Hydration

Do you wake up in the morning feeling drained?

Do you ever feel dizzy when you stand up?

Does your skin feel dry and flakey?

How dark is your urine?

You may be dehydrated.

 

You Are Water

You are 60% water. Every cell in your body requires water to function. The primary component of blood? Yep, that's water too. Hydration is more than a summertime concern; hydration is a lifestyle.

Hydration is a lifestyle.

Maintaining adequate hydration is essential to peak performance, physical and mental. 

 

How Much Water a Day?

The classic teaching is 8 cups a day, or about 2 liters. Unfortunately, this is just one more cookie cutter recommendation that is not universally applicable. The amount of liquid needed varies from person to person, based on weight, gender, physical activity, weather, diet, etc.

The key is your pee.

The color of your urine is the best indicator of your hydration status. Consume enough fluids to make the color of your urine a clear yellow. Clear or light-colored urine is an indication that your kidney does not need to conserve water; in other words, your cells have all the water they need!

Generally speaking, about 80% of fluid intake comes from drinking liquids while 20% comes from fluid containing food, such as fruits and vegetables.

From KidneyStoners.org

From KidneyStoners.org

Hidrate Spark is a company producing a smart water bottle which tracks your hydration status over the day.

Hidrate Spark is a company producing a smart water bottle which tracks your hydration status over the day.


Understand, Prevent & Treat Dehydration

  1. How You Become Dehydrated
  2. Oral Hydration
  3. IV Hydration

How You Become Dehydrated

Skin

Sweating serves to maintain an appropriate body temperature. Remember the hypothalamus? When the body's core temperature rises above the ideal range, the hypothalamus increases release of water from sweat glands. This water evaporates into the air, thereby cooling the skin and your blood. This process is called evaporative cooling and will continue until the hypothalamus detects that body temperature has returned to normal.

  • Exercise: Exercise results in an increase in body temperature, leading to sweating and loss of volume.
    • Tip: Be proactive in maintaining water balance by drinking extra fluids throughout the day when exercising, especially if engaging in cardiovascular training. A reusable, BPA-free water bottle is a great tool to continue hydrating throughout the day.
  • Sauna/Hot Tub/Hot Yoga: Although the steam room can be quite tempting during the brutal New York winter, beware! The high temperature induces sweating to prevent heat overload. The heat feels amazing, but can leave you dehydrated.
    • Tip: Bring your water bottle into the sauna and continue drinking to replace lost volume.

KIDNEY

A diuretic is any substance that prevents the kidney from reabsorbing water, thereby increasing production of urine. The two most common culprits are coffee and alcohol, two fuels of New Yorkers. 

  • Coffee: Sipping joe all day. One of the downsides of coffee is increased urination and loss of volume. If caffeine is consumed excessively, diarrhea can result, thereby exacerbating dehydration.
    • Tip: When consuming large amount of caffeine, make an effort to consume additional fluids to replace water lost through the kidney. Never consume caffeine to the point of diarrhea. 
  • Alcohol: From grabbing a drink after work to partying during the weekend, alcohol prevents reabsorption of water in the kidney. Dehydration is the mechanism of feeling hungover.
    • Tip: Pace yourself while drinking alcohol by having a glass of water between drinks. Before heading out for the night, leave a bottle of water on your pillow. Make sure to drink this water before bed to prevent a morning hangover.

Intestine

  • Diarrhea: Loose bowel movements contain water that was not reabsorbed by the intestine. Loss of this water can rapidly lead to dehydration, depending on the volume and frequency of loose stool.
    • Tip: If you suffer from chronic diarrhea, investigate your diet to identify any diarrhea-inducing triggers. If suffering from acute diarrhea, drink an oral rehydration solution to replace lost volume.
  • Bleeding: Severe blood loss from the intestinal tract--for instance, if you had a bleeding stomach ulcer or bleeding hemorrhoids--can lead to dehydration. Red or black stool can be an indicator of gastrointestinal bleeding; contact your physician immediately.
    • Tip: Limit use of NSAIDs (e.g. ibuprofen, Motrin, Aleve) which can lead to stomach ulcers. Ensure a high fiber diet and drink plenty of water to aid in passage of stool thereby reducing the risk for developing hemorrhoids.
 

Oral Hydration

Dr. Robert K. Crane made a discovery that would prevent millions of deaths: the Sodium Glucose co-transporter.

The discovery that sodium transport and glucose transport are coupled in the small intestine, so that glucose accelerates absorption of solute and water, was potentially the most important medical advance [of the 20th century].
— The Lancet, 1978
Image A: Photo of Dr. Robert K. Krane from the 1960's. Image B: Dr. Krane's hand drawn rendering of coupled Sodium Glucose transport in the small intestine. Images from Kirk Hamilton's paper.

Image A: Photo of Dr. Robert K. Krane from the 1960's.

Image B: Dr. Krane's hand drawn rendering of coupled Sodium Glucose transport in the small intestine.

Images from Kirk Hamilton's paper.

Scientists had understood that sodium attracts water molecules. What scientists hadn't understood before Krane's discovery was that glucose, or sugar, is required to absorb salt from the small intestine. If sugar and salt are not simultaneously consumed when drinking fluids, only a small fraction of water will be absorbed.

Knowledge of this cotransporter provided the basis for oral rehydration therapy, which has prevented millions of deaths in the setting of diarrheal illnesses. 

Make Your Own

Make your own oral rehydration solution by combining (World Health Organization):

  • 6 teaspoons sugar
  • 0.5 teaspoon salt
  • 1 liter of water
Pedialyte is an oral rehydration therapy designed for children with diarrhea. Pedialyte contains the ideal ratio of salt and sugar to optimize rehydration.

Pedialyte is an oral rehydration therapy designed for children with diarrhea. Pedialyte contains the ideal ratio of salt and sugar to optimize rehydration.

G2 provides the same electrolytes as Gatorade, but with half the added sugar. G2's ratio of sugar to salt is suboptimal compared to Pedialyte.

G2 provides the same electrolytes as Gatorade, but with half the added sugar. G2's ratio of sugar to salt is suboptimal compared to Pedialyte.

 

Intravenous Hydration

Oral intake is the preferred route for rehydration. However, if you require rapid hydration or if you are nauseous or vomiting, intravenous hydration should be initiated.

Intravenous administration is the most efficient way to deliver fluids and nutrients to the body.

When a dehydrated person enters the emergency room, the first action is to insert a catheter and administer fluids and electrolytes intravenously. This is the most effective way to restore volume status. I provide the same IV Hydration, in the privacy of your home or office.

What's In Your Drip?

I administer 1 liter of electrolyte and mineral-infused fluids, plus a customized combination of:

  • Vitamins: Boost the immune system
  • Anti-oxidants: Remove oxygen radicals and reduce cellular damage
  • Anti-pain medication: Relieve hangover, headache 
  • Anti-nausea medication: Reduce nausea and vomiting
  • Amino acids: Building blocks for muscle growth
  • Caffeine: Increase energy and focus, treat migraine

Preparation or Recovery

IV Hydration can be delivered as preparation before or recovery after an event.

Plan Ahead, $300. Schedule your IV drip as preparation or recovery (48+ hours advanced notice)

Urgent, $500. Request an IV drip ASAP. Restore volume instantly so you can go about your day.

Groups. Request a group rate at services@DoctorK.nyc; ideal for weddings, bachelor/bachelorette parties, or any event involving sun exposure, physical activity or alcohol consumption.

IV Hydration
from 300.00

Resources

Guerrant, Richard. "Cholera, Diarrhea, and Oral Rehydration Therapy: Triumph and Indictment". Clinical Infectious Diseases. (2003) 37 (3): 398-405.

Hamilton, Kirk. "Robert K. Crane--Na+-glucose cotransporter to cure?" Frontiers in Physiology. 2013; 4: 53. 

Nguyen, Mike. "How Do I Know If I'm Drinking Enough?" 28 May 2011. <http://www.kidneystoners.org/prevention/am-i-drinking-enough/>

World Health Organization. "The Treatment of Diarrhea, A manual for physicians and other senior health workers". 2005.