YOU and Your Doctor Are Your Medical Team – July 2023

Being dehydrated may not seem like a serious condition, but it could become an acute situation if not dealt with.

There are 3 main electrolytes: Sodium, potassium and chloride, along with minerals such as magnesium, calcium, phosphate, and bicarbonates. The kidneys among other organs help maintain a balance between daily consumption and excretion of electrolytes and water.

Older people are more susceptible to dehydration than younger people, unless they are into sports or activities that create that risk

At an older age, your body’s fluid reserve becomes smaller, alongside changes in the water and sodium/potassium balance that naturally occur as people age. Also 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, Alzheimer’s and by the use of certain medications. A Mayo clinic study of seniors found an association of lack of adequate hydration and falls, as well a strong relationship with osteoporosis. Dehydration can be a very common cause of falls in older adults, as it often causes dizziness, drowsiness due to a drop in blood pressure.

Higher altitudes are associated with dehydration as a result of increased urine output, reduced humidity/drier air, unaware how much you are sweating, and more rapid breathing, resulting in a greater loss of bodily fluids. According to the Wilderness Medical Society; your body loses water through respiration at high altitude twice as fast as it does at sea level. High altitude physical activities like hiking, biking, etc.. can also make you need to urinate more often and can also stop your thirst response, increasing your risk of dehydration.

Some signs of dehydration /electrolyte imbalance: Mental confusion, disorientation, irritability, unexplained fatigue, unusual sleepiness, muscle cramps, spasms or weakness, unexplained headache, irregular or increased heart rate [while at rest], unexplained increased breathing, numbness or tingling in limbs, fingers and toes, dizziness – lightheadedness, fainting, loose skin or skin that doesn’t return to normal after pinching or pressing, urinating less than usual, or darker urine color than your normal.

Possible causes of dehydration: (a) The simplest one is if you don’t drink enough fluids because you´re sick, busy, or you have not noticed you have not had something to drink in quite a while, especially in warmer months, (b) Prolonged severe/ acute diarrhea, especially with vomiting, and/or inability to retain fluids which can cause a tremendous loss of water and electrolytes in a short amount of time, (c) Having fever- the higher your fever-the more dehydrated you may become, (d) Having a chronic disease such as uncontrolled or untreated diabetes or a renal/kidney disease-taking some medications that increase your urination, even taking some laxatives, diuretics, etc.., (e) Some weather conditions – not drinking sufficient / 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, and, it is possible-drinking too much water can cause the electrolyte levels in the body to get out of whack and cause sodium levels to plummet.

There are some serious consequences of not identifying and treating dehydration: Heat exhaustion, heat stroke, increased heart rate and potential irregular heart rate. When experiencing prolonged or repeated bouts of dehydration it can cause urinary tract infections, kidney stones and even kidney failure. Seizures can occur if your electrolytes are out of balance, as the normal electrical messages to the brain are affected which can lead to involuntary muscle contractions and sometimes to a loss of consciousness. A most serious situation is “low blood volume shock” (hypovolemic shock) – it occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body.

Most of my health articles try to focus on helping you identify potential health problems before they become larger or have severe consequences. Listen to your body, many times it tries to tell you that you have a problem that should not be ignored, and you should see your doctor to evaluate the situation.  Please learn your body’s normal “behavior” and pay attention to changes that are occurring, that are outside “your normal”.

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Jackie Kellum

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