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How To Spot The Symptoms Of Dehydration, According To Experts
In sweltering summer temperatures, hydration is key to keeping your body healthy. Experts say there are signs to look for to know if you're not getting enough water.
"Your body needs to be properly hydrated to function at its best," explains Dr. Phillip Davis, medical advisory board physician for ShineWater and former FDA physician. "By avoiding dehydration and staying properly hydrated, it allows you to regulate your body temperature best, prevent infection, deliver nutrients to cells and will even result in improved sleep quality."
But how do you know if you're dehydrated?
First, it's important to understand the difference between dehydration and thirst.
"Being thirsty is sensation that your body creates to tell you that it's time to drink water, but I don't want that to be confused with actually being dehydrated. Being dehydrated is a lot more severe and does have some classic signs and symptoms," Dr. Alexa Mieses Malchuk, a family physician with membership-based primary care practice One Medical, explains.
Those signs may include dry mouth and dry or cracked lips, she says — but it doesn't stop there.
Although people often use the terms "thirsty" and "dehydrated" interchangeably, the latter is an actual condition that can have serious consequences.
"If we don't (drink adequate fluids) or if we are losing too much water from our body, then the clinical condition of dehydration can occur," Davis says. "There are a number of causes of dehydration including not enough water intake or excessive sweating and high activity during warm weather, as well as too much salt, GI (gastrointestinal) viruses and conditions like diabetes."
Early signs you need to increase your water intake include:
"If you begin feeling any of these symptoms, especially while outdoors in the summer heat, it's important to rehydrate your body," Davis says.
There are degrees of dehydration, Davis explains. When it becomes more extreme, he says it can become a dangerous situation marked by:
"Anyone experiencing these concerning symptoms should seek immediate medical attention," he says.
According to the Centers for Disease Control and Prevention, dehydration is a primary contributor to heat exhaustion, a dangerous heat-related illness that can lead to life-threatening heat stroke.
The CDC advises drinking water before feeling thirsty.
"By the time you feel thirsty, you are already behind in fluid replacement," the CDC notes on its website. If you're out working in the heat, the agency recommends drinking 8 ounces of water every 15-20 minutes, which adds up to about a quart per hour.
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Some People Are More Vulnerable To Heat Than Others. See If You're At Risk
Death from extreme heat once typically struck scorching locations such as Death Valley. Today, no place seems immune from deadly temperatures.
While heat can kill, it also endangers health by making existing conditions worse, said Dr. Prabu Selvam, emergency medical officer at Americares, a health-focused relief and development nonprofit that has developed heat-related tip sheets for the public.
"With heat emergencies, people are easily dehydrated, and when that happens, people's hearts have to work harder and their lungs have to work harder to get oxygen and blood flow to their organs," Selvam said.
"When they have these underlying health problems, and then the stress of heat is placed on top of that, their bodies just don't have the ability to cope as a healthy person would be able to."
Having heart disease or high blood pressure already stresses the heart, according to the US Centers for Disease Control and Prevention. Being overweight or obese is also a risk factor since excess weight causes the body to retain more heat.
"People with liver disease or lung disease are also at higher risk," Selvam said. "It's important to note that people who are socioeconomically disadvantaged, unhoused, living in public housing without air-conditioning and the like are at the highest risk from heat — and then among those people, any with health problems are at even higher risk."
Do you have kidney disease?More than 1 in 7 US adults have chronic kidney disease, and 9 out of 10 of those don't know it, according to the CDC — and 1 in 3 people with severe kidney disease don't know it.
Ignorance about the condition of your kidneys and heat can be a dangerous combination. Heat can dehydrate the body quickly, especially if you're physically active. You may not know you're dehydrated — by the time you feel thirsty, you've already lost precious fluids, according to the Cleveland Clinic.
Anyone with high blood pressure or diabetes is at risk, as those are the two leading causes of kidney failure, according to the CDC. Other causes of kidney disease include obesity, heart disease, family history, age (over 60), abnormal kidney size or structure, and a long history of taking pain relievers — both prescription and over the counter.
Drinking plenty of water is key. If you exercise, work outside or spend time in the heat, try to drink 1 cup (8 ounces) of water every 15 to 20 minutes, the CDC said.
"This translates to ¾–1 quart (24–32 ounces) per hour," the agency said. "Do not drink more than 48 oz (1½ quarts) per hour! Drinking too much water or other fluids (sports drinks, energy drinks, etc.) can cause a medical emergency because the concentration of salt in the blood becomes too low. Drinking at shorter intervals is more effective than drinking large amounts infrequently."
Water is best, the CDC said, as soda, coffee and energy drinks can be packed with sugar and caffeine. Drinking several energy drinks a day can raise the heart rate, further stressing the body.
Be sure to eat foods that can replace electrolytes when drinking large amounts of water while dehydrated, Selvam said. Foods that contain high amounts of electrolytes such as phosphate, magnesium, potassium, chloride, calcium and sodium include avocados, bananas and citrus fruits, broccoli, dried apricots, leafy greens, lentils, mushrooms, nuts and sunflower or pumpkin seeds, spinach, whole grains and zucchini.
Pregnancy and the fetusPregnancy is a dangerous time to be overheated, experts say, as high temperatures can harm both the mother and the developing fetus.
"Heat exposure has been associated with preterm labor and fetal growth restriction, which is poor growth of the baby because of inadequate blood flow," Selvam said. "There are also increased heart complications in pregnant women, especially during the third trimester, when surrounded by a significant heat emergency."
Pregnant people are more likely to become dehydrated and may be unable to cool themselves by sweating because they are trying to cool the fetus as well as their own bodies, the CDC said. Therefore, they may develop heat exhaustion, heatstroke or other heat-related illnesses more quickly than those who are not pregnant, the CDC said.
One of the causes of early contractions — called Braxton Hicks — is dehydration, according to the American Heart Association. Dehydration can also increase the chance of dizzy spells and fainting.
Overheating from hot tubs or high fevers has been linked to "changes in the structure of the fetal heart and neural tube defects, which can result in conditions such as spina bifida," the AHA said on its website. A 2019 study predicted increases in fetal heart defects between 2025 and 2035 as the planet warms, with the majority likely in the Midwest, the study said.
Pregnant people should take the same steps as everyone else when overheated, the AHA said: "(M)ove to a cooler place, sip water, loosen clothing, apply wet cloths to the skin and sit in cool bathtub water."
Medications and mental healthHeat stresses the brain as well, affecting the ability to think, plan, pay attention and control impulses, experts say. Heat causes the heart to race, blood pressure can drop, and mental processing is weakened. Those changes may remain even after the body has cooled. Studies have found that the ability to resolve cognitive conflicts remains impaired — which may explain why tempers often flare when it's hot.
Heat may be difficult for people to cope who have attention deficit disorders, anxiety, depression and other mental health conditions. Certain medications can contribute to the problem.
"Migraine and allergy medications and other vasoconstrictors, as well as tricyclic antidepressants, phenothiazines, and anticholinergics, all reduce sweating, a key tool in temperature regulation," according to US Pharmacist, a monthly journal for pharmacists.
Laxatives and diuretics also foster dehydration. Beta-blockers used for abnormal heart rhythms can slow blood flow to the skin, the journal noted, "while stimulants used to treat attention-deficit/hyperactivity disorder and narcolepsy raise base body temperature."
Other medications that increase the risk of heat-related illnesses include antipsychotic medications; benzodiazepines, which reduce seizures and assist with anxiety and muscle spasms; calcium channel blockers used to lower blood pressure; and thyroid medications.
The impact of ageConsidering age, the highest risk from heat is for older adults, especially those over 70, and young children, Selvam said.
"For elderly patients that had significant underlying health concerns, just a few hours in temperatures indoor at 80 degrees or above can be enough to put them into significant heat illness such as heat exhaustion or heatstroke," he said.
Children can be at higher risk due to their environment, Selvam said.
"Whereas adults may be spending time inside an office during their day, children are expected to be more physically active, even going outside despite the heat," he said. "During classroom, children may not have access to something to drink regularly unless the teachers allow it."
Regardless of age, those overexerting themselves in the heat are at higher risk, he added.
"If you are in an environment that's 80 degrees only for an hour, but you're significantly exerting yourself or it's a difficult work environment, that can be enough to push you into danger," he said. "It really depends on several factors, not just the temperature you're in."
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How Can You Tell If You're Dehydrated?
Dehydration may affect your energy levels and mental state, and even be life-threatening in severe cases. Symptoms of dehydration, such as fatigue, headaches, and dark urine, may be a sign to drink more fluids.
Maintaining proper hydration is essential to overall good health. Without water, your cells can't function, which is why humans can only survive a few days without fluids (1).
Unfortunately, many adults and kids don't consume enough fluids, which can lead to chronic dehydration (2).
What's more, conditions like diarrhea, vomiting, and excessive sweating can lead to acute or short-term dehydration (2, 3).
Dehydration can negatively affect many aspects of health and even be life threatening in severe cases, so it's important to know the potential signs and symptoms of dehydration in both adults and kids.
This article covers 8 signs and symptoms of dehydration in adults, as well as explains the most common signs of dehydration in infants and kids.
Here are 8 potential signs and symptoms of dehydration to watch out for.
Keep in mind that these symptoms could also indicate an underlying health condition unrelated to dehydration. If you're experiencing one or more of these symptoms, it's important to visit a healthcare professional for appropriate care.
1. FatigueIf you're dehydrated, you may feel more tired than usual (2).
This is because dehydration affects every aspect of health, including your sleep-wake cycles.
One study that included more than 26,000 Chinese and American adults found that shorter sleep duration was significantly associated with inadequate hydration, as well as that people who were adequately hydrated slept longer than those who were not (4).
Being dehydrated can likewise make you feel more fatigued during exercise.
One small study that included 14 male athletes found that acute dehydration of 3.2% body mass led to increased fatigue perception and also negatively affected exercise endurance (5).
2. Dark-colored urine and low urine outputIf you're not drinking enough fluids, your urine will be a darker color and you won't pee very much.
In fact, looking at the color of your urine is considered a practical way to identify dehydration (6).
Darker-colored urine can occur when your body is conserving more water and not releasing it into urine. For this reason, the urine becomes more concentrated with waste products from the body, like sodium and urea (7).
The goal is not to have completely clear urine. Instead, the ideal urine color is a pale yellow, like the color of light straw.
Keep in mind that other factors can affect your urine color, including the use of medications and B vitamins, which can turn urine bright yellow.
3. Dry skin, decreased skin elasticity, and cracked lipsOne of the most common signs of dehydration is dry skin and lips and decreased skin elasticity (8).
If you're experiencing dry skin, dry mouth, and dry or cracking lips, dehydration may be contributing to these symptoms.
Keep in mind that dry skin and cracked lips can also be a sign of many other health conditions, so it's important to get the right diagnosis, especially if you're experiencing dry skin or cracked lips even when you're drinking optimal amounts of water.
Healthcare professionals often use something called the skin turgor test to assess a person's hydration status.
The skin turgor test involves grasping the skin on the lower arm or abdomen between two fingers and then releasing it after a few seconds.
Hydrated skin will rapidly return to its normal position, while dehydrated skin will remain in a "tented" position and take much longer to bounce back (9).
Decreased skin turgor is usually a sign of moderate to severe dehydration (9).
4. HeadachesWhen you're not getting enough fluids, you may get frequent headaches.
Even though dehydration is strongly linked to headaches, researchers aren't exactly sure how dehydration causes headaches.
One theory is that fluid depletion in the body leads to the stretching of blood channels in the brain, leading to headaches (10, 11).
However, researchers acknowledge that there are likely multiple mechanisms behind dehydration-related headaches, and that some people may be more susceptible to dehydration-related headaches than others (11).
Some studies show that increasing water intake may help reduce headache symptoms in people who experience migraine.
One study that included 256 women with migraine headaches showed that migraine severity, frequency, and duration were significantly lower in those who drank more water (12).
5. Light-headedness and dizzinessDehydration may cause you to feel dizzy and light-headed, especially when you stand up (13).
Orthostatic hypotension is the medical term for a reduction in blood pressure when you stand or sit up (14).
Dehydration can lead to orthostatic hypotension. This is especially common among older adults, who are more at risk of developing dehydration and low blood volume (hypovolemia) (15).
Being dehydrated may cause you to feel dizzy and light-headed, especially when you stand or sit up quickly.
Severe dehydration may even lead to fainting in some cases, especially among older adults (16).
6. Heart palpitationsBeing dehydrated may cause cardiac symptoms like palpitations, or a sensation of pounding, fluttering, or an irregular heartbeat (2).
Not drinking enough fluids can negatively affect overall health, including heart health.
According to one review, dehydration may impair heart function in several ways, including by negatively affecting blood vessel function and altering blood pressure regulation (17).
Dehydration can also compromise heart function in people who are performing intense exercise in the heat.
It does this by decreasing the amount of blood pumped out of the left ventricle of the heart and reducing cardiac output — the amount of blood the heart pumps per minute (18).
7. Low blood pressureLow blood pressure is a sign of dehydration that only appears if a person is significantly dehydrated.
As mentioned above, dehydration impairs blood vessel function and blood pressure regulation. Dehydration causes low blood volume — that is, a low amount of fluid circulating within your capillaries, veins, arteries, and chambers of your heart (19).
When your blood volume decreases, your body compensates by increasing your pulse and respiratory rate, as well as by decreasing your blood pressure (19).
Low blood pressure is a sign of severe dehydration, and it can be dangerous. Severe dehydration could lead to significantly low blood pressure, shock, and even death (20).
8. Poor concentration and altered mental stateNot taking in enough fluids can take a toll on your brain and reduce your ability to concentrate.
Some studies have shown that dehydration can be detrimental to short-term memory, concentration, and mood.
A small study including 12 men found that abstaining from drinking water for 36 hours led to higher error rates on tests and negatively affected energy, mood, attention, and memory. Rehydration with water alleviated these symptoms (21).
Many other studies have also shown that dehydration can negatively affect mood and cognitive performance in both men and women (22, 23).
Severe dehydration can lead to an altered mental state, which can seem like confusion and anger (24).
Summary
Many signs and symptoms may indicate dehydration in adults, including dark-colored urine, decreased urination, headaches, fatigue, dry skin, and light-headedness.
A dehydrated infant or child may not show the same signs of dehydration that adults do, making it hard for parents and caregivers to identify potential dehydration.
Infants and kids are more susceptible to dehydration caused by diarrhea, fever, and vomiting. This is because kids have a higher metabolic rate and lose more water on a daily basis than adults do (25).
Plus, babies and younger children depend on caregivers for hydration (25).
Signs of mild to moderate dehydration in babies and young children may include (25, 26):
In addition to the signs and symptoms above, kids with severe dehydration may show:
Although mild to moderate dehydration is common in children who are sick, any kind of dehydration can be extremely dangerous to your child's health if not treated quickly. Severe dehydration can be life threatening.
If your child is showing signs of dehydration, contact their pediatrician for advice. They may suggest that you bring your child to a healthcare facility where they can be appropriately treated and monitored.
Summary
Babies and kids may not show the same signs of dehydration that adults do. If your baby or child is showing signs of dehydration, contact their doctor for advice.
There are many potential causes of dehydration, including vomiting, diarrhea, excessive sweating, medication use, and more (2).
For example, it's common to become dehydrated when you're experiencing symptoms like diarrhea, vomiting, and high fever.
If you or your child is ill, it's important to replace lost fluids with water or other beverages like electrolyte drinks. Consuming foods that are high in fluids, such as soups and fruits, can also help prevent dehydration.
For people who are experiencing chronic dehydration, increasing fluid intake is essential. If you're experiencing symptoms of dehydration like dry skin, headaches, fatigue, and dark-colored urine, try increasing your overall fluid intake.
Most people can meet their fluid needs by drinking water, but fluids like coffee, tea, and sparkling water also count toward your total fluid intake, as do foods like fruits and veggies.
Hydration needs vary widely and depend on factors like activity levels, body weight, pregnancy and breastfeeding status, and the environment.
People who live in hot climates typically need more water, as do pregnant and breastfeeding people. Highly active people, like athletes and those with physically demanding jobs, also require more water than the average person (27).
For many people, quenching your thirst is a smart way to ensure you're getting enough water.
However, how thirsty you feel may not be a reliable indicator of your hydration needs. This may be the case if you have increased hydration needs, as athletes do, or if you're an older person who has decreased thirst (28).
Although hydration needs vary, water recommendations from the Institute of Medicine (IOM) and the European Food Safety Authority (EFSA) generally range from (29):
You can use methods like looking at the color of your urine to make sure you're properly hydrated.
Seek help for severe dehydration from a healthcare professionalYou can usually manage your mild dehydration by increasing your fluid intake. However, it's important to note that severe dehydration can be life threatening and should be treated by a healthcare professional.
If you or a loved one is experiencing signs of severe dehydration, contact a healthcare professional immediately. This is especially important for infants, children, and older adults, who are more susceptible to dehydration.
Risk factors for severe dehydration included prolonged diarrhea or vomiting, extreme exercise, laxative use, burns, and certain medical conditions (2).
Severe dehydration requires immediate medical attention and can't be treated at home.
Summary
Hydration needs vary depending on a number of factors, including your activity levels, age, and body weight. Drinking plenty of fluids on a daily basis is the best way to prevent dehydration. Severe dehydration must be treated by a healthcare professional.
Dehydration is quite common and can be caused by factors like illness, medication use, extreme exercise, or simply insufficient fluid intake.
Signs and symptoms of dehydration include dark-colored urine, decreased urination, headaches, fatigue, dry skin, decreased skin turgor, and poor concentration.
Make sure you're getting enough fluids every day by drinking plenty of water or other fluids. If you're concerned that you or a loved one may be severely dehydrated, contact a healthcare professional for help right away.
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