Drinking enough water is a health message that’s been broadcast loud and clear. But there can be too much of a good thing.
“Some people are such water-drinking devotees that they are aquaholics,” says Manhattan osteopathic physician Christopher Calapai.
The result is overhydration, or hyponatremia, which is a term used to describe a low concentration of sodium in the blood that can be dangerous or even life-threatening.
Overhydration is the most common electrolyte imbalance in hospitals, occurring in about two percent of all people, Calapai says. And although rare, hyponatremia has claimed the lives of marathon runners and military recruits.
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There are a few ways overhydration can happen.
“A person may drink too much water during exercise,” Calapai says. “Some medications can also cause dry mouth and cause an increase in thirst. Increased thirst can also be caused by uncontrolled diabetes. Psychiatric conditions such as can also cause compulsive water drinking.”
Symptoms of hyponatremia may not be recognized in the early stages but can include nausea and vomiting, headache, confusion or disorientation. When sodium levels get extremely low, people may experience muscle weakness, spasms, or cramps; seizures; and unconsciousness or coma.
Thankfully, there are ways to reduce the risk of overhydration.
Generally, people should avoid drinking more than one litre of fluid per hour.
The amount of water an athlete should drink depends on their volume of sweat and the sodium concentration of their sweat– both of which can vary depending on aerobic fitness, exercise intensity, and ambient temperature, according to SportMedBC.
Guidelines of the American Dietetics Association, Dietitians of Canada, and American College of Sports Medicine all state that athletes should drink enough fluid to balance their fluid losses.
To break it down, that means:
- Two hours before exercise, 400 to 600 mL (14 to 22 oz.) of fluid should be consumed.
- During exercise, 150 to 350 mL (6 to 12 oz.) of fluid should be consumed every 15 to 20 minutes, depending on tolerance.
Another reason endurance athletes or anyone taking on intensive athletic exertion should drink plenty of fluids before and during a race or activity is so that that they don’t end up feeling the need to drink excessively afterward.
Sports beverages that contain the electrolytes sodium and potassium are also recommended, since both of those are lost in sweat.
“Because sodium is lost in sweat, it is important for individuals who exercise at high intensity to get adequate sodium before, during and after exercise, especially as they continue to drink water,” SportMedBC explains on its website. “This is even more critical during ultra-endurance competition, for those who are slower (i.e. more than 4 hours, and therefore have more time to drink excessively), and for smaller athletes who can dilute their blood plasma more quickly than larger individuals.”
And while overhydration is a concern, dehydration is much more common, SportMedBC notes.
“It is important for athletes to realize and ‘overhydration’ is a risk mostly associated with ultra-endurance sports and not sports events lasting less than two hours, such as hockey, basketball and soccer, or shorter hikes and runs,” it says. “It is very important to keep the risk of overhydration in perspective.”
Conversely, dehydration has been estimated to occur in up to 80 per cent of athletes in activities such as team sports, tennis, and endurance events. It affects athlete’s physiological homeostasis and performance.
If you experience excessive thirst or an overly strong urge to drink water, contact your doctor, Calapai suggests, as it could indicate a medical condition that requires treatment.
Other tips for being adequately hydrated include:
- Notice how much you pee—and its colour—in the morning. It should be a copious amount and pale or clear.
- Aim to wake feeling hydrated. If you’re thirsty when you get out of bed in the morning, you may not be consuming enough fluids.
- When choosing sports drinks, search for labels with low sugar.
- Remember that coffee, tea, and watery fruits and vegetables count toward fluid intake.
Do you think you might be an aquaholic? Let us know by tweeting to @YahooStyleCA.