Dehydration can be life threatening

You’re thirsty. What do you do? Reach for something to drink. Thirst is your body’s handy way of signaling that you need to replenish your stores of water. Because drinking more is the best way to prevent or combat dehydration, thirst serves the practical purpose of making sure your body has enough water to perform its functions.

Most of us have been mildly dehydrated at some point in our lives; usually, we can replace our lost fluids by drinking more. In some cases, though, mild dehydration becomes severe.

Preventing excess water loss is the best way to ensure that you don’t become severely dehydrated. You can treat yourself if you recognize warning signs; they’ll also help you know if you need to seek medical attention. While dehydration can be hard on your body if it goes too far, complete recovery is very likely if identified and treated early enough.

In a healthy individual, water accounts for two-thirds of body weight. The average adult needs to consume at least 32 ounces of liquid (four 8-ounce glasses) each day to maintain essential functions — an active adult will need to drink at least two or three times that much.

About 10% of water in the body is in the bloodstream and must be kept at a reasonably consistent level to keep the body working correctly. Our bodies need salts called electrolytes, such as sodium, potassium, magnesium, and calcium, for energy conversion to occur at a cellular level. Electrolytes are depleted along with loss of water. As a result, dehydration disrupts the body’s normal functions.

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Initially, dehydration stimulates the part of the brain that tells you you’re thirsty, causing you to drink more liquids. While you can usually correct mild dehydration by drinking more, it may be challenging to keep up with the amount your body needs if you are losing significant amounts of water. In addition, vomiting, diarrhea, excessive urination, or sweating can turn mild dehydration into a severe problem.

Brain cells are susceptible to water loss, so mental confusion and even coma may result in severe cases. In addition, blood pressure can fall, causing lightheadedness and overall weakness. If fluid losses continue, internal organs such as the kidneys may be damaged. If prolonged, dehydration may even be fatal. Drinking water or other fluids is usually the easiest way to replace lost body fluids, but severe cases may need intravenous treatment.

How common is dehydration?

Dehydration can happen to those of any age or gender. However, infants and small children have a high metabolic rate, so relatively large amounts of fluid are required to keep their systems going. The elderly are also at higher risk because their bodies store less water, and they tend to drink less liquid on average. Additionally, they may suffer more severe consequences from dehydration than younger adults do. Dehydration is reported as one of the top 10 reasons for hospitalization among Medicare recipients.

Possible underlying causes

Dehydration occurs when your body uses or loses more fluid than it takes in. This can result from drinking too little liquid or from excreting too much. Water leaves the body in urine, sweat, and in the air, you breathe out. When you have diarrhea, vomit, or work too much from a fever or overexertion, the rate of fluid loss can be greater than you can take in new fluids.

Triggers of dehydration

Dehydration is particularly likely to be triggered by the following factors:

• Insufficient fluid intake
• Repeated vomiting
• Persistent diarrhea
• Excessive sweating from overexertion or fever
• Use of diuretics (also called “water pills”) or excessive urination (seen with untreated diabetes, for example)
• Hot environment, such as a heat wave

Diagnosing the underlying cause

Your doctor will want to know if you’ve repeatedly been vomiting, sweating heavily, or had diarrhea. If they suspect food poisoning or an infection such as the flu is causing your diarrhea or vomiting, your physician may check you for these conditions. They may also investigate to see if you have diabetes, which can cause excessive urination, or take any medications which may contribute to dehydration.

To diagnose dehydration, your physician will want to know your recent medical history and complete a report of any signs or symptoms you have. Then, they will perform a physical exam, take your blood pressure, and check your pulse. They might also analyze your electrolyte levels with blood and urine tests.

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The goal of treatment is to replace lost fluids and make sure your body has enough water and salts. Treatment is also aimed at curing any underlying illness or infection, if possible, or preventing dehydration until illness such as the stomach flu passes.

Drink more fluid. Water is critical, but fluids with extra electrolytes can also help. Try flat ginger ale, fruit juices, or specially formulated sports drinks such as Gatorade. Avoid commercially prepared broth or bouillon since these contain high amounts of salt. Don’t consume anything with caffeine in it.

To combat dehydration in remote areas, the World Health Organization developed an oral rehydration solution (ORS) that replaces lost fluids and electrolytes. You can make your own ORS at home from the following recipe:

• 1 quart water
• 1 cup orange juice
• 1 teaspoon table salt
• 1 teaspoon baking powder
• 4 tablespoons sugar

Drugs most commonly used

• Oral rehydration solutions containing electrolytes such as Pedialyte for children, Infalyte for infants, or similar solution for adults
• Intravenous fluids, salts, and nutrients

Considerations for older people

Dehydration is common among older individuals. If your doctor prescribes any medication for you, be aware that side effects and adverse reactions are more common in older adults. Be sure to remind your physician of any medications you are already taking. People who have difficulty getting around are more prone to dehydration because it’s harder to get to the water. Keeping an easily accessible glass or pitcher of water or juice will help prevent this.

Considerations for children and adolescents

Because dehydration can happen quickly to infants and children, contact your child’s pediatrician at any sign of dehydration. If your child is ill, it is critical to ensure that they drink enough fluids. Watch for signs of dehydration: dry mouth, decreased or absent urination, sunken eyes, and reduced or lack of tears. Dehydrated infants may have a severely sunken fontanel (you’ll see a soft spot or depression in the front of their forehead or scalp). Check with a doctor before giving your child anti-diarrhea medications, which may contain aspirin-like substances that can cause Reye’s syndrome, a potentially fatal condition for children. Seek a physician’s care for any persistent vomiting or diarrhea.

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Preventing dehydration

Prevent dehydration by noticing the color of your urine. It should be almost clear with just a hint of yellow. The less clear it is, the more dehydrated you are.

• Drink six to eight 10-ounce glasses of water or other nonalcoholic and non-caffeinated fluid a day. It’s easiest to sip fluids throughout the day rather than drinking real glasses at once.
• Once you feel thirsty, you’re already dehydrated. Keep drinking, so you never feel thirsty.
• Unless you’re a competitive athlete, you probably don’t need sports drinks. These beverages contain water, sugar, and electrolytes (sodium and potassium). If you want electrolytes, which can be important in severe cases of diarrhea, vomiting, or exertion, just munch pretzels or whole-grain crackers as you drink.
• Don’t overexert yourself in hot weather, especially if the relative humidity is low.
• A rapid change in altitude — flying from Los Angeles to Denver for example — causes dehydration. So does the air in airplanes — it’s low in humidity. Drink as you fly and upon arrival.
• Avoid alcohol, coffee, tea, colas, and other caffeinated beverages. They’re dehydrating.

Additional preventive measures

Any time you contract an illness or infection, realize that you are at an increased risk of dehydration. So if you become ill, make sure you are drinking plenty of fluids. It’s the best way to prevent becoming dehydrated.

Self-care measures

If you get diarrhea, the main risk is dehydration. Increase your fluid intake.

If an infant or toddler gets diarrhea, give rehydration fluids specially formulated for them, such as Pedialyte and Kaolectrolyte. Also, diluted apple juice can be particularly effective, especially for babies who won’t drink their fluids.

When to call the doctor

Seek immediate medical help if you have any of the following signs of severe dehydration:

• Rapid drop in weight (several pounds in a few hours or days)
• Muscle contractions or convulsions
• Temperature of 102 F or greater
• Fainting
• Increased heart rate
• Reduced blood pressure
• Fast breathing
• Sunken eyes
• Bloated abdomen
• Skin that takes a long time to return to normal when pinched
• Vomiting/diarrhea that won’t go away
• Inability to take anything by mouth

In very severe cases, dehydration may result in hypovolemic shock, which may be confused with other types of shock.

Since dehydration can occur quickly in young children and older adults, it is important to seek medical help at even the mildest signs of dehydration. In particular, if you are taking care of a child under age 3, seek medical help if you see the following signs of dehydration:

• Dry mouth and chapped lips
• Severe thirst
• Lightheadedness or weakness
• Skin that takes a long time to return to normal when pinched
• Darkened or decreased urination (fewer wet diapers than usual)
• Crying with few or no tears
• Prolonged vomiting or diarrhea; can’t keep fluids down or won’t drink