By Dr. Max S. Chartrand Ph.D.
 

Note: the following papers are strictly for public education purposes, and are not meant to be taken as medical advice.

Simple, uncomplicated dehydration is something we see more and more these days in patients at our practice, with all the detrimental health consequences it brings.

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.

So, it is not unusual to find otherwise fit and slender people increasingly having to take medications more associated with obesity and high fat diet: hypertension, high cholesterol, arthritis, diabetes mellitus II. On top of that, they also take medication to offset the side effects of the primary medicines--quite a bizarre way to good health.

Such a tragedy from simply not drinking enough water. The question comes up regularly in how something so simple and mundane can affect us so much. In a nutshell, here is the process for a moderately active adult weighing 160 lbs:

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 anit-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

Hearing thresholds can also fluctuate by as much as 10-15dB over time

One reason the cause and effect relationship between water intake and one's health is so obscured is because of the time delay factor. Hence, it requires several weeks, sometimes months, of change in water intake to detect any measurable changes, for better or for worse.

Research further shows that the body is extremely self-adjusting to deficiencies. However, like adrenalin during crises, the body's adjustments are only meant to be temporary, not permanent. When deficiencies become a way of life, medications are needed to maintain 'normality', at least at a symptomatic level.

How Much Water Is Enough

Weight in pounds: Low / Moderate / High Water Intake

*Note:  Electrolyte balance and anitdiuretic hormone (ADH) production become extremely critical in cases of obesity, in which cases adequate water intake requirements can only be determined by extensive clinical tests and your doctor's advice.

Moreover, it's so vital to listen to one's body, giving it what it needs to maintain function and health, while avoiding substances that poison it, such as tobacco, alcohol, and caffeine.

But there is a danger in one who is already under a doctor's care and on medication in making self-adjustments without communicating with their doctor. 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.

What does this all have to do with hearing health? Quite a lot, actually. Presbycusis (progressive hearing loss as we age), tinnitus (ringing in the ears), and vestibular (balance) problems may rapidly increase as a result of blood volume and pH changes. The ears are actually a quite accurate reflection of the of the body's health, and reacts itself accordingly.

CAUTION: Drinking too much water can also have dire consequences, hyponatremia (low sodium levels) or hyper/hypokalemia (high/low potassium), etc.. The amount of water required daily varies according to actual body weight, physical activity, and other health factors. The above is offered only as public education, and is not intended to be taken as medical advice.