.
Abstract
Water metabolism and the responses of the neurohypophysis to changes in plasma osmolality during the water loading and water deprivation tests were studied in nine patients with postviral fatigue syndrome (PVFS) and eight age and six-matched healthy control subjects. Secretion of arginine-vasopressin (AVP) was erratic in these patients as shown by lack of correlation between serum and urine osmolality and the corresponding plasma AVP levels. Patients with PVFS had significantly low baseline arginine-vasopressin levels when compared with healthy subjects. Patients with PVFS as a group also showed evidence of increased total body water content. These results may be indicative of hypothalamic dysfunction in patients with PVFS.
Chronic fatigue disorders: an inappropriate response to arginine vasopressin?
Peroutka SJ.
Spectra Biomedical, Inc., Menlo Park, CA 94025, USA.
Med Hypotheses. 1998 Jun;50(6):521-3.
Abstract
Chronic fatigue disorders are characterized by a subjectively defined group of symptoms such as chronic fatigue, mental confusion, exertional malaise, weight changes, and/or diffuse multi-joint pains. Significant clinical overlap exists between chronic fatigue disorders and the syndrome of serum inappropriate anti-diuretic hormone (SIADH). Both chronic fatigue disorders and SIADH are characterized by lethargy and mental confusion. Both disorders can be induced or exacerbated by viral illnesses, physical exertion, emotional stress and/or hypotension. Both can be treated with salt loading and glucocorticoids. Therefore, altered water metabolism resulting from inappropriate release and/or response to arginine vasopressin (AVP) is proposed as a pathophysiological basis of certain chronic fatigue disorders. Moreover, these data suggest that salt loading and/or direct inhibition of AVP may be an effective therapeutic approach in individuals with chronic fatigue disorders.