Drinking much water when ill harmful, finds study
Doctors warn excessive intake can pose risks for some patients and say medical advice needs to be more specific
The common advice to drink plenty of water when ill is based on scant evidence and can actively harm chances of recovery, doctors have warned.
Medics at King’s College hospital NHS foundation trust, in London, raised the alarm after they treated a patient with hyponatremia – abnormally low sodium – from drinking too much water to help with a recurring urinary tract infection.
In the case highlighted, a 59-year-old woman consumed several litres of water based on medical advice she recalled from previous similar episodes to “flush out her system”. She became progressively shaky, muddled, vomited several times and had significant speech difficulties.
Dr Maryann Noronha, the co-author of the study published in BMJ Case Reports on Thursday, said: “When people are ill they don’t tend to drink very much water because it’s the last thing they want to do and you can become dehydrated very quickly.
“To counteract that risk, doctors have said ‘Make sure you drink lots of water.’ That has perpetrated the myth that you must drink gallons of water. Most people don’t do that but in this case they did it to the letter.”
Tests revealed her high intake of water had resulted in dangerously low sodium levels – 123 mmol/L – classifying it as a medical emergency. A mortality rate of almost 30% has been reported for patients with sodium levels of less than 125 mmol/L.
Doctors restricted her fluid intake to 1 litre over the next 24 hours. By the following morning her blood tests were normal and she was discharged later that day.
In a previous case a woman with gastroenteritis developed hyponatremia and died from drinking excessive amounts of water. Fatal water intoxication has also been reported in people engaged in endurance exercise and using the drug MDMA (ecstasy), when they have sweated heavily and overcompensated with fluids.
The authors stress that it is rare to develop water intoxication with normal renal function but warn that some illnesses drive up levels of antidiuretic hormones, which reduce normal excretion of water.
“Doctors should try to be more specific in their advice,” said Noronha. “I say to people, while they are ill they should at least consume their normal fluid intake and up to half again [ie, up to 150%]. If you drink three litres, you shouldn’t drink six litres when you are ill.”
Public Health England recommends people should drink six to eight glasses of fluid a day, including water, lower fat milk and sugar-free drinks including tea and coffee.
Noronha said the amount needed by different people varies, but the main message is not to change your consumption too greatly when you are ill. “If you are someone who doesn’t drink much water and then suddenly fill your body with masses that’s going to have a very big effect,” she said. She hopes the paper might prompt research in the area so that objective guidance can be drawn up.
Dr Imran Rafi, the chair of clinical innovation and research at the Royal College of GPs, said: “Drinking enough water is important in keeping healthy, both physically and mentally, and patients should keep their fluids up when unwell, particularly in conditions that can cause dehydration.
“There is no steadfast recommendation as to how much water people should drink in order to stay healthy, but the key thing is to keep hydrated – and passing clear urine is a good indication of this.
“This case report highlights that excessive water intake can have important consequences for patients, and this is something that healthcare professionals, and patients, should be mindful of.”
Did you know that drinking too much hot water can have a detrimental effect on your health? While you will find a lot of benefits about drinking hot water, you also should educate yourself about the ill-effects of consuming hot water.
Is hot water really that bad? Does it have serious side effects? You will find answers to all such questions in this post!
Now that you have understood the serious side effects of drinking hot water, you are going to take care on this note, right? Do you agree with the side effects of drinking too much hot water mentioned above? Please do share with us in the comments section!
Doctors have always advised patients to drink plenty of water if
unwell. A new case study reports the risks of drinking too much water
and highlights the need for more research to support this traditional
advice.
![[glass of water]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_svLU8QcwkgOS9ELtvjb0RMXiCHNaNMBVrpOJNGR0y6__PevQnVKYjimSnXSeTd801TtZ5AXLHIF2nhh7n9PUFyIiSsyuxetqisIqc7TlzqIAMWkcMpbngxgN1g1BN-xZEb6MXQTdBiHtQyPrhvGepe68d5q4RW7jVA=s0-d)
New case study shows there is such a thing as 'water intoxication.'
For generations, the predominant medical advice in case of flu or respiratory infections has been to drink plenty of fluids.
Theoretically, this is considered good advice; during a cold, the body secretes more liquids through the nose or may be running a fever, which could lead to more fluid loss.
In the case of infections in general, drinking more water is thought to help with intravascular volume loss, increased vascular permeability, as well as replace the fluids lost in fever and vomiting.
The medical advice to drink plenty of water also rests on the assumption that water consumption is harmless.
A new case report reminds doctors and patients that evidence for the benefits of drinking plenty of water is scarce, and, in fact, drinking too much water can be dangerous.
The woman started to feel the symptoms of a recurring UTI, which had flared up several times in her life previously.
In the case of UTIs, drinking more water than usual has been shown to temporarily reduce the number of bacteria in urine, but the reasons for this remain unclear.
Remembering the doctor's advice of drinking half a pint of water every half hour, the woman drank several liters of water that day, but her UTI symptoms worsened. As a result, she presented herself to the emergency department at King's College Hospital in the United Kingdom with symptoms of lower abdominal pain and dysuria.
Urine tests confirmed a UTI, but the patient was otherwise healthy. She had no medical history apart from a recurring UTI, did not smoke or take any medicine or recreational drugs, had no allergies, and was a moderate alcohol drinker.
In the emergency department, the woman was prescribed antibiotics and analgesics for her UTI. However, she soon started displaying new symptoms, such as shakiness and tremor, vomiting, and speech difficulties.
The patient's Glasgow Coma Scale was 15 - she had an attention deficit, was hesitant in speech, and had difficulty finding her words. Otherwise, the patient was healthy.
Because of her speech impairment, doctors considered the possibility of a stroke. Blood tests and a computed tomography (CT) scan quickly revealed this was not the case. However, blood tests showed signs of hyponatremia.
Acute hyponatremia, which develops in less than 48 hours, is considered an emergency, as it can have fatal neurological consequences. Critically low levels of sodium can lead to cerebral edema with increased levels of intracranial pressure and brain herniation. This leads to seizures, coma, and death.
The mortality rate for hyponatremia cases is 17.9 percent.
In the case report, the patient's sodium level was 123 millimoles per liter. The fatality rate for patients with sodium levels lower than 125 millimoles per liter is almost 30 percent.
Water intoxication, which can lead to fatal hyponatremia, has been reported in endurance exercise, in the use of the drug MDMA, and in psychogenic polydipsia - a disorder where the patient drinks large quantities of water compulsively, usually as a result of a psychiatric condition.
After having her water intake restricted to 1 liter per day, the patient's condition improved significantly in the following 24 hours. Sodium levels were back to normal, and the patient was discharged.
However, if the levels of antidiuretic hormones are elevated, as is the case in some illnesses, this can reduce the excretion of water. In these cases, the authors ask, how sound is the medical advice to drink plenty of liquids?
The case of the 59-year-old woman is similar to a previously reported case, where a healthy young female drank too much water while experiencing gastroenteritis. As a result, she developed acute hyponatremia and died.
In both situations, the patients followed the doctor's advice, although they overdid the recommended intake of water. As the authors point out:
They caution that there is an insufficient amount of research demonstrating the benefits of drinking more fluids during infectious illnesses. In fact, they cite a previous review that found "no randomized controlled trials to provide definitive evidence" of the benefits of such medical advice.
Authors urge doctors not to ignore serum electrolyte levels when presented with a healthy adult who displays severe cerebral symptoms.
"The presentation of a previously, healthy adult with acute cerebral symptoms creates a time-critical clinical challenge," they note. "However, this must not detract from the need for a comprehensive collateral history to guide diagnostic approach. A history of excessive water intake combined with possible intravascular depletion should prompt speedy analysis of serum electrolyte levels."
The common advice to drink plenty of water when ill is based on scant evidence and can actively harm chances of recovery, doctors have warned.
Medics at King’s College hospital NHS foundation trust, in London, raised the alarm after they treated a patient with hyponatremia – abnormally low sodium – from drinking too much water to help with a recurring urinary tract infection.
In the case highlighted, a 59-year-old woman consumed several litres of water based on medical advice she recalled from previous similar episodes to “flush out her system”. She became progressively shaky, muddled, vomited several times and had significant speech difficulties.
Dr Maryann Noronha, the co-author of the study published in BMJ Case Reports on Thursday, said: “When people are ill they don’t tend to drink very much water because it’s the last thing they want to do and you can become dehydrated very quickly.
“To counteract that risk, doctors have said ‘Make sure you drink lots of water.’ That has perpetrated the myth that you must drink gallons of water. Most people don’t do that but in this case they did it to the letter.”
Tests revealed her high intake of water had resulted in dangerously low sodium levels – 123 mmol/L – classifying it as a medical emergency. A mortality rate of almost 30% has been reported for patients with sodium levels of less than 125 mmol/L.
Doctors restricted her fluid intake to 1 litre over the next 24 hours. By the following morning her blood tests were normal and she was discharged later that day.
In a previous case a woman with gastroenteritis developed hyponatremia and died from drinking excessive amounts of water. Fatal water intoxication has also been reported in people engaged in endurance exercise and using the drug MDMA (ecstasy), when they have sweated heavily and overcompensated with fluids.
The authors stress that it is rare to develop water intoxication with normal renal function but warn that some illnesses drive up levels of antidiuretic hormones, which reduce normal excretion of water.
“Doctors should try to be more specific in their advice,” said Noronha. “I say to people, while they are ill they should at least consume their normal fluid intake and up to half again [ie, up to 150%]. If you drink three litres, you shouldn’t drink six litres when you are ill.”
Public Health England recommends people should drink six to eight glasses of fluid a day, including water, lower fat milk and sugar-free drinks including tea and coffee.
Noronha said the amount needed by different people varies, but the main message is not to change your consumption too greatly when you are ill. “If you are someone who doesn’t drink much water and then suddenly fill your body with masses that’s going to have a very big effect,” she said. She hopes the paper might prompt research in the area so that objective guidance can be drawn up.
Dr Imran Rafi, the chair of clinical innovation and research at the Royal College of GPs, said: “Drinking enough water is important in keeping healthy, both physically and mentally, and patients should keep their fluids up when unwell, particularly in conditions that can cause dehydration.
“There is no steadfast recommendation as to how much water people should drink in order to stay healthy, but the key thing is to keep hydrated – and passing clear urine is a good indication of this.
“This case report highlights that excessive water intake can have important consequences for patients, and this is something that healthcare professionals, and patients, should be mindful of.”
Did you know that drinking too much hot water can have a detrimental effect on your health? While you will find a lot of benefits about drinking hot water, you also should educate yourself about the ill-effects of consuming hot water.
Is hot water really that bad? Does it have serious side effects? You will find answers to all such questions in this post!
Let’s have a look at the serious side effects of drinking hot water:
1. Water Balance Is Crucial To The Body:
Water is the elixir of life. Almost 70 percent of the human body consists of water. It hydrates the body and keeps the organs well flushed. We are often told that consuming six-eight glasses of water is a must. This is not so. Like most things in excess, even too much amount water too can be harmful.
[ Read: Side Effects Of Aloe Vera Juice ]
2. Hot Water Has More Contaminants:
Warm/hot water directly from the tap can be full of contaminants. If the pipes are old and rusted, then the chances of lead poisoning are very high. Also, contaminants readily dissolve and to a far greater extent in hot water than cold water. So, do not use hot water directly from the faucet under any circumstance. Instead, take cold water from the tap and heat it in a kettle and then consume.3. Hot Water Can Scald:
Sometimes consuming hot water can be harmful and can easily scald the lips and the lining of the mouth, causing minor burns. It is best to first try a small amount of hot water and check its temperature before gulping it down.4. Hot Water Can Also Injure Internal Linings:
If hot water can cause blisters in the mouth, then it can also damage the sensitive lining of the oesophagus and digestive tract. It can have a far reaching effect on your internal organs because the temperature of hot water is higher than the body temperature.5. Drink When You Feel Thirsty:
Studies have shown that if you drink too much hot water when you are not thirsty, chances are that it could affect your concentration levels. Drink only when you have the urge. Too much water can cause brain cells to swell leading to further complications.
[ Read: Side Effects Of Drinking Too Much Water ]
6. Surplus Intake Disturbs Sleep:
Consumption of unnecessary amounts of hot water, particularly before retiring for the night can also lead to affected sleep patterns as the need to visit the toilet at night increases, disturbing sleep.7. More Can Damage Kidneys:
The kidneys have a specialised capillary system to flush out excess water from your body. They do not become cleaner if you think that consuming excess hot water can help filter the toxins from your system. On the contrary, excessive amounts of water can cause damage because of more work that is required to be done by the system. This leads to the deterioration of kidneys over a period of time.8. Additional Water Affects Blood Volumes:
Ingesting more than the required amount of hot water increases the total volume of your blood. The circulatory system is a closed system and unnecessary pressure has to be borne by your blood vessels and heart.9. Excess Water Dilutes Electrolytes:
If there is excess water in the system, the electrolytes in the blood can become more diluted than that in the cells. Water from the blood will be drawn into the cells to maintain the balance between the blood and cells. This will result in the swelling of your cells. In the brain, this will exert cranial pressure and cause headaches and other problems.10. Overindulgence Can Lead To Breathlessness:
Hot water, if consumed without being aware of how much is being consumed, can lead to several complications as seen above. Ultimately the pressure on your brain and circulatory system can result in breathlessness and serious internal injury.
[ Read: Side Effects Of Barley Water ]
Conclusion:
It is a myth that drinking hot water is beneficial to health. Hot water can be harmful if it is full of toxins, such as lead and other contaminants. Hot water can also injure the insides of the gut and digestive system. It can scald the tongue easily. Consume in moderation and as and when needed to avoid health complications.Now that you have understood the serious side effects of drinking hot water, you are going to take care on this note, right? Do you agree with the side effects of drinking too much hot water mentioned above? Please do share with us in the comments section!
![[glass of water]](http://cdn1.medicalnewstoday.com/content/images/articles/314/314505/glass-of-water.jpg)
New case study shows there is such a thing as 'water intoxication.'
Theoretically, this is considered good advice; during a cold, the body secretes more liquids through the nose or may be running a fever, which could lead to more fluid loss.
In the case of infections in general, drinking more water is thought to help with intravascular volume loss, increased vascular permeability, as well as replace the fluids lost in fever and vomiting.
The medical advice to drink plenty of water also rests on the assumption that water consumption is harmless.
A new case report reminds doctors and patients that evidence for the benefits of drinking plenty of water is scarce, and, in fact, drinking too much water can be dangerous.
Water intoxication in a woman with a simple UTI
A new paper, published in BMJ Case Reports, details the case of a 59-year-old woman who drank too much water as a result of her urinary tract infection (UTI).The woman started to feel the symptoms of a recurring UTI, which had flared up several times in her life previously.
In the case of UTIs, drinking more water than usual has been shown to temporarily reduce the number of bacteria in urine, but the reasons for this remain unclear.
Remembering the doctor's advice of drinking half a pint of water every half hour, the woman drank several liters of water that day, but her UTI symptoms worsened. As a result, she presented herself to the emergency department at King's College Hospital in the United Kingdom with symptoms of lower abdominal pain and dysuria.
Urine tests confirmed a UTI, but the patient was otherwise healthy. She had no medical history apart from a recurring UTI, did not smoke or take any medicine or recreational drugs, had no allergies, and was a moderate alcohol drinker.
In the emergency department, the woman was prescribed antibiotics and analgesics for her UTI. However, she soon started displaying new symptoms, such as shakiness and tremor, vomiting, and speech difficulties.
The patient's Glasgow Coma Scale was 15 - she had an attention deficit, was hesitant in speech, and had difficulty finding her words. Otherwise, the patient was healthy.
Because of her speech impairment, doctors considered the possibility of a stroke. Blood tests and a computed tomography (CT) scan quickly revealed this was not the case. However, blood tests showed signs of hyponatremia.
Excessive water consumption may lead to acute hyponatremia
Hyponatremia is a medical condition caused by abnormally low levels of sodium - lower than 134 millimoles per liter.Acute hyponatremia, which develops in less than 48 hours, is considered an emergency, as it can have fatal neurological consequences. Critically low levels of sodium can lead to cerebral edema with increased levels of intracranial pressure and brain herniation. This leads to seizures, coma, and death.
The mortality rate for hyponatremia cases is 17.9 percent.
In the case report, the patient's sodium level was 123 millimoles per liter. The fatality rate for patients with sodium levels lower than 125 millimoles per liter is almost 30 percent.
Water intoxication, which can lead to fatal hyponatremia, has been reported in endurance exercise, in the use of the drug MDMA, and in psychogenic polydipsia - a disorder where the patient drinks large quantities of water compulsively, usually as a result of a psychiatric condition.
After having her water intake restricted to 1 liter per day, the patient's condition improved significantly in the following 24 hours. Sodium levels were back to normal, and the patient was discharged.
Time to question the medical advice to drink plenty of water
The authors of the case study point out that water intoxication, which can lead to hyponatremia, is a rare occurrence among people with normal physiology. If a patient has normal renal function, it is difficult to drink more water than the body can excrete.However, if the levels of antidiuretic hormones are elevated, as is the case in some illnesses, this can reduce the excretion of water. In these cases, the authors ask, how sound is the medical advice to drink plenty of liquids?
The case of the 59-year-old woman is similar to a previously reported case, where a healthy young female drank too much water while experiencing gastroenteritis. As a result, she developed acute hyponatremia and died.
In both situations, the patients followed the doctor's advice, although they overdid the recommended intake of water. As the authors point out:
"Together these two cases highlight the importance of clear history taking, including a collateral, prompt investigation and correction of electrolyte imbalance and, also the need to qualify our advice regarding water consumption in simple infective illness."
They caution that there is an insufficient amount of research demonstrating the benefits of drinking more fluids during infectious illnesses. In fact, they cite a previous review that found "no randomized controlled trials to provide definitive evidence" of the benefits of such medical advice.
Authors urge doctors not to ignore serum electrolyte levels when presented with a healthy adult who displays severe cerebral symptoms.
"The presentation of a previously, healthy adult with acute cerebral symptoms creates a time-critical clinical challenge," they note. "However, this must not detract from the need for a comprehensive collateral history to guide diagnostic approach. A history of excessive water intake combined with possible intravascular depletion should prompt speedy analysis of serum electrolyte levels."
What is the advice?
- Public Health England recommends drinking six to eight glasses of fluid a day, including but not limited to water.
- There is no official guidance as to how much to drink when ill, but Noronha advises no more than 1.5 times the amount you would usually drink.
- Noronha says water is generally fine but recommends a rehydrations sachet if suffering from gastroenteritis.
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