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.

On International Men's Day, we shift our focus on men's health and why is it important to talk about it. Time and again experts, doctors, and studies have shared how men generally visit GPs less than women. As per the NIH, US, the consultation rate is 32% lower in men than women. The difference is often attributed to a combination of women being more willing to admit sickness and seek help, while cultural factors and barriers for men keep them away from seeking help. However, not anymore, because both sexes require help when they need, especially when it is about their health.

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As per a 2024 study published in the Journal of Clinical Investigation, about 5.7 million men could be living with an autoimmune disease that they do not even know about. The disease in men are often overlooked, all thanks to the social barriers.

Sex chromosomes play a key role in predisposing men or women to an autoimmune disease. Females have XX chromosomes, while male have XY chromosome and each chromosome carries gene sequence, which means specific pieces of DNA. Since X chromosome carries a bunch of gene related immunity,, having two of them could explain why women often have a higher rate of autoimmune diseases.

However, men are less likely to book time with their doctors, which could impact the discrepancies between sexes. They could thus often be undiagnosed or could flag their symptoms only when the disease has progressed.

Four Autoimmune Diseases Men Should Be Aware Of

Psoriasis

This is an inflammatory skin condition which affects both men and women. However, studies including the one published in 2023 in the International Journal of Women's Dermatology have suggested that men could develop this condition near their genitals and butt than women.

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Ankylosing Spondylitis or AS

As happens due to the inflammation of the spine's joints and ligaments and could cause back pain and stiffness. While the condition is rare in itself, it could affect men more than women, that too at a younger age, usually below 40. A South Korean study from 2018, published in Scientific Reports, AS was 3.6 times more prevalent in men than women.

Type 1 Diabetes

The 2018 report by the Centers for Disease Control and Prevention, (CDC), US, provides data that type 1 diabetes may be slightly more in common in men than women. Though, other studies have been a mixed bag. Unlike type 2 diabetes, type 1 is an autoimmune disease, which means, here immune system attacks are specialized. What men should know is that both types of diabetes could up their risk of erectile dysfunction (ED) due to persistently high blood sugar, which could harm their nerves and blood vessels.

A 2016 study published in the International Journal of Impotence Research found that nearly 60% of 151 men being treated for type 1 diabetes had mild ED.

Inflammatory Bowel Disease (IBD)

The most common forms are Crohn's disease and ulcerative colitis, that take hold of digestive system. Chronic inflammation in the gut spikes the risk of colorectal cancer, which is one of the leading cause of death in men between 20 to 49 of ages. In fact, a 2023 study published in the journal Cancers noted that men with IBD faced a higher risk of developing colorectal cancer than women with IBD.

Not every medicine carries the same level of risk. Some drugs can trigger reactions that are severe or even life-threatening. When that possibility exists, the manufacturer is required to place a special notice inside the prescribing information. This highlighted section is known as a black box warning.

A black box warning is meant to draw clear attention to the most serious dangers linked to a drug. Many medicines fall under this category. Still, having the warning in place does not automatically make the treatment unsafe. When a drug is used correctly and monitored by a trained professional, the benefits may outweigh the risks.

The sections below outline what an FDA black box warning means, why a medicine might receive one, and how it may influence your treatment plan.

What Is An FDA Black Box Warning And What Does It Signify?

A black box warning is the strongest caution that the FDA can attach to a prescription drug. You might also see it described as a boxed warning.

The presence of this warning does not mean a person should never take the medication. Instead, it alerts doctors and patients to serious potential harm. This information helps clinicians decide who is an appropriate candidate and under what circumstances the drug should be used.

Many medicines with boxed warnings remain the best or only option for certain conditions.

How Serious Is A Black Box Warning?

A drug receives this type of label when it has been linked to outcomes such as permanent injury, hospitalisation, or death. These warnings should be read carefully, and patients should discuss them openly with their healthcare provider.

Doctors follow specific precautions when prescribing drugs that carry this label to minimize unnecessary risk.

Where Can I Find A Drug’s Black Box Warning?

The warning sits at the very top of the medication’s official package insert. Its placement is deliberate so it stands out immediately. The text is printed inside a bold black border, which is how the term “black box” took hold.

You may not always receive the full package insert from the pharmacy. However, you might receive a medication guide if the drug is considered high-risk. These guides describe proper use and highlight major side effects. You can also look up medication guides online.

Information about boxed warnings is available from multiple sources. The FDA website, the drug manufacturer’s website, and medical reference sites used by clinicians all include these details.

How Does A Drug End Up With A Black Box Warning?

Every prescription drug must go through extensive testing before it reaches the market. During this process, researchers aim to uncover risks that could require a boxed warning from the start. Even so, some side effects only appear once large numbers of people begin using the drug in everyday settings.

Because of this, most black box warnings are added after a medicine has already been approved. The FDA continues to monitor safety reports through MedWatch, a program where patients, physicians, and companies can report problems.

These reports are gathered in a database called the FDA Adverse Event Reporting System. When the agency notices a pattern of serious reactions, they investigate. If needed, they update the prescribing information and add a boxed warning so that future users are clearly informed.

People assigned female at birth live with hormone shifts throughout their lives. These chemical messengers guide nearly every system in the body. The swings linked to periods, pregnancy or menopause are easy to recognise, but many other factors can unsettle hormone levels.

The body produces more than fifty hormones through the endocrine system, and changes in any of them can signal a deeper health concern. Low insulin may point toward diabetes. Excess cortisol can influence weight gain. Other hormones, like melatonin, rise and fall through the day as part of normal rhythm. And the gradual drop in estrogen and progesterone as women approach menopause is also expected.

What Causes Hormonal Imbalance?

Puberty, pregnancy and menopause naturally reshape hormone activity. Beyond these, several conditions can disrupt normal patterns. Problems with the adrenal gland, thyroid disorders, eating disorders, congenital adrenal hyperplasia, Cushing’s syndrome, diabetes or PCOS can all change your hormone levels. Changes may also stem from stress, certain medicines, tumours, cysts or environmental chemicals.

Interest in hormones has grown recently. Earlier this month, the Food and Drug Administration agreed to remove the boxed warning on menopause hormone therapy after reviewing the evidence. The decision prompted fresh discussion among women considering treatment. Clinicians say many patients are reaching out with new questions, especially in an era filled with quick tests and supplements marketed as hormone balancers. It can be difficult to tell when testing is truly needed.

Warning Signs Of Hormonal Imbalance

As each hormone plays a different role, symptoms vary widely. These are some of the more frequent changes seen in people, as per UCLA Health.

1. Menstrual changes: Shifts in estrogen and related hormones can alter the monthly cycle. Periods may become heavier, lighter, irregular or go missing. Stress, diet and exercise can contribute as well, but hormonal swings remain a leading cause.

2. Hair changes: Hair often reacts quickly to hormonal shifts. Pregnancy can bring thicker strands, while imbalances may trigger hair thinning or hair growth in unexpected places. Excessive facial hair may suggest elevated androgens. Hair loss can point toward a thyroid concern.

3. Skin Changes: Hormonal shifts can influence skin colour, texture and oil production. Acne may flare during pregnancy due to rising progesterone. Darkened patches of skin may appear on areas like the neck, groin or beneath the breasts when estrogen or progesterone levels change.

4. Sexual and vaginal symptoms: Lower estrogen levels, especially with age, can reduce libido and cause vaginal dryness or pain during intercourse. Some women may experience vaginal atrophy when estrogen remains low for long periods.

5. Weight changes: Sudden weight gain or weight loss can reflect a hormonal issue. Many women notice weight gain after menopause. Thyroid disorders, PCOS and Cushing’s syndrome are also linked to changes in body weight.

6. Mood and sleep difficulties: Falling estrogen levels influence serotonin, a chemical important for stable mood. Low serotonin can contribute to anxiety, irritability or low mood. These disruptions often spill into sleep. Some women also report night sweats or trouble staying asleep.

7. Digestive issues: Estrogen and progesterone affect digestion. When these hormones shift, the gut may respond with bloating, constipation or diarrhoea. Some research has linked hormonal changes in people AFAB to irritable bowel syndrome. Many notice digestive changes around their menstrual cycle.

What To Do If You Suspect A Hormonal Imbalance

There is no single test that measures every hormone, and at-home kits only cover a few markers. The safest first step is to speak with your primary care doctor. They can look at your overall health and decide what evaluations are appropriate.

Diagnosis may include:

• A physical exam and review of your medical history
• Checking prescriptions or supplements that may influence hormones
• Blood, urine or saliva tests to measure specific hormone levels
• A pelvic exam to check for cysts or growths
• An ultrasound to look at the ovaries, uterus, thyroid or pituitary gland