How Much Is Too Much Water? Understanding The Balance Between Sufficient Water Intake And Overhydration

KUALA LUMPUR, Aug 19 (Bernama) -- The question of how much water is too much has long been a pivotal discussion in the health and wellness circle, and as individuals increasingly prioritise their hydration levels, comprehending the delicate balance between adequate intake and potential overhydration becomes paramount.

Consultant nephrologist and internal medicine physician at Sunway Medical Centre Velocity (SMCV) Dr Radzi Rodzlan Akib discusses hyponatremia, which means low blood sodium level, or in simple terms salt level and its profound health implications.

According to Dr Radzi, various factors can contribute to this condition, and diagnosing hyponatremia necessitates a thorough assessment, including a medical history review, physical examination, and blood and urine tests to determine its underlying cause.

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“Excessive water intake is one of the factors that causes hyponatremia, which manifests from low blood sodium levels due to overhydration,” he told Bernama in an exclusive interview.

He said the kidneys are crucial in maintaining the body's salt and water balance by regulating the excretion and reabsorption of water and electrolytes, including sodium, ensuring that these levels remain within a narrow range, which is essential for normal cellular function.

“If the kidneys are unable to manage this excessive water intake, it can lead to hyponatremia due to an imbalance where the intake exceeds the output,” he said.

Dr Radzi also shared that he often addresses patient inquiries about appropriate water intake by advising them to heed their body's natural thirst cues.

“I always advise my patients to drink when they feel thirsty. Your body diligently monitors blood composition, hormone levels, and sodium levels, signalling when the body has consumed adequate water and should cease intake,” he added.

He explained that certain demographics, particularly endurance athletes like marathon runners and triathletes, face higher risks of hyponatremia and its related complications due to their increased water consumption during rigorous physical activities.

He said in such cases, due to a large volume of water intake in a short duration of time, with the hormonal changes during the intense and rigorous activities, the person is at risk of getting severe hyponatremia and leads to brain swelling which is life-threatening that needs urgent medical attention.

“Preparation is key. Consult your doctor for advice before embarking on such a journey. Adequate fluids intake during the rigorous activity with fluids containing electrolytes and not just plain water is important,” explained Dr Radzi.

Dr Radzi said the elderly constitute another at-risk group due to several factors such as underlying medical conditions or conditions that can cause water retention in the body such as kidney, heart or liver failures, if they are taking certain medications, having low salt intake, and problems with the kidneys' ability to concentrate and dilute urine due to ageing.

“Patients with psychiatric illnesses such as those with psychogenic polydipsia (excessive or abnormal thirst), eating disorders, schizophrenia or bipolar disorder can exhibit excessive drinking behaviours, which can then lead to hyponatremia,” he said highlighting that family members of the elderly group and those with psychiatric illnesses need to ensure that they are following doctor's treatment and attend follow-ups regularly.

Dr Radzi said early symptoms of hyponatremia include mild headache, decrease in attention span may occur, and worrying symptoms at a later stage include the major degree of confusion, a decreased level of consciousness, nausea, vomiting, seizures, or even coma”.

He also shared that monitoring your urine colour would be a good indicator if you are drinking adequately or if you need to drink more water.

“If your urine is clear, it is a sign that you are well hydrated and if your urine is concentrated, it indicates that you are dehydrated for which you will be feeling thirsty – thus it is a good indicator to consider whether you need to drink more or if you have drink sufficiently,” he advised.

Dr Radzi said the treatment for hyponatremia is individualised based on the patient's symptoms and generally, it involves addressing the underlying cause, restricting fluids, and increasing sodium intake through supplements or intravenous solutions, especially hypertonic saline for severe cases.

“Regular monitoring of serum sodium levels and patient symptoms is crucial to avoid rapid correction and complications such as osmotic demyelination syndrome. The approach should be individualised to ensure safe and effective management of the condition,” he added.

In addition to medical advice, Dr Radzi emphasised the importance of a healthy lifestyle, encouraging Malaysians to adopt balanced diets, engage in regular exercise, and prioritise sufficient sleep, while urging the younger generation to prioritise their health amidst the pressures of work and daily life.

“Life can be busy nowadays, but it's essential to maintain a healthy lifestyle with work-life balance, adequate sleep, a nutritious diet, maintain good hydration and regular exercise,” he concluded.

-- BERNAMA

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