Can Water be Harmful? Understanding Water Intoxication

by Sankalan Baidya
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woman drinking water - water intoxication

It may sound strange but it is true. The water that we drink to sustain our life, the water that makes up 70% of our body mass, can kill us!

There is something called water intoxication. Some call it water toxicity. Some call it water poisoning. Some call it hyperhydration. It is also known by the name water toxemia.

Water intoxication or water poisoning is not a concept out of science fiction and neither is it a figment of the imagination. It is very much real and there is a science to back it.

Water can harm people or even kill people in many ways. People may drown. People may be poisoned simply because the water is poisoned with something like arsenic.

But clean and safe drinking water can also lead to a life-threatening situation.

So, in today’s episode of YSKT or You Should Know This, we will cover the topic of water intoxication. While it is important you stay educated, it is also important that you share this information with everyone.

Let us begin!

Understanding the importance of water

In the culture that we live, hydration obsession is not an alien concept. It is true that liquid H2O or water is the sine qua non of life.

You can find water everywhere in your body. It is present in your blood. It is present in the cells of your body, and it is even present in the extracellular space. No wonder, water is essential for our life.

The water in our body tries to escape by various means. Sweating, exhalation, defecation, urination, etc. are all different modes in which the water in our body escapes. It thus becomes essential to replenish what is lost.

However, in an attempt to replenish the lost water, some people simply overdo it. Some accidentally do it. The end results are often too disturbing.

Sometimes, drinking too much water just leads to a fatal overdose of water. People become victims of water intoxication, losing their precious life!

Examples of water intoxication

Some people may say that water intoxication is nothing more than a theory. They should stand corrected. There are examples – real-life examples, where people became victims of water intoxication. Here are a couple of examples:

The Nintendo disaster

In the year 2007, a radio station in California held a contest by the name “Hold Your Wee for a Wii.” It was a water-drinking contest where the winner could walk away with a Nintendo gaming console that was named Wii.

A 28-year-old woman from California named Jennifer Strange participated. She drank a whopping 6 liters of water in just 3 hours. She vomited and then went back home with a splitting headache. After some time, she died of water intoxication.

The fraternity hazing case

In 2005 a 21-year-old boy at California State University, Chico, was forced to drink copious amounts of water between pushup rounds in a cold basement. It was an act of fraternity hazing. The boy died!

How does water poisoning work?

Water poisoning is a serious thing and there is some serious science behind it. The question is, what really happens?

When someone drinks too much water too quickly, a medical condition known as hyponatremia kicks in. In simple words, hyponatremia means insufficient salt in the blood.

Typically, sodium concentration in blood should be between 135 millimoles per liter of blood to 145 millimoles per liter of blood.

If this concentration falls below 135 millimoles, the condition of hyponatremia kicks in. In severe cases of water intoxication, hyponatremia can lead to some symptoms which include nausea, vomiting, headache, mental disorientation, and of course, frequent urination.

But, how does the sodium concentration fall in blood?

kidney cross section
Kidney cross section

The answer lies with the kidneys. Our kidneys are complex organs. They have millions of twisted tubules known as nephrons.

The kidneys are responsible for controlling the amount of salts, water, and solutes leaving our body. This control is possible by sieving the blood through the nephrons.

When someone drinks too much water in a short time frame, the kidneys are overwhelmed. They fail to flush out the excess water quickly. As a result of this, the blood passing through nephrons become waterlogged.

Excess water in blood then reduces the sodium concentration of the blood.

What happens after that?

Well, the blood cannot sit there in kidneys and wait until the excess water is flushed out of the body. This diluted blood or the blood with low sodium concentration keeps traveling across the body.

When that happens, excess water gets attracted to places where salt and other solutes are present in higher concentrations and leave the blood.

The water that leaves the blood enters into the cells. The cells swell up like a balloon to accommodate the water. The water enters the cells simply because the concentration of salt and other solutes inside the cells is higher than in the extracellular space.

Most of the cells in the body are just fine with the extra water entering into them. They can swell and stretch without any problem because they are embedded in tissues like muscles and fats. These tissues are flexible enough.

brain inside skull - water intoxication
Brain inside skull

The problem comes when the excess water starts entering the neurons. Neurons are present in the brain. Unlike other cells in our body, the brain cells are packed very tightly inside the skull, which is nothing more than a boney cage.

The skull is not flexible and the neurons need to share the space inside the skull with two more things – the blood and the cerebrospinal fluid.

In simple words, inside the skull, there is NO ROOM FOR EXPANSION.

When the excess water starts entering the neurons, they expand and this is where the problem starts. When the expansion of the brain begins, the intracranial pressure (the pressure exerted by fluids on brain tissue and inside the skull) increases.

As the intracranial pressure increases, a lot of symptoms start showing up that include drowsiness, headache, lethargy, confusion, hallucination, disorientation, etc.

All of these can eventually manifest into respiratory arrest, herniation of brain stem, seizures, coma, and even death.

Who are at risk of water intoxication?

There are certain categories of people who are at risk of water intoxication. Those categories include:

Exercise:

Man after exercise with water bottle in hand
Man after exercise with water bottle in hand

People who drink a lot of water after long episodes of exercise will have the water content in the body repleted but without having the electrolyte losses corrected.

High antidiuretic hormone:

In people who are engaged in intense or prolonged exercise, another factor comes in – the vasopressin. Vasopressin is an antidiuretic hormone. This hormone is produced by the hypothalamus and the posterior pituitary gland secretes it straight into the bloodstream.

The blood then takes the hormone to the kidneys where the hormone gives the kidneys an instruction to conserve water even if the person is drinking more water than needed.

Torture or competition:

There are people who are forced to drink water in prisons or other places where they are being tortured. Again, there are people who will drink excess water simply because they participated in a water drinking competition (like the case of Jennifer Strange mentioned above).

Psychogenic polydipsia:

It is a persistent sensation of thirst which leads to an excessive craving for water.

How much water consumption is safe?

If your kidneys are healthy, they can, in normal conditions, excrete anywhere between 0.21 to 0.26 gallons (800 to 1000 milliliters) of water every 60 minutes or 1 hour. So, you should not consume any more than 800 ml to 1000 ml of water every one hour.

If vasopressin levels increase, the water excretion capacity of kidneys can fall drastically to 100 ml per hour. In situations like those where vasopressin levels increase after prolonged exercise, marathon, etc., drinking 800 ml to 1000 ml of water every hour can prove to be very dangerous as it can quickly lead to water intoxication.

Image Sources: Envato Elements

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