DEAR DR. DONOHUE: I am a very healthy 36-year-old man who was diagnosed with nephrogenic diabetes insipidus at age 2. Because of this, my urine is dilute. Recently I had to undergo a mandatory drug test. The test result came back as being diluted, and I was accused of drinking a lot of water in order to pass the test. My explanation has fallen on deaf ears. Is there any medicine I can take to stop the dilution? – M.M.

ANSWER: The literal meaning of “diabetes” is “excessive urination.” People are familiar with sugar diabetes – excessive urination due to high blood sugar. Most, however, are not familiar with another kind of diabetes, diabetes insipidus. That’s excessive urination because there’s a deficient supply of a pituitary hormone called antidiuretic hormone – ADH – or because the kidneys do not respond to the ADH hormone. The hormone stops the formation of urine to keep the body in fluid balance.

People with either kind of diabetes insipidus – the pituitary (the more common variety) or the kidney kind (“nephrogenic”) – produce such prodigious amounts of dilute urine that they must make constant trips to the bathroom to empty the bladder.

Who is rejecting your explanation for having dilute urine? If it’s an employer, bring in a statement from your doctor. If the employer still refuses to accept the explanation, ask a lawyer to step in and reinforce the medical explanation with the legal explanation of the ramifications that arise from discriminating against people on the basis of a medical condition that does not affect their work. If it’s an insurer, ask to speak with the medical director of the insurance company.

For people with a defective production of ADH hormone, supplying the hormone in medicine form cures the problem. For those with nephrogenic diabetes insipidus, a water pill can sometimes slow down urine production. That sounds paradoxical, but it works – when it’s needed. It doesn’t sound like you need it.

DEAR DR. DONOHUE: My cardiologist tells me I have a calcified aorta and some coronary-artery calcification. My family doctor, who presumably has my cardiologist’s records, advises me to take 1,500 mg of calcium per day with 500 IU of vitamin D. Does this make sense?

I understand that it’s possible to reverse artery calcification. How? What happens to the stuff that’s removed? – R.H.

ANSWER: It makes no sense if you have a logical mind, as you do. However, in this instance, logic fails in the face of biological complexity.

The supplemental calcium that people take doesn’t hightail it to arteries. It goes to bone.

Arteries become calcified even if people take no calcium. The calcium in arteries comes from body stores and is put there by the body deliberately. The reason is artery inflammation. The body, in an attempt to douse the inflammation, sprays calcium over the artery wall. Ingested calcium, even when taken with vitamin D, is not involved in the process.

It’s theoretically possible to remove calcium from artery walls, but it requires lots of work. One way is to siphon off cholesterol from the artery wall by adopting a diet that features vegetables, fruits and whole grains. Exercise also helps. Sometimes medicines can reverse artery calcification. The removed calcium returns to the body’s calcium storehouse.

DEAR DR. DONOHUE: Some medical newsletters for seniors recommend chewing a plain 325-mg aspirin within minutes of a threatened heart attack. Some friends say their lives were saved by doing this. Druggists tell me that plain 325-mg aspirin is no longer manufactured. Does taking a coated aspirin give the same results? – J.Y.

ANSWER: If by “coated” you mean the aspirin that’s coated for easier swallowing, that’s the kind the articles mean when they say “plain” aspirin. It’s all over the place. The coated aspirin that is not as good for an imminent heart attack is the kind that’s coated to lessen the possibility of stomach irritation as it passes through. That kind is plainly marked as being less irritating to the stomach.

Chewing the ordinary kind of aspirin – the kind that says “coated for easier swallowing” – makes it available for direct absorption through the membranes lining the mouth. It gets to work rapidly.

Aspirin stops blood platelets from sticking to the obstructing material in a heart artery and thereby increasing the size of the obstruction, the basis of a heart attack.



Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.