Aldosterone vs ADH (Antidiuretic Hormone): Differences and Similarities

In this article, we will take a close look at two crucial hormones - Aldosterone and Antidiuretic Hormone (ADH). We will delve into their synthesis, the sites of production, and their significant roles in maintaining the body's fluid and electrolyte balance, regulating blood pressure, and managing the body's sense of thirst.
Jakub Gwiazdecki

Jakub Gwiazdecki

Fifth year medical student at the Medical Faculty of Comenius University in Bratislava.

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What is aldosterone and where is aldosterone produced?

Aldosterone is a steroid hormone. It is a key compound in the regulation of blood pressure. This steroid hormone is a mineralocorticoid and controls the ionic and water concentrations in the body [1, 2].

The primary synthesis of aldosterone takes place in the adrenal cortex. The center of production is the zona glomerulosa, which is the outside zone of the three zones in the adrenal gland [3].

However, there is growing evidence that aldosterone is also synthesized secondarily in other tissues, not only the adrenal gland. It is suspected that aldosterone can also be created by the heart and the vasculature [2, 4].

The body controls aldosterone levels via gene expression. When more aldosterone is needed, the cells in the zona glomerulosa express the gene CYP11B2. This gene encodes the enzyme responsible for aldosterone creation, aldosterone synthase.

The synthesis of aldosterone is controlled via two mechanisms. One is the renin-angiotensin system. In this regulatory process, molecules like renin, angiotensin, and potassium play an important role. The second mechanism that can cause aldosterone production is induction by adrenocorticotropin (ACTH) [3, 5].

What is the function of aldosterone?

Aldosterone’s main function is to control the ion and water balance in the body [6, 7, 8]. It primarily regulates the concentration of sodium and potassium. Via the movement of the first one, water is drawn back or out of the organism [8].

The primary effect of aldosterone is in the kidneys. In this naturally bilateral organ, the hormone induces an ionic exchange. Aldosterone activates the mineralocorticoid receptor, which triggers a cascade. The end effect of the later following reactions is the excretion of potassium and the reabsorption of sodium from the urine [9].

However, aldosterone also works in other organs. It also stimulates the absorption of sodium in the large intestine and salivary and sweat glands [10].

Especially with the control of the sodium concentration in the body, aldosterone also regulates the blood pressure. Therefore, it plays an important role in cardiovascular health. Elevated aldosterone levels can lead to hypertension and cardiovascular disease [11, 6]. Consider reading our other blog on how to lower aldosterone levels can be lowered naturally, if you have elevated aldosterone levels.

Aldosterone was also found to play a role in the regulation of inflammation and oxidative stress [8].

What is ADH and where is ADH produced?

Antidiuretic hormone (ADH) is a protein also known as arginine vasopressin (AVP) or simply vasopressin. It plays a crucial role in the regulation of the water balance in the body. Its effect makes the kidneys absorb more water, which can increase the amount of water found in the blood [12].

The site of production of ADH is neurons. Specifically, vasopressin is produced by the large neurons in the paraventricular and supraorbital nuclei. The synthesized vasopressin is then transported by neuronal projection and terminates in the pituitary gland. This is the place where ADH is secreted into the blood circulation [13].

What is the function of ADH?

ADH is crucial for maintaining the body's water balance, regulating blood pressure, and managing the body's sense of thirst.

The main function of the antidiuretic hormone is to balance the water concentration in the body. It regulates the water concentration by making the kidneys reabsorb more water [12].

The decision of whether to produce more ADH is made based on the ionic concentration in the blood. The release of vasopressin follows when the ionic concentration in the blood is high. There are two causes of such a situation. One is when high levels of sodium are found in the blood. The second situation is dehydration [12].

When one of these situations occurs, the released ADH travels by blood to the kidneys. Once there, it works on the cells, which form the collecting ducts. Vasopressin makes those cells express and transport through their membranes special water channels. These unique proteins are named aquaporins and allow the water to be absorbed back into the organism.

The absorption of water dilutes the blood ionic concentration and, therefore, inhibits vasopressin release. With the absorption of water, the blood pressure increases.

Additionally, ADH is a vasopressor. That means it causes vasoconstriction of the blood vessels. The reduced space for the blood after the constriction of the arteries increases blood pressure [14]. It is also a possible balance to the water inflow caused by ADH.

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Jakub Gwiazdecki

Jakub Gwiazdecki

Jakub is in his fifth year as a medical student at Comenius University in Bratislava, Slovakia. He has special interested in cardiology and in patient-centered medicine. His love for heart health isn't just book-smarts; he wants to know how it works, what it means for our feelings, and how key it is for health and happiness. Jakub thinks real good health care comes from always putting the patient at the centre, treating each person as a whole.