Overhydration: Types, Symptoms, and Treatments (2024)

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Drinking too much water can be dangerous. Some health conditions can also make your body retain too much water, regardless of how much you drink.

All of the major systems of your body depend on water to work properly. Having enough water helps your body:

  • regulate temperature
  • prevent constipation
  • flush out waste products
  • perform all major bodily functions

Most people, especially those who exercise in hot weather, are concerned about not drinking enough water. However, it’s possible to have too much water in your body. This can cause water toxicity. This is when your body’s water is more than your kidneys can excrete. It can lead to a dangerous electrolyte imbalance.

Read on to learn how this can happen, how much water is too much, how to recognize the signs, and what to do.

You can become overhydrated in two ways: By drinking too much water or if your kidneys retain too much water.

In both cases, overhydration can lead to water toxicity, also known as water poisoning. Your body’s water volume becomes too large for your kidneys to excrete, which can cause the electrolytes in your body to dilute.

When the amount of sodium (salt) becomes too diluted, you develop hyponatremia. This is the main concern of overhydration. When the sodium levels in your body are greatly reduced, fluids move inside your cells, leading to inflammation.

Increased water intake

This occurs when you drink more water than your kidneys can remove from your urine. Endurance athletes, such as those who run marathons and triathlons, sometimes drink too much water before and during an event. In healthy people, athletes are at the highest risk for overhydration.

Certain conditions and drugs can also cause increased water intake by making you extremely thirsty. These include:

  • schizophrenia
  • MDMA (commonly known as ecstasy)
  • antipsychotic drugs
  • diuretics

Retaining water

This occurs when your body can’t get rid of water properly. Several medical conditions can cause your body to retain water. These include:

  • congestive heart failure (CHF)
  • liver disease
  • kidney problems
  • syndrome of inappropriate antidiuretic hormone
  • nonsteroidal anti-inflammatory drugs
  • uncontrolled diabetes

The Institute of Medicine has established guidelines for adequate water intake. They recommend that a healthy adult drink 78–100 ounces (oz) (about 9­–13 cups) of fluids per day on average. It’s also important to remember that the food you eat, such as vegetables or fruit, also contains water.

That being said, the amount of water you need to drink can vary and should roughly equal the amount your kidneys release. Children and adolescents may have lower requirements than adults.

It’s also important to remember that water needs vary with sex, weather, activity level, and overall health. Common situations such as extreme heat, significant activity, and illness with fever may require more fluid intake than average.

You may not recognize symptoms of overhydration in its early stages. However, urine is a good indicator of hydration status in a healthy person.

Pale yellow urine that looks like lemonade is a good goal. Darker urine means you need more water. Colorless urine means you are overhydrated.

If you get hyponatremia from water toxicity, you’ll likely experience the following:

  • nausea and vomiting
  • headache due to pressure on the brain
  • changes in mental state, such as confusion or disorientation
  • drowsiness
  • muscle cramps

Ultimately the swelling of brain cells will cause your central nervous system to malfunction. Without treatment, you can experience seizures, enter into a coma, and ultimately die.

Death from drinking too much water in healthy people is rare, but it can happen, especially in athletes. Usually, water toxicity occurs along with an underlying medical condition that causes the kidneys to retain fluid.

Can drinking too much water be fatal? Learn more.

Water toxicity from overhydration is more common among endurance athletes who drink large amounts of water before and during exercise. It has been reported among:

  • people who run marathons and ultramarathons (races longer than 26.2 miles)
  • ironman triathletes
  • endurance cyclists
  • rugby players
  • elite rowers
  • military members involved in training exercises
  • hikers

This condition is also more likely in people with kidney or liver disease. It can also affect people with heart failure.

A doctor will ask about your medical history to determine if your symptoms are caused by water toxicity, hyponatremia, or another condition.

The doctor will also perform a physical examination, and they may order blood and urine tests to check the level of sodium and other markers in your body.

They may observe you for a time to see how much fluid you are taking in versus how much you release in urine or stool. They may measure your weight to watch for changes indicative of insufficient fluid loss.

If you have more obvious water toxicity symptoms, the doctor may identify these sooner and initiate treatment.

How you’re treated depends on whether you show symptoms of water toxicity and what caused the condition. Treatments may include:

  • cutting back on your fluid intake
  • taking diuretics to increase the amount of urine you produce
  • treating the condition that caused the overhydration
  • stopping any medications causing the problem
  • replacing sodium in severe cases

Endurance athletes can reduce the risk of water toxicity from overhydration by weighing themselves before and after a race. This helps determine how much water they have lost and need to replenish.

While there are different guidelines, they generally recommend drinking 14-22 oz of fluid about two-three hours before exercise or physical activity.

If exercising longer than an hour, sports beverages are also an option. These drinks contain sugar and electrolytes such as sodium and potassium, which you lose in sweat. Let thirst also guide you when exercising. If you’re thirsty, drink more.

However, if you are an endurance athlete or planning on starting an endurance training program, you want to talk with your doctor to get hydration advice tailored specifically to you.

The following are the answers to some common questions about overhydration.

How much water a day is overhydration?

Healthy adult kidneys can eliminate about 1 liter (l) or 0.2 gallons (gl) of water per hour. Although no specific amount of fluids can cause overhydration for a person, it’s a good idea not to drink more than your kidneys can handle.

Kidneys of children and older people may be less efficient at removing water, so you should consult with a primary care doctor or pediatrician to understand the appropriate amount. Some doctors recommend that the number of daily cups of water a child drinks should equal their age.

Can overhydration cause permanent damage?

Drinking too many fluids can cause water toxicity by diluting your body’s sodium and other electrolytes, which may cause your cells to swell, including the cells in your brain. This is a life threatening condition. If left untreated, it may cause permanent brain damage and death.

How long does it take to recover from overhydration?

Your recovery will depend on the severity of your symptoms. If you progress to water toxicity, you will need to be hospitalized. If you experience any symptoms associated with overhydration, contact your doctor.

Overhydration due to drinking too much water causes water toxicity, an electrolyte imbalance that can cause symptoms ranging from nausea and headache to unconsciousness and coma.

To avoid overhydrating, try to drink no more than about 9­–13 cups of fluids per day. If you have a medical condition such as diabetes, CHF, or kidney disease, talk with your doctor about the best treatments.

Also, contact your doctor if you’re unusually thirsty. This could signify a medical problem that needs to be treated.

Overhydration: Types, Symptoms, and Treatments (2024)

FAQs

What are the types of overhydration? ›

You can become overhydrated in two ways: By drinking too much water or if your kidneys retain too much water. In both cases, overhydration can lead to water toxicity, also known as water poisoning.

How is overhydration treated? ›

Doctors may have you: Limit the amount of fluid you drink, often less than 4 cups (32 ounces) a day for several days. Sometimes, take medicines that make you urinate more (diuretics, sometimes called water pills) Be cared for in the hospital to adjust your fluids and electrolytes if they are severely out of balance.

What is the medical term for excessive water intake? ›

Polydipsia is the medical definition of excessive thirst. Excess thirst is an abnormal urge to drink fluids at all times.

What organ is most affected by overhydration? ›

Your brain cells are the most likely to be impacted by swelling or low sodium levels. If you are slightly overhydrated, you may have no symptoms, have mild fatigue, or feel distracted. If you don't drink too much water too quickly, the brain cells can adapt to the extra fluid in your body.

How can you tell if someone is overhydrated? ›

However, if you suspect you may be overhydrated, look for symptoms like cloudy thinking, nausea and vomiting, muscle weakness, spasms or cramps and headaches. In severe cases symptoms could include mental confusion, seizures, unconsciousness and even coma.

Can overhydration be reversed? ›

Overhydration can be treated. If you are otherwise healthy and have mild symptoms, simply cutting back on the amount of fluid you are drinking will do the trick. You should start to feel better in a few hours. If you have more serious symptoms, such as confusion, you need to seek medical attention immediately.

How do you treat excess water in your body? ›

Treatment for fluid retention
  1. a low-salt diet.
  2. diuretics (water pills)
  3. treatment for the underlying medical condition – such as hormone replacement (thyroxine) in the case of hypothyroidism.
  4. lifestyle changes in response to the underlying medical condition – such as avoidance of alcohol if liver disease is the cause.

What are the signs of electrolyte imbalance? ›

What are electrolyte imbalance symptoms?
  • Confusion and irritability.
  • Diarrhea or constipation.
  • Fatigue.
  • Headaches.
  • Irregular or fast heart rate (arrhythmia).
  • Muscle cramps, muscle spasms or weakness.
  • Nausea and vomiting.
  • Numbness or tingling in limbs, fingers and toes.

How to fix too much electrolyte? ›

Treatment. If you think you have consumed too many electrolytes, you should seek medical care immediately. Sometimes fluids and certain medications can help balance levels, but medical supervision is important to help safely resolve any electrolyte toxicity.

Why is my body absorbing too much water? ›

Overhydration is an excess of water in the body. People can develop overhydration if they have a disorder that decreases the body's ability to excrete water or increases the body's tendency to retain water. Drinking too much water rarely causes overhydration because normal kidneys easily excrete excess water.

Why am I taking too much water? ›

Overhydration can occur when people drink much more water than their body needs. People, particularly athletes, who drink excessive water to avoid dehydration can develop overhydration. People may also drink excessive water because of a psychiatric disorder called psychogenic polydipsia.

Is 2 gallons of water a day too much? ›

Drinking a gallon of water a day is usually safe for most, but drinking too much water can be risky for those with certain health conditions like kidney disorders or heart problems, says Ellen Landes, RDN, CPT, a registered dietician based in St. Charles, Illinois, and owner of The Runner's Dietitian.

How do you fix overhydration quickly? ›

#2: Severe overhydration symptoms

Severe overhydration symptoms include seizures, coma, abnormal posturing (a sign of brain damage), and dilated pupils. In these cases, seek immediate medical attention. Urgent treatment with IV hypertonic saline fluids (saltwater) can help prevent brain damage or death.

What happens when your body retains too much fluid? ›

Swelling. You may have swelling in your feet, legs, hands, or face. Swelling caused by too much fluid in your body is called edema. It is called pitting edema if you can press on the area of swelling with your thumb and it makes an indentation.

What organ removes excess water? ›

Healthy kidneys filter about a half cup of blood every minute, removing wastes and extra water to make urine. The urine flows from the kidneys to the bladder through two thin tubes of muscle called ureters, one on each side of your bladder.

What is hypertonic overhydration? ›

Hypertonic water overload is an increase in body water content associated with increased effective osmolality of body fluids.

How many glasses of water is overhydration? ›

What is overhydration? Drinking more than 3½ cups to 4 cups of water in an hour may lead to overhydration. It's better to sip gradually throughout the day than to swig a pitcher of water quickly. Overhydration causes an electrolyte imbalance.

Which 3 foods are over 90% water? ›

High in fiber, celery can be chopped up and added to chicken salad, dipped into some hummus, or slathered with peanut butter for the kiddos.
  • WATERMELON: 92% water. Sweet and succulent, watermelon is a staple of summer picnics. ...
  • ZUCCHINI: 94% water. ...
  • STRAWBERRY: 92% water.

What are some of the different ways you can hydrate? ›

Water is the most common hydration solution, but you can also rehydrate your body with other liquids, nutritious foods, and IV therapy. Healthy fruits and vegetables, sports drinks, and other substances are tastier than water and can replenish the body with essential vitamins and nutrients.

References

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