Vasopressin is a hormone of the posterior pituitary that is secreted in response to high serum osmolarity. Excitation of atrial stretch receptors inhibits vasopressin secretion. Vasopressin is also released in response to stress, inflammatory signals, and some medications. Hypotension, morphine, nicotine, angiotensin II, glucocorticoids, and IL-6 all stimulate release of vasopressin.2 Circulating vasopressin levels are usually high in the early phase of septic shock, but vasopressin deficiency as been described in vasodilatory shock states in both adults and children.34,35 The level of vasopressin that is normal in the late phase of sepsis is unclear.36
In general, vasopressin decreases water excretion by the kidneys by increasing water reabsorption in the collecting ducts, hence its other name of antidiuretic hormone. Vasopressin also has a potent constricting effect on arterioles throughout the body.6 Vasopressin potentiates ACTH release leading to cortisol release, which may contribute to its salutary effects in cardiac arrest and vasodilatory shock.2 Vasopressin has been proposed as a replacement or adjunct to epinephrine in the resuscitation of cardiac arrest and of catecholamine-unresponsive shock. The interest in vasopressin for resuscitation is based on the fact that vasopressin may increase coronary perfusion without increasing myocardial oxygen demand and without the arrhythmogenic effects of epinephrine. Also, repeated doses of vasopressin tend to support blood pressure after the epinephrine response wanes.37 When given as the first drug in cardiac arrest, vasopressin has been shown to confer a survival advantage in out-of-hospital arrest but not in arrests occurring in stressed, hospitalized patients.38,39 Vasopressin’s effects on NEI mediators may explain this discrepancy. In a person with normal adrenal reserves of cortisol, exogenous vasopressin may cause a surge of endogenous cortisol, which should improve catecholamine responsiveness. Hospitalized patients with decreased adrenal reserves may not experience this benefit of vasopressin.
Vasopressin is a powerful vasoconstrictor, even in patients with catecholamine unresponsiveness. Because vasopressin dilates the pulmonary, cerebral, and myocardial circulations, it may help to preserve vital organ blood flow. Vasopressin and its synthetic analogue, terlipressin, have also been used as a rescue therapy for severe shock. Case series of the use of vasopressin in patients with catecholamine refractory shock have described the use of doses in the range of 0.00001 to 0.08 units/kg/min.40-43 Vasopressin has also been used as a catecholamine-sparing hormone replacement, with a goal of restoring high-normal levels rather than titrating to clinical effect. A recent, large, randomized controlled trial of low-dose vasopressin infusion in adult patients found a good safety profile but no impact on mortality when compared with norepinephrine alone.44 The only pediatric randomized controlled trial so far showed used a dose of 0.0005 units/kg/min, similar to adult trials, and found an increase in mean arterial pressure but no differences in time to hemodynamic stability or other clinical outcomes.45
High doses of vasopressin are associated with unacceptable side effects, such as gut and digital ischemia and decreased urine output. However, several small clinical studies have suggested that these problems do not occur at physiologic doses.
Vasopressin has effects on the immune system independent of its effect in stimulating the HPA axis. When given intraventricularly to rats, vasopressin decreases the T-cell response to mitogen independently of the HPA axis, probably via the sympathetic nervous system.46 Like CRH, vasopressin stimulates immune responses in peripheral tissues. Circulating or local vasopressin enhances lymphocyte reactions and potentiates primary antibody responses.47 Elevated vasopressin levels are found in a mouse model of autoimmune disease, and antibody neutralization ameliorates the inflammatory response in these mice.2 Vasopressin can potentiate the release of prolactin, a proinflammatory peptide hormone.48
Because vasopressin has immunosuppressive effects when present in the central nervous system and immunosupportive effects when present in peripheral tissues, predicting which effect would predominate during vasopressin infusion in the ICU is difficult.
Diabetes insipidus is a rare condition that occurs when the kidneys are unable to conserve water during the process of filtering blood. This form of diabetes is different than diabetes mellitus or “sugar” diabetes. Both forms of diabetes are associated with excessive urination, but have different causes and treatments.
Diabetes insipidus is caused by a lack of antidiuretic hormone (ADH), also called vasopressin, which prevents dehydration, or the kidney’s inability to respond to ADH. ADH enables the kidneys to retain water in the body. The hormone is produced in a region of the brain called the hypothalamus. It is stored and released from the pituitary gland, a small gland at the base of the brain.
When diabetes insipidus is caused by a lack of ADH, it is called central diabetes insipidus. This form of the disease can be caused by damage to the hypothalamus or pituitary gland.
When the condition is caused by a failure of the kidneys to respond to ADH, the condition is called nephrogenic diabetes insipidus, which may be inherited. This form of the disease involves a kidney defect that prevents the body from reabsorbing water back into the bloodstream. It is the rarest form of this uncommon disease.
Our Approach to Diabetes Insipidus
UCSF is an international leader in endocrinology care. Our team provides comprehensive consultations, evaluations and treatments for a wide range of hormone disorders, such as diabetes insipidus.
We treat this condition with a medication called desmopressin acetate, or DDAVP. The medication is similar to antidiuretic hormone, the hormone implicated in diabetes insipidus. We will adjust the dosage for each individual to find the right balance between controlling symptoms and avoiding complications. Our goal is to help our patients return to healthy, normal lives.
Diurex Diuretic Water Pills42.0ea
Reye’s Syndrome: Children and teenagers should not use this product for chicken pox or flu symptoms before a doctor is consulted about Reye’s Syndrome, a rare but serious illness reported to be associated with aspirin.
Allergy alert: Magnesium Salicylate may cause a severe allergic reaction which may include: hives, facial swelling, asthma (wheezing), shock.
Stomach bleeding warning: This product contains a non-steroidal anti-inflammatory drug (NSAID), which may cause severe stomach bleeding. The chance is higher if you are age 60 or older, have had stomach ulcers or bleeding problems, take a blood thinning (anticoagulant) or steroid drug, take other drugs containing prescription or nonprescription NSAIDs (aspirin, ibuprofen, naproxen or others), have 3 or more alcoholic drinks every day while using this product, take more or for a longer time than directed.
Do not use if you have ever had an allergic reaction to any other pain reliever/fever reducer.
Ask a doctor before use if stomach bleeding warning applies to you, you have a history of stomach problems, such as heartburn, you have high blood pressure, heart disease, liver cirrhosis or kidney disease, you are taking a diuretic.
Ask a doctor or pharmacist before use if you are taking a prescription drug for diabetes, gout or arthritis or taking any other drug.
When using this product, limit the use of caffeine-containing medications, foods or beverages because too much caffeine may cause: nervousness, irritability, sleeplessness, occasional rapid heart beat. The recommended dose of this product contains about as much caffeine as one cup of coffee.
Stop use and ask a doctor if an allergic reaction occurs. Seek medical help right away, pain gets worse or lasts more than 10 days, fever gets worse or lasts more than 3 days, redness or swelling is present, ringing in the ears or loss of hearing occurs, any new symptoms appear, you experience any of the following signs of stomach bleeding, feel faint, vomit blood, have bloody or black stools, have stomach pain that does not get better.
If pregnant or breast-feeding, ask a health professional before use.
Keep out of reach of children. In case of overdose, get medical help or contact a poison control center right away.
For temporary relief of temporary water weight gain, bloat, swelling, full feeling, fatigue, minor aches and pains associated with the premenstrual and menstrual periods.
My feet were puffed up like pierogis. New York City was experiencing a record-breaking heat wave and I was a week beyond my due date. I was anxious to have the baby.
For relief for my swollen feet, I turned to a bit of Old World magic I’d learned from my grandmother and sent my husband out for a head of cabbage. When he returned, I ate some of the cabbage and wrapped a few of the raw leaves around my puffy feet. I put on my socks over the cabbage, elevated my feet, shut my eyes, and let the cabbage work its magic.
Besides being extremely nutritious, cabbage is also a natural diuretic. Diuretics help your body get rid of salt and water mainly by stimulating your kidneys to release sodium into your urine. Water is then pulled from your blood to concentrate the sodium levels. That produces more urine and decreases the amount of fluid flowing through your blood vessels, providing relief from water retention if you’re suffering from edema, high blood pressure, and other conditions where chronic water retention presents an issue.
But it’s not just chronic conditions that can be helped by diuretics. They can help relieve bloating after a salty meal or from monthly hormonal fluctuations.
Over-the-counter diuretics are available in pill form, but there are a couple of reasons you might want to avoid them. While generally safe for occasional use, they can have side effects like hypokalemia, caused by too little potassium, which can lead to heart problems. Other potential side effects include dehydration, muscle cramps, dizziness and rashes. You can avoid these by pairing over-the-counter diuretics with foods high in potassium like bananas, sunflower seeds, apricots, or oranges.
Happily, natural diuretics — like my cabbage — can offer relief from water retention and bloating without taking any pills at all.
“In general, veggies and fruit are high in water and potassium (and some are higher in magnesium and calcium), which can help to offset the constriction of your blood vessels that make you feel bloated when you’ve had excess sodium,” explains Jaclyn London, MS, RD, CDN, Nutrition Director at the Good Housekeeping Institute. “Choosing foods like grapes, celery, watermelon, other types of melon, cherries, apples, grapefruit, oranges and lots of leafy greens is automatically your best bet for feeling better, faster. While no single food in isolation is ever a miracle cure, making sure to add more of these foods to your day will set you up for greater success.”
Here are nine natural diuretics you can snag in the produce aisle of your grocery store.
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From the time of the ancient Greek and Romans, asparagus has been used for its diuretic properties. The vegetable’s diuretic effects come from the amino acid asparagine and has been used to treat swelling, rheumatism, and premenstrual water retention. The distinct smell of urine after eating asparagus comes from asparagusic acid, which is broken down into a sulfur-containing compound when digested.
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Beets are high in potassium, which helps eliminate fluid. (Here’s more about why beets are great and how to grow them.) Betanin, which gives beets their color, has been associated with lower levels of C-reactive protein, making beets an anti-inflammatory as well.
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Cabbage can help reduce water weight. The popular “cabbage soup diet” deploys the diuretic properties of cabbage, along with its high fiber and water content to support weight loss. The Romans used cabbage for hangovers and to help alcoholics “dry out.” Red cabbage is also an anti-inflammatory because it contains anthocyanins.
Remember: If your feet are always swollen or you’re regularly retaining water, a visit to your doctor is a good idea to check for an underlying medical condition.
Hippocrates recommended celery to eliminate excess fluid. Now scientists have identified that the phthalides in celery contribute to its diuretic effect. Uric acid levels in the body are reduced by the COX-2 inhibitors in celery, which makes it an ideal treatment option for gout edema, which results from excess uric acid crystals collecting in the joints.
Native Americans identified the diuretic effects of cranberries, using them to treat a number of conditions including scurvy, which they believed was caused by too much salt. Cranberry juice has been used by women worldwide to prevent and treat UTIs and other bladder disorders, although research results have been mixed.
While the jury is out on the proanthocyanidins in cranberries and their antibacterial effect, as a diuretic, cranberries are especially beneficial for removing fluid without eliminating potassium.
Cucumbers have sulfur and silicon which increase urination by stimulating the kidneys into better removal of uric acid. Loaded with water and potassium and low in sodium, cucumbers also inhibit the production of nitric acid and inflammatory enzymes, thus reducing swelling. Cucumber slices can be used topically to soothe under-eye puffiness.
The same sulfur-based chemical that gives garlic its distinctive smell, allicin, gives it medicinal properties as well. The International Journal of Pharmaceutical Sciences and Research found garlic to be effective as a diuretic. It is also works a potent antioxidant and contributes to the breakdown of fats.
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Parsley, especially as a tea, is a traditional remedy for water retention. Parsley reduces the reabsorption of sodium and potassium salts in the kidney. This causes increased urine volume, which helps reduce bloating.
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Watermelon, with its 92% water content and high potassium content, also has diuretic properties. It contains the amino acid citrulline, which relaxes blood vessels and keeps fluids from leaking into nearby tissue, thus reducing the retention of water.