Everything you need to know about overhydration

As summer continues to pass us by, and mercury hits new highs across the country, the emphasis on drinking fluids of varying kinds is evident. But among all this chatter, have you ever heard of someone suffering because of drinking too much water? It is possible. "Overhydration or water intoxication occurs when the concentration of electrolytes in the body, particularly sodium, becomes diluted due to an excessive amount of water," says Sharanya Shastry, sports and clinical nutritionist-dietitian, at Apollo Spectra Hospital, Bangalore. She tells us that overhydration, also known as hyponatremia, can lead to various health problems, including confusion, seizures, coma, and even demise. To help us further our understanding, she answers important questions, and outlines causes, symptoms, and more.

How much water intake is really required?
Shastry: The recommended daily water intake can vary depending on factors such as age, gender, weight, activity level, and other factors. Generally, (current body weight x 0.036) is the amount of water to be consumed in a day.

However, as a general guideline, the Indian Council of Medical Research (ICMR) recommends the following daily water intake levels: Men should consume about 4 litres of water per day, and women should consume about 3 litres, which includes water from all sources, such as beverages and foods.

But individual needs may vary depending on factors such as age, weight, activity level, and medical conditions. It is important to pay attention to your body's thirst signals and drink water or other fluids as needed to maintain a healthy level of hydration.

What causes overhydration?
Shastry: While it is true that drinking excessive amounts of water can contribute to overhydration, this rarely occurs in healthy individuals with functioning kidneys. In fact, healthy kidneys can easily excrete excess water, and the body's thirst mechanism usually prevents us from drinking more water than we need.

However, certain medical conditions or medications can impair the body's ability to excrete water or increase its tendency to retain water, leading to overhydration. These include kidney disease, heart failure, liver disease, certain medications (such as diuretics), and some hormonal imbalances.

It is also worth noting that overhydration can occur not only from drinking too much water but also from excessive consumption of other fluids, such as sports drinks or even beer. In these cases, it is the total volume of fluid consumed that matters, rather than the specific type of fluid.

What are the symptoms of overhydration?
Shastry: The symptoms of overhydration can vary depending on the severity and duration of the condition. Some common symptoms of overhydration include:

Headaches

Nausea and vomiting

Confusion and disorientation

Fatigue

Muscle weakness, spasms, or cramps

Seizures

Coma

In severe cases, overhydration can also lead to swelling of the hands, feet, and face, as well as shortness of breath and chest pain.

It is important to note that the symptoms of overhydration can be similar to those of other medical conditions, such as dehydration, hyponatremia, or heart failure. If an individual is experiencing any of these symptoms, it is important to seek medical attention to determine the underlying cause and receive appropriate treatment.

How can you prevent overhydration?
Shastry: To avoid overhydration, it is best to rely on the body's thirst signals and the colour of the urine as a guide. Drink water when feeling thirsty and continue to hydrate until the urine appears light yellow or clear. It is important to avoid consuming more than 1 litre of fluid per hour, which will help kidneys eliminate any excess water.

Let's understand this in detail:

1. Pay attention to the body's thirst signals and drink water or other fluids when feeling thirsty.

2. Drink fluids in moderation and avoid consuming more than 1 litre of fluid per hour. If engaged in physical activity or sweating excessively, the body may need more fluids.

3. It is important to be aware of any medical conditions or medications that may increase the risk of overhydration, and talk to a healthcare provider about how much fluid the individual should be consuming each day.

4. Monitor the colour of urine as a guide to the body's hydration level. Dark yellow urine is a sign of dehydration, whereas light yellow or clear urine indicates that the body is well-hydrated.

5. Avoid excessive alcohol consumption, which can impair the body's ability to regulate fluid balance.

How is overhydration diagnosed?
Shastry: Overhydration can be diagnosed through a combination of physical examination and laboratory tests. During a physical examination, a healthcare provider may check for signs and symptoms of overhydration, such as swelling or puffiness in the hands, feet, or face, and listen for abnormal sounds in the lungs.

Laboratory tests can also help diagnose overhydration. These tests may include blood tests, urine tests, chest X-rays, or ECG.

How long does it take to recover from overhydration?
Shastry: In mild cases, where excess water intake is minimal, the body can restore its balance by excreting the excess fluids through urine, and the recovery time can be short, typically within a few hours to a day. However, in severe cases where there is a significant excess of fluid in the body, the recovery time can take longer, usually several days to a week, and in some cases, medical intervention may be required.

Reducing fluid intake is the most effective way to recover from overhydration, and it can lead to a rapid improvement in symptoms. This is because the body can quickly excrete the excess fluids through urine, restoring the normal balance of electrolytes in the blood. In addition, other treatments may be necessary, such as medications to manage electrolyte imbalances or underlying medical conditions that may have contributed to overhydration.

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