Thirsty: first-person account of the real risks of overhydration and water poisoning

JENNY AITKEN
The Martlet (University of Victoria)

VICTORIA (CUP) — “You are suffering from overhydration,” Dr. Wayne Smith said, running a hand through his greying hair. “You are drinking so much water that it is becoming like a poison in your body.”

I stared at him in disbelief. Beside me sat my metal water bottle, its flower pattern chipping from overuse. My tongue felt like sandpaper and I wanted nothing more than to take a gulp from it. But, from that moment on, it was no longer an option.

Overhydration occurs when there is a disruption of electrolyte levels in the body due to overconsumption of water. In today’s society, with most new diets and weight loss plans recommending drinking large amounts of water, more and more people, like myself, are unknowingly putting themselves in risk of water poisoning.

Dr. Smith went on to explain that as a result of all the water I had been drinking, I had developed an extremely low sodium level, and my kidneys were essentially drowning with fluid. Tears pricked my eyes as he listed off my transgressions until, in self-defense, I exclaimed, “But I thought drinking water was healthy!”

Full of nothing

I had always believed that water was the best thing to be drinking, because it has no sugar or calories and is often linked with healthy weight loss.

Although the Canadian Food Guide does not specify a certain quantity, it does recommend water to help with metabolism, stating that it can help ease food cravings. The reason they do not recommend a specific amount is that the fluid needs of each individual are different.

Fitness magazines and speed diets often promote water as a crucial factor in weight loss. As both a fitness enthusiast and an insecure university student, I clung to this idea that water would help me avoid weight gain. It’s not as if I forced myself to drink obscene amounts of water, but I conscientiously tried to stay hydrated throughout the day. Apparently, I had been trying too hard.

Leaving Dr. Smith’s office, I walked to the bathroom at the end of the hall with stiff legs, as if trying to stall myself. Finally, I reached the sink and poured out my entire water bottle. I looked at myself in the mirror, my skin pale and free of makeup. I stared at my reflection, wondering how I could have been so foolish, how I could have let this happen. It was there that I finally let myself cry.

Boiling the problem away

I had been given direct orders: I was only allowed to drink 500 mililitres of water a day, which included any coffee or tea. Everything else had to have salt in it, but I was mainly to drink Gatorade to replenish my electrolytes.

With my limited background in biology, I had nodded my way through my doctor’s appointment, while he threw around words like “osmosis” and “concentration gradient.” It was only later, once I had time to digest the information, that I felt ready to learn more.

According to Dr. Brian Christie, an associate professor of medical sciences at UVic, drinking too much water causes the fluid outside of the cells to be very low in sodium and electrolytes. When this happens, it causes the water to shift into the cell, causing the cell to swell. Christie says, “Like a balloon, if the cell continues to swell it will just pop.” This results in a leaking or damaged cell. Although this is bad for any organ, it can be particularly detrimental to the brain, because the swelling causes a buildup of intracranial pressure.

During the doctor’s appointment that day, Dr. Smith had asked me if I ever got headaches. “Do you get light headed or often feel confused?”

I nodded. “All the time.”

Apparently, these were some of the minor symptoms of overhydration. It could also cause muscle weakness, intense thirst, fatigue and changes in behaviour. It seemed like everything I had simply attributed to school stress or PMS had actually been warning flags of an unexpected and dangerous condition.

People always told me it was strange how much water I drank. Once when I met up with my brother Eric for lunch he asked, “Why do you drink so much? It doesn’t even taste like anything!” I tried to explain that I liked water. How I felt like I was always thirsty and that nothing else would work. He said it wasn’t normal to “pound back” three or four glasses of water during one meal. He was right.

While reading up on overhydration, I discovered a long list of cases of people who had died from drinking too much water. I felt connected to the victims, and couldn’t help feeling that it could have been me.

Jacqueline Henson’s death in 2008 hit particularly close to home. She was a 40-year-old woman, who was trying to lose weight using the Lighter Life Diet Plan. The diet suggested drinking four litres of water throughout the day. Jacqueline drank that entire allotment during less than two hours, while she sat watching TV. A healthy kidney can excrete a maximum of one litre of water a day. Since her body was unable to excrete the fluid, it led to a build up of intracranial pressure. She died the next day of internal bleeding.

Jacqueline’s terrifying experience reminded me of what Dr. Smith had told me about my own condition. We had been poring over my blood work results, and he had pointed out my low sodium levels. I asked him how serious it was.

“Well,” he said, “If you were sixty years old instead of young and resilient, you would probably have already lost cognitive brain function.”

Athletes are also highly susceptible to overhydration, because the combination of prolonged strenuous exercise and excessive fluid can create a life-threatening situation. This was the case for Cynthia Lucero, a runner who collapsed during the 2002 Boston Marathon. Cynthia’s overhydration caused swelling in her brain, and she died shortly after.

There have also been several noted cases of overhydration in ecstasy users. Leah Betts was 18 when she died in 1995. After consuming ecstasy with some friends, Leah started to feel anxiety and panic. Concerned that something had gone wrong she started drinking large amounts of water. In less than three hours she consumed seven litres of water, which caused a build up of pressure in her brain. By the time Leah reached the hospital she had suffered irreversible brain damage.

Even before seeing the doctor, I had known that something was wrong. My skin was pale and lifeless, and I was losing weight without trying to. I was constantly thirsty, and often had to go to the bathroom four or even five times a night. When I told my Mom on the phone I could hear her concern, could picture her eyebrows furrowing. Not wanting to worry her, and because I didn’t want to deal with it myself, I procrastinated on making a doctor’s appointment for as long as possible.

Leaving the doctor that day, I focused mainly on the short-term ramifications. It was New Year’s Eve, and after a night of partying I would not be allowed to drink any water. Visions of the hangover from hell consumed my mind, and let me temporarily avoid reality.

The next day, I stared at the lacklustre contents of my fridge and realized a trip to the grocery store was in order. Half a one-litre carton of milk wouldn’t sustain me for long. At the store I scoured the shelves, picking up grapefruit juice, mango juice, banana kiwi, anything but the apple and orange I had grown tired of as a child. At the checkout, I carefully loaded up the juices, along with twenty bottles of blueberry pomegranate Gatorade.

The cashier, a middle-aged woman with a bob and a sharp nose, gave me a quizzical look. “Are you some kind of competitive athlete or something?” she asked. I nodded, not wanting to delve in to why I was spending $57 on juices and sports drinks.

In the weeks following the diagnosis, I fell into a routine. Every morning I would have one cup of tea with breakfast, and one glass of water with dinner. Apart from that I mainly relied on Gatorade to get me by.

Most of my friends found the whole water thing to be funny, and for my mother it became a conversation starter. “The MacDougalls cannot believe that you can’t drink any water. I told Kim at work, and she can’t believe it either,” she recounted on the phone one night. I could understand why people felt that way — I had hardly believed it myself. Still, the shocked reaction made me self-conscious, and no one seemed to grasp that it was actually hard to deal with. I have always been someone who commits to things to an extreme. The results had always been harmless; cue the time I watched the entire six seasons of Dawson’s Creek in less than a month. Countless online quizzes have categorized me as having an addictive personality, but I never paid it much thought. That personality trait is probably what led to my overhydration — I thought the more water I drank the healthier I would be. Now that I am trying to recover, I see how important it is to have self-control.

In the past month, my sodium levels have slowly started to climb. I no longer find myself sprinting to the washroom at all hours of the night, and I no longer feel the need to chug water. I still need reminders though — stuck above the kitchen sink is a post-it note reading, “Just say no to H₂0!” I will be monitoring my water intake and getting regular blood work done for the next several months, at least.

Good in moderation

My experience with water is far from the norm; in fact, most Canadians do not drink enough water. Water is crucial for carrying oxygen and nutrients to the cells through blood, and plays a large part in digestion and metabolism. According to Christie, moderation is key when it comes to water intake, “You do need water, just don’t go pounding back 8-ounce glasses every hour of the day,” he says.

When I was leaving the appointment, Dr. Smith, afraid I had gotten the wrong impression, assured me, “Water is good for you, and your body does need it. Just remember that with water, like anything, there can still be too much of a good thing.”


Graphic: Ryan Haak/Martlet