Drinking Water - How Much?

There are certain instances where physicians traditionally recommend that patients drink "lots of fluids" - this is a traditional recommendation from physicians to patients with respiratory infections (reference 2). Supposedly, this is to replace losses from fever and respiratory tract evaporation, remedy dehydration from reduced fluid intake, and lower the viscosity of mucus. However, the authors of this paper point out that under certain circumstances, this could lead to fluid overload and hyponatremia (when too much water consumption has resulted in the dilution of sodium and other essential chemicals in the human body.). If the patient is exhibiting its symptoms - irritablity, confusion, lethargy, coma and convultions - fluid restriction is required to manage this. Also, there are no studies that actually demonstrate that giving increased fluids to patients, especially those with lower respiratory tract infections, is beneficial.

Reference 3 provides another example of over-drinking: in 2002, several runners in the Boston marathon suffered from hyponatremia, and one of them died as a result. Several other marathon deaths have been reported - not as you might expect, from dehydration! Rather, they are a result of hyponatremia resulting from over-hydration. The elite runners (those who finish under 4 hours) are experienced enough to drink very little during the race, and do not suffer from this problem. However, the less experienced athletes (typically those who run 4 hours and more) think they need to drink profusely, and consequently suffer from this life-threatening problem.

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