Chronic Dehydration: A complete guide to the importance of water intake

It’s a hot summer day, we have been running around doing errands and have forgotten to drink water for several hours. Everyone has had this happen before, about 75% of us suffer from chronic dehydration, but what is chronic dehydration? What are the signs, symptoms, causes, and treatments? What are the short-term and long-term effects of chronic dehydration on both the body and the brain? How can it be tested for and prevented?

What is chronic dehydration?

Our bodies are made up of about 60% water, our blood is 85% water, our bones are 25% water, our brains are 75% water, and our muscles are 80%. Dehydration happens when more fluid is lost or used than is taken in. The body doesn’t have enough water to be able to carry out its everyday functions. Most people don’t think that they are dehydrated- some probably think that it’s something that happens to people in the desert when they run out of water.

However, there is a chronic version that isn’t sudden nor as severe. Roughly 75% of us suffer from chronic dehydration– a state of constant dehydration. It’s incredibly widespread today and chronic dehydration affects anyone and everyone who isn’t drinking enough liquid- especially water.

Some people recommend drinking 2-3 liters of water a day, some say 8- 8oz glasses (64 oz.)  those are just general rules. In reality, the amount one needs to drink depends on their size, diet, climate, activity, and diuretics.

• Size: One should drink half their body weight every day. For example, someone who is 200lbs (90 kg) should drink 100 oz. (3 liters) of water a day.
• Diet. Super sugary or salty diets require a higher water intake to be able to process and metabolize properly.
• Climate. Living in hot, airy, or high altitude climates require a high water intake.
• Activity. If you spend the day sitting, you’ll need less water than someone who spent an hour in a sauna or doing hard labor. Water needs to be replaced through sweat.
• Diuretics. Diuretics are drinks that contain caffeine or alcohol. It means that the drink actually dehydrates you. Diuretics aren’t absorbed- they go straight through the digestive system and take some water with it. People who drink a cup of coffee need to drink the same amount as the coffee in water, plus some water, to be able to digest the coffee without losing liquid. Some people also have to take diuretic pills for conditions such as low/high blood pressure.

As our bodies become more accustomed to chronic dehydration, we lost sensitivity to our water deprivation. Essentially, our bodies stop telling us that we are thirsty and/or dehydrated because it becomes used to having lower water intake and levels. This makes it difficult to know that we need to drink more water.

A doctor can often easily diagnose chronic dehydration simply by the physical signs. However, they may also take a blood test to see if the number of electrolytes (especially potassium and sodium) are at good levels and to see how well the kidneys are working. A doctor may also use a urinalysis to see how dehydrated you may be and to check for any signs of a bladder infection.

Signs and symptoms of chronic dehydration

Signs and symptoms can differ by age. Many people, especially older people, don’t begin to feel thirsty until they are already dehydrated- making thirst an unreliable indicator of chronic dehydration. The body produces saliva regardless if it’s short on water or not.

• Continuous digestive problems. For example irritable bowel syndrome, acid reflux, or frequent constipation. Our digestive system depends on fluids that even slight dehydration can throw it all off balance.
• Headaches. When the blood supply to our brain is reduced to dehydration, our brains can’t work properly because it depends on the blood supply to function. This often results in headaches because out brain is trying hard to still work while it has less blood supply.
• Lack of focus, fogginess.
• Mental and emotional imbalances.
• Depression.

• Bad breath. Saliva contains antibacterial properties and prevents bacterial overgrowth in the mouth. When dehydration prevents the body from making enough saliva, bad breath occurs.
• Fever. The hotter the body gets, the more liquid it’s losing.
• Muscle weakness. Dehydration plays with the salt and electrolyte levels in our bodies. Both compounds needed to support our working muscles. When chronic dehydration occurs, it causes our muscles to weaken because they don’t have the elements they need to work.
• Muscle cramps.
• Slower metabolism. Naturally, our metabolism slows down when it doesn’t have enough water to help it process the food intake we have. Drinking just 16 oz. of water has been shown to increase the metabolic rate by 30%.
• Troubles with weight loss. A slower metabolism causes our bodies to have trouble with weight loss. Dehydration also makes it difficult for our bodies to use fat as fuel, the way we lose weight.
• Weight gain. Often we mistake what we think to be thirst as hunger. This is why many people might pick up snacks instead of a sip of water. Enough chronic dehydration and snacking could lead to obesity.
• Acne. Water reduces the toxins in our kidneys and liver which leads to overall clearer skin.
• Food cravings (specifically for sweets.) Organs like the liver, which uses water to release the stored glucose, can make you crave foods while dehydrated. The body has a hard time breaking down the glycogen (stored glucose) into the bloodstream to be able to use it for fuel.
• Dry skin. People find that their skin is hard to moisturize, even with the best moisturizers, because they need to hydrate from the inside out. When dehydrated skin is pinched, it takes time to bounce back to its normal state.

Early signs and symptoms of dehydration include:

• Few tears when crying
• Headaches
• Sticky, dry mouth
• Irritability
• Dizziness
• Sleepiness, drowsiness
• Dry skin
• Cravings for both food and drinks
• Minimal urine

Causes of chronic dehydration

• Stress. When we feel stressed or our bodies go into fight-or-flight mode, our bodies react by getting rid of fluids.
• Diarrhea. Our large intestine absorbs water from the food we eat. That’s why foods like cucumber and watermelon are great- they’re pretty much all water! However, when we have diarrhea, our bodies can’t absorb the water and expels it instead. Diarrhea is the #1 cause of dehydration.
• Diabetes. High blood sugar levels lead to increased urination and subsequent loss of fluids. One of the tell-tale signs of diabetes is a dry mouth, “cotton mouth”. Those with diabetes are especially prone to chronic dehydration.
• Sweating. As our body’s natural cooling mechanism works to keep us from overheating, it drains fluids from us. Whether it be from hot temperatures, anxiety-induced sweating, or working out, sweat adds to our fluid loss.
• Living at high altitudes. Due to the fact that humidity is lower at higher altitudes, sweat evaporates quickly. This quick evaporation makes it difficult to know how much water is being lost and difficult to know how much water should be drunk to compensate.
• Vomiting. The main cause among children of chronic dehydration is vomit. Keep an eye out for constant vomiting and visit your local physician as soon as possible.
• Sunburns. Sunburn is caused by burn to living tissue, such as skin, which is produced by overexposure to ultraviolet (UV) radiation, commonly from the sun’s rays. The body releases liquid due to the increased body temperature, creating an environment for chronic dehydration.
• Processed foods. Processed foods might not contain as much water as natural plants and fruits, therefore a higher risk of dehydration. Some examples are sodas, salty foods like potato chips, etc.

Effects of chronic dehydration on the body

Chronic dehydration can lead to conditions such as constipation because there isn’t enough water in the body to help the digestive system process everything. Overall, a lack of water slows down the metabolism- just 16 oz. raises the metabolism by 30%.

In the long-term, chronic dehydration can also lead to an increased cholesterol, premature aging, rapid breathing due to a rapid heart rate, lower blood pressure, and dry skin. Other long-term effects of chronic dehydration can also include genetic issues such as cancer and autoimmune disease. This is because chronic dehydration causes a chemical change in the body which leads to structural changes– including changes to the genetic blueprint of the body such as DNA. It can also lead to conditions such as kidney stones.

Effects of chronic dehydration on the brain

Our brains are 75% water. When we lack water, so do our brains.  Chronic dehydration causes a reduced blood supply to the brain which results in memory loss, lack of concentration and mental focus, and impaired nerve cell function. Chronic dehydration can also affect our moods. One study found that dehydration in healthy young women causes a complete and total mood disturbance.

It’s been found that we shouldn’t drive dehydrated, either- it can reduce our cognitive and motor skills. In one study done on driving while dehydrated, the participants had a much higher number of errors while dehydrated during a two-hour driving simulation such as late braking and lane drifting. Their performance was so bad that it’s actually equivalent to that of people who drive while at the limit for blood alcohol content. This is because dehydration reduces reaction time (motor skills) and concentration (cognitive skills).

Dehydration can make us more sensitive to pain. Japanese researchers in 2014 found that immersing an arm of their (dehydrated) participants in cold water while having their brains scanned showed that they have felt pain sooner (had a lower pain threshold) and had increased brain activity (in the areas involved with pain) compared to the non-dehydrated participants.

The brain actually shrinks when dehydrated! If we are dehydrated and our bodies don’t have any extra water to use, our bodies borrow water from brain cells to use in order to function properly This causes the cells in the brain to shrink. During the shrinking process, the brain pulls away from the skull and puts stress on the areas around it which are what gives us dehydration headaches. One study done in the UK found that just 90 minutes of sweating without drinking and replenishing the fluids can shrink the brain as much as a year of aging- the same as 2.5 months of Alzheimer’s disease.

Dehydration negatively affects memory in both the short-term and the long-term. Researchers at Ohio University in 2010 looked at the hydration status of 21-year-old women and had them complete tests using both declarative and working memory. A strong connection was found between memory and hydration. The women who had the lowest dehydration levels performed the tests poorer than those who were more hydrated. However, with enough chronic dehydration, our memories will get poorer and poorer as they begin to fade.

One study found that losing just 1.1% of body water causes the brain to increase greatly in neural effort to perform normal cognitive tasks- memory, problem-solving, and arithmetic.

How to test for chronic dehydration?

An easy way to test for dehydration is to, after emptying your bladder, drink .37 oz. of water per 2.2 lbs (11 ml of water per kg of body weight). Wait about an hour and then pee into a cup. If the amount of urine is less than the total amount of water that you had drunk before, then the body is retaining water and is dehydrated.

Pay attention to the frequency that you urinate. On average, hydrated people urinate between 4-7 times a day. Also, pay attention to the color of the urine. Hydrated, healthy urine needs to be a light, pale yellow. The color of urine is determined by the number of waste products in the fluid. The more water the body has for the kidneys to mix with the waste, the lighter the urine will be. Make sure that the urine is odorless– the more concentrated the urine is due to the waste products eliminated by the kidneys, the stronger the smell (of ammonia) will be in the urine.

Treatment of chronic dehydration

The best treatment is to drink water, pure water, to cure chronic dehydration. Teas and juices don’t hydrate as much because they aren’t pure water. Drinks that are caffeinated such as coffee, black tea, and soda don’t hydrate because they are dehydrating diuretics– the body excretes all the liquid in the drink, plus some water that helps to digest the drink. End of story: water is the best option to hydrate possible.

Another great treatment solution is to use IV rehydration hydration therapy. This is because it restores the fluid imbalance inside the body and contains water and electrolytes. It’s said that IV therapy hydrates as quickly as water. If severely dehydrated, it’s great because vitamins and minerals can be added to the IV solution to help give the body a boost. This type of treatment is done with the assistance of a licensed doctor or nurse.

In order to replace the electrolytes and fluids lost, eat lots of veggies and fruits which are easy to digest. There is also the option of sports gels, drinks, and gummies, but they have lots of sugar. However, if a baby is dehydrated, they should try the “baby version” of a sports drink such as Equate or Pedialyte. Small sips of water are also recommended.

How long does it take to reverse chronic dehydration?

Depends on the severity of the dehydration. If severe, reversal takes about 1-2 weeks for complete recovery. This gives the body time to start working properly, allows the kidneys to gain proper function, and the body to hydrate enough. Milder forms of chronic dehydration can be reversed in a few hours if at the emergency room and a couple of days if hydrating at home.

Tips to prevent chronic dehydration

• If you have a headache, sometimes the only thing needed is a bit of water. So, try drinking water before taking a pill.
• Keep the water bottle handy. You’ll find that you’ll sip it throughout the day.
• Try drinking tap water rather than bottled water. Research has shown that tap water is safer than bottled water because it has more regulations with it. Plus, tap water is available everywhere! Even if this is the best options some countries don’t have the best quality of water so make sure to verify it’s safe. 
• Try fruits and veggies with high water content such as watermelons, cucumber, cantaloupe, and strawberries. Bananas also have some water content and are great for restoring potassium levels.
• Take a sip of water before/instead of eating a snack.
• Monitor the color of your urine- hydrated people have pale, yellow urine.
• Make water fun by adding lemon, chia seeds, or both!
• Try using other hydrating drinks (without sugar if you can) like tea and juice! Coconut water was proven to be incredibly hydrating!
• Make drinking water a game, always challenge yourself to meet the objective!
• Try to drink the majority of necessary water during the morning and early afternoon to prevent the need to get up in the middle of the night to urinate (disturbing sleep) and keeping the mind alive, awake, and enthusiastic all day.

How do you prevent dehydration? Let us know what you think in the comments below!

Anna Bohren

Anna is a freelance writer who is passionate about translation, psychology, and how the world works.