Overhydration: what happens when you drink too much water?

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It’s no secret that it is essential to drink water regularly to ensure the proper functioning of the body. The body is made up of 60% water on average and can lose several liters of it per day. Without water, the body cannot transport the food ingested, eliminate toxins from the kidneys, or operate the intestine or the brain. This is why it is important not to neglect your hydration and to compensate for water loss, even if you do not feel the need to drink.

For this, it is advisable to ingest at least 1.5 liters of water per day, and even more so during a heat wave or during physical exertion. Although hydration is important, it is important not to drink too much water in a very short period of time. The risk ? Hyperhydration, a phenomenon less known than dehydration. Yet it must also be taken seriously because it is just as dangerous.

What is overhydration?

Overhydration is excess water in the body. This phenomenon occurs when water consumption is greater than the body’s needs. In this case, the body absorbs more fluid than it loses. Too much water usually causes a decrease in sodium concentration in the blood, i.e. hyponatremia, which can have adverse health effects.

However, consuming too much water does not lead to overhydration if vital organs are functioning properly. “To exceed the body’s capacity to eliminate excess water, adults with normal kidney function should drink more than 22 liters of water per day on a regular basis”, specifies the MSD Manual on its site.

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Who is affected by overhydration?

Anyone can be affected by overhydration. However, this phenomenon is particularly common among athletes, who are tempted to hydrate excessively during or after a major effort, such as a marathon. People who drink too much water to avoid becoming dehydrated are also more likely to develop overhydration. Another profile subject to this excess water: the elderly. They sweat less and thus excrete less water than the rest of the population.

What are the different types of overhydration?

There are two types of hyperhydration: extracellular hyperhydration and intracellular hyperhydration.

When water collects outside the tissues, it is called extracellular hyperhydration. In this case, the excess water in the body is caused by a failure of the heart, kidneys or liver. This type of overhydration is linked to a low blood level of protein, which causes water to exit the blood vessels and stagnate around the tissues because it no longer has to balance the proteins.

Conversely, we speak of intracellular hyperhydration when water accumulates in the tissues. In this case, it is an imbalance in the water balance. This type of overhydration is always accompanied by hyponatremia, which is a decrease in the sodium concentration in the blood.

Hyperhydration: what are the causes?

The origins of hyperhydration are multiple. It can be caused by pathologies, such as heart, kidney or liver problems. These conditions decrease the body’s ability to excrete water or promote fluid retention. Infants can also develop overhydration from their kidneys, which are still immature. Another cause: the drugs. Some antidepressants can cause excess water in the body.

“Overhydration can also be due to the syndrome of inappropriate secretion of antidiuretic hormone. In this syndrome, the pituitary gland secretes excess vasopressin (also called antidiuretic hormone), which stimulates water retention by the kidneys while this is not necessary “, indicates the MSD Manual.

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What are the symptoms of overhydration?

Overhydration is most often asymptomatic. However, symptoms can occur with severe overhydration. The signs that should alert are:

  • Vomitings
  • Nausea
  • Headaches
  • Significant fatigue
  • Lethargy (long-lasting deep sleep)
  • Balance disorders

When the hyperhydration worsens, the patient may experience confusion, seizures and may even fall into a water coma.

Hyperhydration: how to diagnose it?

These characteristic symptoms of overhydration should prompt a patient to consult their doctor. The practitioner will examine the signs present in the patient in order to differentiate hyperhydration and excess fluid in the blood. They will then ask the patient to do blood and urine tests to check the sodium levels.

How to treat overhydration?

Treatment for overhydration is based on restricting fluid intake and treating the cause of the excess water in the body. Limitation of water intake is necessary, regardless of the cause of overhydration. “A daily intake of liquids of less than one liter generally results in improvement within a few days”, specifies the MSD Manual.

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If the excess water in the body is accompanied by excessive blood volume caused by heart, kidney or liver disease, sodium intake should be reduced with a low-salt diet. The reason is simple: sodium retains fluids in the body.

Drugs that are suspected of causing overhydration should be stopped. The practitioner may also prescribe diuretics to the patient to increase urine production and promote the elimination of water and sodium.

In some cases, limiting water intake and taking diuretics do not work. Fluids should therefore be removed by dialysis or by surgery, called paracentesis.

Hyperhydration: how to avoid it?

To avoid developing hyperhydration, it is advisable to drink when thirsty throughout the day. It is also advisable to manage the quantities and take care to absorb between 1.5 and 2 liters of water per day.

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