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

Update: Exertional Hyponatremia Among Active Component Members of the U.S. Armed Forces, 2007–2022

Urgent action is required to strengthen diagnostics and vaccines to address gaps in dengue treatment, public health experts said.

The experts, including scientists and policymakers, were speaking at a day-long dialogue hosted in New Delhi by the Drugs for Neglected Diseases initiative (DNDi) in collaboration with the Translational Health Science and Technology Institute (THSTI), the Ministry of Health and Family Welfare, and the WHO South-East Asia Region.

The convening assumes significance ahead of the monsoon season, which historically sees a rise in Aedes aegypti mosquito populations and dengue transmission across health systems in South and South-East Asia.

"The WHO South-East Asia Region alone accounts for more than half of the global dengue burden, with 1.3 billion people living at risk across 10 endemic countries," said Dr Catharina Boehme, Officer in charge, World Health Organization, South-East Asia Regional Office.

Dr. Boehme called the rising burden of dengue both an economic crisis and a social crisis. She noted that beyond health system costs, dengue often leads to "lost productivity, lost wages, lost futures".

"To change this trajectory, we must close the gap on diagnostics, on vaccines, on therapeutics, and on health system resilience," Dr. Boehme said.

Also read: New dengue vaccine over 80% effective, prevents severe disease for up to 5 years

India Advancing in Dengue Fight, Gaps Remain

India reported over 2.89 lakh dengue cases in 2023, though experts believe the actual burden could be significantly higher due to underreporting and surveillance gaps.

Taruna Madan Gupta, Scientist G and Head, Development Research Division, ICMR, called dengue an "unequivocally a national health priority for India."

Gupta noted that "India is advancing on multiple fronts—from strengthening public health systems to enabling public-private partnerships, including Phase III trials of an indigenous tetravalent dengue vaccine with over 10,000 participants, and regulatory progress on global vaccines".

However, the expert flagged a critical gap, which is "the absence of an effective therapeutic" for the mosquito-borne disease.

The experts noted that even though there are improvements in surveillance and scientific understanding, patients still lack access to specific treatment options.

“Addressing this gap requires sustained commitment from governments, funders, and partners," said Dr Sanjay Sarin, Continental Lead Asia and Director South Asia, DNDi.

What Is Dengue?

Dengue fever is a viral disease transmitted by Aedes mosquitoes, which are most active during the daytime. Dengue fever typically has minor or no symptoms, but it can occasionally result in severe sickness, hospitalization, and even death.

Common Symptoms include:

• Sudden onset of high-grade fever.
• Intense headache
• Severe muscle, joint, or bone pain.
• Skin Rash that often appears 2–5 days after the fever starts
• Nausea and Vomiting
• Fatigue

It estimates that:

• About 390 million dengue infections occur annually worldwide
• Nearly 100 million people develop symptoms each year

These vaccines are designed to protect against all four serotypes of the virus, with a focus on reducing severe disease and hospitalizations.

In today’s fast-paced, wellness-driven world, looking fit does not always translate to being reproductively healthy. Currently, even fit and active individuals are facing fertility challenges due to hidden hormonal and metabolic imbalances. Hence, it is necessary to focus on reproductive health. Dr. Meenu Handa, Director of Fertility & Head Academic of Reproductive Medicine, Motherhood Hospitals, Gurgaon, decoded the link and listed some of the common fertility issues that most people overlook.

Now, a large number of people are opting for various activities such as yoga, Zumba, Pilates, the gym, and kickboxing to stay fit. Those who are health-conscious are also maintaining an optimum weight with a proper diet. These habits, in turn, can help to ensure good fertility. Shockingly, many people who are perfectly fit and fine on the outside may also struggle with fertility problems. Yes, that is right! This is also a common occurrence nowadays. Couples are panicking as they seem to adhere to a well-balanced lifestyle but still fail to conceive. So, this can be referred to as “invisible fertility issues," where underlying hormonal or metabolic imbalances silently affect reproductive health.

Decoding invisible fertility issues

Dr Handa said that many men and women who exercise regularly may suffer from issues such as hormone imbalance, fluctuating insulin levels, poor thyroid function, and compromised reproductive organ health. Conditions like polycystic ovary syndrome (PCOS), thyroid disorders, insulin resistance, and even chronic stress can exist without obvious physical signs and can take a toll on fertility. The expert also shared some of the common hidden infertility issues.

Even couples who are physically fit today often deal with high mental stress due to demanding jobs and poor work-life balance. This ongoing stress can quietly disturb hormonal balance in the body. Increased cortisol levels may affect ovulation in women and sperm production in men and, over time, can impact egg and sperm quality—making natural conception more difficult. That is why managing stress is just as important as staying physically fit when planning a pregnancy.

Women may have issues like poor ovulation, compromised egg quality, or hormonal imbalance, even if their menses tend to be regular. In some cases, even subtle symptoms like fatigue, acne, hair fall, or mood swings may be overlooked but can signal deeper hormonal concerns. Men can struggle with low sperm count, which can affect their fertility. Even insufficient sleep, excessive exercise, or extreme dieting can increase the chances of hormonal imbalance and fertility issues. It is necessary to consult an expert and seek timely help. Pollution and lifestyle stress also contribute to the trend.

Couples should not just plan a pregnancy because they are fit and exercise daily. Pregnancy should not rely only on outward fitness as a sign of reproductive health. Regular health check-ups, including hormone tests and fertility assessments, can help identify hidden issues early.

Follow these tips

1. Couples should eat a well-balanced diet, exercise daily, stay stress-free by practicing yoga and meditation, and get enough rest.
2. It is also imperative to maintain blood pressure and blood sugar levels within the recommended range, include healthy fats and proteins in the diet, avoid overtraining, and manage stress through relaxation techniques like yoga or meditation, which can support hormonal balance.
3. If a couple is unable to conceive even after 6–12 months of trying (depending on age), a detailed fertility evaluation is recommended.
4. Seeking timely medical advice is equally important if conception is delayed.
5. Couples who find it challenging to conceive may be advised to use ARTs, such as in vitro fertilisation (IVF).

So, awareness, balanced lifestyle choices, and timely medical support can make a huge difference in improving fertility outcomes.

A heatwave is getting worse with each passing day, and with it come dehydration, stomach flu, and sometimes even mood swings. But little do people realise that the risks associated with a heatwave could be much worse - it turns out that exposure to extreme heat could also give you a stroke. Dr Deep Das, Consultant - Neurology, CK Birla Hospitals, CMRI, in an interview with Health and Me, decoded the link between heatwaves and the risk of stroke.

How does a heatwave affect stroke risk?

Dr Das said that in very high temperatures, the body does not always cope in predictable ways. The brain is particularly sensitive to these shifts. One of the concerns is stroke. In the heat, people tend to lose fluids without realising how much. Blood volume drops, and circulation is affected. In some cases, the blood becomes more prone to clotting. At the same time, blood pressure can fluctuate. This combination increases the chances of a disruption in blood flow to the brain.

Can extreme heat give you a seizure?

Seizures are another risk, especially in those who already have epilepsy. Even when the condition has been stable, heat can unsettle things. Dehydration and changes in electrolyte balance make the brain more reactive than usual. A person who has been well-controlled for months may still have an episode during a prolonged heatwave. What makes this difficult is that these changes are not always gradual. Symptoms can appear suddenly.

What are the symptoms of a stroke?

A stroke refers to a potentially fatal medical emergency. It can be sudden or gradual, and it is characterised by a blockage in blood circulation to the brain. It can result in rapidly dying brain cells and requires immediate medical attention. The symptoms of stroke can be identified as FAST:

1. Face: Face drooping on either side
2. Arms: Weakness in the arms or inability to move the arms
3. Speech: Slurred speech
4. Time: Time is an important factor; immediate action can be life-saving for stroke patients

Apart from this, other symptoms of a stroke are:

1. Severe, unusual headaches
2. Confusion
3. Loss of consciousness
4. Dizziness
5. Loss of balance
6. Inability to see clearly from one or both eyes

How to dodge a heatwave-related stroke?

In this weather, small precautions matter more than they seem. Some of the best ways to dodge a stroke amid a heatwave are:

1. Drinking water regularly helps, even before you feel thirsty
2. Staying indoors during peak afternoon hours reduces strain on the body
3. Living spaces need some form of airflow, even if it is basic ventilation

It also helps to keep an eye on people who may not notice these changes early—older adults, those living alone, or anyone with an existing medical condition.

Should you be worried?

Some people are more prone to stroke risk than others. Therefore, it is important to be aware of the risk factors, especially during a heatwave. If you are dealing with any of the following comorbidities, think twice before stepping out amid a worsening heatwave:

1. Hypertension
2. Diabetes
3. Irregular heartbeat
4. Sleep apnoea
5. High cholesterol

Furthermore, people who are 65 years and above must avoid stepping out from 12 noon to 4pm. Even people who have a family history of stroke must not step out during these hours.