Dehydration

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Dehydration

Overview

Dehydration occurs when you use or lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions. If you don't replace lost fluids, you will get dehydrated.

Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults.

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The most common cause of dehydration in young children is severe diarrhea and vomiting. Older adults naturally have a lower volume of water in their bodies, and may have conditions or take medications that increase the risk of dehydration.

This means that even minor illnesses, such as infections affecting the lungs or bladder, can result in dehydration in older adults.

Dehydration also can occur in any age group if you don't drink enough water during hot weather — especially if you are exercising vigorously.

You can usually reverse mild to moderate dehydration by drinking more fluids, but severe dehydration needs immediate medical treatment.

Symptoms
Thirst isn't always a reliable early indicator of the body's need for water. Many people, particularly older adults, don't feel thirsty until they're already dehydrated. That's why it's important to increase water intake during hot weather or when you're ill.

The signs and symptoms of dehydration also may differ by age.

Infant or young child
Dry mouth and tongue
No tears when crying
No wet diapers for three hours
Sunken eyes, cheeks
Sunken soft spot on top of skull
Listlessness or irritability
Adult
Extreme thirst
Less frequent urination
Dark-colored urine
Fatigue
Dizziness
Confusion
When to see a doctor
Call your family doctor if you or a loved one:

Has had diarrhea for 24 hours or more
Is irritable or disoriented and much sleepier or less active than usual
Can't keep down fluids
Has bloody or black stool
Request an Appointment at Mayo Clinic
Causes
Sometimes dehydration occurs for simple reasons: You don't drink enough because you're sick or busy, or because you lack access to safe drinking water when you're traveling, hiking or camping.

Other dehydration causes include:

Diarrhea, vomiting. Severe, acute diarrhea — that is, diarrhea that comes on suddenly and violently — can cause a tremendous loss of water and electrolytes in a short amount of time. If you have vomiting along with diarrhea, you lose even more fluids and minerals.
Fever. In general, the higher your fever, the more dehydrated you may become. The problem worsens if you have a fever in addition to diarrhea and vomiting.
Excessive sweating. You lose water when you sweat. If you do vigorous activity and don't replace fluids as you go along, you can become dehydrated. Hot, humid weather increases the amount you sweat and the amount of fluid you lose.
Increased urination. This may be due to undiagnosed or uncontrolled diabetes. Certain medications, such as diuretics and some blood pressure medications, also can lead to dehydration, generally because they cause you to urinate more.
Risk factors
Anyone can become dehydrated, but certain people are at greater risk:

Infants and children. The most likely group to experience severe diarrhea and vomiting, infants and children are especially vulnerable to dehydration. Having a higher surface area to volume area, they also lose a higher proportion of their fluids from a high fever or burns. Young children often can't tell you that they're thirsty, nor can they get a drink for themselves.
Older adults. As you age, your body's fluid reserve becomes smaller, your ability to conserve water is reduced and your thirst sense becomes less acute. These problems are compounded by chronic illnesses such as diabetes and dementia, and by the use of certain medications. Older adults also may have mobility problems that limit their ability to obtain water for themselves.
People with chronic illnesses. Having uncontrolled or untreated diabetes puts you at high risk of dehydration. Kidney disease also increases your risk, as do medications that increase urination. Even having a cold or sore throat makes you more susceptible to dehydration because you're less likely to feel like eating or drinking when you're sick.
People who work or exercise outside. When it's hot and humid, your risk of dehydration and heat illness increases. That's because when the air is humid, sweat can't evaporate and cool you as quickly as it normally does, and this can lead to an increased body temperature and the need for more fluids.
Complications
Dehydration can lead to serious complications, including:

Heat injury. If you don't drink enough fluids when you're exercising vigorously and perspiring heavily, you may end up with a heat injury, ranging in severity from mild heat cramps to heat exhaustion or potentially life-threatening heatstroke.
Urinary and kidney problems. Prolonged or repeated bouts of dehydration can cause urinary tract infections, kidney stones and even kidney failure.
Seizures. Electrolytes — such as potassium and sodium — help carry electrical signals from cell to cell. If your electrolytes are out of balance, the normal electrical messages can become mixed up, which can lead to involuntary muscle contractions and sometimes to a loss of consciousness.
Low blood volume shock (hypovolemic shock). This is one of the most serious, and sometimes life-threatening, complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body.
Prevention
To prevent dehydration, drink plenty of fluids and eat foods high in water such as fruits and vegetables. Letting thirst be your guide is an adequate daily guideline for most healthy people.

People may need to take in more fluids if they are experiencing conditions such as:

Vomiting or diarrhea. If your child is vomiting or has diarrhea, start giving extra water or an oral rehydration solution at the first signs of illness. Don't wait until dehydration occurs.
Strenuous exercise. In general, it's best to start hydrating the day before strenuous exercise. Producing lots of clear, dilute urine is a good indication that you're well-hydrated. During the activity, replenish fluids at regular intervals and continue drinking water or other fluids after you're finished.
Hot or cold weather. You need to drink additional water in hot or humid weather to help lower your body temperature and to replace what you lose through sweating. You may also need extra water in cold weather to combat moisture loss from dry air, particularly at higher altitudes
Illness. Older adults most commonly become dehydrated during minor illnesses — such as influenza, bronchitis or bladder infections. Make sure to drink extra fluids when you're not feeling well.

https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086

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The official blog of the Lung Institute.

HOME/BLOG/STAYING HYDRATED WITH COPD

Staying Hydrated with COPD
28 Aug 2016 | Under COPD, Diet and Nutrition, Lifestyle, Tips | Posted by Lung Institute | 2 Comments
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Staying Hydrated with COPD
For people living with chronic obstructive pulmonary disease (COPD), staying properly hydrated can be challenging but is an important part of managing COPD. For example, many people with COPD experience increased mucus production. The excess mucus becomes thick, sticky and difficult to cough up. However, drinking enough water can thin mucus and make mucus easier to clear out from the lungs. So with your health in mind, the Lung Institute has put together a few facts and tips about staying hydrated with COPD to help you breathe easier.

Why is water so important to staying hydrated with COPD?
In order to stay hydrated, it’s important to drink enough of the right kinds of fluids every day. Drinking water, of course, is an excellent way to stay hydrated. In fact, water is one of the most crucial nutrients the body needs and works with many of the body’s processes, including:

Hydration
Lubricating joints
Regulating body temperature
Protecting the eyes and mouth
Removing waste from the body
Transporting other nutrients throughout the body
Actually, water makes up more than 50 percent of the human body. Through sweating, urinating and breathing, a person can lose 2-3 quarts of water per day, so it’s crucial for people to replace the water in their bodies by staying hydrated. Typically, doctors recommend that people with COPD drink around 64 to 96 ounces of water, which is about 8 to 12 glasses. Of course, it’s important to discuss your personal hydration needs with you doctor before drinking more water.

As previously stated, for people with COPD, excessive, sticky mucus can make breathing difficult. Drinking enough water can thin the mucus, making it easier to cough up. However, there are more benefits to staying hydrated with COPD.

Drinking enough water can also help people with COPD fight off infections better. For people on oxygen therapy, the oxygen can cause symptoms of dryness and irritation in the nasal passages and airways. The good news is that drinking enough water can help prevent this dryness while keeping you hydrated.

What drinks should I avoid, and what drinks will help keep me hydrated?
Staying Hydrated with COPD

While there are many drink options available, it’s important to know which liquids to avoid. Drinks that contain caffeine such as tea, soda and coffee as well as alcoholic beverages can actually dehydrate you or pull water away from your body. It’s best to avoid these drinks or only drink them in moderation followed by a glass of water.

Many people like to use sports drinks like Powerade and Gatorade to replenish electrolytes and rehydrate the body. While these drinks may help, they can also contain high amounts of sugar. To reduce the sugar amount, you can try watering sports drinks down and drinking them in moderation under the guidance of your doctor.

There are many fluid options that will help hydrate or rehydrate you as well. You guessed it; water is the best hydrating liquid. The best drinks for staying hydrated with COPD include:

Water
Broth soups
Fruit Juice (100 percent, natural fruit juice)
Decaffeinated coffee
Decaffeinated tea
Coconut water
Can certain foods help with hydration?
You can actually eat your water and receive important nutrients, vitamins and minerals from certain foods. Foods that are excellent sources of water and also contain vital nutrients include:

Cucumbers
Celery
Radishes
Tomatoes
Bell peppers
Watermelon
Spinach
Strawberries
Baby carrots
Cantaloupe
Even though these foods have a high water content, they also provide important nutrients. In fact, celery contains folate and vitamins A, C and K, and watermelon is rich in the antioxidant lycopene. Spinach contains lutein, potassium, folate and vitamin E, and cantaloupe provides you with vitamins A and C.

Electrolytes and staying hydrated with COPD made easy
Staying Hydrated with COPD

Staying hydrated with COPD isn’t just about drinking enough water. It’s also about eating foods rich in water and maintaining a healthy balance of your electrolytes.

When you become dehydrated, you may also experience an imbalance in your electrolytes. Electrolytes are electrically-charged minerals, which aid in regulating water quantities, muscle activity and pH levels in your body. If you’re trying to replenish your electrolytes while you hydrate as well, try eating foods that contain potassium, magnesium, calcium and some sodium.

For example, bananas, sweet potatoes, baked potatoes, oranges, almonds, raisins are rich in potassium. Excellent sources of magnesium include bran cereal, brown rice, almonds, molasses, bananas, okra and Lima beans. When it comes to calcium, try foods such as sardines, salmon, kale, mustard greens, dried figs, hazelnuts, almonds as well as both dairy milk and fortified almond, rice or soy milk.

Remember to discuss your personal hydration needs with your doctor before you change your diet or treatment plan. If you’re looking for more tips on foods for your COPD diet, check out our article about COPD-friendly foods. With these tips and facts, staying hydrated with COPD will be easier.



https://lunginstitute.com/blog/staying-hydrated-copd/

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You and Your Hormones

Hyponatraemia

Hyponatraemia means abnormally low levels of sodium (salt) in the bloodstream or a deficiency of sodium in the body.
Glossary
All Endocrine Conditions
Resources for Endocrine Conditions
Alternative names for hyponatraemia
Low blood sodium; sodium deficiency; low sodium levels; hyponatremia

What is hyponatraemia?
Hyponatraemia means abnormally low levels of sodium in the bloodstream or a deficiency of sodium in the body.

What causes hyponatraemia?
Hyponatraemia is a deficiency of sodium in the blood. The type of hyponatraemia that an individual has can be categorised according to the water volume levels ('hydration status') in particular parts of the body:

Dehydration (hypovolaemic hyponatraemia) – this means that a person will be in a dehydrated condition, with low water levels in the body. It is caused by two mechanisms:
Loss of sodium and water through the kidneys as a result of:
Addison’s disease

kidney problems

the use of diuretics (particularly thiazide diuretics such as bendroflumethiazide).

Loss of sodium and water through other sources such as:
diarrhoea and vomiting

pancreatitis

trauma

burns

fistulas.

Fluid overload (hypervolaemic hyponatraemia) – in this case, the patient will have swelling of the arms and legs due to too much water in the body. The causes can include:
cardiac failure

cirrhosis of the liver

nephrotic syndrome.

Normal hydration status ('euvolaemic hyponatraemia) – this means water levels in the body are normal so the condition can be caused by:
syndrome of inappropriate secretion of anti-diuretic hormone. This is due to the secretion of too much anti-diuretic hormone, the hormone which is responsible for managing the excretion of fluid and salt from the body. Syndrome of inappropriate secretion of anti-diuretic hormone can be caused by a number of medications taken to treat other conditions. It can also be the result of chest infection (pneumonia) or cerebral disorders such as meningitis

water overload, which can be caused by drinking excessive amounts of water

a severely underactive thyroid gland (hypothyroidism). The reason for this is unknown.
What are the signs and symptoms of hyponatraemia?
The symptoms of hyponatraemia depend on the severity of the condition. In mild cases, there are usually no symptoms but, as the severity increases, patients may experience headache, nausea, vomiting, lack of energy and anorexia. More serious hyponatraemia can lead to confusion, muscle cramps and weakness, problems with gait and personality changes.

In severe cases, the main symptoms are seizures and/or drowsiness. However, there are other signs that could lead to a diagnosis of hyponatraemia. These are generally:

neurological symptoms, including reduced level of consciousness, fits, difficulty in breathing and coma

dehydration-related symptoms, including dry mucous membranes and reduced elasticity of the skin

over-hydration-related symptoms, such as swelling of the arms, legs, swelling of the abdomen and breathlessness.
How common is hyponatraemia?
Hyponatraemia is the most common electrolyte condition and is most often seen in elderly, female and hospitalised patients. Estimates of how common it is do vary. It is thought that approximately 3–5% of all hospitalised patients, and 30% of elderly patients have severe hyponatraemia. Hyponatraemia is common in patients taking certain medciations including thiazide diuretics, and drugs that cause syndrome of inappropriate secretion of anti-diuretic hormone, such as anti-epileptics and some antidepressants.

Is hyponatraemia inherited?
Hyponatraemia is not itself inherited. However, some conditions with a genetic component can be associated with hyponatraemia. Because there are so many different causes of hyponatraemia, it is important to consider all causes in patients whatever the underlying chronic illness.

How is hyponatraemia diagnosed?
In the community, hyponatraemia is usually picked up by a routine blood test. This test is usually may be carried out annually by the GP if a patient is on any medication that could affect kidney function. In hospital, almost every patient has a blood test on admission.

Once hyponatraemia is diagnosed, there is a need for other tests to identify causes of hyponatraemia. These would be glucose, a cholesterol profile, cortisol and thyroid function tests. A very high glucose or cholesterol can make sodium levels appear low. Other specialised tests to establish the cause of low sodium may also be carried out, such as a serum and urine test for osmolality and to establish the amount of sodium being passed in the urine. Chest x-rays should be taken for patients showing symptoms of a cough and loss of weight to exclude lung cancer, as this is a common cause of syndrome of inappropriate secretion of anti-diuretic hormone.

How is hyponatraemia treated?
The treatment given will depend on the underlying cause. In cases of mild hyponatraemia, where the patient has no symptoms, or very minimal symptoms, treatment can be managed as an outpatient. This can include:

Stopping any medication that may be responsible for the condition such as diuretics, antidepressants or anti-epileptics. Sodium levels are then rechecked regularly and, if levels do not rise, further investigations need to be started.

Starting specific treatment if blood glucose or cholesterol levels are high.

Restricting daily fluid intake to 1.0–1.5 litres if necessary, if the diagnosis is syndrome of inappropriate secretion of anti-diuretic hormone. Usually the sodium will correct when the underlying cause of syndrome of inappropriate secretion of anti-diuretic hormone is treated.

Administering a medication called demeclocycline if sodium levels do not improve after the above action has been taken, although this drug is not commonly used and is usually supervised by a specialist.
Where hyponatraemia is more serious, patients will usually be admitted to hospital. Treatment will include:

Initially, controlled fluid replacement if dehydration is diagnosed.

Stopping any medication that may be responsible for the condition.

Assessing the amount of fluid a patient has. If fluid overloaded is diagnosed, the fluid and salt intake may be restricted and the relevant specialist may be consulted depending on whether overload is due to heart, kidney or liver problems.

Patients are often given diuretics to offload the excess fluid, and this requires close monitoring of sodium levels.

A new class of drugs called ‘vaptans’ may rarely be given in syndrome of inappropriate secretion of anti-diuretic hormone patients with lung cancer, although this requires a specialist to prescribe them.
In the most severe cases of hyponatraemia, the majority of patients will show neurological symptoms and will require admission to a hospital high dependency unit. Correction of sodium levels will be carefully controlled.

Are there any side-effects to the treatment?
The majority of patients with hyponatraemia do not experience side-effects to treatment. However, a small minority may experience:

A rare adverse reaction in the brain causing reduced conscious level and a ‘locked-in’ syndrome. This is called osmotic demyelination syndrome (ODS), previously called central pontine myelinosis. It refers to loss of the lining of the nerve fibres (‘demyelination’) in the brain stem, if hyponatraemia is corrected too rapidly.

Drug-specific side effects – demecolycline can cause nausea, vomiting, gastritis, skin rashes and blood-related disorders such as anaemia and low platelet count. The vaptans may cause a dry mouth and thirst and/or increased urinary frequency, and may also give rise to over-rapid correction of sodium, so require close monitoring of blood sodium levels.
If the patient has any concerns about these side-effects, they should speak to their doctor.

What are the longer-term implications of hyponatraemia?
The longer-term implications of hyponatraemia depend on the underlying cause of the condition and how severe the hyponatraemia is.

In cases of chronic or long-term hyponatraemia, neurological impairment such as confusion or altered attention can result. It can affect the gait, which can lead to trips and falls, and recent studies indicate that chronic hyponatraemia can also cause osteoporosis.

Last reviewed: Feb 2017



http://www.yourhormones.info/endocrine-conditions/hyponatraemia/