Water Intoxication
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Medically reviewed by Jordana Haber Hazan, MD
Water intoxication, also called water toxicity, happens when a person consumes excessive water, diluting levels of electrolytes that their body needs to function properly. While it's considered to be rare, water toxicity typically occurs in situations where a person over-hydrates, like after an intense athletic session or due to an underlying health condition.
Water intoxication causes symptoms like disorientation, nausea, and vomiting—and if not treated, can potentially be life-threatening.
Water Intoxication Symptoms
Signs of water intoxication are similar to symptoms of dehydration, or when your body doesn't have enough water to function properly. Symptoms of water toxicity may also resemble psychosis.
If you have water intoxication, you may notice:
Disorientation
Confusion
Vomiting
More severe symptoms can also develop, including experiencing an altered mental state or a loss of consciousness.
What Causes Water Intoxication?
Water intoxication happens when you take in significantly more water than your body needs—negatively impacting the levels of electrolytes (minerals like sodium) in the blood. Electrolytes are important because they help keep the body operating normally, playing a role in the nervous and muscular systems as well as in functions like blood pressure regulation.
Typically, the kidneys can regulate the balance of water and electrolytes. But if the kidneys can't excrete (naturally get rid of) excess fluid fast enough, the body's electrolyte levels can become dangerously diluted. When sodium levels fall too low, the extra water consumed can enter the cells and trigger swelling, which leads to severe symptoms.
Research shows that water intoxication is most commonly triggered by situations where the person goes through excessive sweating and then over-replenishes the lost fluids—like during prolonged exercise or while working outside in the sun.
Someone may also ingest too much water during a water drinking competition or from having excessive thirst, which can happen due to a variety of reasons.
Risk Factors
There are a couple of factors that can make it more likely to experience water intoxication.
For example, having a health condition that interferes with the body's ability to excrete water normally can increase the risk of water intoxication. This includes conditions like kidney or liver disease and heart failure. Diabetes may also be a factor, particularly when thirst has increased and there are uncontrolled blood sugar levels.
Some drugs may also play a role in developing water intoxication and its complications, as they can cause increased thirst. These include certain types of antidepressants, vasopressin (a diabetes treatment), and diuretics (a blood pressure and heart failure treatment). Taking psychedelic substances like MDMA that can lead to extreme thirst may also trigger over-hydration.
Diagnosis
Because the symptoms of water intoxication tend to be more vague, it can be difficult for a healthcare provider to immediately diagnose the condition.
The provider will perform a physical examination and ask about your medical history. Then, they'll likely order a blood or urine test, or both, to confirm water intoxication.
A blood test measures the amount of sodium in the blood, with 135-145 milliequivalents per liter (mEq/L) as the normal range. A urine test measures the sodium levels present in the urine, with 20 mEq/L representing a normal level in a random sample.
The provider may monitor you to oversee how much fluid you're taking in and releasing via urine. This may also include weight measurement to note any changes that may signal you're not releasing enough fluid.
Water Intoxification Treatment
The goal of treating water intoxication is to prevent complications from occurring and return the body to normal functioning. Specific treatment tactics can vary based on how severe the symptoms are and how far water intoxication has progressed.
In mild cases, a healthcare provider will help limit your water intake so that the kidneys can adjust and get the fluid-electrolyte balance back to normal. This may involve restricting your water consumption to less than a quart (or 4 cups) daily for several days.
Other treatment options may include:
Monitoring sodium intake, if underlying heart, liver, or kidney disease is the cause
Stopping any medications that may be triggering the issue
Taking diuretics (sometimes known as water pills), if applicable, to increase the amount of urine the body produces
In more severe cases, a healthcare provider may administer intravenous (IV) medications to raise sodium levels slowly and safely. This helps avoid overcorrecting the imbalance too quickly, which can lead to other complications.
Prevention
To avoid water intoxication, you need to make sure you're not taking in more water than your kidneys can eliminate. However, there aren't set guidelines on what defines excessive water intake, because exact daily hydration needs can vary slightly by person.
The general recommended amount of fluids to consume daily is 15.5 cups for people assigned male at birth and 11.5 cups for people assigned female at birth. This metric includes fluids taken in from foods and water, so you may need to drink slightly less than this amount—for example, 9-13 cups vs. 11.5-15.5 cups.
Here are some other tips to help prevent water intoxication and its complications:
Don't drink more than 48 oz of fluid within an hour
Stop drinking if you start to feel suddenly bloated or nauseous
Use electrolyte drinks in moderation, especially if you're an endurance athlete, to help replace both water and sodium losses
Be mindful of running in hot temperatures, as the heat induces more sweat and prompts greater hydration requirements
Keep an eye on the color of your urine, as extremely light yellow or clear fluid may be an indicator of over-hydration
Complications
Severe cases of water intoxication can progress into hyponatremia, which means that an excessive water or fluid intake has lead to dangerously low levels of sodium in your bloodstream.
If left untreated, there is the potential that this condition can trigger the following complications:
Brain damage, which occurs when the lack of sodium in the body triggers brain cell swelling
Seizures, where the body convulses uncontrollably as a result of abnormal brain activity
Coma, a state of prolonged loss of consciousness
Death (in rare cases)
A Quick Review
Drinking excess amounts of water can throw off the electrolyte balance in the body—leading to water intoxication. This rare condition is more likely to develop in people who participate in endurance sports and people with certain medical conditions.
To avoid severe and potentially life-threatening complications, seek medical attention if you notice symptoms like nausea, vomiting, and confusion after consuming an excessive amount of fluids.
Frequently Asked Questions
How much water should you drink a day?
Daily water intake can vary slightly by person based on multiple factors. In general, experts recommend drinking around 9-13 cups of water daily. You should also get some water intake through food.
Is water intoxication as harmful as dehydration?
Some experts caution that over-hydrating can be more dangerous than not hydrating enough. That's because water intoxication can lead to harmful complications like seizures or coma, and in rare cases, can be life-threatening.
Which foods can help improve water intoxication symptoms?
There aren't any specific foods recommended for improving water intoxication symptoms. Overall, consider being mindful of replacing both water and electrolyte levels to maintain a balance in your body. Electrolyte drinks or foods like bananas, oranges, or avocados may be beneficial in this regard.
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