Forty-one years ago (1984) at the Summer Olympics in Los Angeles, women’s long distance runner Gabriela Andersen-Schiess stunned the world as she entered the stadium for her final lap of the women’s marathon staggering and struggling toward the finish line. An individual who had trained for years for a single athletic event was collapsing in front of the world from fatigue and extreme dehydration as she kept pushing herself to the finish line. It was a message to the world of not only human endurance, but also the potential price paid.
What is dehydration?
When the body uses more fluid than it’s able to take in, it begins to lose the ability to function properly. This is dehydration. It can range anywhere from being thirsty to a life-threatening medical emergency. Consider the stages of dehydration:
Mild dehydration
- May include an 1 – 2% body weight loss.
- Signs / symptoms: General thirst; darker colored urine (amber or darker yellow); general tiredness.
- Treatment: drinking water or an electrolyte solution, e.g., Gatorade sports drink or water flavor / electrolyte enhancements.
Moderate dehydration
- May include a 3 – 5% body weight loss, sometimes observable as sunken eyes and/or cheeks.
- Signs / symptoms: Increased thirst, headache, fatigue and faint or dizziness when changing body position; tiredness, unexplained muscle weakness or cramping; and/or mood change. Additionally, there may be dry skin with a loss of elasticity (observable as “tenting” on the back of the hand). Frequently persons report a reduction in sweating and urination (with even darker colored urine); for very young children this means fewer wet diapers.
- Treatment: Fluid replacement with water and frequently an electrolyte solution.
Severe dehydration
- May include 5 – 10% body weight loss and is frequently observable as sunken eyes and/or cheeks.
- Sign / symptoms: Extreme thirst; tachycardia or heart rates over 100 beats per minute; increased heart rates typically include increased breathing rates, also; and the inability to sweat or produce tears. Urine output ceases. Skin may become cool or clammy with a bluish tint. This is a true medical emergency that is frequently missed by the individual as the deterioration is frequently accompanied with mental changes of confusion, delirium, and/or lethargy. The dehydration victim cannot process what is happening.
- Treatment: This is a medical emergency and should be treated with a 911 response or intervention at the nearest emergency care facility. Untreated severe dehydration can lead to death.
How does dehydration happen?
People lose approximately 15 – 20% of their fluid volume naturally through regular breathing. Add to this routine additional loss of body fluid through sweating, crying, and using the bathroom. Failure to replace routine fluid loss can easily create mild dehydration.
Sometimes people lose body fluid at an accelerated rate due to:
- Intense exercise or heavy sweating in hot weather
- Illnesses that increase fluid loss, e.g., high fevers, vomiting, or diarrhea
- Increased urination from medications, e.g., diuretics or uncontrolled high glucose levels from diabetes
- Forgetfulness to stop and intake fluids, a dislike of available fluid source, or a lack of access to clean drinking water
Not everyone experiences dehydration the same way. Consider the following observations:
Adults may not feel thirsty immediately, especially older adults whose baseline thirst reflex decreases with age. It becomes important to watch for the progressing signs of dehydration.
Children lose fluids much faster than adults due to higher metabolic rates and smaller bodies for fluid retention. The most common source of dehydration in children is diarrhea and vomiting. Older adults frequently just forget to drink fluids. Again, it becomes important to be proactive and encourage regular fluid intake in addition to watching for signs of dehydration.
How do you reduce the risk of dehydration?
The recent FIFA (International Federation of Association Football) World Cup was a recognition of the seriousness of dehydration and a clear demonstration of hard-wiring dehydration prevention into the rhythm of the soccer championship with mandatory water-breaks. For the everyday, non-professional athlete it’s recommended:
- Watch the urine color. Urine should be a pale, straw-like yellow color. If it’s a darker yellow color, you may need to increase the fluid intake. Six to eight glasses of fluid are recommended daily with increased amounts in hot weather, dry climates, when ill or during physical activity.
- Don’t wait until you feel thirsty to take in fluids. Feeling thirsty is the body’s way of saying you should have been drinking fluids before the feeling.
- Be sensitive to selecting drinks that have a diuretic effect (alcohol and caffeinated drinks) and contribute to fluid loss.
- Feel free to add to fluid intake by consuming water-rich foods like cucumbers, watermelon and other fresh fruits and vegetables.
- Be proactive in monitoring fluid intake if taking a known diuretic or other medication that might impair your body’s fluid regulation.
Key takeaways
Anyone can become dehydrated. Certain age groups or conditions can make a person more prone to dehydrated with dehydration being more serious for infants, children and older adults. While drinking more fluids usually prevents or corrects mild to moderate dehydration, severe dehydration needs medical treatment right away.