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Hydration Extends Beyond Mere Water Consumption

Ken Yu

July 17, 2023 • 3 min read

While hydration is commonly equated with increased water intake, optimal hydration hinges on maintaining proper electrolyte balance. Although optimal daily water intake varies significantly among individuals, most experts advise a total daily water intake from all sources of approximately 8 to 12 glasses (1). However, fluid intake represents only one dimension of hydration—proper hydration depends on a balanced ratio of water to electrolytes within the body.

Inadequate or excessive water intake can lead to serious health complications, particularly during intense physical activity. Research has established a “J-shaped relationship” between sodium intake and cardiovascular risk, wherein both extremely low and high sodium diets are associated with an elevated risk of heart disease (2).

The normal range for blood sodium levels is 135 to 145 milliequivalents per liter (mEq/L). Insufficient water intake or excessive salt consumption can elevate blood sodium levels above 145 mEq/L, resulting in hypernatremia—characterized by nausea, dizziness, drowsiness, and/or muscle weakness (3). Conversely, excessive water intake or inadequate salt consumption can lower blood sodium levels below 135 mEq/L, leading to hyponatremia. Symptoms of hyponatremia include fatigue, headache, muscle cramps, cognitive impairment, seizures, or even death (4)(5).

The media frequently claims that 75% of adults suffer from chronic dehydration; however, this assertion lacks support from medical literature (6). To assess suboptimal hydration, one should look for one or more of the following symptoms: dry lips, dry tongue, dry mouth, thirst, hand swelling, dizziness, headache, lethargy, elevated blood pressure, or dark-colored urine (7). Additional strong indicators include consuming fewer than six cups of water daily, ingesting more than 2,300 mg of salt per day, excessive sweating, severe diarrhea, or persistent vomiting (7)(8).

If you consume large amounts of water yet still feel dehydrated or thirsty, you may be overhydrating while insufficiently consuming salt. Many individuals who drink more than 12 cups of plain water daily or ingest less than 900 mg of sodium per day report symptoms akin to dehydration (9). Drinking beyond the point of thirst can dilute blood sodium levels, causing excess water to move into body cells and resulting in swelling or bloating (10).

If you are not drinking enough water, avoid electrolyte drinks, sports drinks (e.g., Gatorade), Pedialyte, coconut water, salty soups, diuretics, or any products with excessively high sodium content. Conversely, if you drink adequate water, sweat heavily during exercise, or restrict salt intake, an electrolyte supplement can aid in maintaining fluid balance by facilitating proper water distribution throughout the body.

Electrolytes are indispensable for fundamental cellular function in the human body (11). Key electrolytes include sodium, potassium, calcium, magnesium, chloride, and phosphate (12). Imbalanced electrolyte levels can disrupt cellular electrical charge, impacting hydration status, body temperature regulation, pH balance, glucose levels, heart rhythm, muscle contractions, and overall nervous system function.

Sodium is critical for maintaining cellular homeostasis, extracellular fluid balance, blood pressure regulation, and overall electrolyte balance. Potassium supports intracellular processes such as membrane potential and the electrical excitation of nerve and muscle cells (13). Calcium is essential for bone mineralization, muscle contraction, nerve signal transmission, blood clotting, and hormone release (13). Magnesium participates in metabolism, muscle contraction and relaxation, glucose regulation, bone development, and neurological function (13). Chloride regulates cell volume, smooth muscle contraction, synaptic transmission, pH balance, muscle activity, and immunity (14). Phosphorus—regulated by the kidneys—plays a pivotal role in metabolic pathways, DNA/RNA replication, and serves as the energy source for adenosine triphosphate (ATP) pathways (14)(15).

For individuals with low electrolyte levels, incorporating electrolytes into one’s routine is an effective strategy to enhance athletic performance, reduce electrolyte loss during cardiovascular exercise, prevent dehydration symptoms, and improve overall well-being. To boost salt intake, commercial electrolyte products (e.g., Kaged Hydra-Charge, 6am Run Hydrablast BCAA, Ryno Power Electrolytes Capsules) are readily available. Alternatively, homemade oral rehydration therapy (ORT) can be prepared by adding electrolytes and glucose to water. Below is a recipe aligned with the World Health Organization’s (WHO) recommended formulation (16):

World Health Organization Oral Rehydration Recipe

32 oz of water

1/2 tsp table salt (sodium chloride)

1/4 tsp Morton Salt Substitute® (potassium chloride)

1/2 tsp baking soda (sodium bicarbonate)

2 tbsp sugar or a glucose-based sweetener

Optimize your hydration status and observe enhancements in your performance.

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