What is chronic dehydration?
Chronic dehydration is constant, long-term water deficiency. By definition, chronic dehydration lasts for more than one day 14. Dehydration is usually defined as water deficiency that results in loss of more than 1% body weight.
Obviously, insufficient drinking causes chronic dehydration.
Who is at great risk to become chronically dehydrated?
- Decreased feeling of thirst
- Anorexia due to chronic disease
- Swallowing problems
- Fear of incontinence
- Long-term use of diuretics
- Bedridden elderly people in nursing homes may have limited access to water
- Reference 12
1. People who do not drink enough:
- Students who skip meals
- Young athletes 8
- People who have constant nausea and therefore avoid drinking and eating, such as pregnant women with severe morning sickness (hyperemesis gravidarum)
- Individuals under chronic stress who may feel less thirsty 15
- Women with anorexia nervosa
- Chronic alcoholics or drug addicts with irregular diet. Alcohol by itself probably does not cause significant dehydration.
- People who consume very little salt and are therefore less likely thirsty.
2. People who sweat excessively:
- Workers in a hot climate (miners, workers in rubber, iron producing factories and such)
- Travelers, hikers, climbers or outdoor workers who do not have beverages in reach
- Individuals with thyroid disease (hyperthyroidism)
3. People with chronic diarrhea:
- Small children with recurrent diarrhea due to gastroenteritis (rotavirus infection, cholera)
- Individuals with celiac disease or Crohn’s disease, mainly in young adults
4. Individuals with excessive urination (polyuria):
- Individuals with untreated diabetes mellitus or diabetes insipidus
- Individuals who regularly take diuretics
5. People with chronic vomiting:
- Individuals with chronic kidney failure, cirrhosis, pancreatitis
- Women who have bulimia nervosa
- Thirst (often absent), dry mouth, bad taste
- Bad breath
- Dizziness and increased risk of falls
- Fatigue, sleepiness and yawning
- Constipation and eventual bloating
- Poor appetite, nausea
- Headache, migraine attacks (in individuals who already suffer from migraine)
- Dry skin
- Anxiousness, depression, impatience, irritability, difficulty falling asleep (insomnia)
- Short attention span, impaired short-term memory
- Joint stiffness and pain, such as knee pain, muscle soreness
- Morning sickness (in pregnant women)
- Craving for sugar and other carbohydrates
- Fast heart rate or palpitations (in more severe dehydration and in people under stress)
- References 1,6,10,11,12
Signs and Diagnosis
Diagnosis of chronic dehydration can be made from a combination of symptoms and signs:
- Reduced body weight
- Dry mouth mucosa and tongue
- Dry skin, brittle hair
- Prolonged skin turgor test
- Prolonged capillary refill time
- Dark urine
- History of insufficient drinking
Blood and urine tests are not very useful for estimation of chronic dehydration 12.
Chronic dehydration is a risk factor for kidney stones, especially in individuals with other risk factors, such as high dietary oxalate intake and genetic predisposition for kidney stones 4,5,6.
What is chronic cellular dehydration?
Dehydration regularly leads to dehydration of the body cells, and when dehydration is chronic it leads to chronic cellular dehydration. The term has no specific meaning and is mainly used by advertisers who try to sell remedies that “cure” dehydration.
Other Possible Effects
According to the medical literature, other consequences of chronic dehydration may include:
- Urinary tract infections (UTI) and incontinence 6,12
- Acid reflux, which can cause heartburn 3,7
- Digestive disorders. In dehydration, smaller amount of saliva and digestive juices are secreted, which may result in poor digestion 3.
- Allergies. Dehydration stimulates the release of histamine, which stimulates the release of cortisol, which suppresses the development of white blood cells (leukocytes), which results in greater susceptibility for allergies 1.
- Asthma. Lack of body water results in thicker mucus in the bronchi, which may be harder to cough up 7,9. Increased histamine release may aggravate asthma symptoms 7.
- Postnasal drip 9
- Chronically constipated people often strain during bowel movements and can therefore develop hemorrhoids or large-intestinal diverticles (diverticulosis) 3.
- Obesity. Thirst is often confused with hunger. Someone who does not drink enough craves for foods high in water and may thus gain excessive weight 4.
- High blood cholesterol levels. In one study, during fasting, which included water deprivation, blood cholesterol levels was higher than during fasting with drinking 2.
- Diabetes 2 3
- Decreased kidney function that may lead to chronic kidney failure in individuals with pre-existing kidney disease 12.
- Pressure ulcers in bedridden patients 12
- Increased risk of hospital-acquired pneumonia 12
- Increased risk of stroke 12
- Liver damage 13
Other Commonly Mentioned Effects of Chronic Dehydration, but Lack of Evidence
- Candida infection
- High blood pressure
- Hair loss
- Hives (urticaria)
- Irritable bowel syndrome (IBS)
- Muscle spasms
- Ringing in the ears (tinnitus)
- Fluid retention (edema)
How to recover from dehydration?
- Drink more fluids or eat appropriate fruits to get more water regularly. How much water do I need to drink in a day?
- If you think you have a disease that causes dehydration, visit a doctor.
Are there any remedies to treat dehydration?
- Remedies for dehydration include drinking water and regular diet.
- Zinc supplements can help individuals with chronic diarrhea caused by zinc deficiency 11. It is not likely zinc will help those with normal blood zinc levels.
What are signs of recovery from dehydration?
- Excreting at least 300 mL of clear or bright yellow urine in the morning.
- Good skin elasticity — skin on the back of the hand recoils instantly when you pinch and release it.
- Kokopellisearcandling.com (Dehydration complications)
- PubMed (Fasting, dehydration and cholesterol levels)
- Batmanghelidj, F., MD, Water for Health, for Healing, for Life, Warner Books, 2003
- PubMed (Kidney stones statistics)
- PubMed (Urolithiasis)
- Hawaii.edu (Dehydration consequences)
- Olin.edu (Effects of dehydration)
- Uark.edu (Dehydration in young athletes)
- Nyee.edu (Dehydration, allergies and laryngitis)
- PubMed (Terminally ill patients)
- Zinc.org (Zinc deficiency and diarrhea)
- Nursingtimes.net (Dehydration in the elderly)
- NHS.uk (Dehydration complications)
- Fiu.edu (Dehydration in athletes)
- WebMD (Dehydration and stress)