Dr. George Redmon
While there has been massive marketing campaigns and programs aimed at stemming or reducing dangerous levels of blood alcohol consumption, efforts are now being made to educate professional and laypersons alike concerning the negative effects of drinking too much water - known as hyponatremia, or water intoxication.
This article was originally published in American Fitness Magazine.
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Hyponatremia: Water Intoxication
While there have been massive marketing campaigns and programs aimed at stemming or reducing dangerous levels of blood alcohol consumption, efforts are now being made to educate professional and laypersons alike concerning the negative effects of drinking too much water - known as hyponatremia, or water intoxication.
The word intoxication is often associated with drinking too much alcohol. This activity reduces the efficiency of the central nervous system resulting in loss of fine motor coordination and muscle tone, i.e. the staggering drunken gait or stupor of overconsumption of alcohol. Blood alcohol levels of 0.10 to 0.125 can lower heart rate, blood pressure and respiration rates, resulting in slower reflex responses, reaction times, impairment of motor coordination, nausea, loss of balance, slurred speech and loss of proper judgment. At blood alcohol levels of 0.25 to 0.30, mental confusion can occur as well as loss of consciousness. Extreme blood alcohol levels of 0.40 and above can result in coma and possible death due to respiratory failure.
Sixty to sixty-five percent of your internal makeup is water. A thin person has a larger percentage of water in their body than those overweight and obese because fat is almost water-free. Women, because of their physiological predisposition (i.e. more body fat), contain less water than men. For example, under normal circumstances, an adult male’s body weight is about 65 percent water, while an adult female’s body weight is about 55 percent water.
Fluid is distributed in the body between the extracellular compartments (fluid in spaces outside cells) and the intracellular compartments (fluid inside cells). Extracellular fluid is also found within blood vessels and fluid surrounding cells.
Water is considered the universal nutrient. We can go without most essential nutrients for days - even weeks and months - but we cannot survive without water for more than a few days. In today’s fitness and health conscious society, healthcare professionals have stressed the importance of proper fluid intake to guard against dehydration (i.e. the loss of water from the body). Severe dehydration can lead to shock - and even death. In scientific terms, a change in fluid concentrations within intracellular and extracellular compartments of cells is the problem. A 10 percent loss of body fluids (four liters) is considered serious, while a 20 percent loss (eight liters) is usually fatal.
Generally, the body loses two to three quarts of water daily from urination, defecation, sweat and water vapor expelled during respiration. Additional losses of water also occur when exercising, taking medications and at times of stress or illness. Fever, diarrhea and vomiting are examples of common ailments that cause further water loss. Soda and caffeinated beverages like coffee and tea have a diuretic effect on the body and also cause further loss of water.
The Other Side of Dehydration
Healthcare professionals have expressed concerns about the rising trend in increased water consumption and the resulting cases of hyponatremia. Hyponatremia is the opposite of dehydration and is often associated with long-distance events like running and cycling. It can be life threatening, so it’s important that professional and amateur athletes, weekend warriors and water-drinking enthusiasts are aware of this condition. Hyponatremia’s associated symptoms mirror that of dehydration and alcohol intoxication to a large degree.
If you, or anyone you know, experience any of the symptoms listed below following physical activity or an athletic event, you should seek medical attention immediately:
Paradoxically, some individuals show no symptoms of hyponatremia. Like dehydration, if hyponatremia is left untreated, it can lead to extreme fatigue, coma and death. Overhydration In a study published in Annals of Internal Medicine in May 2000, Dr. J. Carlos Ayus, professor of medicine at Baylor College of Medicine in Houston, Texas, reported that consuming too much water during a marathon caused brain swelling as a result of water intoxication. Ayus found that excess water is absorbed into the blood, causing fluid to build up in the brain. Eventually, fluid accumulates in the lungs, causing the individual to become breathless and nauseated.
When you consume large amounts of water over the course of a few hours or a day, blood plasma (the liquid of blood) increases, diluting the salt content of the blood. If you are involved in strenuous physical activity you also lose salt - one of several very important mineral electrolytes - by sweating. Sodium and potassium maintain a balance of body fluids inside and outside the cell, while regulating blood pressure in the blood vessels. Too much water and excess sweat can dilute the contents of blood. This disrupts the normal balance required for the body to function properly. Sweat loss can vary from 16 ounces to three quarts during each hour of exercise. (Note: Electrolytes are mineral elements whole molecules split into electrically charged particles called ions when completely broken down and dissolved in body fluids [water].
When minerals become electrolytes, they become active and usable in human tissue, causing all cellular structures to become alive by the electricity they produce.
According to Brenda Bigelow-Kemp, associate professor at the Division of Nursing at D’Youville College in Buffalo, N.Y., and Adele Pillitteri, professor at the College of Nursing at Niagara University in New York, water balance in the body depends on the body’s ability to maintain equilibrium when facing disturbances in water intake and output. These researchers remind us that water intake not only occurs when drinking, but also from solid foods and the metabolism (breakdown) of food. In fact, both fat and carbohydrate metabolism release about 100 milliliters of water for each 100 grams consumes. Protein produces about 40 milliliters of fluid for each 100 grams of protein consumed. For those involved in activities like bodybuilding or similar sports where large amounts of food are consumed (e.g. protein), understanding the above ratios is vital in efforts to maintain homeostasis.
Diet, Drugs and Hyponatremia
There is considerable evidence showing poor dietary habits and the consumption of large amounts of beer (i.e. beer potomania) as predisposed factors that can cause hyponatremia (Hettema and Halma, 1999). Hyponatremic symptoms have also been noted after the use of the recreational drug N-methyl-3, 4 methylenedioxylamphetamine, commonly known as ecstasy (Holmes, Banerjee and Alexander, 1999). Water intoxication can also be caused by many medications according to Dr. Sandy Craig, MD, associate program director and clinical instructor at the Department of Emergency Medicine at the University of North Carolina.
Some well-known culprits are:
1 Acetazolamide (glaucoma pills)
2 Carbamazepine (anti-cancer drug)
3 Clofibrate (cholesterol reducer)
4 Cyclophosphamide (anti-cancer drug)
5 Halopenidol (tranquilizer-anti-psychotic)
6 Indomethacin (arthritis-aspirin substitute)
7 Opiates (pain medications)
8 Thiazide Diuretics (reduces water retention)
9 Selective Serotonin Reuptake Inhibitors (depression and mood disorder medication)
If you weigh:
If you are a Female, you may contain:
(Suggested Fluid Intake: In 8 oz. glasses)
100 lbs. 55 lbs of water 50 fluid oz. 6 glasses
120 lbs. 66 lbs. of water 60 fluid oz. 7 glasses
140 lbs. 77 lbs. of water 70 fluid oz. 8 glasses
160 lbs. 88 lbs. of water 80 fluid oz. 10 glasses
180 lbs. 99 lbs. of water 90 fluid oz. 11 glasses
200 lbs. 110 lbs. of water 100 fluid oz. 12 glasses
220 lbs. 121 lbs. of water 110 fluid oz. 13 glasses
If you weigh:
If you are a Male, you may contain: (Suggested Fluid Intake: In 8 oz. glasses)
100 lbs. 65 lbs. of water 50 fluid oz. 6 glasses
120 lbs. 78 lbs. of water 60 fluid oz. 7 glasses
140 lbs. 91 lbs. of water 70 fluid oz. 8 glasses
160 lbs. 104 lbs. of water 80 fluid oz. 10 glasses
180 lbs. 117 lbs. of water 90 fluid oz. 11 glasses
200 lbs. 130 lbs. of water 100 fluid oz. 12 glasses
220 lbs. 143 lbs. of water 110 fluid oz. 13 glasses