nafione
Established Member
For the men with nocturia, desmopressin was shown to normalize testosterone levels over 12 weeks: https://pubmed.ncbi.nlm.nih.gov/24680454/
Surely there has to be something scientifically intriguing in that symptom with Me/Cfs. The feeling of always being thirsty after consuming way more water than the normal amount. I know not everyone has that symptom though.I am also very thirsty all the time.
I am hearing more and more about this and people struggling with it, and in pwLC, so there is definitely something worth investigating. Again.Surely there has to be something scientifically intriguing in that symptom with Me/Cfs. The feeling of always being thirsty after consuming way more water than the normal amount. I know not everyone has that symptom though.
Thank you for such an informative comment.I am glad I saw this thread. I will share my experience (ongoing) in case it might help others or provide any clues:
This is how it started for me as well. Like everything with my ME/CFS though, it continued to progress. If anyone is experiencing these symptoms, consider tracking fluid intake/output for a few days, and maybe catch it earlier than I did. Finally a 24-hr urine test for something else in which I collected an excessive volume, and could prove it was far less than the volume I had consumed, convinced my primary doctor to make an endocrinology referral.
I have been diagnosed with partial central DI, (Arginine vasopressin deficiency, AVP-D). A plot with my osmolality values are attached. Copeptin/ADH were present, but low.
My understanding is that in the absence of a pituitary tumor or traumatic brain injury, other idiopathic cases of Central DI are considered to be immune/infection/inflammation, or autoimmune-driven. The endocrinologist called it "Lymphocytic infundibulo-neurohypophysitis." (Diagnosis and Management of Central Diabetes Insipidus in Adults, 2022) There is an antibody, anti-rabphilin-3A, that is being studied in this context, but as far as I can tell it is not used clinically yet. (my endocrinologist knew about it, but did not have a way to order it)
I started Desmopressin (DDAVP) about 6 weeks ago. My endocrinologist is having me slowly titrate up and drawing labs every week to monitor for hyponatremia.
What has improved:
- Less thirst and polyuria/nocturia
- Fewer PVC / skipped beats (perhaps blood volume increasing?)
What has not improved:
- All other ME/CFS symptoms (activity threshold, ability to recover from minor exertion, sleep quality, etc.)
- Tachycardia (but as I have said in other threads, mine seems to be "exertional" not "positional"/POT)
Random thoughts about other puzzle pieces:
- I had echocardiograms ~6 months apart. The cardiologist who reviewed the second one said "Your heart has shrunk 20%." .. Was this a compensation for low blood volume? Or some other ME process?
- Vasopressin has other functions in the body (vasoconstriction, glycogen breakdown, ACTH secretion, circadian rhythm, cognition and emotion) and there are multiple AVP receptors. (Wikipedia) DDAVP only acts on the V2 receptor, which allows water to be reabsorbed. It does not act on the other receptors. So, if AVP deficiency is contributing to other symptoms, DDAVP will not help.