Water Makes Me Puffy

bloaty The almost universally promoted notion that it is a good idea to be continuously consuming water, has made it such that in some parts of the world it’s practically a crime to walk down the street without a full bottle in your hand.

Even though a healthy person can usually get away with drinking plain water for the purposes of hydration – without sufficient salt and other minerals to go with it – the idea that water (rather than orange juice or milk or some other kind of salty sugary drink) is necessarily therapeutic can be very harmful and even dangerous when metabolism is vulnerable.

The ability of the body to properly regulate salt and water is heavily dependent upon the functioning of thyroid and related metabolic energy systems, and when compromised, can be a central issue in the development of many symptoms of degeneration and disease.

In fact the consumption of too much water (especially when metabolism is already sub-optimal) can become one of the factors interfering with thyroid energy system function, in some cases limiting or preventing metabolic recovery. What is promoted is a kind of general physiological condition where salt is excessively lost, and water is retained.

“Mild hyponatraemia…may be corrected simply by restriction of water…Severe hyponatraemia…may produce profound neurological disturbances requiring urgent correction…hypertonic saline should be infused to raise the serum sodium concentration…the early pathological change found in patients with severe hyponatraemia is cerebral oedema…”

When thyroid function is under active, water that might otherwise be evaporated through the skin or lungs is held in the tissue, causing a kind of swelling or edema (with cells in essence becoming water logged).

This helps to direct metabolism further towards a stress state, releasing free fatty acids for fuel over sugar, similar to the diabetic state and numerous other inflammatory conditions associated with aging and degeneration.

“…the metabolic adaptation to acute hypo-osmolality resembles that of acute fasting, that is, it results in protein sparing associated with increased lipolysis, ketogenesis and lipid oxidation and impaired insulin sensitivity of glucose metabolism.”

“Our study shows that low salt intake is associated with higher insulin resistance…We found an increase in aldosterone and norepinephrine, both of which may contribute…”

This general shock-like state of stress where water is retained and salt is lost (and where tissue can become hyper-hydrated) is interrelated with issues regarding the proper regulation of the alkaline minerals, calcium, magnesium and potassium.

“The content of calcium (Ca) and magnesium (Mg) in sweat during exercise is considerably higher during a relatively low intake of sodium (Na)…we found positive correlations between Na intake and Ca and Mg balances in humans.”

In some cases where respiratory metabolism is compromised by stress (for example if sugar is chronically restricted leading to insufficient energy production) increasing sodium intake is often enough to reduce water retention and swelling and protect against some of the harm, improving overall mineral regulation and general metabolic function.

“…a new strategy to improve the chronic diuretic response by increasing Na [sodium] intake and limiting fluid intake. This counterintuitive approach underlines the need for a better understanding of factors that regulate sodium and water handling in chronic congestive HF [heart failure].”

Whenever thyroid is interfered with and the ability of the body to produce metabolic energy is being limited, it can take smaller and smaller amounts of water to cause further disruption to physiological processes, and this can then add momentum to a downward spiral of worsening metabolism and rising stress.

“Hypothyroid states are associated with significant changes in renal function, one of which is hypoosmolar hyponatremia.”

“Hyponatremia is the most common electrolyte abnormality in hospitalized patients…Failure of the brain to adapt to the hyponatremia leads to brain damage…In menstruant women, estrogen + vasopressin inhibits the Na(+)-K(+)-ATPase system and decreases cerebral oxygen utilization, impairing brain adaptation.”

“…hyponatremia was three times more common in postoperative patients with the acute phase response. In both studies, many patients received hypotonic fluids (38 and 55%, respectively). Thus, the acute phase response likely caused a state of antidiuresis, which resulted in hyponatremia because a source of electrolyte-free water was administered.”

Any situation involving stress and the suppression of thyroid metabolism also relates to digestive function, and the consumption of excessive amounts of water can be one example of this.

For starters, drinking too much (or too cold) water in one go can cause stress to the intestines, promoting the release of serotonin – and other stress substances like estrogen and prolactin – all of which encourage the conditions promoting water retention and metabolic suppression.

“The plasma 5-HT [serotonin] concentrations in IBS patients were significantly higher than those of controls…after cold water intake.”

“…we found that cold water intake inhibited colonic motility at least partially through oxytocin-oxytocin receptor signaling in the myenteric nervous system pathway, which is estrogen dependent.”

“Women and men are equally likely to develop hyponatremia and hyponatremic encephalopathy after surgery. However, when hyponatremic encephalopathy develops, menstruant women are about 25 times more likely to die or have permanent brain damage compared with either men or postmenopausal women.”

“E2 [estrogen] augments osmotic AVP secretion, thereby implicating elevated AVP as a contributor to water retention in high E2 states…”

The increased release of the inflammatory substances can lead to further interference with digestive function and thyroid metabolism. This is likely to magnify bacterial issues and raise endotoxin levels, promoting stress and potentially making conditions more water logged.

Inflammation has been shown to be able to directly interfere with proper regulation of water and minerals. The consumption of plain water (when conditions are stressful and metabolism is suppressed) can further interfere with metabolic function, and it makes sense that this can lead to a vicious circle type situation where water consumption promotes inflammation, leading to more water retention and loss of sodium, promoting further inflammation.

“A growing body of evidence now points to an important role for interleukin-6 in the non-osmotic release of vasopressin…The importance of these connections extends to several clinical scenarios of hyponatremia and inflammation, including hospital-acquired hyponatremia, postoperative hyponatremia, exercise-associated hyponatremia, and hyponatremia in the elderly.”

“Hyponatremia was predicted by the presence of malnutrition, inflammation and fluid overload…Malnutrition, inflammation, fluid overload…were independent predictors for all-cause mortality.”

Too much water can also reduce stomach acid, further interfering with digestive processes, encouraging inflammation and fueling existing bacterial and metabolic stress related issues.

If fat released out of storage as a result of stress is polyunsaturated, this promotes chronic inflammation and more serious long term interference with thyroid function and cellular energy production, including mineral regulation.

It isn’t uncommon for people to consume too much water at the worst possible times. Whenever glycogen stores are low and salt has been lost, metabolism will be in more of a stressed state. Under conditions like this, excessive water drinking can be harmful and dangerous.

“Hyposmotic swelling in brain occurs in numerous pathologies associated with hyponatremia. This condition occurs either from water excess or from a Na+ deficit. Water excess may come from excessive oral intake…or…impaired renal water elimination as a consequence of…hypothyroidism, and renal or hepatic failure.”

Abnormally high levels of thirst leading to excessive water consumption is sometimes seen with patients suffering from psychotic illness, and there is a relationship between metabolic energy system suppression and schiziophrenia as well as other mood related conditions.

“Water intoxication is a fatal disorder with brain function impairment, defined as hypo-osmolar syndrome resulting from an excess intake of water, with dilutional hyponatremia…occasionally observed in psychiatric patients with polydipsia, or it may develop as a result of iatrogenic water overloading.”

There is relationship between hyponatremia and Alzheimer’s, and dementia has been demonstrated to be connected to stress and metabolic suppression.

“…hyponatremia patients had 2.36-fold higher chances of suffering dementia, including Alzheimer’s disease (AD) and non-AD dementia…A dose response relationship was observed between hyponatremia and dementia.”

Mood disorder symptoms have been able to be improved with increased intake of the alkaline minerals such as sodium, magnesium and potassium, and it makes sense that anybody suffering from the effects of chronic stress and metabolic dysfunction, can make the situation worse with less than what would be considered excessive intake of plain water.

Regardless, extreme water consumption also occurs in response to all sorts of other circumstances, which probably involve certain mistaken beliefs with regards to the safety and effectiveness of plain water intake for the purposes of rehydration.

“Cases of water intoxication without psychotic illness have been reported, including a case of massive water intake in the context of serious diarrhea, excess water supplementation for thirst during military training, compulsory water drinking as a form of child abuse and massive water drinking during military urine drug screening. Some of these cases demonstrated prolonged hyponatremia even at 20 h or more after the discontinuation of water intake…”

“Acute symptomatic hyponatraemia is a life-threatening emergency… the most common aetiological factors are psychotic polydipsia and different iatrogenic causes…We describe a case in which dehydration due to common gastroenteritis in combination with excessive intake of water caused the death of a young, previously healthy woman.”

There have been many reported cases of ecstasy-associated hyponatremia associated with high fluid intake, leading to hospitalization and death, with most deaths occurring in women.

“Ecstasy ingestion has been demonstrated to increase the secretion of AVP, oxytocin, prolactin, ACTH and cortisol…females are at significantly increased risk of developing ecstasy-associated hyponatremia compared with males…as (i) estrogen…stimulates AVP secretion…The condition that is most similar to ecstasy-associated hyponatremia is exercise-associated hyponatremia…Any partygoer with ecstasy-associated hyponatremic encephalopathy, with either mild or advanced symptoms, should be immediately treated with a 100 mL bolus infusion of 3% NaCl [salt]…”

For some reason which is beyond my comprehension, plain water is often given to people in hospital, even though it seems to be well known scientifically and medically, that this can be deadly and that the additional risk can be avoided reasonably easily with the addition to the water, of a small amount of salt.

“Iatrogenic hyponatremia is a common problem in hospitalized children. It may occur in children who are at risk of excessive ADH production. Potential stimuli are pain, nausea, stress, vomiting, and volume depletion. Administration of hypotonic fluid can result in severe hyponatremia with life-threatening neurologic complications…The use of isotonic maintenance fluids is the main preventive measure…”

It’s probably tempting to assume that the dangers associated with the consumption of water exist only in cases where very large amounts are being consumed, however there is plenty of evidence showing the potential for what today is considered by most to be normal levels of plain water intake, to be able to cause a worsening of stress related metabolic dysfunction.

Many popular diet recommendations (the avoidance of calcium and protein from dairy, salt and sugar restriction, polyunsaturated fats, excessive intake of fibers and starches) can foster a cocktail of metabolic stress related issues which when combined with excessive water consumption, can in some circumstances create serious and dangerous shock-like states resulting in severe and chronic illness, even death.

“…dietary salt restriction…increased noradrenaline excretion by 77%…strong positive relationship between the excretion of serotonin and of noradrenaline…Salt restriction stimulates the serotonergic system in man.”

It’s not that water per se isn’t important, but there is plenty of water in food and drink, and the culture of continuous water guzzling to improve ‘health’ is in many situations, contextually inappropriate.

I’m not a doctor and this isn’t health advice, but it seems to me that popular guidelines regarding daily water intake requirements, are not often founded on good physiology, and commonly fail to take into account individual variations in the state of metabolism.

“…individual body fluid loss (and sweating rates) are influenced by a number of factors, including pubertal status, and can vary considerably between athletes and exercise conditions…dehydration accompanying prolonged exercise, especially in warm environments, can have health implications…SM [skim milk] is more effective than W [water] or a commercially available sports drink at replacing sweat losses and promoting rehydration.”

Those with youthful high metabolism allowing lots of leeway sometimes do not notice the harm from continuous interference with thyroid systems until much later. But life is full of stress and when combined with restrictive diets plus all the water enforcement, damage happens faster and all sorts of problems become more common at an earlier age.

The suppression of energy systems can eventually manifest in a wide variety of symptoms, very often involving a gradually worsening degree of inflammation and water retention, heading towards an increasing susceptibility to aging, degeneration and disease.

Although the science looking at the link between suppression of thyroid energy system function, electrolyte disorders and water consumption, can be somewhat hit and miss, many study results appear to have been influenced by factors including inaccurate methods for measuring thyroid performance, less than optimal treatment (especially for women) of thyroid related issues with thyroxine (T4) only medications, as well as other disputable biological doctrines, in particular misleading information with regards to the relationship between metabolism and estrogen.

Ambiguous thyroid function analysis aside, stress promotes endotoxin, inflammation, high cortisol, serotonin and estrogen, and all of these things can interfere with thyroid energy metabolism and proper mineral and water regulation. These inflammatory things can be promoted by the consumption of too much plain water, and it is logical that this then can further suppress metabolism.

Regardless of whether or not it is officially accepted that there is a direct relationship between hyponatremia and sub optimal thyroid performance, it has been proven that there are a number of stress related things which can influence the effect that plain water consumption has on metabolic function. If symptoms are not immediately noticeable, this does not necessarily mean that no long term damage to metabolism is being done, or that plain water is ever the best choice.

In any case, it’s usually better to hydrate on the basis of individual needs. Thirst is a good indicator especially when a person is healthy, however metabolic changes and variations in climate can make satisfying thirst with plain water more risky.

“Seizures due to hyponatremia have been reported in an NFL player…who consumed 2 to 3 gallons…of water and at least 1.8 L of sports drinks during the first day of a mini-camp and was encouraged to consume more sports drinks at home. Hyponatremia due to overhydration was ruled to be the cause of death in a high school football player from California.”

“This report describes a series of hyponatremia hospitalizations associated with heat-related injuries and apparent over-hydration…Most patients were in good health before developing hyponatremia. The most common symptoms were mental status changes (88%), emesis (65%), nausea (53%), and seizures (31%).”

Good measures for overall thyroid metabolism function include pulse and temperature analysis, Achilles reflex tests, carbon dioxide exhalation tests, as well as numerous other indicators including digestive regularity, temperature of extremities, sleep quality, mood and energy stability, and weight regulation.

Milk and sugar, sweet fruits and fruit juices, all containing varying quantities of sodium (and calcium, magnesium and potassium) and providing sufficient protein and sugar, help protect against stress, inflammation, thyroid suppression and related symptoms like swelling or edema.

“The effectiveness of low-fat milk, alone and with an additional 20 mmol/l NaCl [salt] at restoring fluid balance after exercise-induced hypohydration was compared to a sports drink and water…Subjects remained in net positive fluid balance…after drinking the milk drinks but returned to net negative fluid balance 1 h after drinking the other drinks.”

Using salt and sugar cravings as a guide can be useful when experimenting with general stress reduction and thyroid promotion therapy. Salty, sugary chocolate milk has been known to do wonders.

See More Here

Long-term effects of dietary sodium intake on cytokines and neurohormonal activation in patients with recently compensated congestive heart failure.

Treatment of hyponatraemic seizures with intravenous 29.2% saline.

Milk as an effective post-exercise rehydration drink.

Effect of milk consumption on rehydration in youth following exercise in the heat

Effects of changes in hydration on protein, glucose and lipid metabolism in man: impact on health.

Characteristics of the hydration status of patients with hypothyroidism.

Hyponatremia may reflect severe inflammation in children with febrile urinary tract infection.

Neuroendocrine control of body fluid metabolism.

Hypo-osmolar hyponatremia and orthostatic hypotension as the chief symptom in primary hypothyroidism

Thyroid function and serum electrolytes: does an association really exist?

Estrogen influences osmotic secretion of AVP and body water balance in postmenopausal women.

A forgotten but important risk factor for severe hyponatremia: myxedema coma

Inflammation and hyponatremia: an underrecognized condition?

Concurrent Serotonin Syndrome and Hyponatremia: A Case Report and Review

An analysis of the relationship between serum cortisol and serum sodium in routine clinical patients

End-tidal CO2 levels lower in subclinical and overt hypothyroidism than healthy controls; no relationship to thyroid function tests

Hyponatremia in cirrhosis: Pathophysiology and management

Life-threatening hyponatremia due to cessation of L-thyroxine.

Fatal hyponatraemic brain oedema due to common gastroenteritis with accidental water intoxication.

Estrogen-induced modulation of hypothalamic osmoregulation in female rats.

Ecstacy-associated hyponatremia: why are women at risk?

Prostaglandins in severe congestive heart failure. Relation to activation of the renin–angiotensin system and hyponatremia.

Effect of dietary salt restriction on urinary serotonin and 5-hydroxyindoleacetic acid excretion in man.

Low-salt diet increases insulin resistance in healthy subjects.

Hyponatremia due to Severe Primary Hypothyroidism in an Infant

Hyponatremia with increased plasma antidiuretic hormone in a case of hypothyroidism.

Aldosterone inhibits uncoupling protein-1, induces insulin resistance, and stimulates proinflammatory adipokines in adipocytes.

Hyponatremia and Inflammation: The Emerging Role of Interleukin-6 in Osmoregulation

Sweat Rates, Sweat Sodium Concentrations, and Sodium Losses in 3 Groups of Professional Football Players

Hypothyroidism and hyponatraemia: diagnostic relevance of ADH measurement

Unraveling the relationship between mortality, hyponatremia, inflammation and malnutrition in hemodialysis patients: results from the international MONDO initiative.

Positive Correlation Between Dietary Intake of Sodium and Balances of Calcium and Magnesium in Young Japanese Adults–Low Sodium Intake Is a Risk Factor for Loss of Calcium and Magnesium–

Hyponatremia and increased risk of dementia: A population-based retrospective cohort study

Hyponatraemia, hypothyroidism, and role of arginine-vasopressin

Norepinephrine stimulates testosterone aromatization and inhibits 5 alpha reduction via beta-adrenoceptors in rat pineal gland.

Hypo-osmolar hyponatremia as the chief symptom in hypothyroidism.

Beyond Blood Pressure: New Paradigms in Sodium Intake Reduction and Health Outcomes

Fatal child abuse by forced water intoxication.

Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes

Increased salt consumption induces body water conservation and decreases fluid intake

Pathophysiology of Hyponatremia in Children

Metabolic base production and mucosal vulnerability during acid inhibition in a mammalian stomach in vitro.

Brain cell volume regulation in hyponatremia: role of sex, age, vasopressin, and hypoxia.

[Electrolyte abnormalities associated with cancer: a review].

Acute water intoxication during military urine drug screening.

A Case of Water Intoxication with Prolonged Hyponatremia Caused by Excessive Water Drinking and Secondary SIADH

Plasma and gastric mucosal 5-hydroxytryptamine concentrations following cold water intake in patients with diarrhea-predominant irritable bowel syndrome

Oxytocin decreases colonic motility of cold water stressed rats via oxytocin receptors

Tumor-Related Hyponatremia

Depolarization, exocytosis and amino acid release evoked by hyposmolarity from cortical synaptosomes.

Postoperative hyponatremic encephalopathy in menstruant women.

Hyponatremia associated with overhydration in U.S. Army trainees.

Dietary salt restriction increases plasma lipoprotein and inflammatory marker concentrations in hypertensive patients.



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2 Responses

  1. Avatar Jay says:

    I am a former player and now coach. Let’s say the players are in a game or strenuous football practice for 3 hours in 100 degree heat, are you saying the common guzzling of plain water is problematic in these circumstances for youthful athletes or should they drink fruit juice instead? (milk wouldn’t work in the heat). Or gatorade would work fine too?

    Reading this article makes me cringe many years ago I dieted for 3 months with an acid/alkaline pesce-vegetarian diet and they recommended a gallon a day of water! No wonder I was cold all the time during that weight loss. I have put my body through a lot experimenting! I have also drank probably 1/2 gallon many days over the years as a lasting after effect psychologically following the general advice.

    Thanks for putting the nail in that coffin stupid idea!

    • DanM@cowseatgrass DanM@cowseatgrass says:

      If it were me, I would drink oj or milk with salt and sugar, or even gatorade or water with added electrolytes …anything but large amounts of plain water.

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