Water, How Much is Too Much?

Water, How Much is Too Much?

Water the Stuff of Life!, lalpinist photo

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Water, How Much is Too Much?
Disclaimer: I am not a medical professional. I have heard about people that have consumed too much water and suffered kidney damage and even death. I also know that any substance even water can be dangerous if too much is taken in a short duration of time. In my research on SummitPost I found no information on the Risks of Over Hydration. If this article can save one life then I would feel that I was successful. The information contained and uncredited photo were gleaned from the internet as well as my own experience in first aid training. Please feel free to make suggestions.

The following true story underlines the importance for all of to read: Water, How Much is Too Much?

On January 12, 2007, a 28-year old Californian wife and mother of three children died from drinking too much water. She was found dead at her home after drinking an estimated two gallons in a short time during a contest to win a Wii machine. Despite noticeable discomfort and complaints the promoters continued the contest. She died of water intoxication.

What Is Water Intoxication?

Water Intoxication is also known as hyperhydration or hyponatremia. Hyper and Hypo are both Latin prefixes. Hyper means “excessive” and hydration refers to “the process of providing an adequate amount of liquid to bodily tissues.” Hypo means “less than normal” and natremia means “the presence of sodium in urine”.

Sodium (or salt) helps regulate the body’s fluids. Water intoxication occurs when the body’s most important electrolyte, sodium, is too quickly diluted by consuming large amounts of water in a short duration of time. This causes the cells in the body to swell and malfunction.

Essentially when large amounts of liquids are placed in the body in a short duration of time the kidneys fail to keep up to the demands that it can normally keep up to in the every day routine. This causes an imbalance in the concentration of electrolytes in the blood as well as an excess of blood volume. This causes excess water to enter the blood stream and the cells swell.

From the cell's point of view, water intoxication produces the same effects as would result from drowning in fresh water.

When this happens in the brain the pressure can cause headaches and impaired breathing. It also causes the heart to work overtime as well.

What are the Symptoms of Water Intoxication?

Awareness to what is going on in your body is probably more crucial than knowing the symptoms since in most cases once Water Intoxication occurs it is sometimes too late.

Major hallmark symptoms include: a severe headache and impaired breathing.

Other symptoms can include: weakness, dizziness, nausea, muscle cramps, slurred speech, confusion, loss of consciousness and in severe cases seizures.

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The following contribution is from knoback: Hyponatremia (low blood sodium) is a dangerous and likely under recognized problem, especially in the mountains. It has become more common with the advent of bottled water and advice from medical professionals to rehydrate primarily with water.

The symptoms-weakness, nausea, headache-are easily confused with altitude sickness or even dehydration. The one potentially distinguishing sign, dizziness and loss of balance, often occurs late in the course, and of course, is also a symptom of high altitude cerebral edema.

Small, frequent drinks are better than guzzling. Having some salt and glucose in your fluids also helps. There are many formulas out there, but the simplest is to cut a commercial sports drink 50/50 with plain water. This solution may be absorbed faster from the stomach and greatly lessens your chances of hyponatremia. Thanks knoback for the additional information!

Treatment for Water Intoxication

Proper hydration is crucial for people who are exposed to hot weather, exercise, have diarrhea, vomiting, and illness. Intake of fluids with electrolytes such as sports drinks is highly recommended. Many sports drinks contain too high of concentration of electrolytes and could easily be diluted to a two part water one part sports drink and be more beneficial over the long term. By having the proper balance of electrolytes will enable the body to run in an optimal condition.

Victims with slurred speech, confusion, severe weakness, or loss of consciousness need medical attention immediately. If possible call for advanced medical support immediately.

Ask the victim about the recent history of fluid intake. If they have been drinking at least a pint of fluid per hour during exercise, consider the possibility of hyponatremia. In cases of rapid massive water intake consider the possibility of hyponatremia.

Victims of hyponatremia need salt. In minor cases -- usually just when nausea is present -- before cramps, dizziness or confusion occur, victims may feel better with salty food intake. Be very careful not to treat dehydration as hyponatremia and suggest salty foods when the victim really needs fluid. Assume any victim complaining of thirst is dehydrated.

Avoid over the counter medications ibuprofen, aspirin, or naprosyn as pain relievers may make symptoms worse.

Who Should Be Concerned?

lingana photo.

Those who participate in binge drinking at parties and contests.

Individuals who use drugs are at risk due to excessive fluid intake while trying to dilute urine prior to a drug test.

Athletes who sweat while exercising and loose large amounts of water and sodium. Care should be taken to replenish with liquids that have electrolytes such as sports drinks.

Rule of Thumb...Additional Comment from The Chief
Your system can only process 23-25 oz of H20 per hour at peak aerobic output and 12-15 oz. during normal body exertion. Anything over those intake amounts and you are setting yourself up for disaster.

Over hydration (Hyponatremia) is Fatal. Under hydration is not.

In the world of Endurance Performance, the practice of "Less is Best" will definitely keep you alive and going further with better results.

Okay So How Much Water is Enough?

neghafi photo.

Actually it is much less about how much water you drink.
It is much more important how fast you drink it.

The answer to this question depends on a number of circumstances, including diet, exercise habits, and environment.

A diet high in fruits, vegetables and whole grains will require less water than a diet that is high in sodium and protein. Salts and spices increase the bodies need for water.

Kidneys can process up to 15 liters of water each day. In general most healthy adults require about three quarts of liquids each day. Most of the fluids we get is from food so the 8 to 12 glasses per day is a great recommendation.

There are situations that require increased amounts of hydration such as being outdoors in high heat as well as at altitude. The key is gradual consistent replacement of fluids using sips rather than consuming large amounts of liquids in a short duration of time.

The color of your urine is a great indicator to your hydration level. Yellow urine can indicate that more water is needed in the body. Be aware of other factors that can cause yellow urine such as vitamins and foods such as red beets.

People With kidney conditions should consult their physician before changing diet or hydration intake. They should also consult with their physician prior to starting any new exercise program.

Final Words

Balance is the key to many things in life. Whether you are riding a mountain bike or climbing a steep mountain wall balance must be maintained. Balance of fluids is crucial to a healthy lifestyle. Having too much water can be as fatal as not having enough.

Sip sparingly throughout the day and keep balance.

References

Hyponatremia

Kidney Disease

Too Much Wateris dangerous

Water Intoxication

Comments

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FlatheadNative - Jun 8, 2008 8:52 pm - Hasn't voted

Re: Rule of Thumb...

Thanks your comments are quite helpful and I have incorporated them into the How Much is Enough Section in this article.

txmountaineer - Jun 11, 2008 6:29 pm - Voted 10/10

Personal Experience

I can definitely confirm that after a long day of hiking in West Texas, and downing about 1.5gl water over the course of the day, the only thing that made me feel better was the McDonald's fries that I stopped to get after finishing!

suddendescent - Jun 13, 2008 5:15 pm - Hasn't voted

Feeling intoxicated

Thanks for the advice ! I tend to drink a phenomenal amount of it in one gulp without taking the mandatory salt supplement (I prefer sea salt) to replenish the salt lost through perspiration. Although I've routinely observed beer drinkers take in a phenomenal amount of the more intoxicating brew in a sitting without much after-effect apart from getting drunk... (mind you beer is relatively rich in salt ). I know you folks expected the dummy which I am to make such a comment...

To seriously get back to the article; a crash course in the matter teaches us that in essence osmotic pressure rises within cells thus potentially causing their disruption if there is a major disequilibrium in salt concentration between the intracellular medium and the exta-cellular one (I read about this somewhere some years back. Although what you said about kidney malfunction is totally new to me) ... That's something most people don't consider once they are thirsty enough to gulp down a bucket full in one sitting... And that is something I routinely do... So thanks again for reminding me of the dangers !

nomad - Jun 14, 2008 11:04 am - Hasn't voted

great information

thank you for the information, it helped me know a lot on drinking water amounts.

FlatheadNative - Jun 14, 2008 11:25 am - Hasn't voted

Re: great information

Thanks I am glad it helps. That was my goal.

ClimberMan420 - Jul 7, 2008 2:14 am - Hasn't voted

To much water

This is good info to know, many years ago and new to mountaineering I drank about 3 litres of water very quickly before heading up to sleep on a dry summit (The Black Tusk) and had a horrible ascent, mostly just dizzy and extremely lethargic. It was after many already long days and my body was probably already low on salt. It was a very uncomfortable experience that nobody wants. Hopefully people will read this and avoid such situations.

FlatheadNative - Jul 7, 2008 9:41 am - Hasn't voted

Re: To much water

I have heard of a few others including myself who have had similar experiences. Thanks for the comments and the metric conversion as well.

ClimberMan420 - Jul 7, 2008 2:18 am - Hasn't voted

metric

amounts in litres and ml would be great.
Maybe I should but I dont know quarts and oz exactly.
1000ml = 1 litre
Thanks

CORDILLERAORIENTAL - Jul 10, 2008 2:35 am - Voted 10/10

Nice work!

This information is very useful.
Thanks for taking the time to write the article.

Cheers,

Ruben

hundy - Jul 15, 2008 11:36 pm - Voted 10/10

Thank you

Thank you, that was very imformative.

GERTS - Feb 25, 2010 9:21 am - Voted 10/10

WOW!

I never thought of that. Thanks for the info..

Proterra - Jul 9, 2013 8:53 am - Voted 10/10

I suppose this refers to normal conditions?

Because you refer to one pint per hour during exercise. But what about hiking in particular vile climates such as the desert southwest of the US in July? I always thought that one pint per hour is far too little in such a case, and one would need to drink at least one litre per hour (about 35 oz.) to avoid dying of dehydration...

Also, you say that your body only processes 12-15 oz. of liquid per hour under normal conditions, but does this also apply to beer? Because yesterday I drank about one gallon of beer over the course of 4-5 hours and this morning I was more dehydrated than anything else...

mtneering - Jul 10, 2013 5:37 am - Hasn't voted

FYI

Natremia- The presence of sodium in the blood

reboyles - Jul 10, 2013 12:42 pm - Hasn't voted

Hyperhydration

I heard from rangers that this is fairly common with hikers in the Grand Canyon. They reported that most hikers carry plenty of water but that is not the problem, it's over hydration that results in a sodium imbalance that can be very dangerous and even lead to death. The solution they recommend is salty junk food like chips, crackers, etc.

jrnewmann - Jul 13, 2013 12:06 am - Hasn't voted

Thank you

I drink a greater amount of water than most when I am on the trail or mountain but I am familiar with the effects of over hydration. Thank you for helping to educate the good folks of this site, this is a very serious and important issue!

boisedoc - Jul 13, 2013 9:49 am - Hasn't voted

a suggested article

http://www.outsideonline.com/blog/outdoor-adventure/tim-noakes-on-the-serious-problem-of-overhydration-in-endurance-sports.html

Dr Noakes is the guru of exercise related hyponatremia. This summitpost article and the comments have a few inaccuracies. I think water intoxication is much more likely to occur in ultra runners who have access to frequent aid stations or a support crew with water. I doubt many mountaineers carry enough water to give themselves severe hyponatremia. In any event, the best advice by far is to drink water when you are thirsty. The human thirst mechanism has been regulating our sodium level for hundreds of thousands of years

FlatheadNative - Jul 13, 2013 10:08 am - Hasn't voted

Re: a suggested article

Thanks doc. I wrote this a number of years ago and as you know there is quite a bit of research going on with hydration. Thanks for the link.

Cheers

Liba Kopeckova - Jul 15, 2013 9:16 pm - Voted 10/10

?

Is this article an excuse for you guys to drink more beer? hahaha

http://www.backpacker.com/blogs/1074 = beer rehydrates better than water

MattGreene - Jul 16, 2013 2:46 pm - Hasn't voted

Good Article

Thanks for the article, because not many people are aware of the dangers of water intoxication. In my early 20's I was a Peace Corps volunteer in Papua New Guinea and didn't know any better. One day I decided to hike 40 miles (no joke) between two Catholic missions. The temps were in the high 80s, the humidity was near 90%, and there was clean water everywhere, so I drank, drank, and drank again with very little to eat. By the end of the hike I was confused, irritable, and had a massive pounding headache. I thought I was dehydrated, and just drank more. I'm lucky that I didn't end up like the lady in your article. Anyways, I researched my symptoms, learned about water intoxication, and made sure to eat plenty of bananas, sugar cane, and salty tortillas the next time I made the hike. What a difference!

abrennalinerush - Jul 23, 2013 11:16 am - Hasn't voted

Great article!

Swollen digits/hands can be another sign of hyponatremia. For me, that's a definite indicator that I need more salt/electrolytes ASAP.

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