Excessive Drinking - A Habit Or A Hormonal Disorder?

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Excessive Drinking - A Habit Or A Hormonal Disorder?
Excessive Drinking - A Habit Or A Hormonal Disorder?

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Excessive drinking - a habit or a hormonal disorder?

Drinking too much fluids can be both a harmless habit and a rare hormonal disorder, a new procedure will help you quickly distinguish between these conditions.

Excessive drinking - a habit or a hormonal disorder?
Excessive drinking - a habit or a hormonal disorder?

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Drinking too much fluids can be a relatively harmless habit, but it can also indicate a rare hormonal disorder. A study led by Dr. Mirjam Christ-Crain, Professor, Head of Clinical Research at the University of Basel and University Hospital Basel, revealed a new diagnostic method that is fast and reliable. They reported their results in the New England Journal of Medicine.

Drinking more than three liters of fluid a day with an equivalent increase in urination is considered excessive. This water-drinking, known as polyuria-polydipsia syndrome, usually develops over time out of habit or is a side effect of mental illness.

In rare cases, excessive drinking can be caused by diabetes insipidus, a condition in which the pituitary gland secretes an insufficient amount of the antidiuretic hormone vasopressin, which regulates water and salt in the body. These people have a reduced ability to concentrate urine, so they lose a lot of fluids and, accordingly, must increase their fluid intake to prevent dehydration.

The distinction between what is considered “harmless” primary polydipsia and diabetes insipidus is critical because their therapy is fundamentally different. People with diabetes insipidus need to take the hormone vasopressin, while patients with primary polydipsia require behavioral therapy to change their drinking habits. Inappropriate therapy can have life-threatening consequences, as treatment with vasopressin without appropriate indications can lead to water intoxication.

Previously, a "water deprivation test" was performed to differentiate the two conditions, in which the patient was not allowed to drink any liquid for 16 hours, after which the doctors interpreted the urine concentration. However, this test was often misleading, since the correct diagnosis was made only in about half of the cases. In addition, the 16-hour water deprivation trial is itself extremely unpleasant and stressful for patients.

The study involved 156 patients in 11 medical centers. Scientists compared the traditional "water deprivation test" and the new diagnostic method. After a two-hour infusion of a hypertonic saline solution into the blood of patients, the concentration of a biomarker, plasma copeptin, was measured (its level indicates the content of the hormone vasopressin in the blood).

The new method showed a very high diagnostic accuracy - 97% of patients were correctly diagnosed and treated. This test is available for clinical use.

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