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

Scoliosis is a fairly common spinal condition that is most often detected during adolescence. Each year, nearly 3 million new cases are diagnosed in the United States, and most of these fall under idiopathic scoliosis, a form that typically develops during the teenage years without a clear cause. In many cases, structural changes in the spine go unnoticed by parents until they begin to show outward physical signs. Scoliosis and kyphosis are among the most frequently seen spinal disorders, both involving abnormal curvature of the spine.

Scoliosis refers to a sideways curve of the spine and is most commonly seen in children and teenagers, though it can affect people at any age. Congenital scoliosis, in particular, may not be visible at birth. It can remain hidden for years and often becomes noticeable during periods of rapid growth. What begins as a minor internal change can gradually turn into a clearly visible curve as a child enters puberty.

To understand this condition better, we spoke with Dr Saraswati Viswanathan, Consultant – Orthopaedics at Manipal Hospital, Kanakapura Road, who shared her insights.

What Is Scoliosis?

Scoliosis is a condition in which the spine curves from side to side, unlike the spine’s normal front-to-back shape. In many cases, the curve is mild and may not cause noticeable symptoms, but it can sometimes lead to back discomfort and changes in posture. The condition is most commonly diagnosed during adolescence. According to the Cleveland Clinic, treatment options may include physical therapy, the use of braces, or surgery, depending on the severity.

Symptoms Of Scoliosis

As noted by the Cleveland Clinic, scoliosis often does not cause obvious symptoms. However, when symptoms do appear, they may include:

• Back pain.
• Trouble standing straight.
• Weakness in the core muscles.
• Pain in the legs, or sensations such as numbness or weakness.

What Are The Types Of Scoliosis?

There are three main types of scoliosis:

• Idiopathic scoliosis: This is the most common form. The term “idiopathic” means that the exact cause is unknown. Research suggests it can run in families and may have a genetic connection.
• Congenital scoliosis: This is a rare condition caused by abnormal spinal development before birth. It occurs when the vertebrae do not form properly during early embryonic growth.
• Neuromuscular scoliosis: This type is linked to conditions that affect the muscles and nerves supporting the spine. It is often seen alongside neurological or muscular disorders such as cerebral palsy, spina bifida, muscular dystrophy, or after certain injuries.

How Can We Identify This Condition Early?

According to Dr Viswanathan, while a visible S-shaped or C-shaped curve is a well-known sign of scoliosis, one of the earliest indicators parents can look for at home is uneven shoulder height. If one shoulder consistently appears lower than the other, it may suggest an underlying spinal curve. Other signs to watch for include a noticeable hump on the back, uneven rib or chest appearance, or hips that look tilted or asymmetrical when the child is standing straight.

If you notice any of these changes, there is no need to panic, but it is important to take action. One simple screening method is Adam’s Forward Bend Test. Ask your child to bend forward at the waist and look for any unevenness in the shoulders or a raised area on one side of the back. Early screening and timely care can make a significant difference in managing spinal health and preventing the condition from worsening. Scheduling a visit with a pediatrician or orthopaedic specialist for proper physical and clinical evaluation can help rule out structural issues and ensure your child gets the right support as they grow into adulthood.

Last week, the Royal Pharmaceutical Society (RPS) advised the public to not use nasal decongestant for more than seven days. The guidelines said that it contains xylometazoline or oxymetazoline. Prolonged use of which could cause 'rebound congestion' or increase dependency on these sprays to breathe easily.

Recently, with the flu cases rising, flu-like symptoms, including nose congestion too have gone up. It is because of this reason, many are using nasal spray continuously, which could cause rebound congestion.

To understand this better, Health and Me spoke to Dr Pranita Bauskar, ENT, Apollo Spectra, Pune.

What Did The Doctor Say About Nasal Spray Usage?

Nasal sprays are widely used by many people to relieve a blocked or stuffy nose caused by colds or allergies. Dr Bauskar explained, "These nasal sprays are known to provide immediate relief. Using decongestant nasal sprays for more than 5 to 7 days could worsen the congestion and steal the piece of mind."

Read: Nasal Spray Warning Over 'Rebound Congestion'; Experts Say It Should Not Be Used For More Than 7 Days

What Does Rebound Congestion Mean?

Doctor says that as the nose becomes more blocked once the medication wears off, this creates a cycle of dependency. "Hence, it is necessary to limit the use of decongestant sprays to a few days only."

What Can Be Used Instead?

Dr Bauskar says, "you can try safer alternatives such as saline nasal sprays or rinses to keep nasal passages moist." Furthermore, the doctor suggests to not to forget to take steam "at least two times a day". "Doing so will help to ease congestion. Ensure to take warm showers, and you will feel better," noted Dr Bauskar.

It is imperative to have allergy medications like antihistamines if allergies persist, as prescribed by the doctor, noted the doctor.

"Everyone is also advised to stay hydrated by drinking enough water and liquids. Try to use a humidifier at home. If a person has congestion for over a week and is unable to breathe ,then don’t rely on nasal sprays and consult the doctor to rule out infections or other underlying problems," said Dr Bauskar.

Is Rebound Congestion Preventable?

It is a preventable condition, and is scientifically known as rhinitis medicamentosa, which causes the symptoms to worsen. Patients become depended on the sprays to breathe more easily.

RPS survey of 300 pharmacists found that 59% think the public is not aware of the risks, while 75% said packaging should be clearer about the seven-day limit. 63% said they had intervened in cases of suspected overuse.

Professor Amira Guirguis, chief scientist at RPS told the ITV News, "Nasal decongestant sprays can be helpful for short-term relief, but using them for longer than seven days can make your congestion significantly worse. Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realizing they could be prolonging their symptoms. We'd like to see clearer warnings on the packaging which you can't miss and greater awareness of the seven-day limit. If your congestion lasts more than a week, speak to your pharmacist. There are safe and effective alternative options to help you manage your symptoms."

Another survey by ITV News suggests that more than a fifth of adults have used the products for longer than seven days. This means 5.5 million people in the UK may have risked developing a dependency.

A one-year-old baby from Uzbekistan rom suffering from a rare genetic liver disorder and was saved by his father who donated a part of his liver. The child was suffering with Alagille syndrome. The timely intervention of the doctors as well as father stepping in saved the child from a life-threatening disease.

What Happened to The Child?

Right after birth the child got jaundice, while it is common for newborns, and appears two to three days after birth, it often resolves in one to two weeks. However, this was not the case with him. The baby required neonatal intensive care. When he was of just two months, he was diagnosed with biliary atresia, a condition that blocks the normal flow of bile from liver. The baby underwent a Kasai procedure, which is a surgery performed in infancy to help restore bile flow.

Also Read: The Great Healthcare Plan Explained: What Is In President Trump's Health Care Proposal?

However, his condition continued to worsen. The baby suffered from persistent jaundice, severe itching, poor weight gain, delayed growth and pale stools. All of these symptoms indicated progressive liver failure.

This is when the family sought help from specialized liver care in India. Upon a careful assessment, a serious heart ailment too was detected in the baby. The investigation confirmed that the baby had Alagille syndrome.

What Happens In Alagille Syndrome?

As per the National Institute of Health, Alagille syndrome is a multisystem autosomal dominant disorder with a wide variety of clinical manifestation. Johns Hopkins Medicine says it is an inherited condition in which bile builds up in the liver because there are too few bile ducts to drain the bile. This causes liver damage.

This is caused by JAG1 gene mutation and could be passed from parent to child. If the child has one parent with Alagille syndrome, the child has 50% chance of developing the condition. Its rarity makes it appear in one out of 70,000 babies.

Upon the case review, it was identified that only a liver transplant could save the child's life, this is when his father stepped in.

What Does The Expert Say?

Dr Ajitabh Srivastava, Director HPB Surgery and Liver Transplant, Max Super Speciality Hospital, Patparganj, whose team led the transplant said, "“Infants with prolonged jaundice are commonly evaluated for biliary atresia, for which the Kasai procedure is an early surgical treatment aimed at restoring bile flow and delaying the need for liver transplantation." However, he noted, rare conditions like Alagille syndrome could also mimic biliary atresia in early infancy.

"In such cases, the Kasai procedure may not provide lasting benefit because the underlying problem is genetic rather than structural and in fact the wrong procedure (Kasai) worsens the condition of the child. As the liver disease progressed despite early surgery, a timely living donor liver transplant became the only life-saving option," the doctor explains.

The transplant has been successful, noted Dr Srivastava, and the child is on a "steady path to recovery". The doctor especially pointed out how early diagnoses could save lives even from the rarest of the rare diseases.