Hydration is important for everyone. Folks with chronic pain get really tired of being asked if they’re drinking enough water. I know my son does.
But how much you should drink is a more complicated question than it first appears. And important enough to think about before rolling your eyes when asked – one more time – if you’re hydrating.
A few things to keep in mind:
- We need water to live. It’s critical for cell functioning. It makes up 50%–70% of our body weight. A pint is a pound, so that’s a LOT of water.
- People need around 3 liters of water a day to stay healthy – more if you’re bigger and less if you’re smaller.
- That ‘3 liters’ includes ALL the water. Your coffee, tea, and soda. The water in your soup and the apple you had for lunch. It is not 3 liters on top of everything else you eat. (I feel better already.)
- If 20% of your water comes from food, we’re down to two and a half water bottles (or tea or . . . )
Staying hydrated can be harder if you’re living with pain.
Chronic pain can cause intestinal slowing and inflammation – which means that your guts are not absorbing water and nutrients as well as they should be. If you have gastroparesis – problems with the stomach emptying properly – your body is less efficient at absorbing water than most people’s. Gastroparesis is common during migraines and also a frequent cause of vomiting and reflux.
All of these issues linking the digestive system with hydration and pain are why doctors keep pestering us to drink enough water.
Dehydration mimics the symptoms of chronic illness.
Headache and body aches are early signs of dehydration. I can always tell I haven’t drunk enough (OR have exercised too much without replenishing OR have had too much salt – discussed later) because my eyes just ACHE. It took me years to know that’s why my eyes hurt when I went camping.
How can you tell you’re getting enough water?
If your pee is clear or light yellow and you’re going every few hours, you’re drinking enough water. It’s that simple.
However, you also need to consider the balance of water and electrolytes and salt that you consume. The balance of water to electrolytes changes water absorption because absorption depends on osmosis – the relative density of water molecules across membranes.
As I kid, I always have problem with dehydration while camping. We were canoing in the sun, so I sweated a lot. I didn’t drink a lot because we carried in or boiled all our water and it tasted kind of gross. The food we ate was light and dry (salami, dried fruit) and added little water to my diet. And almost everything we ate was REALLY SALTY.
When you eat more salt, you need more water to keep things balanced. One reason people with POTS have to be so very careful to drink enough is that they also need to eat a lot of salt to keep their blood pressure up. Water and salt (electrolytes) need to stay balanced.
Balance is particularly important if your system is a bit touchy. We had a beagle who ate 8 oz of chocolate – poison to dogs. After that, she developed seizures when she didn’t get enough water. Dog food is really salty. If she didn’t drink enough, her water/electrolyte balance got thrown off and she’d seize.
Am I drinking TOO MUCH water?
The opposite is true too. If you drink TOO MUCH water, you can get hyponutrenia. You may have heard of ‘water poisoning’ where runners drink lots of water during a race, sweat out most of their salt, and become disoriented, sick, or even die. Just as when you need more water if you eat a lot of salt, you need more SALT (and other electrolytes) when you drink a lot of water.
It’s about balance. (Isn’t it ALWAYS about balance?)
The symptoms of hyponutrenia are headache (everything causes headache), weakness, disorientation, and confusion. It can cause death.
Dehydration and hyponutrenia cause similar symptoms. But I’m sure you can tell which you’re suffering from.
So what’s the bottom line?
There are a few take homes here.
- EVERYONE needs to drink a lot of water. Just count it. If you’re eating a normal diet, think 2.5 water bottles. That’s around 85 oz, 8-10 mugs of liquid, or 5 big 16 oz glasses. I try for one before lunch, one before dinner, one before bed plus something to drink at each meal and snack.
- Look at your pee. You should have to urinate every few hours. It should be light. If you’re doing that, you’re drinking enough.
- If you don’t like water (my mother HATES water), drink something else. Or eat a lot of soup – you can put that in your thermos instead of tea. (And remember, some things like coffee can make you have to pee more often, so you don’t ‘keep’ as much of it as you might.
- Balance water and salt. And by ‘salt’ I mean electrolytes. Sports drinks have a lot of sugar, but they also advertise their electrolyte content. So does ‘hydration multipliers’, which are designed to make your body absorb water more effectively because of their electrolyte content.
- If you are eating a lot of salt, make sure to up your hydration. The salt pulls water from your intestines, reducing absorption.
- If you are drinking a lot of liquid, make sure you are getting enough salt and other electrolytes. Water poisoning is rare, but it definitely happens.
(c) 2021 Nancy Darling