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Thread: Drinking Too Much Water Can Kill You: Report

  1. #1

    Drinking Too Much Water Can Kill You: Report

    Drinking Too Much Water Can Kill You: Report
    Tue Jul 2, 5:34 PM ET
    By Alison McCook

    NEW YORK (Reuters Health) - A new review of three deaths of US military recruits highlights the dangers of drinking too much water.

    The military has traditionally focused on the dangers associated with heat illness, which has killed a number of healthy, young enrollees, Colonel John W. Gardner of the Office of the Armed Forces Medical Examiner in Rockville, Maryland told Reuters Health. However, pushing the need to drink water too far can also have deadly consequences, he said.

    "The risk has always been not drinking enough," Gardner said. "And then people who aren't medically attuned get overzealous," inducing recruits to drink amounts of water that endanger their health, he added.

    "That's why we published this paper: to make it clear to people that overzealousness can be dangerous," Gardner explained.

    In September 1999, a 19-year-old Air Force recruit collapsed during a 5.8-mile walk, with a body temperature of 108 degrees Fahrenheit. Doctors concluded he had died of both heat stroke and low blood sodium levels as a result of overhydration.

    During January 2000, a 20-year-old trainee in the Army drank around 12 quarts of water during a 2- to 4-hour period while trying to produce a urine specimen for a drug test. She then experienced fecal incontinence, lost consciousness and became confused, then died from swelling in the brain and lungs as a result of low blood sodium.

    In March 2001, a 19-year-old Marine died from drinking too much water after a 26-mile march, during which he carried a pack and gear weighing more than 90 pounds. Although he appeared fine during the beginning stages of the 8-hour walk, towards the end he began vomiting and appeared overly tired. He was then sent to the hospital, where he fell into a coma, developed brain swelling and died the next day. It is unclear how much water he drank during the march, but Marines were given a "constant emphasis" on drinking water before and during the activity, Gardner writes in the latest issue of Military Medicine.

    In an interview with Reuters Health, Gardner explained that drinking too much water is dangerous because the body cannot excrete that much fluid. Excess water then goes to the bowel, which pulls salt into it from the body, diluting the concentration of salt in the tissues.

    Changing the concentration of salt, in turn, causes a shifting of fluids within the body, which can then induce a swelling in the brain. The swollen organ will then press against the bones of the skull, and become damaged.

    The researcher added that previous cases of water toxicity have been noted in athletes who consume excessive amounts in order to avoid heat stroke. In addition, certain psychiatric patients may drink too much water in an attempt to wash away their sins, or flush out poisons they believe have entered their bodies.

    In 1998, the Army released fluid replacement guidelines, which recommend a certain intake of water but limit it to 1 to 1-1/2 quarts per hour and 12 quarts per day.

    It takes a while for these guidelines to get "permeated out" to everybody, Gardner admitted. In the meantime, he suggested that bases take notice of the mistakes of others, and "not wait for somebody to die from (water toxicity) again," he said.

    "You can't prevent everything bad from happening," Gardner noted. "But when it does, you have to learn from it."

    SOURCE: Military Medicine 2002;167:432-434.

  2. #2
    Max

    Member posted Jul 03, 2002 11:26 AM テつ*
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    Drinking Too Much Water Can Kill You: Report
    Tue Jul 2, 5:34 PM ET
    By Alison McCook

    NEW YORK (Reuters Health) - A new review of three deaths of US military recruits highlights the dangers of drinking too much water.


    The military has traditionally focused on the dangers associated with heat illness, which has killed a number of healthy, young enrollees, Colonel John W. Gardner of the Office of the Armed Forces Medical Examiner in Rockville, Maryland told Reuters Health. However, pushing the need to drink water too far can also have deadly consequences, he said.

    "The risk has always been not drinking enough," Gardner said. "And then people who aren't medically attuned get overzealous," inducing recruits to drink amounts of water that endanger their health, he added.

    "That's why we published this paper: to make it clear to people that overzealousness can be dangerous," Gardner explained.

    In September 1999, a 19-year-old Air Force recruit collapsed during a 5.8-mile walk, with a body temperature of 108 degrees Fahrenheit. Doctors concluded he had died of both heat stroke and low blood sodium levels as a result of overhydration.

    During January 2000, a 20-year-old trainee in the Army drank around 12 quarts of water during a 2- to 4-hour period while trying to produce a urine specimen for a drug test. She then experienced fecal incontinence, lost consciousness and became confused, then died from swelling in the brain and lungs as a result of low blood sodium.

    In March 2001, a 19-year-old Marine died from drinking too much water after a 26-mile march, during which he carried a pack and gear weighing more than 90 pounds. Although he appeared fine during the beginning stages of the 8-hour walk, towards the end he began vomiting and appeared overly tired. He was then sent to the hospital, where he fell into a coma, developed brain swelling and died the next day. It is unclear how much water he drank during the march, but Marines were given a "constant emphasis" on drinking water before and during the activity, Gardner writes in the latest issue of Military Medicine.

    In an interview with Reuters Health, Gardner explained that drinking too much water is dangerous because the body cannot excrete that much fluid. Excess water then goes to the bowel, which pulls salt into it from the body, diluting the concentration of salt in the tissues.

    Changing the concentration of salt, in turn, causes a shifting of fluids within the body, which can then induce a swelling in the brain. The swollen organ will then press against the bones of the skull, and become damaged.

    The researcher added that previous cases of water toxicity have been noted in athletes who consume excessive amounts in order to avoid heat stroke. In addition, certain psychiatric patients may drink too much water in an attempt to wash away their sins, or flush out poisons they believe have entered their bodies.

    In 1998, the Army released fluid replacement guidelines, which recommend a certain intake of water but limit it to 1 to 1-1/2 quarts per hour and 12 quarts per day.

    It takes a while for these guidelines to get "permeated out" to everybody, Gardner admitted. In the meantime, he suggested that bases take notice of the mistakes of others, and "not wait for somebody to die from (water toxicity) again," he said.

    "You can't prevent everything bad from happening," Gardner noted. "But when it does, you have to learn from it."

    SOURCE: Military Medicine 2002;167:432-434.
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    Posts: 1399テつ*|テつ*From: Montreal,Province of Quebec, CANADAテつ*|テつ*Registered: Jul 25, 2001StarlightAngel

    Member posted Jul 03, 2002 11:42 AM テつ*
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    Oh my.
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    Posts: 291テつ*|テつ*Registered: Feb 28, 2002

  3. #3
    Super Moderator Sue Pendleton's Avatar
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    They learned a lot from the Gulf War but unless a person has had a previous history of heat stroke no one really knows this stuff when they need to. I used to take the saline tablets that we used to dissolve to make contact lens cleaner and swallow one or two an hour on hikes (none of the drills knew this of course). With the extra water I was fine.

    But it appears that if the military insists on the yellow tide tests (pee tests for drugs) they should go back to the good old days. Twenty years ago during my barracks first one the Sergeant Major had a keg of beer and any container you wanted to fill cost a quarter. The proceeds went back to the unit fund and we had people trying to bud in to the front of the line cause they had to go so bad.

  4. #4
    Senior Member Van Quad's Avatar
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    The point of this post, I assume, is the parallel between the marine's situation and us bladder fixated quads/paras.

    I drink 3 to 4 l. a day, and I've had urologists tell me it's too much. What to do?

  5. #5
    The SCI population can suffer from water intoxication as well Van Quad, especially if their kidneys aren't functioning well.

    J Am Paraplegia Soc 1990 Oct;13(4):78-83
    Hyponatremia in spinal cord injury.

    Sica DA, Midha M, Zawada E, Stacy W, Hussey R.

    Department of Medicine, Medical College of VA, Richmond 23298-0160.

    Hypoosmolar hyponatremia (serum Na+ less than 130 mmol/L) has proven a common and incompletely explained phenomenon in the spinal cord injured patient. When present, it has generally been preceded by excessive fluid intake and environmental/dietary factors which reversibly restrict free water excretion. We have attempted to more fully characterize the determinants of SCI-associated hyponatremia by retrospectively analyzing its features and treatment response in a series of 14 hyponatremic SCI patients. In most instances, hyponatremia could be attributed to uncontrolled fluid intake in the presence of an acute or semiacute illness and thus stimuli for non-osmotic releases of arginine vasopressin. Treatment measures generally included administration of 3% saline, with all patients recovering uneventfully from their episode of hyponatremia.

  6. #6
    Super Moderator Sue Pendleton's Avatar
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    Van, Ask your urologist to specify why he thinks you drink too much. If you like that much water then ask how to make things work. When I worked on farms as a teenager (AB) I took saline tablets and my doc had ok'd them. You might try replacement salts if absolutely necessary but maybe switching to low calorie juice or a sports drink for a few glasses should manage what you're drinking.

  7. #7
    Senior Member TD's Avatar
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    A perfect example of my dilemma

    When I was first discharged from Rehab my PMR told me to "drink plenty of water". I asked "how much is plenty of water?" and got no reply. I have always tried to drink between 2 and 3 liters of water a day but now my urologist says that is too much. I am currently having yet another dilemma.

    I am told to drink at least 8-8 ounce glasses of water a day by my PMR and PCP. My urologist says to drink only 64 ounces of fluid a day (fluid restrictions imposed!). To this he has added that I need to cath every 3 hours. I am getting very little sleep, am having small outputs during the day and large ones over night (last night I produced 1500 ml between 1:00 am and 12:00pm), I get very strong urges within 2 and 1/2 hours which produce 500 ml of pee when I am rehydrating which exceeds the 350 ml which is my urologist's target because of high pressures. Talk about confusion!!

    "And so it begins."

  8. #8

    how much water to drink

    For clarification, since different amounts and measures have been discussed, 8 - 8oz glasses of fluid is 64 oz or 2 quarts or slightly under 2 liters. I can understand the confusion that many of you are experiencing. The searching of several sources has shown that the least amount of recommended intake is 64 oz. This amount is exclusive of caffeinated and alcoholic beverages, both of which act as diuretics and deplete the fluid balance. Further, the 64 oz is an amount necessary to attain a more normal fecal consistency. There was more variation in the upper limit, with the range being just under 2 liters (64 oz) to 2 1/2 to 3 liters.

    If you are having problems with large output at night, I would suggest that you begin reducing your hourly intake by 6 PM. When you lie down at night, or are in a reclining position, the circulatory system has a greater ability to remove the fluids being stored in the interstitial tissues. Once transported into the circulation, the filtering then occurs as the blood traverses the kidneys, thus resulting in increased fluid output/urine.

    I believe, in all that one does to care for oneself, moderation, founded in knowledge and understanding, is the key! CRF

  9. #9
    Super Moderator Sue Pendleton's Avatar
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    TD.....You keep using the term "rehydrating". It sounds like someone sitting there and chugging down a half gallon first thing when they wake up. The 8 cups of liquid are meant to be spread out fairly evenly until you start cutting back in the evening. This includes drinking some of the fluids with meals. Another way to reduce some of the night time over kill is to lay down for an hour nap or to read in the mid to late afternoon. Especially if you can raise your legs a bit that may allow a well needed cath before getting back up instead of in the middle of the night or at least it may reduce the amount in the middle of the night.

  10. #10

    drinking too much water

    Thanks, Sue - good point about spreading the amount over the day and would heartily agree with the midday time out of chair, flat and even with legs slightly elevated! I know this latter practice has many negative aspects depending upon one's caregiver situation, work schedule, etc, but would still recommend if at all possible. CRF

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