The more we know, the more we know we don’t know. Now, doesn’t that sound like we’re talking about fibromyalgia? It seems there are new facets of the illness found every week (although that’s probably a stretch). Yet, connections are made with other conditions and illnesses that may never have been connected before. A case in point would be the possible connection between fibromyalgia and diabetes insipidus.
There’s Another Diabetes?
Most of us, when we hear the word diabetes, automatically attach mellitus to it. Diabetes mellitus is the condition in which blood sugars remain in a chronically high place. However, according to WebMD, diabetes is a general term for conditions that cause increased urine production. This is where diabetes insipidus beats all others because it results in excessive urination and extreme thirst. Diabetes insipidus puts those affected with it at increased risk for dehydration and it is caused by trouble with a hormone that is produced in the brain.
Problems related to a specific hormone called antidiuretic hormone (ADH) or its receptor, are the cause of diabetes insipidus. ADH is produced by the hypothalamus and is stored by the pituitary gland in the brain. It is this hormone that causes the kidneys to hold onto water – hence the name “antidiuretic hormone”. The urine, because it is held longer, is more concentrated when this hormone is doing its job properly.
Under normal conditions, ADH levels rise in response to thirst or slight dehydration, which causes the kidneys to reabsorb more water and emit more concentrated urine. If an individual were to drink a gallon of water, then ADH levels would fall and the urine would be diluted and clear in color rather than dark and concentrated.
When Things Aren’t Working Right
When ADH is problematic, either too much is being produced, or the right amount is produced but the kidneys aren’t handling it properly. Too little ADH causes a condition called central diabetes insipidus and the improper response by the kidneys to adequate production of the hormone is called nephrogenic diabetes insipidus. Regardless the situation – either way – the kidneys can’t do their job and the person is excreting an abnormally high amount of diluted urine. This is where the descriptive word insipidus comes in. The urine is insipid, that is weak and diluted – it is no reflection upon the sufferer.
When there is an excessive amount of fluid lost from the body, as is the case with diabetes insipidus, the results can be disconcerting. The initial and most prominent signs are excessive thirst and polyuria – excessive production of urine. When these symptoms become more extreme they cause dehydration.
The Fibro Connection
You may wonder what all of this has to do with fibromyalgia. The connection lies in the similarities between dehydration and fibromyalgia. According to Mayo Clinic, dehydration can be the cause of the following symptoms:
· Dry mouth and skin
· Muscle weakness
· Low blood pressure
· Electrolyte imbalances, which is the loss of minerals in urine
· Dry, sunken eyes
· Fever, headaches or both
· Rapid heart rate, as a result of the heart trying to compensate for low blood pressure
· Weight loss
· Poor mental function, likely due to low blood pressure
· Muscle and joint pain
· Dizziness, again due to low blood pressure
· Cold hands and feet, also due to low blood pressure
What is important to know is that you don’t need to have all of these symptoms to be dehydrated – just a few will do.
Ironically, the symptoms of dehydration are very similar to those of fibromyalgia – wouldn’t you know it? How many other conditions mimic FMS? Now, how do the two situations link up?
One of the potential causes of FMS is trauma, particularly head trauma possibly caused by a vehicle accident. Often, people with diabetes insipidus have sustained such injury as well. Research indicates that the cause of central diabetes insipidus is most often due to damage to the pituitary gland or hypothalamus, commonly associated with surgery, a tumor, meningitis or other types of brain disease, inflammation or a head injury. The damage causes a disruption in the normal production, storage and release of ADH.
How to Determine if You’ve Got Diabetes Insipidus
If you have been diagnosed with fibromyalgia, a good way to determine if diabetes insipidus is a factor in your illness is to measure the amount of urine excreted every 24 hours. Normal excretion of urine is 1.5 to 2.5 liters in a 24 hour period. Volume in excess of 3.0 liters is abnormal and could be causing some of the symptoms associated with fibromyalgia.
There is a medication that is proven effective for diabetes insipidus that could be advantageous for a person with fibromyalgia experiencing overflowing urine production. The medication is called Desmopressing or DDAVP.
Diabetes insipidus may not be your issue. You can learn more about the various urinary symptoms associated with fibromyalgia in our article in this section.