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Can You Drink Too Much Water?
Image Credit: Canva
SummaryDrinking excessive water can lead to water intoxication, causing symptoms like confusion, nausea, and seizures; severe cases may be fatal.
From controlling body temperature and flushing out toxins, adequate hydration plays a vital role in our general health and well-being, water is a life essential. However, while dehydration garners significant attention, overhydration, or drinking excessive amounts of water, is a condition that can have serious and sometimes fatal consequences.
Although it may sound bizarre since drinking water is said to be the solution for most health related problems it is important to recognize how much water is considered "too much" or the risks involved with being overhydrated can maintain a healthy balance.
What Is Water Intoxication?
Water intoxication, also termed hyperhydration, water poisoning or water toxemia, develops when an individual drinks much more water than the kidney can excrete. The main function of the kidneys in the human body is the processing and excretion of excess water. However, the human kidneys can process only up to 0.8 to 1.0 liters of water at a time. Drinking an amount that exceeds this may overwhelm the kidneys and put the electrolyte balance out of sync in the human body.
Electrolytes, especially sodium, are essential in maintaining fluid balance within and outside cells. Hyponatremia is the condition when sodium levels fall below 135 mmol/L, resulting from excessive water intake. This causes water to shift into cells, swelling them. In the brain, this can cause severe complications, including coma or even death.
Symptoms of Water Intoxication
The symptoms of water intoxication vary from mild to severe. Early symptoms are often similar to dehydration, which makes self-diagnosis challenging. Common symptoms include:
- Headaches
- Nausea and vomiting
- Muscle cramps or weakness
- Fatigue or drowsiness
- Confusion and disorientation
In more serious cases, water intoxication can cause seizures, loss of consciousness, or swelling in the brain. These complications can be fatal if left untreated.
A notable case occurred in 2007 when a woman participating in a water-drinking contest tragically died after consuming nearly two gallons of water in under two hours. More recently, actress Brooke Shields experienced a grand mal seizure attributed to excessive water consumption.
Causes of Water Intoxication
Water intoxication is rare, but certain scenarios can increase the risk:
1. Sporting Events and Endurance Training
These endurance athletes are prone to water intoxication, especially if they drink large amounts of water without replacing lost electrolytes. Hyponatremia usually happens during long races or marathons as individuals mistake fatigue and muscle cramps for dehydration and continue drinking water in excess.
2. Military Training
Overhydration among military personnel is usually due to severe physical activity in extreme environmental conditions. The total number of hyponatremia cases documented from 2007 through 2022 for the active duty in the United States exceeds 1,600, with a note to this problem on exertion-related overhydration.
3. Mental Health Conditions
Compulsive water drinking, known as psychogenic polydipsia, is linked with some mental illnesses such as schizophrenia and psychosis. People with these conditions tend to drink too much water, causing a hazardous electrolyte imbalance.
4. Drug Abuse
Drugs such as MDMA (ecstasy) raise the body temperature and make people thirsty, and at times, some people tend to drink excess water at events like music festivals. MDMA also leads to urine retention, thus exacerbating the dangers of water intoxication.
How Much Water Is Too Much?
The exact amount of water that causes intoxication varies from one person to another. However, drinking more than 1 liter of water per hour for several hours raises the risk. For healthy individuals, the risk of overhydration is low unless taking part in extreme physical activity or ignoring thirst cues.
Certain medical conditions, such as kidney or liver disorders, can impair the body's ability to process fluids, and even moderate water intake may be harmful. Similarly, certain medications, such as diuretics and antipsychotics, can affect the perception of thirst or fluid regulation.
How Much Water Is Enough?
The widely touted recommendation of eight 8-ounce glasses of water per day has little basis in fact. According to the National Academy of Medicine, a daily total fluid intake is about 15 cups (3.7 liters) for males and 11 cups (2.7 liters) for females, from beverage sources and from food. Usually, about 20 percent of daily hydration comes from foods such as fruits and vegetables.
A better rule of thumb is to listen to your body and drink water based on thirst. Use the color of your urine as an indicator:
- Light yellow urine indicates proper hydration.
- Dark yellow urine may indicate dehydration.
Older adults, whose thirst mechanisms may decline with age, should be proactive about maintaining hydration, especially during illness or hot weather.
Water Intoxication vs. Dehydration
The symptoms of water intoxication—such as headaches, fatigue, and muscle weakness—are similar to those of dehydration. If you are unsure which condition you are experiencing, seek medical attention immediately rather than self-treating with more water.
Preventing Water Intoxication
To avoid the dangers of overhydration:
- Drink water gradually throughout the day rather than consuming large amounts at once.
- Replace lost electrolytes post high-intensity exercise or heavy sweating.
- Consider using sports drinks or salty snacks to help replenish sodium.
- Keep track of fluid consumption during long-duration activities, and do not consume more water than the body is losing in terms of electrolytes.
- If on medications or have specific medical conditions, check with your doctor regarding the safety of drinking water.
For signs of severe water intoxication-including confusion, drowsiness, seizures, and loss of consciousness-customer is advised to seek medical assistance immediately. In the meanwhile, a salty snack would help to temporarily correct low sodium levels.
Hydration is important to health, but overhydration can be a serious risk; the secret is in finding a balance. Drink enough water to satisfy your body, but not so much that it overwhelms your system. Remember, water is life, but moderation keeps it that way.
Hyponatremia (low sodium level in the blood). National Kidney Foundation. 2023.
Water Toxicity. NIH. 2023
Exercise-Associated Hyponatremia: 2017 Update. Front Med (Lausanne). 2017
End of Article