Overhydration: How Much Water Can The Body Handle & What Happens If You Become Overhydrated?

It is a commonly heard fact that the more you hydrate, the better it is for your body and your health. We have always heard that since the human body is mostly made up of water, we should be drinking as much as we can to remain hydrated – this translates to roughly having at least eight to ten glasses of water every day. Drinking plenty of water helps flush out any toxins from your body, helps clear out your skin, helps the common cold, and also helps in weight loss. While everyone is seeing carrying around water bottles these days, but should we really be chugging water at every given opportunity? While getting adequate water is extremely crucial for our health, it is also possible to consume too much water or become overhydrated. Read on to find out how much water can the body handle and what happens if you become overhydrated?.

The term dehydration seems to be always in the spotlight and getting highlighted for the dangers it poses to your health. However, there are many risks associated with becoming overhydrated as well.

Remaining adequately hydrated is essential because it ensures the proper functioning of the critical bodily functions, including heart rate, blood pressure, cognition, muscle performance, and many others.

It is nearly impossible to have a fixed definition of what is ‘proper hydration.’ This is because the fluid requirement by each individual varies by gender, age, diet, the weather, and even on the level of physical activity you indulge in.

Pregnancy and health conditions like kidney or liver disease can also have an effect on the amount of water you should be drinking every day. Furthermore, certain medications alter the body’s fluid balance, changing the amount of hydration a person needs.

On a general level, though, most medical experts advice calculating your weight and then half it, and drinking that number of ounces of water every day. For example, if you weigh 150 pounds, then you should be drinking a total of 75 ounces of water every day, or roughly 2.2 liters of water.

According to the Dietary Reference Intake set up by the Institute of Medicine ⁽¹⁾, here is a rough guideline for what is the ideal water consumption for children and adults:

• Children of ages 1 to 3: 44 ounces or 1.3 liters
• Children of ages 4 to 8: 57 ounces or 1.7 liters
• Female children of ages 9 to 13: 71 ounces or 2.1 liters
• Females of ages 14 to 18: 78 ounces or 2.3 liters
• Females aged 19 or older: 91 ounces or 2.7 liters
• Male children of ages 9 to 13: 81 ounces or 2.4 liters
• Males of ages 14 to 18: 112 ounces or 3.3 liters
• Males aged 19 or older: 125 ounces or 3.7 liters

These target amounts, though, does not only include water and other fluids you drink on a daily basis, but it also takes into account water that you get from food items as well. After all, several foods provide liquids as well. Food sources such as popsicles, soups, watermelon, and many other products are well-known sources of foods that contain water. There are also many less obvious choices of such types of foods, including dairy products, fruits, and many vegetables that are also known to contain significant amounts of water. These include:

• Broccoli
• Green cabbage
• Cauliflower
• Spinach
• Oranges
• Apricots
• Blueberries
• Peaches
• Pineapples
• Raspberries
• Plums
• Cantaloupe
• Melon
• Strawberries
• Cucumber
• Lettuce
• Zucchini
• Celery
• Plain yogurt
• Tomatoes
• Bell Peppers
• Grapefruit
• Coconut
• Cottage Cheese

So it is not necessary that you need to only remain hydrated by chugging water. Other fluids can also keep you hydrated and also provide you with the essential nutrients that your body does not get from regular water.

Every living organism requires sufficient water to remain in good health. But, the fact is that the body has its limits as to how much water it can handle. In some rare cases, overloading on fluids can have some dangerous complications and consequences.

So how much water becomes too much for the body? There is no specific number here since there are many factors like age and gender and pre-existing medical conditions that are known to play a role in determining this, but there is still a generalized limit.

It is believed that an average person who has healthy functioning kidneys can drink nearly 17 liters of water if they drink it slowly. This much amount of water will not cause any change to their serum sodium levels.

The kidneys are known to flush out most of the excess water that you consume quite promptly. However, the fact is that the kidneys are only able to excrete around one liter of water in an hour ⁽²⁾. This is why the speed at which a person consumes water is known to also change their body’s tolerance to excess consumption of water.

If you are drinking too much of water too fast, or you have an underlying kidney condition, and your kidneys are not working correctly, then you may reach a state of overhydration much sooner than another person whose kidneys are functioning properly or who is drinking the same amount of water, but at a slower rate.

In day to day functioning, the human body strives to maintain a state of balance at all times. A big part of this is maintaining the ratio of fluid to electrolytes present in the bloodstream. We need to have certain specific levels of electrolytes such as potassium, sodium, magnesium, and chloride present in our blood to maintain functions such as muscles contracting, proper functioning of the nervous system, and also keeping the body’s acid and base levels in check.

When you end up drinking too much water, it causes a disruption to this fluid to electrolytes ratio, throwing off balance. The electrolyte which gets affected the most with overhydration is sodium. Too much of the fluid present in the body ends up diluting the levels of sodium in the bloodstream. This can lead to abnormally low sodium levels, a condition known as hyponatremia. ^{(3) (4)}

The symptoms of hyponatremia might be mild to moderate at first, such as a feeling of bloating or nausea, but over time, the symptoms start becoming more severe, particularly as the sodium levels drop suddenly. Some of the acute symptoms of hyponatremia include: ⁽⁵⁾

• Weakness
• Fatigue
• Irritability
• Confusion
• Headache
• Muscle spasms
• Convulsions
• Unsteady gait
• Water Intoxication and Hyponatremia

People often tend to mistake the condition of hyponatremia as being the same as water intoxication or water poisoning. However, they are not the same thing. The state of hyponatremia occurs when the levels of serum sodium are low in the body, falling to less than 135 mEq/liter. Water intoxication, on the other hand, means that the patient is symptomatic from low sodium levels.

If you do not seek immediate treatment for water intoxication, it can lead to brain disruptions because without the adequate levels of sodium to control the fluid balance within the cells; the brain is likely to swell up dangerously. Depending on the level of swelling in the brain, water intoxication can result in coma or even death.

Water intoxication, though, is a rare condition and it is genuinely quite difficult for an average person to drink so much water to the point of reaching water intoxication. However, dying from drinking too much of water or from overhydration is also a real possibility. ⁽⁶⁾

If you are overall in good health, then it is doubtful that you will develop any type of dangerous condition from drinking too much water. This is because our kidneys are adept at removing any excess fluids from our body through urination.

The only thing that is likely to happen if you are consuming large amounts of water to remain well-hydrated is that you will need to make frequent trips to the bathroom rather than a trip to the emergency room.

Nevertheless, there are certain groups of people who are at a higher risk of developing water intoxication and hyponatremia. One such group of people are those who have any type of kidney disease. This is because the kidneys are responsible for regulating the balance of fluids and minerals within the bloodstream.

People who have late-stage kidney disease are generally at a higher risk of overhydration since their kidneys are not able to process and flush out the excess water.

Overhydration can also occur in athletes, especially those who are preparing for or participating in endurance events such as marathons, and that too in hot weather.

Athletes who are training for several hours at a stretch or who are practicing outdoors are at a much greater risk of overhydration if they do not replace the vital electrolytes such as sodium and potassium.

Due to this, athletes need to be mindful that they are losing electrolytes through the process of sweating as well, and this cannot be replaced by water alone. For replacing electrolytes that are lost through sweat, it is recommended that they have an electrolyte replacement beverage such as a sports drink with them during the lengthier bouts of training or exercise. ⁽⁷⁾

Overhydration has also been reported among the following group of people:

• Ironman triathletes
• Endurance cyclists
• Rugby players
• Elite rowers
• Hikers
• Military members who are involved in training exercises

Some of the initial signs and symptoms of overhydration are usually as simple as minor changes to your bathroom habits. You might find yourself having to urinate so frequently that it starts to disrupt your day to day life. You might also find yourself having to go to the bathroom multiple times in the night and being unable to sleep properly due to this. These signs are usually the first indication that it is time to reduce your fluid or water intake.

Passing completely colorless urine is also another indication that you are probably over-drinking.

Signs and symptoms that are indicative of a more severe overhydration problem are the ones that are also commonly associated with the condition of hyponatremia. These include:

• Nausea
• Vomiting
• Weakness
• Headache
• Changes in mental state such as disorientation or confusion
• Fatigue
• Loss of coordination

If left untreated, overhydration can lead to dangerously low levels of sodium in the bloodstream, and this can lead to more severe symptoms, including:

• Seizures
• Coma
• Unconsciousness
• Muscle spasms, cramps, or weakness

If you feel you might be overhydrated, then you should consult a doctor at the earliest and cut back on your fluid intake. When you visit a doctor, they will perform a blood test to check what your serum sodium levels are and then recommend any treatment if needed. They may also prescribe certain urine tests.

It is a good idea to drink when you are feeling thirsty, and it is better to pick water as your choice of beverage as often as possible. It is just essential to pace yourself and to sip water slowly throughout the day rather than drinking it all at once. You should also be extra careful after you have had a long and sweaty exercise session. Even if you feel like downing an entire bottle, you need to resist the urge and drink slowly.

Some people also find it helpful to only fill their water bottle with the recommended level of water that is considered to be sufficient. They then proceed to drink it at a steady pace throughout the day. This is especially helpful for those people who struggle with drinking adequate water or are unable to get a clear idea of how much water they need to drink daily.

For most people, though, it is merely practical to watch out for any signs of thirst and then to focus on drinking a sufficient amount of water every day.

Some of the signs of being adequately hydrated include:

• Pale yellow urine
• Frequent urination, but not excessive to the point of disrupting your sleep at night
• Feeling satiated and not thirsty
• Ability to produce sweat
• Normal to good skin elasticity, meaning that the skin bounces back when you pinch it

Treatment for overhydration depends on what caused the condition and how severe your symptoms are. Some of the treatments of overhydration include: ⁽⁸⁾

• Cutting back on your water or fluid intake
• Taking diuretics (medications that increase the production of urine)
• Treating the underlying condition that led to overhydration
• Replacing sodium in the bloodstream in severe cases
• Stopping any medicines that caused the problems

If you suffer from kidney disease or any other medical condition that affects the body’s capability to flush out excess water, it is essential to keep in mind basic fluid intake guidelines that you should discuss with your doctor. Your doctor is also likely to instruct you to limit your intake of water to prevent a condition that leads to a dangerous electrolyte imbalance in the bloodstream.

Additionally, if you are an endurance athlete who participates in endurance events such as a marathon or long-range cycling, then your hydration on the day of the event will definitely look different than it is on any regular day. It is important then that you have a hydration plan in place for the event, preferably after discussing it with your doctor or coach.

Endurance athletes can successfully decrease their risk of overhydration by taking their weight before and after a race. This will help them find out how much water they have lost during the event and need to replenish it. It is usually recommended that athletes drink 16 to 20 ounces of fluid of every pound of weight that is lost.

While it is reasonable to feel occasionally thirsty throughout the day, especially in hot weather, but if you feel like you are always thirsty, you should consider seeing your doctor. This might also be a symptom of an underlying health condition that may require treatment.

References

1. Ncbi.nlm.nih.gov. (2019). – Dietary Reference Intakes for Calcium and Vitamin D – NCBI Bookshelf. [online] Available at: https://www.ncbi.nlm.nih.gov/books/NBK56068/table/summarytables.t4/?report=objectonly [Accessed 4 Aug. 2019].
2. Medical News Today. (2019). Water intoxication – when you drink too much water. [online] Available at: https://www.medicalnewstoday.com/articles/318619.php [Accessed 4 Aug. 2019].
3. Adrogué, H.J. and Madias, N.E., 2000. Hyponatremia. New England Journal of Medicine, 342(21), pp.1581-1589.
4. Upadhyay, A., Jaber, B.L. and Madias, N.E., 2006. Incidence and prevalence of hyponatremia. The American journal of medicine, 119(7), pp.S30-S35.
5. Melissa Conrad Stöppler, M. (2019). 12 Hyponatremia Signs, Symptoms, Causes & Treatments. [online] RxList. Available at: https://www.rxlist.com/hyponatremia/article.htm [Accessed 4 Aug. 2019].
6. Gardner, J.W., 2002. Death by water intoxication. Military medicine, 167(5), pp.432-434.
7. Noakes, T.D., Goodwin, N.E.I.L., Rayner, B.L., Branken, T.R.E.V.O.R. and Taylor, R.K., 1985. Water intoxication: a possible complication during endurance exercise. Medicine and Science in Sports and Exercise, 17(3), pp.370-375.
8. Survival Mastery. (2019). Overhydration: Symptoms, Effects, Treatment And Prevention. [online] Available at: http://survival-mastery.com/med/health/overhydration.html [Accessed 4 Aug. 2019].

Also Read:

• Overhydration: Dangers of Drinking Excess Water, Signs, Treatment, Prevention