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Why You Might Be Dangerously Dehydrated

Posted: 07/23/11 04:15 AM ET

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By Rachael Moeller Gorman, contributing editor for EatingWell Magazine

It was 7 a.m., but Jill Donnelly was already sticky-hot. The 40-year-old mother of three had woken up early that June day to run her first 10K race. As she waited at the starting line in Annapolis, Maryland, with thousands of others in the thick summer air, she tightened her shoelaces and wiped a few beads of sweat from her forehead.

The gun sounded. She took off, and quickly. She skipped the water stations and kept pushing, excited to be running so well. At mile three, however, she started breathing strangely. At mile 4.5, she could see the race's leaders. Whoa! she thought. I'm going fast!

And that's the last thing she remembers. When her eyes finally fluttered back open, EMTs were rolling her stretcher from an ambulance into Anne Arundel Medical Center's ER and she was being pumped with intravenous fluids. She couldn't remember the names of close friends and she was nauseated.

Later, when she had recovered, the doctors asked what she'd had to drink recently. She thought. The day before, another scorcher, she had lounged by the pool with her kids. One of them had knocked over her full glass of iced tea and she had never refilled it. At dinner, she had sipped a glass of red wine with her pasta. She realized she had had nothing else to drink all that day; on race morning all she had was a couple sips of water.

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Jill might have been 2 percent [mildly] dehydrated before she even started the race, said Sam Cheuvront, Ph.D., an exercise physiologist, when he heard her story. (A 10-kilometer, or 6.2-mile, race is usually too short to produce significant dehydration by itself.) This is not terrible. But, said Cheuvront, "86 degrees and humid and trying to run a 10K fast -- even if you're marginally dehydrated, in a hot environment the effects are exacerbated."

In Jill's case, that meant deeper dehydration -- and a dehydrated body can't cope as well in hot weather. (In fact, for every 1 percent of body mass lost due to dehydration, your body temperature rises by about a third of a degree Fahrenheit.) This most likely led to Jill's heat exhaustion, which probably caused her collapse.

This is an extreme example, though. Had Jill been sitting at her desk while slightly dehydrated, she wouldn't have collapsed, but she would have felt thirsty, probably tired, a bit irritable and less willing to work. Her brain would have suffered as well -- at least until she drank something. Studies have found that slight dehydration worsens our ability to recall new information. Other studies show that our ability to pay attention and do math is also impaired. This mild, 2 percent dehydration, while fairly common, makes it difficult to be physically active. Several studies have reported that being dehydrated, especially when it's hot, reduces the amount of aerobic exercise you can do: people who were just slightly dehydrated were typically only able to run, for example, about 75 percent as hard as usual.

When you skimp on fluids (check out the ideal amount here), it's hard on your body, which makes sense because water is essential to just about every process in our body and, in fact, to the very existence of life on Earth. Life first emerged in the salty, primordial ocean; it stayed there until it was able to capture a bit of that water inside itself, the so-called "milieu intérieur" in which cells are bathed. Our inner ocean is a calm, salty broth providing cells with the raw materials they need to function, removing waste products, allowing them to communicate with each other and buffering them from the unpredictable world outside.

This water within accounts for about 60 percent of our body -- about 11 gallons, or 92 pounds, inside a 155-pound person. Most of it lurks inside our cells (where all sorts of important substances are dissolved in water) and outside them (the milieu interieur), but we also use it to cool our body with sweat, to circulate oxygen and fuel to our organs and to take away waste products via blood. The elderly, infants and sick children are most prone to dehydration, but no one is risk-free. "lf you're really busy, it's easy for all morning to go by and you don't really drink much until you notice you are thirsty, at which point you're already slightly dehydrated," says Cheuvront. And when we exercise hard, such as playing soccer or football or running distances in the summer, and forget to hydrate, we can easily lose 4 to 5 percent of our body weight (take a look at the best after-workout drinks here).

Sam Cheuvront should know. He studies hydration for the U.S. Army Research Institute of Environmental Medicine (USARIEM), whose mission is to "protect, sustain and improve the performance of the Warfighter." Cheuvront spends his days testing soldiers to see how their bodies perform when they're hot, dehydrated, in humidity, at high altitudes and in other extreme conditions. At USARIEM in Natick, Massachusetts -- where most of Cheuvront's work is conducted -- scientists simulate different environments, putting real soldiers in an assortment of climate chambers, from the Tropics Chamber to the Arctic Chamber. Called the Doriot Climatic Chambers, these are some of the world's largest and most sophisticated environmental test chambers.

Researchers can march five soldiers in full gear on a treadmill built for a horse and pummeled by winds at 100-degrees fahrenheit while it's raining, to test exactly how much they're sweating, their heart rate, how much energy they're expending and their body temperature. They could even have soldiers simulate living on top of Pike's Peak in Colorado (atmospheric pressure equal to an altitude of 14,000 feet) for two weeks to see how they fare.

Cheuvront's studies on hundreds of soldiers have helped create the official military doctrine for how much soldiers need to eat and drink to prevent dehydration and heat stress under a variety of different conditions. To the Army, a hydrated soldier is a tactical weapon.

The intelligence also helps solve other problems. It's a logistical nightmare to transport water to troops in Iraq and Afghanistan; some soldiers may need more than three gallons per day and water transport accounts for one-third of on-the-ground wartime costs. Additionally, water convoys are prime targets for the enemy. Cheuvront recently created formulas for estimating the water needs of soldiers that are 58 to 65 percent more accurate than the old water formula (developed 30 years ago, it overestimated soldiers' needs). When the new formulas are implemented, the military will no longer ship too much water to troops, saving money and, potentially, lives.

Cheuvront's work on hydration filters down -- and can be applied to everyone, not just soldiers and athletes. For example, Cheuvront has synthesized his research into three simple questions to determine whether someone's dehydrated: Am I thirsty? Is my morning urine dark yellow? Is my body weight this morning more than a couple pounds (or about 1 percent) lower than it was yesterday morning? If you answer yes to one of these questions, you might be dehydrated. Yes to two: you are likely dehydrated. Yes to three: you are very likely dehydrated.

Understanding how much water a soldier needs when in full gear versus shorts and a T-shirt (something Cheuvront has also studied) provides greater understanding of, say, how much water you need if you're a weekend warrior or someone gardening on a 90-degree day. Are you thirsty yet?

Contributing editor Rachael Moeller Gorman recently won a James Beard Award for her EatingWell story "Captain of the Happier Meal" (May/June 2010).

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By Rachael Moeller Gorman, contributing editor for EatingWell Magazine It was 7 a.m., but Jill Donnelly was already sticky-hot. The 40-year-old mother of three had woken up early that June day to ru...
By Rachael Moeller Gorman, contributing editor for EatingWell Magazine It was 7 a.m., but Jill Donnelly was already sticky-hot. The 40-year-old mother of three had woken up early that June day to ru...
 
 
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HUFFPOST SUPER USER
Chuck Bluestein
Always searching for latest health breakthrough
06:11 PM on 07/25/2011
A good way to rehydrate is by eating juicy fruit. Water is by definition tasteless. It is a lot more enjoyable to rehydrate yourself by eating watermelon, grapes, peaches and other fruits. Also they have the best electrolytes that you can get. You do not want to buy electrolyte drinks with chemicals and sweeteners in them.

Also keep in mind that the more sodium you consume, the more water you need to consume. Now unsalted foods have a little bit of sodium in them. But salt is not a food and contains 40% sodium. So salted foods can greatly increase your need for water. http://bit.ly/salt-free The above says that you can lose pounds of water. Consuming a lot of salt will require you to retain pounds of water! So consuming a lot of salt can make you many pounds heavier and that includes sea salt. So salt has no calories but can make you much heavier.
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02:21 AM on 07/26/2011
Very true!
I juice cucumber, cilantro/parsley and add with coconut water. These are also internal hydrating and cooling vegetables that keeps me hydrated during long hikes.
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HUFFPOST SUPER USER
Chuck Bluestein
Always searching for latest health breakthrough
05:14 PM on 08/12/2011
Since almost everyone consumes salt, they have excess sodium. But potassium helps the body get rid of excess sodium faster and easier. Coconut water has more potassium than any other drink. That is why many report feeling better after drinking coconut water.
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HUFFPOST SUPER USER
madcityy
12:08 PM on 07/25/2011
the army gave me heat stroke,,at fort wood, in the summer one yr...............here is a tip...

it never goes away..u r weak in heat forever from it......................foreverrrrrrrrrrrrrrrrrrrrrrrrrrrrr and

it will killllllllllllllll you............................thank God for good medics..............................
04:02 AM on 07/25/2011
As the article says, previous figures were excessive.

In Yemen in the Sixties, with the British Army, on the edge of the Empty Quarter, we were advised that five English gallons a day were required per man. Four gallons to drink; one gallon to wash. We would pool the washing gallon and share a makeshift shower. There was rarely any left by bedtime.
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Caseybug
Religion and WS are businesses without a product
03:41 AM on 07/25/2011
Solution: More tonic, less vodka
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HUFFPOST SUPER USER
MikeyJaii
Socialism.
01:04 AM on 07/25/2011
My electric bills is going to make me go broke....
HUFFPOST SUPER USER
alteredstory
Hold on to the center
01:01 AM on 07/25/2011
A few years ago, two streams I was relying on while backpacking turned up dry when I hit them. Then, when I finally found a muddy puddle, my filter broke. I ended up filtering muddy water through a tshirt, and boiling it, then letting it cool enough to drink. 28 miles that day, the last four of which were in the dark, and hunting for water.

It only takes one night like that to make water the sweetest, best tasting drink in the world.
HUFFPOST SUPER USER
HawaiianLady
My name means Gift of God.
10:13 PM on 07/24/2011
I spent a week in the hospital a year ago as a result of dehydration caused by vomiting (I had an allergic reaction to codeine, which I didn't know was in a drug I was taking for bronchitis). I hadn't replaced the fluids I was losing by being sick. I was so disoriented that when a friend came over she found me unable to remember my own name or tell her where I lived. She called the ambulance, they hooked me up to an IV and took me to the hospital, where they diagnosed me as being in kidney failure and altered mental state. My heartbeat was irregular as well.

About halfway to the hospital, as the IV fluids took hold, I began to regain my memory. In the hospital they restored the balance of my calcium, sodium, potassium, etc., all thrown off by the dehydration.

I had had no idea dehydration was so serious. No longer. I'm careful now to be certain I have enough water in my system. No recurrences since then, and my kidneys are back to normal. It was a close call, however. Thank God for my friend visiting that night. She may have saved my life.
HUFFPOST SUPER USER
Duane7
08:39 PM on 07/24/2011
Having worked with body builders for for decades I can give you some good advice on hydration. If you are tired by 2pm check your water levels. If your urine is dark at night check your water levels. If muscle soreness runs more than 2 days check your water levels. If you drink alcohol, tea, coffee, or soda check your water levels. If you eat chocolate, chips or anything with High Fructose Corn syrup check your water levels.

I've found my body builders need 8 to 12 glasses a day when in training. Less when on maintenance. Heat and humidity are a big part of the equation. All this said be careful you aren't flushing away all your nutrients and vitamins. An extra C/B complex stress vitamin might be wise in the evening if you are sweating and urinating heavily. Toxicity builds with too little water, don't risk it if you are an athlete, HYDRATE!
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HUFFPOST SUPER USER
bsultan
Universal truth is not measured in mass appeal.
09:16 PM on 07/24/2011
Thanks for the informative post!
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07:20 PM on 07/24/2011
I can't believe, in this heat, someone could be so absent minded to not hydrate properly before a 10k race.
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soundping
America: Love it or leave it !
04:31 PM on 07/24/2011
Just think all the water we drink is dead water.

Natural water has life teaming in it but now our water has to be chemically treated killing all the life in it.

Maybe this will make it through??
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HUFFPOST COMMUNITY MODERATOR
ConfuciusSay-
Aglets: their purpose is sinister.
05:48 PM on 07/24/2011
Water is a chemical compound.
Microorganisms, worm eggs, larvae, viruses and fungal spores are not water.

I would rather not drink them.
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alteredstory
Hold on to the center
01:09 AM on 07/25/2011
Actually, drinking "dead" water is a good thing.

Any backpacker will tell you that the ONLY water you drink without filtering or treating, is water that's coming straight from a spring - that has little to no life in it.

E. coli, Giardia, Cryptosporidium, and so on - all potentially fatal, all contractible by drinking untreated water.

Giardia is particularly common, and death by dehydration because you can't stop squirting makes "dead water" seem pretty nice.

Then, of course, there's the problems with drinking water with a dead animal right upstream.

If you want to drink untreated water, feel free to do so, but do it with health insurance, and pay for your own emergency room visit.

and please don't get evac'd if you're in the wilderness - it's not nice to make everybody else pay for your ignorant foolishness.

Oh, and if you want to know what it looks like when "live" water is what's available in a city, go look for pictures of the Nairobi river, around Kibera Slum - you won't get the lovely odor that precedes the river by some distance, but you should get the lovely colors - usually milky or green. If you want to drink that, by all means do, but you've got so much to live for...
04:10 PM on 07/24/2011
Your body is a battery, too much water dilutes electrolyte balance then the battery has no juice, and you have no heartbeat.
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HUFFPOST COMMUNITY MODERATOR
ConfuciusSay-
Aglets: their purpose is sinister.
05:50 PM on 07/24/2011
Water intoxication actually affects the brain first, but what you suggest does have a grain of truth in it. Hypokalemia stops the heartbeat.
07:45 PM on 07/24/2011
Correct, my mom has had this problem of flushing out her electrolyes. Without proper electrolye balance, you can not stay hydrated..You don't sweat water, you sweat out electrolytes..

Look it up dehydration is cause by either not drinking enough water or drinking too much water
04:09 PM on 07/24/2011
Your article is helpful but you are citing extreme cases: mothers running in a 10k on a hot day, soldiers in full battle dress, etc. The last part of your article finally gets to what common sense and my mother always told me: drink if you are thirsty and make sure your pee stays pale yellow. And she didn't even have a "study" to confirm this, much less a PhD in exercise physioolgy. Peter Klika, Kapaau, Hawaii ( we drink when we are thirsty here-how novel).
HUFFPOST COMMUNITY MODERATOR
Gib
My micro-bio is empty
05:36 PM on 07/24/2011
Agreed. What a steaming pile ...
i the ys
eternity takes no time at all
08:46 PM on 07/24/2011
No forget Peter you live Kapa'au. I will drink to that. FBI aloha
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HUFFPOST BLOGGER
Kim Stagliano
Author All I Can Handle I'm No Mother Teresa A Lif
02:19 PM on 07/24/2011
I learned his lesson recently. I began a rigorous boot camp style kick boxing class last Spring. One day, I went to donate blood. the technician said my blood pressure registered somewhere around, "Call the morgue..." She was quite concerned and asked if I was feeling OK. I felt fine, but was not able to donate blood. At home I Googled low blood pressure, trying to ignore the horrible options for disease. Then I saw it - "Dehydration." Ah ha! I increased my water intake, had a physical two months later and my blood pressure was fine. I gave blood last week. I had no symptoms of being thirsty - just super low BP.
01:34 PM on 07/24/2011
Thirst is evolution's way of helping you pass on your genes to the next generation. All this dehydration nonsense is bottled water company propaganda. This article was posted by a magazine trying to sell ad space to bottled water companies. Does it make sense that humans would lose the ability to feel the need for water and somehow have survived as a species? If one is ill or old one might need medical assistance with dehydration. Otherwise drink when you feel thirsty.

http://www.scientificamerican.com/article.cfm?id=strange-but-true-drinking-too-much-water-can-kill

http://www.dailymail.co.uk/health/article-348917/Aquaholics-Addicted-drinking-water.html
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HUFFPOST SUPER USER
Ed Saletnik
Renaissance Man
04:22 PM on 07/24/2011
Well said. This article will now have people worried that they are going to suddenly die of dehydration. All they have to do is drink when they are thirsty.
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HUFFPOST SUPER USER
Foucek
Love my doggies!!
07:11 PM on 07/24/2011
I've taken care of a lot of dehydration patients...all ages.Can be scary.
12:23 PM on 07/24/2011
The actual medical facts are the average healthy person does NOT need 8 or more glasses of water / day.
If you hydration is low you feel thirsty. Thirst is a sign you need water.
If you drink when your thirsty, you don't need more.
This was a fad started a number years ago and of course people jumped on the bandwagon, along with the other who take a thousand vitamins a day and think they are doing themselves some favor.
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NyJimbo
You wanna go that way? Oh, we'll go that way !
12:46 PM on 07/24/2011
"If you hydration is low you feel thirsty. Thirst is a sign you need water. "

NO!. Even though I agree that 8 glasses a day is probably too much for people indoors in normal conditions, dehydration does not automatically make you feel thirsty. Lethargy, weakness and stomach related issues are often indicated before actual thirst.
HUFFPOST COMMUNITY MODERATOR
Gib
My micro-bio is empty
05:38 PM on 07/24/2011
What b.s.! All animals, including humans, get thirsty when they need water. How else do you think we have all survived for hundreds of millions of years??
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HUFFPOST SUPER USER
MrBadExample
Friends call me ‘exampleicious’
02:01 PM on 07/24/2011
The actual medical facts are the average healthy person does NOT need 8 or more glasses of water / day.

They do if they're moving about. Sedentary people probably can hydrate with colas or coffee, but anybody who's doing any sort of regular exercise should be going through a quart of water a day. Somebody on a bicycle should be going through about a liter an HOUR--even more in cold weather.

Americans are exercise averse, but anybody who's trying to get in a few hours of cardio a week (anything from running to vigorous walks or cycling) should be hydrating about a quart a day.