Every day, certain media bombard us with the idea that we must drink between 2 and 3 liters of water a day, assuming that a "normal" person does not ingest enough liquid for their body to function properly. The problem is that this statement can be misleading, when it is interpreted that this quantity does not include the water present in foods such as fruits and vegetables.
In the context of the fashion of not parting with the water bottle at any time of the day, I wanted to analyze a potential consequence that most are unaware of: what happens if we drink more water than we should? What are the symptoms of overhydration in the human body? Is it possible to get 'poisoned' by too much water?
Symptoms
Under normal conditions, a healthy person whose hypothalamus (region of the brain where the center that controls thirst is located), the kidneys and the heart function without problems can drink, although is not recommended, up to 7 liters of water per day with a maximum of 1.5 liters per hour.
Exceeding these amounts would cause water intoxication. In this process, the kidneys become overworked and the cells swell temporarily. In the brain, the swelling causes pressure against the skull, which is why one of the first signs is a headache. Other symptoms that accompany this process are muscle cramps and fatigue as a result of the dissolution of sodium and potassium in the blood, nausea, swelling or fluid accumulation in the lower legs, hyponatremia (low concentration of sodium in the blood, which seriously affects the functioning of the brain), congestive heart failure (a lack of potassium can change the rhythm of the heart muscle), deep and prolonged sleepiness, hallucinations, convulsions and partial or complete paralysis. In the most severe cases, it can lead to coma or death.
However, the body has defense mechanisms prior to water intoxication. The brain, for example, reacts to excessive water intake by activating defense mechanisms such as inhibition of the act of swallowing. In other words, it "closes the throat" making swallowing difficult, as this study from Monash University found.Advertising
Also, depending on the speed at which water is ingested, neurons (particularly sensitive to hyperhydration) are able to adapt. It would be the case of a gradual or moderate intake. On the contrary, at a higher speed the probability of the aforementioned symptoms appearing increases.
Although all these processes occur in extreme situations, drinking too much water without becoming overhydrated is detrimental in a healthy person, especially if the mineral salts that are lost with the elimination of liquid are not replaced.
Finally, water intoxication can have other causes not related to excess water but to kidney function problems, such as in the presence of heart disease, kidney disease, or liver disease, or in premature babies whose kidneys have not yet matured. It can also be the result of syndrome of inappropriate secretion of antidiuretic hormone, in which the pituitary gland secretes too much vasopressin (also called antidiuretic hormone), which stimulates the kidneys to retain water unnecessarily.
Who does it affect?
The main population group facing this risk of water intoxication is elite athletes, or people who exercise for more than 4 hours a day in what is known as 'exercise-associated hyponatremia'.
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One of the “classic” examples is that of marathon runners, who usually drink large amounts of water just before running a marathon. This excess causes sweating to over-eliminate mineral salts with the consequent hydroelectrolyte imbalance and the risk of overhydration.
There is also a psychological disorder called potomania or psychogenic polydipsia, which is the impulsive desire to drink large amounts of fluids and which can lead to hyperhydration.
How to “Cure” It
The first step in stopping the process is to restrict fluid intake. Reducing water consumption to 1 liter per day usually improves the condition of the affected person in a few days.
When hyperhydration occurs with excessive blood volume due to heart, kidney, or liver disease, restricting sodium intake is also beneficial, as sodium stimulates the body to retain water.
The use of diuretics and other drugs would be a more important medical measure, but the main action would have to be aimed at replenishing the minerals lost with excess water.
Real cases
It is not too frequent to find known cases of overhydration, with the exception of some marathon runners and cases directly related to gambling or unconscious games. This would be the case, for example, of Jennifer Strange, a Sacramento woman who died from hyperhydration after taking part in a "Hold Your Wee for a Wii" contest.
Another true case is that of the hazing suffered by Matthew Carrington at California State University, in which 4 members of the Chi Tau House forced him to drink excessive amounts of water while performing calisthenics in an extremely cold basement. Carrington collapsed and died from hyperhydration.
As for athletes, the event of the 2002 Boston Marathon is famous, in which Cynthia Lucero lost her life due to excessive hydration. In 1999, during US Air Force training, Michel J. Schindler died after spending two days in serious condition due to hyperhydration sustained while hiking more than 9 kilometers. New Zealand athlete Craig Barrett also suffered a collapse due to excess water in the last kilometers of the 50 km race at the 1998 Commonwealth Games, although luckily he was treated in time.
In Spain, the risk of hyponatremia has been observed in long tests, of more than four hours, and under certain climatic conditions. A combination that occurs in events such as the Transgrancanaria.
Tips
Drink water when you are thirsty, and not beyond the capabilities of the human body. Isotonic drinks are a good option when it comes to long-term exercises: they replenish sodium levels and other electrolytes that are lost during exertion.
On the other hand, to compete in tests with this type of physical demands, the best thing is a good professional preparation that teaches how to measure hydration during exercise and how to regulate sodium levels, which translated is between 1-1, 5 grams of salt per liter of non-energy drink (1/5-1/3 of a teaspoon) and 0.5-0.7 grams of salt/liter in the case of energy drinks.
Other sources: 1, 2, 3, 4, 5.