Diabetes insipidus (DI) is a rare medical condition that disrupts the body's ability to regulate water, resulting in excessive thirst and an unusually high volume of urine. This condition affects the kidneys' ability to concentrate urine and causes individuals to produce between 3 and 20 quarts of dilute, colourless urine daily, compared to an average of 1 to 2 quarts. It is pertinent to note that DI is not related to diabetes mellitus, which disrupts the body's insulin production.

Types Of Diabetes Insipidus

This condition results from damage to the hypothalamus or pituitary gland, which impairs the production or release of vasopressin, a hormone responsible for water retention. When vasopressin levels are inadequate, the kidneys fail to conserve water, leading to excessive urination. It can result from Brain injuries or surgeries, tumours, infections or inflammation and aneurysms.

Nephrogenic Diabetes Insipidus

This type occurs when the kidneys fail to respond to vasopressin, causing excessive fluid loss. Common triggers include chronic kidney disease, and electrolyte imbalances, such as high calcium or low potassium levels. Additionally, medications like lithium

and urinary tract blockages can also cause Nephrogenic DI.

Gestational Diabetes Insipidus

A rare condition seen only during pregnancy, this occurs when the placenta produces an enzyme that breaks down vasopressin or increases prostaglandin levels, reducing kidney sensitivity to the hormone. Symptoms of this are usually mild and often resolve postpartum but can recur in future pregnancies.

Symptoms And Warning Signs

• Severe thirst, often leading to the consumption of over a gallon of water daily
• Frequent urination (polyuria), sometimes exceeding 20 quarts per day
• Nighttime urination and bed-wetting
• Weakness, muscle pain, and preference for cold drinks

In severe cases, dehydration may develop, manifesting as fatigue, dizziness, dry mouth, confusion, nausea, or fainting. Infants and children with DI may exhibit crankiness, poor feeding, slow growth, fever, or vomiting.

Causes And Risk Factors

DI stems from issues with vasopressin production or response. Central DI arises from damage to brain structures, while nephrogenic DI relates to kidney dysfunction. Risk factors include:

- Genetic mutations affecting water regulation

- Certain medications like diuretics or lithium

- Metabolic disorders that alter calcium or potassium levels

- Brain injuries or surgeries

Diagnosis And Testing

Diagnosing DI involves a combination of medical history, physical exams, and specialized tests:

- Urinalysis: Evaluates urine concentration and glucose levels to distinguish DI from diabetes mellitus.

- Blood tests: Check electrolyte, glucose, and vasopressin levels.

- Water deprivation test: Measures changes in weight, blood sodium, and urine concentration during fluid restriction.

- MRI: Detects abnormalities in the hypothalamus or pituitary gland.

- Genetic screening: Identifies inherited risk factors.

Although DI is rare, affecting about 1 in 25,000 people, early diagnosis and targeted treatment can significantly improve quality of life. Researchers continue to explore its causes and treatments to better support those living with this challenging condition.

Vaccines against influenza, COVID-19, respiratory syncytial virus (RSV) and shingles are given to prevent infections. But new research suggests they may also help protect the heart, especially in older adults and people who already have cardiovascular disease.

A recent report published by The Washington Post speaks about the evidence of these four vaccines to lower rates of cardiovascular problems.

The evidence varies across vaccines, and not all studies establish that vaccination directly prevents heart disease. However, experts say preventing severe infections may help reduce the strain viruses place on the cardiovascular system.

“We’re beginning to understand the large number of problems these viruses can cause beyond, say, a cough and fever,” said Paul Heidenreich, a professor of cardiovascular medicine at Stanford Medicine, in the report.

Shingles Vaccine Linked To Lower Heart Disease

Shingles occurs when the varicella-zoster virus, which causes chickenpox, reactivates in the body. It can cause a painful rash and nerve pain. Research has also linked shingles to cardiovascular complications, including heart attacks and strokes.

A study published in Nature Medicine in August 2026 compared adults aged 60 and older who received the newer shingles vaccine, Shingrix, with those who received the older vaccine, Zostavax.

Over seven years of follow-up, people who received Shingrix had lower rates of ischaemic heart disease and heart failure than those who received Zostavax. The study did not prove that the vaccine caused the difference, but it added to earlier research on shingles vaccination and cardiovascular health.

A separate 2025 study of adults aged 50 and older also found an association between receiving two doses of Shingrix and a lower risk of stroke and heart attack.

Noreen Nazir, a cardiologist and co-author of recent American College of Cardiology guidance, described the new findings as “a really great addition to the literature”.

Also read: EXCLUSIVE: Ex-CDC Vaccine Advisor Says Measles Outbreak Bigger Than Reported, Slams RFK Jr’s ‘No-See Evil’ Approach

Flu Vaccine May Reduce Heart Attack Risk

Annual influenza vaccination is recommended for nearly everyone aged six months and older in the United States. Influenza can cause more than fever, cough and body aches. The infection can trigger inflammation, increase the strain on the heart and worsen cardiovascular disease.

According to The Washington Post, influenza infection was linked with a sixfold increase in hospitalisations for heart attacks during the week after a positive flu test.

The risk is concerning for people with existing heart disease. Severe influenza can worsen underlying conditions and increase the likelihood of cardiovascular complications.

William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center and a co-author of the American College of Cardiology paper, said people hospitalised with an underlying high-risk condition like heart disease are “much more likely to have a cardiovascular event”.

Also read: Washington Reports Human Bird Flu Case After Dairy Cattle Exposure: Should You Be Worried?

COVID-19 Vaccines May Help Prevent Heart Complications

COVID-19 can affect the cardiovascular system during and after infection. Complications include heart attacks, strokes, abnormal heart rhythms and pericarditis, which is inflammation of the sac surrounding the heart.

People with pre-existing heart conditions are also at greater risk of severe COVID-19. During the pandemic, people with heart disease were three times as likely to develop severe infection, according to the report.

Research has also linked COVID-19 infection to longer-term vascular changes. A 2025 study published in the European Heart Journal found an association between COVID-19 and early vascular ageing, a process in which arteries become stiffer and less elastic.

The report notes that updated COVID-19 vaccines have been approved in the United States for adults aged 65 and older and younger people with at least one underlying health condition that increases their risk of complications.

RSV Vaccine May Help Protect Older Adults With Heart Disease

Respiratory syncytial virus causes a respiratory illness in infants and young children, but it can also cause severe disease in older adults. RSV can also worsen existing cardiovascular conditions, including heart failure.

A study spanning five RSV seasons found that nearly one-quarter of adults aged 50 and older who were hospitalised with RSV experienced an acute cardiac event, often involving heart failure. Those who had a cardiac emergency had nearly twice the risk of severe outcomes compared to those who did not.

Schaffner said, “There continues to be a high risk of cardiovascular events even after you recover from these viral infections,” he said.

The US Centers for Disease Control and Prevention recommends a single dose of RSV vaccine for adults aged 75 and older and adults aged 50 to 74 who are at increased risk of severe RSV illness.

The discrepancy between Pennsylvania’s reported measles-associated deaths and the US Centers for Disease Control and Prevention’s national tally sparked a political and public-health controversy.

In an exclusive interview with HealthandMe, Dr Paul Offit, paediatrician and director of the Vaccine Education Center at Children’s Hospital of Philadelphia and former member of the CDC’s Advisory Committee on Immunization Practices, accused US Health Secretary Robert F. Kennedy Jr. of adopting a “see-no-evil approach” to the outbreak.

He criticised the Trump administration’s handling of measles deaths, the proposal to split the measles, mumps and rubella (MMR) vaccine, and a new federal initiative to expand vaccine-injury reporting.

Pennsylvania reported six measles-associated deaths, according to its Department of Health. The CDC, meanwhile, had confirmed two deaths.

The figures have become the focus of a dispute over how deaths among measles patients should be classified and included in government data.

‘These Are Measles-Related Deaths’: Dr Paul Offit On CDC’s Death Toll

Also read: US Shelved Poultry Vaccination Due To RFK Jr’s Vaccine Skepticism: Can Vaccine Help Control Bird Flu?

During the interview, Offit spoke about the discrepancy between Pennsylvania’s report of six deaths and CDC’s count of two. “These are measles-related deaths,” he said, arguing that measles had contributed to the deaths reported by the state.

“Had these children or adults not had measles, in the case of the one-day-old and few-month-old, they would have never died,” Offit said.

He accused Kennedy of refusing to acknowledge the state’s report and said the federal government’s approach risked obscuring the seriousness of the outbreak.

“This is just Robert F. Kennedy Jr. refusing to acknowledge the fact that he is an excellent anti-vaccine activist,” Offit said.

The disagreement involves more than a difference in numbers. Pennsylvania health officials count deaths that meet the state’s epidemiological definition of measles-associated fatalities.

The federal government has moved towards requiring confirmation through the National Center for Health Statistics. It now considers the fact that measles is listed as the underlying cause of death before including a fatality in its tally. This process can take longer than state reporting.

A death occurring in someone with measles does not automatically establish that the infection caused the death. However, measles can lead to serious complications, including pneumonia and brain inflammation, which can be fatal.

US Measles Outbreak Is ‘The Tip Of A Much, Much Bigger Iceberg’

Also read: Sixth Measles-Associated Death Reported In Pennsylvania As Cases Cross 1,100

Offit said the reported number of measles cases in Pennsylvania could substantially underestimate the actual scale of transmission. “You can assume that's off by a factor of at least five. I think there's between 5,000 and 10,000 cases of measles in our state,” he said during the interview.

Pennsylvania’s Department of Health reported 1,260 confirmed cases across 42 counties as of October 16, alongside 225 hospitalisations. “So this is the tip of a much, much bigger iceberg,” Offit said.

He also highlighted the risk among adults who may neither have acquired immunity through previous infection nor received vaccination.

“The thing that strikes me about measles right now is it's an adult disease,” he said, pointing to people in their 20s, 30s and 40s who may remain susceptible.

Offit argued that the resurgence should be attributed to failure to vaccinate rather than a failure of the vaccine itself. “Certainly not a vaccine failure. The vaccine doesn't work if you don't get it,” he said.

On MMR Split Proposal

Also read: Trump Signs Order To Change Childhood Vaccine Schedule Amid Measles Outbreak, Split MMR Into Three Shots

While addressing the measles crisis in the United States, Offit also addressed President Donald Trump’s proposal to separate the combined MMR vaccine into three individual shots.

The MMR vaccine has been used for decades. Trump’s executive order to split the vaccine had revived a debate that the combined vaccine causes autism, which has been discredited.

He referred to research conducted over several decades that has not established a causal link between MMR vaccination and autism. “There was the MMR vaccine in 1971. So we've had 50 plus years of the MMR vaccine,” he said.

Offit argued that separating the vaccines would increase the number of injections children receive without providing an established benefit.

“There's no reason to do it. Just makes it more expensive, less available, and has a longer period of time when children aren't getting vaccines,” he said. “And they get six shots instead of two for no benefit.”

He also said the proposal had made parents more skeptical about vaccination.

The debate sparked concerns as delaying vaccination can leave children susceptible to measles during the period before they receive protection. Any changes to vaccine schedules or formulations need to be assessed against evidence of safety, effectiveness and practical consequences for vaccine access.

On RFK Jr.’s Vaccine-Injury Reporting Proposal

Offit also criticised Kennedy’s initiative to expand research into vaccine injuries and improve reporting through the Vaccine Adverse Event Reporting System (VAERS).

Announced by the US Department of Health and Human Services in October, the initiative includes a new National Institutes of Health clinic, plans to record vaccine-related adverse events in electronic health records, modernisation of VAERS and a proposal to reimburse doctors for reporting suspected vaccine injuries.

When asked if the initiative was a useful step towards vaccine safety monitoring, Offit replied: “Not in his hands.”

He alleged that the information collected under the programme could be misrepresented to support claims linking vaccines to chronic diseases, including autism, diabetes and multiple sclerosis.

Offit also questioned whether the existing reporting system was being misunderstood. He said that "we did a pretty good job" establishing the existing vaccine injury reporting system.

He further described VAERS as a “noisy warning system”, explaining that reports can help identify adverse events but cannot establish that a vaccine caused a reported health problem.

The CDC says VAERS accepts reports of health problems after vaccination even when the person reporting them is unsure whether the vaccine caused the event.

Offit cited the example of the RotaShield rotavirus vaccine to illustrate how safety signals should be investigated. Reports of a possible serious adverse event prompted further study, which helped establish a link and led to the vaccine’s withdrawal.

His did not say that vaccine safety should go unexamined, but that reports must be investigated using reliable scientific methods.

When Andrea de Armas was diagnosed with breast cancer at 26, she was preparing for a future that looked very different from the one she was suddenly handed.

Along with surgery and chemotherapy, she had to make decisions about her fertility and adjust to the of long-term consequences from treatment.

Now 30 and cancer-free, the US woman is still taking hormone therapy. The treatment has put her into temporary menopause.

“I’m really lucky. I feel like I’m doing OK,” de Armas told CBS News. “It took me a little bit to kind of adjust. It wasn’t immediate; it took time. It took understanding the kind of changes my body was going through. But I’m able to live a pretty normal life for a 30-year-old.”

Andrea’s experience highlights a revealing challenge of breast cancer in younger women. Young women who survive breast cancer face a series of emotionally heavy decisions about menstrual cycles, fertility, sexual health and emotional well-being, and menopause that comes decades earlier than expected.

Effects Of Breast Cancer Treatment On Young Women

Also read: Why Peak Incidence For Breast Cancer In India Occurs Between Ages 40–50, Compared To 60–70 In The US & Europe

De Armas initially struggled to get her concerns taken seriously. She was eventually diagnosed with breast cancer in 2023 and discovered that she carried a genetic mutation associated with an increased risk of the disease.

She underwent a lumpectomy in June, followed by chemotherapy. She later had a bilateral mastectomy and reconstruction, scheduling treatment around her studies so she could continue her physician assistant programme.

“We worked together as a team,” said Dr. Cristina Lopez-Penalver, the surgical oncologist at Baptist Health's Herbert Wertheim Cancer Institute who treated her. “She was really not about ready to let this breast cancer get in her way.”

De Armas graduated as a physician assistant in 2025 and began working a month later. However, despite completing surgery and chemotherapy, she continues to take hormone therapy because of the characteristics of her cancer.

That medication has placed her in temporary menopause, a treatment-related effect that can be particularly difficult for younger women to navigate.

Early Menopause Due To Hormone Therapy

Also read: Breast Cancer: Know the Risks, Recognise the Signs & Get Checked

Menopause occurs when the ovaries stop releasing eggs and producing lower levels of hormones, particularly oestrogen.

Although natural menopause usually occurs in the late 40s or early 50s, some cancer treatments can bring on menopause much earlier.

According to the American College of Obstetricians and Gynecologists (ACOG), chemotherapy can damage the ovaries, causing periods to become irregular or stop altogether.

Hormone therapy can also block oestrogen's effects to help prevent hormone-sensitive breast cancer from returning.

Some women experience temporary ovarian suppression, in which medication switches off ovarian function during treatment.

Others may develop permanent ovarian damage and early menopause. The outcome depends on the treatment, the woman's age and her ovarian function before treatment. In de Armas' case, hormone therapy has brought on temporary menopause.

The transition can be more abrupt than natural menopause, leaving women with symptoms that affect daily life. Common effects include:

• Hot flashes and night sweats: Sudden waves of heat and sweating can disrupt sleep and daily activities.
• Sleep disturbances and mood changes: Hormonal changes may contribute to insomnia, irritability and low mood.
• Vaginal dryness and sexual discomfort: Reduced oestrogen can affect vaginal tissues and sexual health.
• Changes in fertility: Damage to ovarian function can reduce the chances of conceiving naturally, sometimes permanently.
• Bone health concerns: Low oestrogen levels can accelerate bone loss, increasing the risk of osteoporosis over time.

The National Cancer Institute notes that treatment-related ovarian insufficiency can also cause joint pain, reduced libido and difficulty concentrating.