Over-Hydration - Drinking too much can kill

Greebo

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http://www.nytimes.com/2005/04/14/opinion/14thu2.html?

Excerpt from Article said:
In the 2002 Boston Marathon, for example, a 28-year-old woman found herself exhausted after running for five hours and gulping sports drinks along the way. Wrongly assuming that she was dehydrated, she chugged down 16 more ounces of a sports drink. She promptly collapsed and was later declared brain-dead. The concentration of salt in her blood was found to be lethally low.
Question for our resident medical experts:

Just how much over-drinking does it take to cause this kind of situation? I try to drink between 1 and 2 L of water per day, and I usually feel better when I get my water than when I don't (that reminds me, I need to fill my bottle...) - but I can't imagine how much extra you'ld have to drink to have this issue.

Also the article seems to imply that drinking sports drinks can cause this - but I thought Gatorade had salt and electrolytes in it to help with this? Maybe they're talking about other sports drinks? Or am I missing something?
 
wow, good question!

I try to drink 8, 8oz glasses a day but don't always succeed. I can do 4-6 pretty easily though.
 
A young gal died last year, iirc, at CU Boulder after taking ecstacy, which caused an uncontrolled thirst. She basically drowned herself. Of course, the above recollection is under duress, so I may have it completely hosed up.
 
Anything is toxic, administered at a high enough level.
Excess water (faster intake than the kidneys/sweating etc can liberate) causes ionic disturbances as well as physically swelling the red blood cells (and maybe other cells/tissues) to the point of rupture, I have heard.
 
We had a few instances at Lackland AFB of water intoxication. We had to recite this at AF BMT every single day...

Winter Months: "I will drink 1/2 to 3/4 canteen per hour, not to exceed 12 canteens per day."
Summer Months: "I will drink 3/4 to 1 canteen per hour, not to exceed 12 canteens per day."

(Note: We were out drilling and doing physical conditioning most of the time, so if you're not as active, you probably don't need as much.. but to give you an idea of the limits the military sees.)

I believe a canteen was 32oz. Of course we were drinking water, not sports drinks. When you start dealing with those, you've got all kinda extra stuff that you could oversaturate your body with. But water can kill you too. Limit yourself. Also realize that your thirst mechanism lags behind your body's actual need, so that's not a good determination. The docs always told us that when your urine is clear, you're properly hydrated.
 
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Drinking an imbalance can kill

Greebo said:
http://www.nytimes.com/2005/04/14/opinion/14thu2.html?
Question for our resident medical experts:Just how much over-drinking does it take to cause this kind of situation?

Medical physiology 101. The human body preserves vascular volume at all costs. It does so by retaining salt; water follows. If you sweat too much and don't replace the salt, then replace with too little salt containing water, the water dilutes the salt. The cells are slow to lose their salt, so the water charges in and swells the cells: brain cells don't like to swell- convulsions-->death if not intervention made.

Moral: under tremedous stress, you have to take in proportionate amounts of salt and water. The body is in "retain, retain, retain mode". Better get the mix right and have plenty of it so that the kidneys can make the right selections and keep the chemistry correct. If you starve the system of either, you get a heap-o'trouble.

This is why after salt water intoxicaton (lost at sea survivors) you DON'T go giving them fresh water (solute free water) right away. Their brains will swell and that be bad.
 
woodstock said:
so Gatorade and so on would be better? it will replace things apart from water?
Well, the best thing would be to push enough liquid AND solute (salt) through so that the kidney can choose which it wants to keep- and to know you have pushed enough through there has to be enough left over so that you can pee. I don't think she urinated along the course....
 
Re: Gatorade

Mike Schneider said:
Elizabeth, I have no clue what happens with body chemistry, but I will stick my neck out and say Gatorade would be much better than water. That is based on personal experience of running 31 marathons and 1 ultra marathon. That is a poor sampling of one subject, but it does present a straw man for anyone to shoot at. I have seen all kinds of stuff and would like to know if regular strength Gatorade is really a good choice. If someone knows a better choice that is readily available, I would like to hear about it. -- Mike

I suspect the answer is Pedialyte--but having tasted it I can't imagine an adult consuming it except at gun point. I suspect Gatorade is closer to water than an ionic strength matched to the human body.
 
maybe an inappropriate time to bring this up, but if anyone here reads Gene Weingarten's humor column in the Post, he occasionally will make random calls to companies' customer service lines.

He called Coors and here is what was said:

Coors Brewing Co.

Me: I see that, in addition to brewing beer, Coors also owns something called the Rocky Mountain Water Co. And suddenly it hit me: Is it possible that, tragically, the two products sometimes inadvertently get mingled? Might that explain it?

Amy Valdez: No!

Me: Are you sure?

Amy: Yes!

Me: Darn. I thought I had it figured out.

:rofl:
 
Just so that everyone understands, it's not that she drank too much. It's that she didn't drink enough. If there is no river left coming out of the bladder, that means the sluice gates above (kidneys) are holding back everything. If you hold back everything, that means the kidney cannot influence the conposition of your plasma.

What then influences it is relative loss of salt vs. water, vs. input of salt and water.
 
Bruce: Is that called HypoNatremia? where you drink so much water that it dilutes your sodium/potassium / electrolyte balance. I think it can screw your heart up pretty bad ( kill you) or make you high. I had a client once who was mentally ill, poor guy and he would cousume massive and I mean massive amounts of water because it literally got him wasted.
 
Just so that everyone understands, it's not that she drank too much. It's that she didn't drink enough.

"The concentration of salt in her blood was found to be lethally low."

I am having a hard time relating these two. Help!
 
There are some metabolic disorders, in the category of "syndrome of inappropriate antidiuretic hormone secretion" that can do this. Some of the antipsychotics can render one more vulnerable to this. But in the cited newspaper report- the kidneys didn't have a chance. The sluice gates at the kidney were completely slammed shut. No pee below the dam.
 
Re: In the World of Practicality

Mike Schneider said:
Here is an article from Runner's World.
http://www.runnersworld.com/article/0,5033,s6-78-0-0-438,00.html
My view: This appears to happen mostly to women that are under weight and finish a 26.2 mile marathon in over four hours. I have seen many folks in distress (down on the ground) for not taking in enough fluids in my 31 years of running road races and my four years of coaching cross country running. I have never seen a runner in distress from taking in too much water. Obviously, it happens and that is a sad thing. I would like to know how many folks die from taking in too much water in the U.S. each year and compare that that die from not ingesting enough fluids. My guess is that it is analogous to the folks that got polio from the polio vaccine. So, if you are not running 5 miles or more (or other similar activity) at a rate that puts a good bit of strain on your body, the odds of killing your self by ingesting too much water would be infinitesimally small. In my mind the hoopla is nothing more than hype. -- Mike
...and that would be correct. The truth is between the US army (salt tablets) and Runner's world (drinking free water)....you have to do lots of both. And, the only guarantee that you have enough is....to have to pee.
 
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