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

Delhi's air quality deteriorated significantly after Diwali. Several monitoring stations recorded ‘severe’ air quality on Monday morning (November 9) after a night of Diwali festivities which resulted in widespread emission of firecracker smoke. It worsened the situation in a city already grappling with soaring air pollution due to vehicular exhaust, construction dust and stubble burning in neighbouring states.

Due to this, Delhi residents, who continue to breathe polluted air, may face symptoms like scratchy throat, coughing and irritation. But how can you tell whether your sore throat is caused by pollution or an infection that needs medical attention?

How Does Air Pollution Cause A Sore Throat?

Polluted air contains particulate matter, including PM2.5, as well as gases and other irritants. When inhaled, these pollutants come into contact with the lining of the nose, throat and respiratory tract, triggering irritation and inflammation.

Dr. Rahul Sharma, Director, Pulmonology & Critical Care, Fortis Greater Noida told HealthandMe, “People exposed to high levels of pollution may experience throat irritation, dryness, a burning sensation, frequent coughing and discomfort while swallowing. These symptoms may be more noticeable in people who spend long hours outdoors and are difficult to control.”

People with asthma, allergies or existing respiratory conditions may be more sensitive to these pollutants.

Dr Sharma added, “Pollution can also aggravate existing respiratory conditions like asthma and allergic airway disease. It is important to remember that a sore throat is not always due to infection; environmental exposure can also be a cause.”

Also read: El Niño Could Worsen Dengue, Malaria And Heat Illness: Why WHO Declared A Health Emergency

Pollution-Related Sore Throat Or Infection?

The symptoms can overlap, so a sore throat alone cannot establish its cause. However, certain accompanying signs may offer clues. Experts help us understand when a sore throat is a result of inhaling particulate matter.

Dr. Sushil Upadhyay, Consultant Pulmonologist, Kailash Deepak Hospital, Delhi told HealthandMe, “Throat irritation as an early sign. A scratchy throat is the canary in the coal mine for lung inflammation. It is the first sign that your airways defenses are overwhelmed and deep inflammation is starting.”

A pollution-related sore throat is more likely to involve dryness, scratchiness, coughing and irritation of the eyes or nose.

Dr Samir Garde, Director of Dept of Pulmonology and Lung Transplant, Gleneagles Hospital, Parel, told us, “Pollution-related irritation usually causes a dry or scratchy throat, coughing and eye irritation, which may worsen outdoors or during periods of poor air quality.”

An infection, on the other hand, may be accompanied by fever and other symptoms. They may include body aches, swollen lymph nodes, painful swallowing, tonsil inflammation or white patches on the tonsils. Viral infections can also cause a runny nose, cough and fatigue.

Dr Upadhyay said, “The flu brings high fever, body aches, and extreme exhaustion. If staying inside an air-conditioned, filtered room clears your throat, it's pollution. Otherwise, think of it as flu.”

A bacterial infection such as strep throat may cause sudden throat pain, fever and difficulty swallowing, sometimes without a cough.

Also read: New COVID-19 Variant PJ.2.1 Spreads Globally: WHO Says Symptoms Resemble Cold, Flu

When Should You See A Doctor?

A mild sore throat often improves within a week. However, medical evaluation is recommended if you have difficulty breathing, cannot swallow, are drooling because you cannot swallow, or experience rapidly worsening symptoms.

Dr Upadhyay said, “Do not ignore a sore throat if it moves to your chest. If you develop wheezing, severe breathlessness or a fever, you need a medical evaluation immediately. Seek help right away if you are gasping for air or cannot finish a single sentence in one breath.”

Persistent hoarseness, a lump in the neck or a mouth ulcer lasting more than three weeks should also be evaluated.

Dr Garde recommended, “Seek medical attention if there is chest tightness, high fever or persistent symptoms. Severe breathlessness, bluish lips or difficulty speaking due to breathing problems require immediate emergency care.”

Also read: Delhi AQI Crosses 2,000 Mark After Diwali: What Happens To Your Body Within Hours Of Exposure?

How Can You Protect Your Throat During Severe Pollution?

According to the doctors, while pollution levels remain high, reducing exposure is important. They recommend:

• Avoid outdoor exercise and limit unnecessary time outside.
• Wear a well-fitting N95 or N99 respirator when going outdoors.
• Keep windows closed during periods of high outdoor pollution and use a HEPA air purifier if available.
• Drink enough water to prevent throat dryness.
• Gargle with warm salt water to soothe irritation.
• Avoid smoking, incense and other indoor sources of smoke.

Do not start antibiotics just because your throat hurts. Antibiotics do not treat throat irritation due to pollution or viral infections. They should only be used when prescribed for a confirmed bacterial infection under doctor’s supervision.

Delhi AQI After Diwali

The city's average Air Quality Index (AQI) reached 406 on November 9, placing it in the 'severe' category, according to the Central Pollution Control Board (CPCB).

But private monitoring platform AQI.in reported an AQI of 2,283, classifying the air quality as ‘hazardous’. The reading showcased a grim post-Diwali pollution peak, an issue that has turned into an annual environmental crisis.

The stark difference in readings is because India’s AQI scale is limited to 500 while other private air quality monitoring platforms measure higher readings. So even if CPCB’s data shows 500 AQI, it can mean that the amount of harmful pollutants could be much higher.

The Supreme Court had implemented restrictions on celebrating Diwali with firecrackers by limiting time between 6 am and 7 am and 8 pm and 10 pm on November 7 and 8 and allowing only green crackers. However, firecrackers were reportedly burst beyond permitted hours.

Ahead of World Diabetes Day observed on November 14, singer Nick Jonas recently opened up about living with type 1 diabetes for almost 21 years. Diagnosed at the age of 13, Jonas spoke about his daily decision-making that revolves around managing the condition. From monitoring blood glucose levels to adjusting insulin doses around meals and physical activity, Jonas expressed the emotional challenges of living with the disease.

In an open letter written for Dexcom's A Letter to Diabetes campaign, Jonas described the condition as an ongoing part of his everyday life. “Twenty-one years, and you haven’t changed a bit,” he wrote, addressing diabetes.

He also explained how frequently he has to monitor his glucose levels and make treatment decisions. “Staring at my phone to see where my glucose is. Reaching for my pump to bolus because I’m about to eat something with 17 carbs. Those are just a couple of the hundreds of little decisions I make every week,” Jonas wrote.

He described diabetes as “an ongoing conversation between your body, your mind, and your devices.”

The singer also recalled the emotional challenges of living with a chronic condition. However, he said that speaking openly about diabetes helped him find a sense of community and connect with others experiencing similar challenges.

What Is Type 1 Diabetes?

Also read: Can Ozempic, Mounjaro Drugs Protect The Brain? What A New Review Found

Type 1 diabetes is a chronic autoimmune condition in which the body's immune system mistakenly attacks and destroys beta cells that produce insulin in the pancreas.

Insulin is a hormone that helps move glucose from the bloodstream into cells, where it is used for energy. When the body produces little or no insulin, glucose builds up in the blood, resulting in high blood sugar levels.

Type 1 diabetes is different from type 2 diabetes as the latter occurs due to insulin resistance and can be a result of genetic and lifestyle factors. In short, type 1 diabetes is not caused by eating excessive carbohydrates and sugar, obesity or leading an inactive lifestyle.

Type 1 diabetes can also develop at any age, although it is frequently diagnosed during childhood or adolescence.

Symptoms Of Type 1 Diabetes

Also read: High-Fibre Diet Outperforms Metformin In Blood Sugar Control And Weight Loss, Study Finds

Symptoms can develop quickly, sometimes over a few weeks. Common warning signs include:

• Excessive thirst: Constantly feeling thirsty even after drinking water.
• Frequent urination: One may feel the urge to urinate frequently as the kidneys attempt to remove excess glucose through urine.
• Unexplained weight loss: The body starts breaking down fat and muscle for energy when it cannot use glucose properly.
• Increased hunger: Cells are unable to access enough glucose for energy.
• Extreme fatigue: High blood glucose and reduced energy availability can cause chronic tiredness.
• Blurred vision: Changes in blood glucose can affect the fluid balance in the eyes.

If type 1 diabetes is not diagnosed and treated on time, it can lead to diabetic ketoacidosis (DKA), a life-threatening complication.

Warning signs including nausea, vomiting, abdominal pain, deep or rapid breathing, fruity-smelling breath and confusion need immediate medical attention.

Management Of Type 1 Diabetes

Managing type 1 diabetes involves maintaining blood glucose levels within a specific target range to reduce the risk of both high and low blood sugar. Treatment includes:

1. Insulin Therapy

People with type 1 diabetes need insulin throughout their lives. It may be administered through multiple daily injections or an insulin pump which delivers insulin continuously.

2. Regular Glucose Monitoring

Blood glucose can be monitored using instant finger-prick tests or continuous glucose monitoring (CGM) devices. CGM systems use a sensor to track glucose levels throughout the day and night.

3. Dietary Management

People with type 1 diabetes need to understand how carbohydrates affect blood glucose levels so they can adjust insulin doses accordingly.

4. Physical Activity

Exercise is encouraged, but physical activity can affect glucose levels depending on its intensity, duration, timing and the amount of insulin in the body. People may need to adjust their food intake or insulin doses to reduce the risk of hypoglycaemia.

5. Regular Medical Follow-ups

Routine assessments help monitor glucose control and identify complications affecting the eyes, kidneys, nerves and cardiovascular system.

Type 1 diabetes diagnosis does not mean a person has to give up their career, travel, exercise or other ambitions. But living with this condition involves planning and attention to blood glucose levels, food, medication and physical activity.

Jonas has spoken about the importance of not allowing the condition to define his life. In an earlier interview with NIH's MedlinePlus Magazine, he shared a message for others living with type 1 diabetes, “Know that you can still do anything you want to do with your life.”

There is no cure for type 1 diabetes currently but advances in insulin delivery, glucose monitoring and research into therapies that preserve or replace insulin-producing cells are expanding treatment possibilities.

Pregnancy is often something women prepare for months in advance. They discuss nutrition, exercise, supplements, medical check-ups and what to expect as their bodies change. Menopause, however, rarely receives the same attention. It is often treated as a stage that women will simply reach one day and somehow manage along the way.

But menopause is also a major transition in a woman’s life, and being prepared for it can help make the experience easier to understand and manage.

Menopause itself is defined as the point when a woman has gone 12 consecutive months without a menstrual period. However, the transition usually begins earlier, during perimenopause, when changing hormone levels can lead to irregular periods, hot flashes, night sweats, sleep problems, mood changes and other symptoms. These changes can begin several years before menopause itself.

Preparation does not mean trying to prevent menopause or “balance” hormones before it happens. Most healthy women do not need supplements or hormones simply because menopause is approaching. Instead, preparation is about understanding what is happening and building a strong foundation for health.

What can women do before menopause?

Also read: At 58, She Mistook Memory Lapses For Menopause Brain Fog, But Tests Revealed Alzheimer’s Risk

Regular physical activity is one of the most useful habits to establish. Weight-bearing and resistance exercises can help maintain bone strength and muscle mass, which become increasingly important in midlife and beyond. Exercises that improve balance, coordination and proprioception, or the body’s awareness of its position and movement, can also support mobility and help reduce the risk of falls as women age.

Nutrition is equally important. A well-balanced diet should provide adequate protein along with essential vitamins and minerals. Calcium and vitamin D are particularly important for bone health, while a varied diet rich in vegetables, fruits, whole grains, pulses, nuts and other nutrient-dense foods can support overall health. Maintaining a healthy weight is also beneficial during this transition.

It is equally important to pay attention to cardiovascular and metabolic health. Regular checks of blood pressure, cholesterol and blood sugar can help identify common non-communicable diseases early. Avoiding smoking, staying physically active and maintaining healthy lifestyle habits can also support long-term health.

Preventive healthcare should not be overlooked either. As women enter midlife, keeping up with age-appropriate cancer screenings and routine health check-ups becomes an important part of looking after their health. The appropriate screening schedule can vary depending on age, family history, personal risk factors and local guidelines, so these should be discussed with a healthcare provider.

Just as importantly, women should become familiar with their own symptoms. Changes in periods, sleep, mood, body temperature, sexual health or concentration should not automatically be dismissed as “just ageing.” Keeping track of symptoms can help women recognise patterns and have more productive conversations with their healthcare provider.

Medical support is also an important part of preparation. Not every woman will experience menopause in the same way, and treatment is not automatically necessary. However, when symptoms begin to interfere with sleep, work, relationships or everyday life, hormonal and non-hormonal treatment options can be discussed with a doctor.

Perhaps the biggest change we need is in how we talk about menopause. It is not an illness, nor is it something women should simply suffer through in silence. It is a natural stage of life, but that does not mean its symptoms or its wider effects on health should be ignored.

Preparing for menopause is ultimately less about predicting exactly what will happen and more about entering this stage with knowledge, healthy habits and access to the right medical support. Women spend years preparing for major changes in their bodies. Menopause deserves that same attention.

By Dr Ponny M S, Consultant - Gynaecologist & Laparoscopic Surgeon, Apollo Adlux Hospital, Keralam