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

Anemia remains one of the least talked about threats to a safe pregnancy in India. The National Family Health Survey-5 data shows that 52.2% of pregnant women in India were anemic. This translates to at least one in two expectant mothers entering pregnancy with insufficient hemoglobin to meet her own and her baby’s needs.

Pregnant women with iron-deficiency anemia may feel unusually tired, weak or short of breath. Some women may suffer from dizziness, headaches, palpitations or reduced ability to concentrate. However, symptoms can be subtle and this is why routine antenatal screening is important even if the woman feels well.

Left unaddressed, it raises the risk of preterm birth, low birth weight, postpartum haemorrhage, and maternal fatigue severe enough to affect daily functioning and recovery after delivery.

Severe anaemia can also reduce a woman's ability to tolerate blood loss during delivery, making even an otherwise uncomplicated birth potentially more challenging.

Why pregnancy makes it worse? Well, blood volume expands by nearly 50% during pregnancy, and the growing fetus draws heavily on maternal iron stores, especially in the second and third trimesters. Most Indian women begin pregnancy with iron stores already depleted by poor dietary intake, frequent pregnancies, or heavy menstrual blood loss. So, the added demand tips many into overt anaemia.

Do's:

1. Start Antenatal Care early. You should get a baseline haemoglobin test at your first antenatal visit, and repeat this each trimester or more if needed.

2. Iron and folic acid tablets must be taken in accordance with the prescription given. It is best to start with them before conceiving or as soon as possible in the pregnancy process, preferably in discussion. The dietary consumption may not always be sufficient to cater to the increased demands during pregnancy.

3. Pair iron-rich foods with vitamin C. A squeeze of lemon with dal or leafy greens meaningfully improves absorption. Indian gooseberry (amla), guava, oranges and tomatoes improve absorption of non-heme iron from plant based foods.

4. Include iron-dense foods regularly like leafy greens, jaggery, dates, legumes, eggs. If non-vegetarian, eat lean meat or fish, meat or poultry.

5. Treat underlying causes. Get heavy periods, worm infestations or unexplained fatigue evaluated before conception if possible.

6. Ask about your ferritin level, not just haemoglobin, since ferritin reveals depleted iron stores earlier.

Anaemia is not always caused by iron deficiency. B12 or folic acid deficiency, problems with haemoglobin production, infections, and many other medical conditions can also be contributing factors.

Also read: 'My Periods Are Painful' Is Not Always Normal: When Could It Be A Sign of Endometriosis?

Don'ts:

1. Do not stop iron supplements simply because you feel better. Treatment usually needs to continue for the recommended period to replenish iron stores.

2. Don't take iron tablets with tea, coffee or milk. These block absorption. Space them at least an hour apart.

3. Do not skip supplements because of nausea or constipation. Ask your doctor for alternate formulations instead of foregoing the supplements.

4. Don't assume fatigue is ‘normal pregnancy tiredness’ without a haemoglobin check. Persistent breathlessness, dizziness or a racing heart need evaluation.

5. Don't self-medicate with over-the-counter iron doses. Both too little and too much iron can cause harm.

6. Don't ignore mild anaemia on the assumption that it will ‘sort itself out’. It typically worsens as pregnancy progresses and has to be actively treated.

Anemia in women is mostly preventable and treatable early. Regular antenatal check ups, proper supplementation, balanced diet and timely treatment can go a long way in reducing its impact on the mother and baby. The key message is simple, really. Screen early, do not wait for symptoms, treat appropriately and maintain adequate iron stores throughout pregnancy.

Blood tests are often a source of dread for people in our society. While many people dread the needle stick, most are scared of what the results may show. Even before consulting a physician, most people nowadays would consult an AI-powered platform to verify and interpret the values of their blood tests. However, such online searches most often give rise to more uncertainties and confusion rather than answering the basic queries. Thus, this article is an attempt to shed some light on the basics of common blood test results.

LIPID PROFILE

Lipid profile is one test that everyone should do, at least occasionally, after the age of 40. This is a silent epidemic, and without blood tests, no clinical symptoms can reliably identify raised lipid parameters. There are multiple parameters printed in the report, but the main values we are looking for are total Cholesterol, triglycerides, LDL, and HDL. There are many others, but the interpretation of those is best left to your physician. Total Cholesterol should be less than 200, triglycerides less than 150, and the “bad” cholesterol, or LDL, should be below 100. On the other hand, HDL, the “good” cholesterol, should be above 40 for men and above 50 for women. So, for HDL, we want the values to be higher! However, whether deranged lipid parameters warrant treatment and, if so, for how long, will be the clinical decision of your doctor.

CBC

CBC means complete blood count. This is the most basic test done for every patient. In this test, we check for levels of haemoglobin, total leukocyte count, differential white cell count, platelet count, and ESR. Besides, there are numerous other parameters printed in your report, like MCV, MCH, MCHC, RDW, and PDW. But let’s first look at the basic parameters. Haemoglobin is perhaps the most important parameter to look at. It shows how much oxygen your blood can carry. Low hemoglobin is called anemia. If you have anaemia, you need to get treatment ASAP. The standard normal values of hemoglobin depend on age and gender and also physical states like pregnancy. The normal hemoglobin of an adult male will be different from that of an adolescent girl. There are many different causes of anaemia in our society, like iron deficiency, worm infestation, thalassemia, and kidney disease. Your doctor will do further tests to elucidate the cause.

The next most important parameter is total leukocyte count. This gives an indication of whether you have any infection or inflammation. Conversely, in some conditions like Typhoid, the counts may be low despite fulminant infection. Platelet count is also important in infections like dengue, where it may get dangerously low. We need to check platelet count repeatedly, sometimes even twice or thrice the same day, in dengue infection. Platelet count may be low in some forms of blood cancer too.

The other parameters like MCV and RDW are too complex to be discussed in this short article. Suffice it to say, they are deranged in conditions like Thalassemia, sickle cell disease, vitamin B12 deficiency, and hereditary Red cell membrane disorders.

Also Read: BTS’ V Opens Up About 2-Year Battle With Hearing Loss

And finally, the ESR is a very non-specific parameter. It can be raised in multiple conditions, ranging from cancer to inflammation. It is usually interpreted in unison with other necessary tests.

Dr Rudrajit Paul, Consultant Physician, Manipal Hospital, Kolkata

“All That” star Christy Knowings has died after reportedly suffering an asthma attack that led to cardiac arrest and brain damage.

The 46-year-old actress was hospitalized on August 7 after the attack and placed on life support, TMZ reported.

According to TMZ, citing family sources, Knowings suffered cardiac arrest following the asthma attack. Her family decided to take her off life support on August 11.

Knowings, who was born on February 25, 1980, in the Bronx, is the second former All That cast member to die this year, following the fatal hit-and-run death of Kianna Underwood in January in Brooklyn.

In a Facebook post, Knowings’ aunt wrote that her niece was an “outstanding actress, comedian, twin sister” and an “amazing daughter.”

Knowings’ reported death after complications from an asthma attack is a reminder that while asthma can often be managed, it should not be taken lightly, health experts told HealthandMe.

What Is Asthma? How Severe Can It Turn?

Dr. Abhijit Ahuja, Consultant Pulmonologist, Saifee Hospital, Mumbai, explained that asthma is a condition that makes it difficult to breathe because the airways become inflamed and narrow.

Many people with asthma can control their symptoms with medication. However, an asthma attack can sometimes become severe and life-threatening.

During an asthma attack, symptoms suddenly worsen and usual medication may not provide enough relief. A person may experience difficulty breathing, wheezing, chest tightness, severe coughing or trouble speaking.

“If you use your inhaler but still have trouble breathing, you need to go to the hospital right away,” Dr Ahuja said.

When the airways become so narrowed that the body does not receive enough oxygen, the asthma attack can turn severe. The lungs may also be unable to remove carbon dioxide properly.

“If this keeps happening, it can hurt parts of the body like the brain and the heart,” Dr Ahuja said.

A severe asthma attack can lead to difficulty breathing, loss of consciousness, brain injury and cardiac arrest.

When Can an Asthma Attack Be Deadly?

Dr. Taniya Mehta, Consultant Respiratory Medicine, Sterling Hospitals, Gujarat, told HealthandMe that while most asthma attacks can be treated, a very severe attack can become deadly when the airways become so tight that the lungs cannot get enough oxygen.

“If treatment isn't given quickly, low oxygen levels can cause the lungs to stop working, damage the brain, cause the heart to stop and lead to death,” she said.

Signs That an Asthma Attack Is an Emergency

Seek emergency medical help if a person has:

• Breathing difficulty or wheezing that is rapidly getting worse.
• Trouble speaking more than a few words because of breathing difficulty.
• No improvement after using a quick-relief inhaler.
• Blue, grey or very pale lips, fingernails or skin, which may indicate low oxygen.
• Severe confusion or loss of consciousness.

Who Is More Likely to Have a Severe Asthma Attack?

People may be at greater risk if they:

• Have had a severe or life-threatening asthma attack before.
• Need to use their quick-relief inhaler frequently.
• Do not use their asthma medicines as prescribed.
• Do not have their asthma under control.
• Cannot recognise when their symptoms are getting worse.

Do Not Wait Out a Severe Asthma Attack

Deadly asthma attacks are uncommon, but they can happen quickly, the doctors warned.

Taking asthma medication as prescribed, knowing how to use inhalers correctly, attending follow-up appointments and undergoing lung tests when needed can help keep asthma under control.