Every now and then there is a report in the news about someone dying of water intoxication. It usually gets a lot of attention because the headlines are so shocking. How is it that drinking water killed someone, especially when they are so young and healthy! What is worse, it seems to fly in the face of conventional wisdom that you need to be drinking more water not less.
What Is Water Intoxication?
Water intoxication is a condition where the body’s level of sodium has been rapidly diluted with too much water. It is also known as hyponatremia or hyperhydration. Sodium is an important electrolyte that helps regulates the body’s fluids. When the body’s sodium level is changed rapidly by drinking a lot of water, the extra water then causes the cells in the body to swell and malfunction. The cells in the nervous system are particularly sensitive and can lead to symptoms that can mimic alcohol intoxication. Hence the name water intoxication.
Are You At Risk For Dying From Too Much Water?
If you are now worried that drinking those extra eight 8-oz glasses of water a day is going to put you at risk for dying, don’t be. The risk of dying from water intoxication by drinking an extra 64 ounces of water (or about 1.5 liters) a day is very low. The reason is that it really isn’t that large of an amount of water (except for a baby) and under normal circumstances, your kidneys can get rid of almost a liter of extra water an hour or 15-20 liters a day.If for some reason your kidneys aren’t getting rid of the extra water, which can happen with a lot of conditions and by a number of medications, the body’s cells can adapt to the changing levels. In fact, it is not uncommon to have very low sodium levels and not have any symptoms. When the hyponatremia does cause symptoms, they tend to come on relatively slowly (days to weeks) and there is usually time to treat it before fatal levels are reached.
If you have had problems with your sodium or fluids in the past, talk to your doctor first before starting a new hydration regimen. Certain conditions or medications can limit the kidney’s ability to get rid of extra water.
When Does Fatal Water Intoxication Tend To Happen?
When somebody dies of water intoxication, it is usually caused by the combination of a very large amount of water (often 5 liters or more) over a relatively short period of time (minutes to hours).
- Excessive Sweating: Some of the most famous cases of water intoxication have involved athletes. They got in trouble because they were losing larges amounts of both water and sodium in their sweat but they were replacing their fluid loses with water only. The use of electrolyte solutions instead of water to prevent dehydration reduces the risk substantially.
- Binge Drinking: There have been at least two reported cases of people dying from binge drinking as part of drinking contests and fraternity hazing. These deaths were completely preventable.
- Drug Use: Water intoxication has occurred in people trying to dilute their urine to pass a drug test. There have been at least two cases of teenagers dying after using ecstasy and then drinking excessive water. Impairment of the kidney’s ability to remove the extra fluid by the drugs (particularly ecstasy) was an important factor in their deaths.
- Other Cases: There have been a number of other cases involving giving the wrong intravenous fluids in the hospital, feeding infants water only by mistake, and excessive consumption of beer.
What You Can Do to Protect Yourself
The best way to protect yourself is to recognize if you are really at risk. If you plan on performing heavy exertion, especially in the heat, plan on replacing the fluids you are losing with an electrolyte solution. Unless you have a medical condition that requires drinking very high levels of water, such as kidney stones, don’t drink more than moderates amounts of water (2 liters a day). Finally, don’t participate in potentially dangerous binging activities.
Cases of Water Intoxications
- 2007 – Water Drinking Contest - Jennifer Strange
- 2005 – Fraternity Hazing - Matthew Carrington
- 2005 – Bicycle Training - James McBride
- 2002 – Boston Marathon - Cynthia Lucero
- 1998 – 50 Kilometer Walk - Craig Barrett
- 1995 – Ecstasy Drug Use - Leah Betts
- 1995 – Ecstasy Drug Use - Anna Wood