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Author
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Topic: Overhydration warning.
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David Pennington
Member
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posted 07-09-2002 08:11
   
Received this via E-mail and thought it appropriate.
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. IP: Logged |
Andy0331
Novice
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posted 07-09-2002 08:43
"he had died of both heat stroke and low blood sodium levels as a result of overhydration"I'm not a doctor, but I've got to call BS. This study is primarily based on the deaths of 3 recruits, give me a break! I've seen far too many guys drop & do the funky chicken from lack of hydration, than from too much. Again, not being a doctor, but shy of drinking from a firehose with your mouth duct taped on, I'm pretty sure your body can get rid of fluids. Can you drink too much & puke? Yep. You might even have to piss every 10 minutes, but I sincerely doubt that having too much water is even remotely as dangerous as drinking too little. I wonder if autopsies were performed to see if any of these isolated cases were the result of underlying problems? Me, I'll keep drinking! Andy IP: Logged |
Keld
Novice
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posted 07-09-2002 09:39
quote:
Originally posted by David Pennington:
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.
I wont call BS.
This should be the core of the message: Drink pure water before activity, and drink water with added electrolytes, during activity. Because the body washes out minerals during sweating, you replenish these minerals when you drink drinks like Gatorade and similar during exercise.
If these three deaths could be avoided by doing this, well thats three families that would be without tragedy from a training routine. Cheers,
Keld Knudsen
www.tactical.dk IP: Logged |
JohnRov
Novice
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posted 07-09-2002 13:09
I'm not saying it's wrong or right, but it does raise some questions. Having been involved in athletics all of my life through particiapation and coaching and having read more than my share of reports and articles on nutrition, hydrations, and similar subjects, I have never heard of this occurring. Of course that means nothing but it does seem suprising.
A good rule of thumb is to hydrate before activity and keep sipping during. Once you feel thirsty you are already starting to get dehydrated and studies have shown that even mild dehydration begins to cause performance loss. IP: Logged |
Ronin
Member
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posted 07-09-2002 13:33
All three of these cases were extremely abnormal - I was able to see some of the reports at the time. One of the things that stuck in my mind was the lack of acclimitization & that the person involved was not in the best of shape as it was. This is a rare situation & the media is of course working with only half the info. As always, acclimatize, BE IN SHAPE, take care of yourself & know your limits. The hard-core medical guys here can give you more science on it than I can, but the basic problem boiled down to electrolyte shift - too much pure water & not enough other stuff in the system. Gatorade or your favorite equivilent works fine, as does eating good nutritous meals.Of a related note, those who uses supplements such as creatine or any ephedra-containing items (a whole separate issue!) need extra hydration over their normal baseline levels due to the effects of these substances in the body. -R IP: Logged |
Tim Burke
Member
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posted 07-09-2002 14:21
quote:
I'm not a doctor, but I've got to call BS.
I am, it isn't.
This is not a new problem; IIRC, the medical textbooks refer to it as water intoxication. One of my roommates in med school ended up in an intensive care unit from this after an ultramarathon in 1984. More people get into trouble from dehydration than from water intoxication, so one should keep these reports in perspective.------------------
TB., NC IP: Logged |
Gordo
Member
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posted 07-09-2002 15:20
Yes, it is rare. (But not as rare as you think)
Yes, it is real.
Don't think of it as drinking too much water. Think of it as excessive intake of water over a short time period. The body is unable to remove water from the system as fast as it is taken in. (One non-fatal victim drank 3-liters in three hours (Fortean Times_ (#60, Dec. 1991) without urination.) Often I have read "you should drink half a liter for every pound of weight you lose during exercise until pre-exercise weight is regained". What didn't make it to the mass media was the rate of consumption. During college we performed work capacity studies in various tempatures on human subjects. The most remarkable was one subject had a 25-lb change in body weight during an 8-hour work day. Read that as 16-lb difference in starting and ending bodyweight, plus 9-lbs of water/Gatorade consumed. There was a small lake under the treadmill when he was done.  No BS. For your reading education:
See; [URL=" TARGET=_blank>http://www.alpharubicon.com/med/watertox.htmlTooMuchWater Also; [URL=]http://www.hhp.ufl.edu/keepingfit/ARTICLE/toomuchwater.htm]ExcessiveWater
From the end of the article;
"End Note: Water intoxication is a problem not only among athletes. For instance, it has become one of the most common causes of serious heat illness in the Grand Canyon. Some people hiking the canyon drink large amounts of water and do not eat enough food to provide for electrolyte (salt, potassium) replacement and energy. Fears of dehydration has led to a mistaken belief that the safe thing to do is to drink as much and as often as possible. But even with drinking water, there can be too much of a good thing." Now go back and re-read Ronin's post, if you exercise and/or operate in hot/humid conditions. [This message has been edited by Gordo (edited 07-09-2002).] [This message has been edited by Gordo (edited 07-09-2002).] [This message has been edited by Gordo (edited 07-09-2002).] [This message has been edited by Gordo (edited 07-09-2002).] IP: Logged |
EchoFiveMike
Member
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posted 07-09-2002 15:53
We had our first fatality in the Chicago Marathon last year due to this. It's something to keep in the back of your mind, but as long as you intake enough salts/electrolytes, there should not be a problem, right? That's the real problem, lack of electrolytes, not excess water, correct? S/F...Ken M IP: Logged |
Mr. Janet Reno
Member
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posted 07-10-2002 03:27
No medical training here, but I do have a few things to add:1. I first heard of this a few years ago while doing research into the club drug ecstacy(sp?). The myth when your brain is frying on this drug is, "the more water you consume, the better". Not true! 2. Uhm, I think the health problem arises because of a lack of sodium in someone's body. Sorta like, excessive water dilutes the sodium, and this lack of sodium is what gets you into trouble. Did I read this and similar articles wrong? 3. If you're working out/running a marathon/or just overextending your body during this time of year, the danger from high body temperature is a much, much greater probability than excessive water. What has always served me best is this: I want to drink enough water to keep my urine white, but not so much water that I'm peeing more than once every hour or so (while excersizing). IP: Logged |
Tabasco
Member
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posted 07-10-2002 09:43
Any Doctors or Medics out there,I am on Zestoretic (http://www.zestoretic-us.com/zestoretic/ ) to treat my borderline hypertension, 2 x 20/25 mg tablets per day ( 20 mg Zestril, 25 mg HCTZ ). I understand that these medications modify how your body retains water and salt, so I was wondering if there is anything I should be aware of regarding the over hydration, under hydration thing. FYI- I have begun to increase my physical activity quite a bit (5 to 8 miles walking per day, 300+ pushups and crunches every other day with some weight training) and I also like to go camping in the high desert of Nevada which is extremely dry and will literally suck the water from your body. Thanks in advance.
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MapleFlag
Novice
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posted 07-11-2002 16:36
Interesting thread. I had never heard of this before, but word must be getting around, because when I asked around, two others I work with have heard of it, and one of them saw someone go down from water intoxication last summer. That individual took in 4 litres of water in 20 minutes while on a march. They got sick and collapsed, but lived through it.LR. IP: Logged |
NS
Member
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posted 07-12-2002 11:58
I guess this one is a pretty head-on for Camelbak claims! Naw just kidding. No professional medical training, But under realistic situations I dont really understand why someone can manage to drink couple gallons of water in such short period of time. I guess you risk a lot of bathroom time on the march, way more than death. In common sense this is an obvious way to waste water. Our fellows have well put that all hydration packs should include electrolytes during hot weather. Ask your medics for them, or even bring a bit on your own along with water purifying tablets.
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Bodasafa
Novice
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posted 07-14-2002 05:10
Adding some sea salt to their water will probably solve the over hydration problem. Sea salt should contain most of the base minerals and all the sodium that the recruits lose while running or whatever.IP: Logged |
MickAv8r
Novice
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posted 07-14-2002 13:50
Powdered Gatorade. All the necessary electrolytes only downside is a bit too much sugar.IP: Logged |
Keld
Novice
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posted 07-14-2002 14:06
Sugar equals energy, which is good during physical activities of prolonged lenght.
Cheers,
Keld Knudsen
www.tactical.dk
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RFB
Member
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posted 07-14-2002 22:46
Sirs:GSSI: The Gatorade Sports Science Institute
http://www.gssiweb.com/ It is a proprietary site to promote their product, but they have performed reputable research re. the benefits of carbohydate/electrolyte enhanced rehydration. Respectfully
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Flipper
Member
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posted 07-15-2002 01:46
I would highly recommend either Poweraid or perhaps Cytomax (spl?) for the serious athlete. It’s something to do with them using long strand glucose polymers (or some such) instead of the simple sugars found in Gatoraid. A more complete explanation can be found in Mark Twight’s book Extreme Alpinism. It has an excellent section on nutrition and supplements for endurance athletes. It also has some interesting perspectives on equipment selection that could be creatively applied to military/LE applications. It is available at boarders and barns & noble. As to the over hydration issue in general, as a whole the military medical profession has some serious issues when it comes to accurate & up to date information. I remember seeing charts in the head in boot camp that advised you to "immediately consume 2-3 quarts of water if your urine was [a certain shade]" FWIW [This message has been edited by Flipper (edited 07-15-2002).] IP: Logged |
Shawn Dodson
Novice
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posted 07-15-2002 21:17
quote:
Excess water then goes to the bowel...
I can personally attest to that! I drank too much water in preparation to run during an Army Physical Fitness Test on a hot, muggy Summer morning, when I was in OCS. It was everything I could do to keep from cr@pping my gym shorts during the run, and afterward I could barely make it to the latrine fast enough. And when I did, it was nothing but water coming out.------------------
/s/ Shawn Dodson
Firearms Tactical Institute IP: Logged |
Glock-A-Roo
Novice
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posted 07-16-2002 11:26
1) Heat stress and dehydration are two distinct problems that happen to occur in similar environments. I don't care how well-hydrated you stay, if your core temperature exceeds human limits you will get heat stroke and die.2) Replacement of electrolytes is extremely important in high-sweat environments. Pay attention, though, to the electrolyte replacement therapy you choose. The aforementioned book by power/endurance master Mark Twight is an excellent reference. I quit drinking Gatorade long ago in favor of Gookinaid (www.gookinaid.com). Gookinaid's use of moderate levels of glucose is far superior to Gatorade's massive amounts of sucrose. I'm sure there are other properly formulated drinks on the market now in addition to Gookinaid. Consume such drinks for hydration and electrolytes, not calories. 3) Maintaining energy levels (read: blood sugar level) is essential in extended high-extertion activities, and is a separate issue from heat stress and dehydration. Even if you keep your core temp at reasonable levels and stay hydrated, if you're energy level dips too far you will "hit the wall" and be hating life in a serious way. Good references for this area are the adventure racers and "do it in a day" hikers/climbers. Search their material for the term "bonking". You've got to steadily dribble in the calories and keep your pace sub-anaerobic as reasonably possible so as to mix in some fat burning with the raw blood sugar. Eat too much and you will impede the absorption of water by the digestive system. Again, see Twight's book. Twice I have hiked down into the Grand Canyon and back out in a day, covering about 25 miles each time, in the dead of summer. Each time I consumed about 3 gallons of fluids (50% of which was Gookinaid) and maintained a steady caloric intake of roughly 400 calories/hour (the upper limit, to be sure). I had no problems, enjoyed myself immensely, and the only post-hike symptom was slightly sore calves. [This message has been edited by Glock-A-Roo (edited 07-16-2002).] IP: Logged |
ajp3jeh
Member
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posted 07-17-2002 09:24
FWIW, be careful with relying totally on Gatorade as your hydration source. Several years ago, two wildland firefighters were hospitalized in Florida for near kidney failure. They had been working all day and consumed nothing but Gatorade. Apparently, they had too much electrolyte and this really screwed them up. All the info for firefighters I've seen recommends that you either double the amount of water you add to your gatorade mix or alternate a glass of water with a glass of gatorade.IP: Logged |
GQ
Novice
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posted 07-17-2002 13:19
My Company just did a 25 miler as the culmination of a 10 day FTX. A soldier in my platoon (a seasoned NCO)went down due to overhydration. I saw him down 2 quarts of straight water an hour for 6 hours prior. He continued drinking water during, but was sweating more than he was keeping. At mile 22, I saw our medic put 2 bags in him (he got another 2 at the BAS). Our post policy is once you've been stuck you're done so he couldn't finish with us, but he was pretty wasted anyway.Just wanted to add personnal experience to the discussion. Stephen ------------------
High Performance Tactical Gear!
www.Lightfighter.com [This message has been edited by GQ (edited 07-17-2002).] IP: Logged |
miketm
Moderator
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posted 07-17-2002 22:03
Stephen, Did the doc say that it was definitely OVER hydration? Just curious. I need the whole picture. Did the dude have ANY prior medical history? Anything? Any meds on a regular basis? Was he a prior heat casualty? Is that why he was OD'n on the water? Was he trying to saturate his tissues? What were his symptoms? Was he alert and not oriented? Vomiting? Did he have a syncopal episode? What I'm trying to say is, I've never seen water intoxication. I know, I know, just cause I've never seen it doesn't mean it doesn't exist. IMHO, it is much more common for those active folks, those folks that are on this type of message board to run into dehydration rather than OVER hydration. I think this particular case, this case you mention, the guy was a seasoned road-marcher, he should have know better. I'm sure he knows that now. Check out the medical forum. Everyone should know their own physiology and be aware of what they need and don't need. If your pissing and your piss is reasonably clear and doesn't reek, you are probably OK. I'm just saying to know your limitations.IP: Logged |
fedaykin
Novice
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posted 07-24-2002 14:06
this is actually old news to sports medicine.i am a long distance runner/triathlete/adventure racer, former military. hyponeutremia(correct spelling?), or water intoxification. due to lack of nutrients (sodium, potassium, etc.) your body does not absorb water too well and the muscles don't work very well either.
at one point, training for a double marathon, i was doing a 26 mile run in an isolated desert area and i got water intox. to the point where i got "exercise induced hypothermia" (this was what my doctor said).
it was summer about about 90 degrees, but my body temp started to drop!!
i did make it back. started cramping to the point where i was immobile for some time.
some mountain bikers helped me stretch out again. i ate some salty food and put down some protein and plenty of water.
i was fine after a two hour nap.
this has happened to me before when i did not watch my food intake very well for a well balance intake and i simply kept on drinking water with no nutrients.
ever since that time (about four years ago) i just make sure i pay attention to what my body needs and i have not broken down once no matter what the event is i am doing. forgive the spelling errors! good training, will IP: Logged | |
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