Last week we discussed the controversy and fear surrounding the safety of energy drinks like Red Bull. It’s interesting to see how people will rush to believe that certain things are inherently dangerous while believing that other things simply could not be. People are often shocked to learn that WATER can be toxic to your health.

Yes! Simple H2O can kill you. You might be saying to yourself…”well yes, if you get it into your lungs…”, but ingesting water can be toxic to your health also. If you drink too much water in a given period of time you can become very ill and even die from water intoxication.

Recent News

Just recently a couple was arrested for causing the death of their newborn by diluting breast milk with water. Initially, one might think that the worst that could come of that would be malnutrition. However, diluting the breast milk caused the baby to take in too much water- more than her body could get rid of in time – and she died as a result of it.

*During my research of the databases, it turns out this situation was not all that rare. I stumbled upon many case reports of newborns who had their milk diluted with water and suffered water intoxication as a result.

Other News

Just last summer in August of 2014 Zyrees Oliver a high school football player died from drinking too much water after a game. He had consumed 2 gallons of water plus Gatorade. He suffered cramping and collapse before being rushed to the hospital where it was found that he had swelling of the brain.

In 2008 a 44 year old  man died from a heart attack after consuming 10 liters of water a day for several days. He was using the water to numb his gingivitis pain.

Water Intoxication

Water intoxication is a rare condition characterized by an overconsumption of water that results in low blood sodium. It is also known as “dilutional hyponatremia” and “water-poisoning” as a result of over-hydration.  It is mostly seen  in athletes, drug users (ecstasy), and psychiatric patients ( e.g. bipolar disorder, schizophrenia). When large amounts of water is ingested in a short period of time, the kidneys capacity to compensate and elimante the excess water is exceeded. This results in a severe loss of electrolytes and hyper-hydration. Water begins to flow into the central nervous system resulting in cerebral edema, which may lead to brain damage due to loss of blood flow and oxygen, and death.

Signs and Symptoms Early signs and symptoms of this condition  are headaches, confusion, muscular weakness, twitching, vomiting, irritability, and drowsiness. Most patients will present with seizures.  Fatal pulmonary edema, cardiac arrest, or sudden death may also occur.

Treatment and Prevention  If caught in time 3% hypertonic saline can be administered intravenously in the hospital. The high salt solution can reverse the hypotonic state and resolve the condition.  As a means of prevention sports drinks with a high sodium content should be consumed during endurance sports in place of water, and fluid intake should not exceed 10 liters a day. Drinking more water than you need is not necessary before or after working out, only drink as much as to satisfy thirst.

The mechanism  behind how water intoxication occurs is controversial (meaning it is not sure). It is believed that excess amounts of water in the body causes inappropriate secretion of the antidiuretic hormone arginine vasopressin from the hypothalamus region of the brain. Vasopressin is normally responsible for the retention of water in the body and for the constriction of vessels. Dilution of sodium in the blood further impairs water excretion by the kidneys. In addition, muscle cells swell due to the hyponatremia (low serum sodium), when they return to normal they push out potassium. This imbalance of ions (potassium and sodium) can cause muscle cells to burst leading to a condition known as Rhadomyolysis. Since the heart is a muscle this may be the mechanism behind the associated cardiac arrest and muscle weakness.

Summary

Approximately 60 -70 percent of the adult human body is composed of water. that amount is higher still in babies and children. Babies get all the water they need from breast milk or formula, they do not need to be given anymore. On average we as adults intake 2 to 3 liters of water from eating and drinking daily. We tend to excrete about the same amount. The body must maintain a balance between the amount of water taken in and the amount of water expelled, as well as the amount of water inside the cells of the body and the amount of water in the extracellular fluid of the body. Disturbances in water balance are associated with many diseases, and brain edema is a pathological condition of stroke , sepsis, brain tumor, meningitis, and hydrocephalus, as well as hyponatremia.

Although considered rare, there have actually been many reports of babies and adults dying from water intoxication ( Google and see for yourself). Many people are not aware that drinking too much water can deplete the electrolytes in their bodies. It is especially important to be aware now, as many health and diet fads are promoting the consumption of more and more water.  By siting that it is 75% of your brains weight and stating that it leads to younger looking skin, flushes toxins from the body, and even helps control  calorie intake and burns fat, water is being glorified as a miracle substance. Caution  should be taken as we often forget that in addition to drinking water we also get about 20% of our water from the food that we eat. Age, gender, weight, level of activity, and climate (hot or humid), all factor in to how much we need to drink on a daily basis. The best advice is to eat a balanced diet and to “drink to thirst” not to match a standard or a commonly accepted notion.