The result is dehydration: the condition of losing more fluid and electrolytes than you are taking in, until you don’t have enough left for your body to function normally. (1) Knowing the signs and symptoms can help you to avoid being among the roughly half a million people who are hospitalized in the United States for dehydration each year. (2) That thirst drive declines after age 50, putting older people at greater risk of becoming dehydrated than younger adults, Dr. Arkun says. Medications, chronic health conditions, dementia, and a decrease in fluid volume as we age can also increase the risk of dehydration in seniors. On the other end of the age spectrum, children are at higher risk for dehydration than adults because they more often have diarrhea, vomiting, and a high fever, and the youngest ones are unable to let you know they’re thirsty. (3) Even in younger adults, the thirst drive doesn’t always push them to keep up with their fluid needs. Arkun says most will replenish with water or another beverage after experiencing one or more of these top three early warning signs:
FatigueDizzinessHeadache
“If one of those three things happens, they usually slow down doing whatever they are doing,” and drink some water, he says.
In Adults (1,3,4)
Urinating less often than normalDark-colored urineFeeling thirstyMuscle crampsFeeling tired or lethargicFaintingConfusionDry, shriveled skinConstipation
In Children
When children become dehydrated, it can come on suddenly, says Arielle Levitan, MD, an internal medicine doctor at NorthShore Medical Group in Highland Park, Illinois, who owns the personalized vitamin company Vous Vitamin. “They get pretty lethargic and weak suddenly. You have to be watchful.” If you suspect dehydration in a child, one way you can tell is by pinching their skin, she adds. If it doesn’t snap back quickly, that is known as tenting, a telltale sign. Other signs that an infant or child is dehydrated include: (3)
Crying without tearsDry diaper after more than three hoursLess urination that normalDry mouthSunken eyes and cheeksA sunken soft spot on top of skullIrritability
Any fluid is better than none, but Coupe suggests cool water. “You don’t want it [too] cold because it doesn’t get absorbed in your stomach as quickly. Cool water is the best. Commercially available rehydration drinks such as Gatorade or Powerade are okay for the salt intake, but you do have to be careful about how much glucose, or sugar, is in them.” Salt is a compound containing sodium and chloride, two important electrolytes (minerals that have the ability to conduct electricity in the body). Along with potassium, calcium, and sodium bicarbonate, these electrolytes are necessary for the healthy functioning of cells and tissues, as well as maintaining the right level of fluid. Dehydration can throw off the balance of electrolytes in the body. (4) Dehydration can elevate your blood glucose level as well. If you have uncontrolled or poorly controlled diabetes, your blood sugar may already be too high. Elevated blood sugar leads to increased excretion of sugar in the urine, which pulls water along with it, thereby dehydrating you even further. Taking in a sugary solution — even if it contains important electrolytes — can worsen the problem. (5)
Mild (5–6 Percent of Body Fluid Lost)
This is when you experience those three early warning signs Arkun described: fatigue, dizziness, and headache. You might have a dry mouth or you may have muscle cramps, brought on by an electrolyte imbalance. Drink plain water or a sports drink immediately.
Moderate (7–10 Percent)
At this stage the loss of fluid can lead to low blood pressure and severely decreased urination. You may have a faster-than-normal pulse, or dry skin that tents when you pinch it. A child who is in this stage should receive oral hydration and medical attention. Anyone who is dehydrated and vomiting, particularly for more than four to five hours, should go to the emergency room. (4,6)
Severe (Over 10 Percent)
This stage can be life-threatening, says Arkun. Someone who is severely dehydrated is prone to fainting and injury, and electrolyte abnormalities can induce seizures. It goes without saying that someone who’s severely dehydrated needs to go to the ER. There, doctors will replenish fluids intravenously with water and sodium chloride. Death is likely if fluid loss reaches 15 to 25 percent of the person’s total body weight, he says. But this level of dehydration is rare and usually only happens if someone is isolated for an extended period of time and can’t rehydrate themselves or get help. Still, don’t let dehydration get even to the moderate stage. Heed symptoms such as a dry mouth or a headache, and drink water, says Brian Schulz, MD, an orthopedic surgeon and sports medicine specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. “Certainly anytime that someone is feeling faint, not sweating in an area in which they should be sweating, not making urine, or [if] they experience any kind of mental status changes, that is a sign they are dehydrated. If the problem doesn’t correct itself after they take in fluids, then they should pursue medical attention.” If the problem is severe enough to warrant an ER visit, how you’re treated will depend on the way you come in, says Sanjey Gupta, MD, the chair of emergency medicine at Southside Hospital in Bay Shore, New York. If you enter on your own two feet, that may signal that your dehydration isn’t severe. “If this is a younger person that [is] maybe a little dehydrated just because they did not drink enough when they were out running or exercising then we may actually just have them drink a sports drink or another liquid, as long as they can swallow and are not nauseous.” Regardless of severity, the first steps toward diagnosing dehydration involve taking vital signs and a medical history. Your healthcare team may also run lab tests for electrolyte abnormalities. “If it is advanced dehydration, sometimes you’ll see that someone’s heart rate is elevated,” says Dr. Gupta. “If it’s really bad, sometimes you’ll see that their blood pressure has decreased. That might determine if an IV fluid treatment is needed, rather than giving them something to drink.” Typically, intravenous treatment with a sodium chloride and water solution will restore a person’s fluid balance and they can return home within a few hours, Arkun says. A doctor may administer medication to control fluid-depleting symptoms such as nausea and diarrhea if there’s an underlying illness. It’s easy to prevent dehydration. Dr. Levitan says that while looking for the signs of it are key, it’s even more important to get out ahead of it and drink enough fluid before you have any symptoms. Be aware of environmental conditions that will put you at risk, such as hot weather or dry indoor heating in the wintertime; medications and illnesses that are depleting you of fluid; or overexertion. “Be proactive. It is much better if you can think ahead and hydrate well in advance of exercising or doing something active. You’ll feel much worse if you get to that point of being dehydrated than if you just preemptively stay hydrated in the first place,” Levitan says.
