Am I drinking too much water?

              I have had a number of patients over the past four years who have come in for complex conditions which include the symptoms of difficult concentration, fatigue, poor memory, chronic bloating, diarrhea and frequent urination.  While these conditions in and of themselves are not that rare for me to see, they are made more unusual by the fact that they are all occurring together in the same person, at the same time.  As I have treated these patients, often middle aged females who eat a food concious diet, I have continually seen the improvements which were gained falter after only a day or two.  There seemed to be a pattern of relapse that I could not overcome.  I would take time going over diet, sleep patterns, and exercise habits with the patient.  I made efforts to discuss any depression or anxiety that they may have been feeling and many did indeed have a history of panic attacks and anxiety to report. I was always looking at the patient for some clue as to what they might be doing to increase the severity of their symptoms.
       Just recently the light bulb popped on for me while I was doing an initial consult with a new patient. The answer was not contained within the patient’s story of their illness. The answer was held right there in the patient’s hand.  The water bottle. Not just any water bottle, but the liter bottle of water, or larger, that they carried with them everywhere they went.  It came with them into the clinic from the car. It came with them from the consult room to the treatment table. It sat next to them even though they could not reach for it, in a comforting sort of way, and it was quickly grasped as soon as the treatment was over.
        “How much water are you drinking each day?” I started asking.  The responses were shocking. 2 liters…3 liters…close to 4 liters. “Why?” I asked. “Because it’s good for you”, they would inevitably reply. “Are you drinking because you are thirsty or because you think it’s good for you?” I would follow.  Not a single person in this group has replied, “because I am thirsty”.
         The fluids in the human body work within a closed circulatory system. We can only sustain so much fluid within our vessels and tissue at any one time, based on our body size, fat distribution, and the environment we live in. If a person continues to drink past this point fluids will pool in areas of the body where they should not. We place ourselves in a diseased state of edematous swelling where we start to see puffy ankles and feet, puffy faces and hands, and a constant stream of trips to the bathroom as our body tries to eliminate the fluid. We are not a system of hoses and pipes which should be flushed all day with liters of water. Our bodies are a balanced chemical blend of cells, minerals, neurotransmitters and proteins, all of which must be in balance in order for our nerves to function.  When we continually ingest water, beyond our thirst levels or environmental needs, our hearts have to work harder to move the increased volume of blood and our kidneys have to work harder to eliminate the increased volume of fluids. We have diarrhea to void extra water or have constant copious and clear urination which slowly removes the salts and minerals from our body.  The water we pass contains many of the healthy components we need to survive and function. If water is drank in great excess our brains, digestive tracts, or filtration organs can fail.
       Some of you may have heard of people dying from over consumption of water in marathons or in training but what are the effects of a lower level of constant over hydration? In high levels on ingestion is causes the cells to swell and can leading to vomiting, seizures, and even death. In lesser levels of toxicity is can cause foggy thinking, bloating, swelling, and electrolyte imbalances. The standard advice in the United States of 8 glasses a day is not based on anything scientific. It does not take into account the weather, the activity level of the individual, their age or size (surely a 100 pound woman does not need as much water as a 200 pound man), or the diet they eat which may already be rich in water dense food. Fruits and vegetables, even coffee and tea, are also made up mostly of water. So if an individual eats a diet rich in these foods and has 8 glasses of water what astronomical amount of daily water are they up to then?
            Chinese Medicine places great emphasis of the presence or absence of thirst in the patient, maybe we need to move back towards drinking to quench thirst, and not forcing fluids in an attempt to prevent something which may not be there at all.



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