Hello Barry1941,
The basic answer is 6-8 glasses of water per day. Figures vary
some what, depending on age, climate, activity and authoritative
agency! Mistakenly, some people think that if they take a diuretic
(Hydrochlorothiazide is a diuretic), they should not consume 6-8
glasses a day. A diuretic does relieve the body of excess fluid, but
interestingly, the more water you consume (within reason), the less
water your body will retain!
If you were to drink 6-8 glasses of water daily, within a very
short time, your body would self regulate and no longer retain fluid.
Your blood pressure actually increases from inadequate water
consumption. I would, however, recommend that you discuss with your
doctor, your need for electrolyte replacement, particularly potassium.
Consider eating a banana and/or some orange juice during the day to
replace lost potassium from your medication.
?When water intake equals water loss, the body is in fluid balance.
When water loss is greater than intake, or vice versa, a fluid
imbalance may result.?
?For a normal adult, a daily intake between 0.74-0.84 US quarts
(700-800 ml) is required to meet water losses and maintain fluid
balance. To protect against dehydration and developing kidney stones,
a greater water consumption between 1.5-2 US quarts/day (1.4-2 L/day)
is advised. Water losses occur through evaporation in expired air and
through the skin. Sweat losses are usually minimal but can be
significant in warmer climates or with accompanying fever.
The body can accommodate extreme changes in water intake when the
brain and kidneys are functioning normally. It is usually possible for
a person to consume enough water to maintain blood volume and
electrolyte balance in the blood. However, if a person is unable to
consume enough water to equal excessive water loss, dehydration may
result.?
?An adult would have to drink more than 2 US gallons per day (7.6 L
per day) to exceed the body's ability to excrete water. Excessive body
water causes electrolytes in the blood, including sodium, to become
overly diluted.?
http://health.enotes.com/nursing-encyclopedia/fluid-balance
?Many physicians give little or no guidance with regard to how much
water should be consumed. General rules for a healthy diet apply,
including eating small, regular meals and keeping water intake up. If
the goal of the diuretics and low salt diet is to increase sodium loss
from the body, then a normal level of water consumption (8 glasses per
day) would help achieve this aim. Some physicians apparently advise
their patients to limit water intake, presumably to aid in the
dehydrating effect of the diuretic. To my knowledge, there are no data
supporting either point of view.?
http://oto.wustl.edu/men/mntreat.htm#DM2
?The average adult needs about four quarts of water daily to
maintain blood volume, body pH, and optimal kidney function. Yet many
older adults are reportedly drinking about half that much, some as
little as one quart a day.?
?1. At a half-gallon per day, the blood volume (BV) begins to fall,
and the kidneys respond by concentrating the body?s sodium content.
2. At one quart of water per day the body develops hypernatremia
(extremely high sodium) as a result of secretion of anti-diuretic
hormone (ADH) in the body.
3. Chronic hypernatremia results in body pH imbalance, which, not
unlike hard water in one?s water pipes at home, eventually causes a
host of other problems:
? The body's cells become toxic & increase in size
? Blood pressure rises (hypertension)
? Blood lipids (cholesterol, triglycerides etc.) do not dissolve
? Calcium doesn?t absorb causing osteoarthritis (1-2% loss per annum)
or osteoporosis (3-5% loss)
? Hypoglycemia develops, and later diabetes mellitus II
? Inner ear/vestibular problems increase?
?How Much Water is Enough?'
(Daily/in quarts)
Physical Activity Level
Body Weight (lbs) Low Moderate High
100-125 2.5 2.5 3.0
126-150 2.5 3.0 3.5
151-175 3.0 3.5 4.0
176-200 3.5 4.0 4.5
201-250 4.0 4.5 5.0
251-300* 4.5 5.0 5.0?
?For instance, after correcting a water intake deficiency, blood
pressure may drop dramatically if medication levels are maintained. If
the pH rises, because of increased kidney efficiency, and the patient
remains on high levels of anti-cholesterol medication, muscle wasting
or liver damage may eventually develop.?
http://www.digicare.org/Dehydration-Diuretics.asp
?Older people have very similar water requirements to those of
younger adults. Earlier estimates recommended that total water intake
(including water contained in food) should be approximately 1ml per
kcal of energy expenditure per day.(i) More recent guidance(ii) has
increased the recommended total water requirements for adults aged 51
and above to 3.7 litres per day for men (of this amount, approximately
3 litres should be obtained from beverages) and 2.7 litres per day for
women (of which, approximately 2.2 litres should be obtained from
beverages). This is based on an individual who undertakes 60 minutes
of moderate physical activity throughout the day and consumes a diet
containing about 2200 kcal.?
?However, a conservative estimate for older adults is that daily
intake of fluids should not be less than 1.6 litres per day in order
to ensure adequate hydration.(iv)?
http://www.water.org.uk/home/water-for-health/ask-about/older-people
?The problem is that, though many decide to increase their water
intake, very few stick with it. It's understandable. During the first
few days of drinking more water than your body is accustomed to,
you're running to the bathroom constantly. This can be very
discouraging, and it can certainly interfere with an otherwise normal
day at work. It seems that the water is coming out just as fast as
it's going in, and many people decide that their new hydration habit
is fruitless.
Do take heed , though. What is really happening is that your body is
flushing itself of the water it has been storing throughout all those
years of "survival mode". It takes a while, but this is a beautiful
thing happening to you. As you continue to give your body all the
water it could ask for, it gets rid of what it doesn't need. It gets
rid of the water it was holding onto in your ankles and your hips and
thighs, maybe even around your belly. You are excreting much more than
you realize. Your body figures it doesn't need to save these stores
anymore; it's trusting that the water will keep coming, and if it
does, eventually, the flushing (of both the body and the potty) will
cease, allowing the human to return to a normal life. It's true. This
is called the "breakthrough point."
?"Eight glasses a day? Are you kidding?!" It's really not that much.
Eight 8-ounce glasses amount to about two quarts of water. This is
okay for the average person, but if you're overweight, you should
drink another eight ounces for every 25 pounds of excess weight you
carry. You should also up this if you live in a hot climate or
exercise very intensely.
This water consumption should be spread out throughout the day. It's
not healthy at all to drink too much water at one time. Try to pick
three or four times a day when you can have a big glass of water, and
then sip in between. Don't let yourself get thirsty. If you feel
thirsty, you're already becoming dehydrated. Drink when you're not
thirsty yet.?
http://www.inch-aweigh.com/water.html
?The normal daily turnover of water is approximately 4% of total
body weight in adults.(iv) The amount of water required by the body is
that which is necessary to balance the insensible losses. This can
vary markedly, depending, for example on climatic conditions. Other
factors determining water loss include the amount of water required by
the kidneys to excrete waste products (the solute load). This may vary
with dietary composition and other factors. In view of these
limitations, in 1989, the National Research Council (US) noted that
the estimation of water requirement was complex and highly variable
and concluded that it was impossible to set a general water
requirement. Nevertheless, for practical purposes they recommended
that the water requirement for adults could be estimated as "1ml per
kcal energy expenditure for adults living under average conditions of
energy expenditure and environmental exposure" - thus a person eating
2900kcal would require 2900ml of water.?
?In spite of this, some authorities still advise that we should drink
"six to eight glasses" or "2500-3000ml" of water per day. However,
this guidance may have been influenced by the additional
recommendation made by the Food and Nutrition Board of the National
Research Council in 1989, that as "there is so seldom a risk of water
intoxication ? the specified requirement for water is often increased
to 1.5ml/kcal to cover variations in activity level, sweating, and
solute load."?
?The advice from the British Dietetic Association is: "In a moderate
climate like ours, most of us need around 6-8 glasses of fluid a day;
for example, water, milk, fruit juice, tea or coffee, to keep the
balance right. However, if we have sweated a lot, because it's hot or
we've been exercising, our requirements increase; a good guide is to
have an extra one litre of water for every hour of strenuous
exercise."
http://www.water.org.uk/home/water-for-health/ask-about/adults
?Even normally, thirst is experienced late in water depletion. By
the time you feel thirsty, you are already dehydrated. This
little-known fact is even more true as you age. Though you are fully
capable of requesting and obtaining water, you will experience thirst
less and less as you age.
One study explored the effect of 24 hours of water deprivation in
active, healthy older men (67-75 years) compared to younger men (20-31
years). The older men lost the same amount of weight but showed large
increases in concentrations of salts in the blood. Their urine
analysis reflected inadequate excretion of salts. Nevertheless, the
older men were not thirsty. In fact, all failed to correct their water
deficit after two hours. Conclusion: people over forty, if left to
their own thirst mechanisms, are likely to become dehydrated and to
lose blood volume, even though they may appear healthy. People whose
mental state has been compromised are particularly at risk. Many
immobilized people with communication problems inhabit a virtual
desert simply because they cannot ask for water.?
?Many drugs, especially diuretics (which are used to treat heart
failure), deplete body water volume. Unfortunately, many people report
that they deliberately cut down on fluid intake to "help" their
medications. They think that if their diuretic pills are supposed to
get rid of excess water, then decreasing water intake will be that
much better. But in doing so, they put themselves at risk of falling
blood pressure, confusion, pseudodementia, and kidney problems.
Often older people ignore their thirst because drinking does not
relieve persistent dry mouth or because they're afraid of becoming
incontinent. Some nursing homes, concerned with inadequate water
intake by their residents, ask doctors to prescribe four to six
glasses of water a day for their patients. Once the order is written,
nurses must give water, then witness and document the fluid intake.
Water, then, has many virtues:
? Water is the best diet drink around. If you are interested in
losing weight, water gives the feeling of fullness with zero calories.
? Water helps reduce wrinkles. Well-hydrated skin is smoother and
less prone to developing fine wrinkles. Water is probably the best
anti-aging "vitamin" available for skin.
? Water helps the urinary tract resist bacterial invasion. By
drinking water and keeping the kidneys flushed, patients prevent
recurrent infections.
? Water is the only "medicine" that has no side effects!
What You Can Do
You must make an effort to drink plenty of water each day. To maintain
optimum hydration, you should drink at least a quart of water
(preferably two quarts) every day. Six to eight 8-ounce glasses of
water a day are the minimum you should be drinking for good health.?
http://users.rcn.com/mags/water.html
Notice that you are encouraged to take your medication with a full
glass of water:
What is the most important information I should know about hydrochlorothiazide?
? To reduce nighttime urination, take hydrochlorothiazide early in
the day unless otherwise directed by your doctor.
? Use caution when driving, operating machinery, or performing other
hazardous activities. Hydrochlorothiazide may cause dizziness. If you
experience dizziness, avoid these activities.
? Hydrochlorothiazide is a thiazide diuretic (water pill). It
decreases the amount of fluid in your body by increasing the amount of
salt and water you lose in your urine.
Take each dose with a full glass of water.
http://www.drugs.com/hydrochlorothiazide.html
I hope this has helped you! Be sure and read each posted web site
for complete information. Please request an Answer Clarification, and
allow me to respond, if any part of my answer is unclear. I will be
happy to assist you further, before you rate my answer.
Sincerely, Crabcakes
Search Terms
============
Daily water intake + diuretics
Water intake + Hydrochlorothiazide
Hydrochlorothiazide + water balance + drink |
Clarification of Answer by
crabcakes-ga
on
30 Apr 2006 20:44 PDT
Hello Barry1941,
It DOES get confusing, doesn't it? Remember, these are guidelines,
and not strict "rules" for water consumption. The source I posted that
suggests up to 3.7
liters a day was for a person who is exercising at a moderate rate,
for an hour a day. Eight glasses of water a day is considered an
average. Should you engage in a marathon, or trim trees on a warm
day, you would naturally, need to consume more water.
8 oz., a cup, is considered a glassful in the US.
"?Older people have very similar water requirements to those of
younger adults. Earlier estimates recommended that total water intake
(including water contained in food) should be approximately 1ml per
kcal of energy expenditure per day.(i) More recent guidance(ii) has
increased the recommended total water requirements for adults aged 51
and above to 3.7 litres per day for men (of this amount, approximately
3 litres should be obtained from beverages) and 2.7 litres per day for
women (of which, approximately 2.2 litres should be obtained from
beverages). This is based on an individual who undertakes 60 minutes
of moderate physical activity throughout the day and consumes a diet
containing about 2200 kcal.?
?However, a conservative estimate for older adults is that daily
intake of fluids should not be less than 1.6 litres per day in order
to ensure adequate hydration.(iv)?
http://www.water.org.uk/home/water-for-health/ask-about/older-people
Even experts disagree:
"Obey your thirst - When it comes to how much water one should consume
on a daily basis, experts cannot seem to agree. The rule of thumb has
been to drink eight 8-oz. glasses of water a day -- but even that
recommendation has been contested lately. Some experts say simply
drinking water when one is thirsty is sufficient, while others say the
body already is dehydrated by the time thirst hits.
According to Teller Swett, a cardiovascular nutritionist at the
University's Heart and Vascular Center, a normal healthy adult at rest
who eats about 2,000 calories a day needs approximately two liters of
water to replenish what is lost through urination, body waste and
insensible perspiration. The standard size water bottle sold in
vending machines is half a liter."
"Swett said the average adult loses about two and a half quarts of water a day."
http://www.cavalierdaily.com/CVArticle.asp?ID=23395&pid=1296
"Recently, I read two conflicting articles about this issue. One says
that this issue of drinking eight 8-oz. glasses of water is a "myth"
and that we should drink only when we feel we need to. As well, this
article said that drinking "other liquids" as a substitute was fine.
That runs contrary to everything I have ever heard about our need for
water.
The other article took a different position. In fact, this physician
said that we should be drinking water based on our body weight.
Namely, that we should divide our body weight by two and that is the
number of ounces of water (without substitutes) that we should consume
on a daily basis.
I firmly believe that water plays an essential role when dealing with
pain issues. For those who suffer from osteoarthritis, pain management
is a big issue. I decided to try these two different theories for
myself to see what kind of results I had."
http://www.arthritis-glucosamine.net/article-detail.php?ID=56
"It is to be emphasized that the conclusion is limited to healthy
adults in a temperate climate leading a largely sedentary existence,
precisely the population and conditions that the "at least" in 8 × 8
refers to. Equally to be emphasized, lest the message of this review
be misconstrued, is the fact (based on published evidence) that large
intakes of fluid, equal to and greater than 8 × 8, are advisable for
the treatment or prevention of some diseases and certainly are called
for under special circumstances, such as vigorous work and exercise,
especially in hot climates. Since it is difficult or impossible to
prove a negative---in this instance, the absence of scientific
literature supporting the 8 × 8 recommendation---the author invites
communications from readers who are aware of pertinent publications."
http://intl-ajpregu.physiology.org/cgi/content/abstract/283/5/R993
If you feel you are not drinking water in sufficient amounts, watch
for signs of dehydration:
"Dehydration is a condition that occurs when the loss of body fluids,
mostly water, exceeds the amount that is taken in. With dehydration,
more water is moving out of our cells and then out of our bodies than
the amount of water we take in through drinking.
We lose water every day in the form of water vapor in the breath we
exhale and as water in our sweat, urine, and stool. Along with the
water, small amounts of salts are also lost.
When we lose too much water, our bodies may become out of balance or
dehydrated. Severe dehydration can lead to death."
http://www.emedicinehealth.com/dehydration_in_adults/article_em.htm
As long as you are drinking 2 liters a day, when NOT exercising
heavily, you will be ok. Don't forget, we get a lot of water from the
foods we eat-particularly fruits and vegetables. I also want to
re-iterate that you still need to drink adequate amounts of water,
even though you are taking a diuretic designed to eliminate excess
water. It's important to introduce "fresh" water to your systtem, to
keep it fluid levels balanced and circulating!
If you have further questions, don't hesitate to ask!
Bottoms up!
Regards, Crabcakes
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