What happens if you drink a lot of water?

What happens if you drink a lot of water?


Joseph C. Ferbalis is chair of the Department of Endocrinology and Metabolism at Georgetown University and a specialist in pituitary function.

Q: I know it’s important to stay hydrated, but what happens if you drink too much water in one sitting? Is it possible to overdrink?

a: What happens when you drink a lot of water depends on your health and activity at the time and how much you mean by “too much”.

The most likely outcome is that you will urinate frequently to get rid of the extra water.

But it is possible to go overboard. Normal kidneys can release up to a quart of fluid every hour. If you drink more than that, you will retain excess water in your body, causing a condition known as Hyponatremia It can be dangerous to your health. Mild hyponatremia causes few symptoms, but more severe cases–when blood sodium levels fall below 130 mEq/L–can lead to brain swelling and progressive neurological symptoms, including confusion, disorientation, seizures, coma, and sometimes death.

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Hyponatremia was the cause of death for one of the participants in 2007 radio competition In California, the prize went to whoever drank the most before urinating. The contestant died after she reportedly drank nearly two gallons of water over the course of two hours – clearly exceeding what her kidneys could handle, which would be about a quart, or half gallon, over the course of two hours. Excessive water intake also led to the death of students during that Opposite Brothers Rituals.

But it’s important to remember that these are contrived situations that most people will never go through.

Your body carefully regulates the amount of water

To understand why this is unlikely in your normal life, you need to know how we regulate the amount of water in our bodies. The body’s water balance controls twofold: thirst and the release of a hormone called arginine vasopressin (AVP, also known as antidiuretic hormone) from the pituitary gland.

When you’re outside on a hot summer’s day, the loss of sweat causes a gradual dehydration. The brain senses changes in blood concentration – mainly increased sodium – and releases AVP, which travels to the kidneys and tells them to supply water. As a result, very little urine is excreted; It also becomes very concentrated and has a dark yellow color.

But at a certain point, urine concentration alone is not enough to prevent dehydration. That’s when higher centers in the brain are activated to stimulate thirst.

When you’re not dehydrated and you’re drinking extra water, the brain senses this as well through opposite changes in blood concentration – essentially low sodium. AVP secretion is inhibited, which tells the kidneys to excrete more water. Then a large volume of diluted urine – pale in color – is passed out to get rid of the excess water.

You also won’t feel thirsty. But this is not very useful: we do not usually drink liquids because of thirst. Instead, our fluid intake tends to be flavor-driven (like my daughter’s love of Diet Coke); our need to accompany solid foods with drinks; And desirable side effects as with coffee and alcohol.

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However, there are some conditions and activities that can limit the amount of urine your kidneys produce and your likelihood of developing hyponatremia. These include health conditions such as syndrome of inappropriate antidiuretic hormone secretion; medicines, including diuretics and antidepressants; Even nausea and exercise.

Perhaps the best studied is exercise-related hyponatremia, particularly in marathons, triathlons, or ultramarathons. These cases of hyponatremia were initially thought to be due to a loss of sodium in sweat, but later studies have shown that they were mostly due to ingestion of too much fluid during the events.

Fluid intake during exercise rarely exceeds a quarter gallon per hour. But exercise stimulates the release of AVP, so even “normal” amounts of water consumption can cause water retention and hyponatremia under these conditions. Nausea has a similar effect on AVP secretion.

So if you’re exercising or feeling nauseous, you can’t get your water out the usual way like when you’re sitting comfortably and watching a movie – unless, of course, the movie makes you feel nauseous.

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So how much water should I drink?

I participated in consensus conferences On exercise-related hyponatremia, which came to a very simple conclusion: you should drink according to your thirst, during exercise or during rest, but not in a randomly determined amount. (I consulted with Otsuka Pharmaceutical, which makes a drug to treat hyponatremia.)

The ideal fluid intake varies from person to person, depending on a variety of factors. There are some medical conditions in which it is recommended to increase fluid intake, such as a tendency to form kidney stones.

Particular attention should be paid to older individuals, who generally suffer from decreased sense of thirst. This does not usually lead to dehydration, but under conditions of increased fluid loss (increased sweating during heat waves, diarrhoea), they should be encouraged to drink more fluids even if they are not thirsty.

But for most people, drinking more than necessary to maintain water balance is neither medically necessary nor beneficial.

In fact, it is recommended to drink eight eight-ounce glasses of water per day not supported Through evidence-based data or known physiological principles.

Bottom line: If you’re not feeling thirsty, you’re probably properly hydrated. But if you feel thirsty, drink as much as you need until the thirst is gone.

This is not only the best medical advice for maintaining the water balance in the body, but it is also the common sense that has enabled the survival of the human race for thousands of years. We should not abandon that successful strategy now.

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