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Dehydration, Diuretics & Adverse Effects Upon Human Hearing

By Max S. Chartrand Ph.D.

Includes the following articles: How Much Water Should You be Drinking Daily? & Overuse of Diuretics and Hypertensive

At a half-gallon per day, the blood volume (BV) begins to fall, and the kidneys respond by concentrating the body's sodium content. 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. 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 and 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

The patient's daily total water intake must be appropriate to body weight and activity level (see Patient Prompt Sheet #1) Several blood pressure readings should be taken, especially in resting state. (A BP reading in a clinical setting may or may not reflect a patient's usual stress state). Dietary factors, such as tobacco, caffeine, and other medications should also be addressed and counseled. Stress and psychosocial factors should be weighed into the health profile, and counseling given accordingly. Hearing/vestibular health is also considered, including:

  • Chronic semi-dehydration
  • High sodium/low potassium diet
  • High LDL cholesterol, triglycerides
  • Renal/circulatory decline
  • Contributive psychosocial/stress factors
  • Progressive sensorineural hearing loss
  • Tinnitus (ringing in the ears)
  • Vertigo and other balance disorders
  • Ataxia, dyspraxia (coordination problems)
  • Nystagmus (visual, focus problems)
  • Dementia (Alzheimer's, etc.)
  • Heart disease
  • Reduced hormone secretions (thyroid, insulin, anitdiuretic hormone or ADH)
  • Reduced renal (kidney) function

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:

(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.

Fig. 1

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

*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.


One of the most misunderstood issues among both patients and their healthcare professionals is the significance (or lack of) of one's blood pressure. This brief monologue will review some of the basic principles governing issues surrounding artificial control of the circulatory system and its influence on hearing health.


One of the greatest fallacies in controlling abnormal blood pressure is ignoring the facf that our circulatory system is comprised of two systems, not just one. The most obvious is the 'Macro System', comprised of the larger arteries and veins. Because of the sheer volume of blood coursing through the Macro System, slight pervasive changes in cholesterol plague, hardening of the arteries, varicose veins, as well as a host of inner and outer wall conditions, can drastically affect overall blood pressure.

But, more important for our hearing, balance, brain, heart, and certain hormone-secreting organs is the lesser-known 'Micro System'. Comprised of millions of tiny blood vessels and capillaries, it provides critical oxygen and nourishment to the above-mentioned organs of the body. When constricted, whether due to low blood pressure, high blood lipids, or constricting vascular disease of any kind, one may experience any of the following conditions:


Today, there exists widespread overuse of medications to control high blood pressure, and a host of other medications taken to offset their side effects. Most are prescribed based upon scant information and very little medical examination. Diuretic medications can be dangerous to one's health, completely throwing off electrolyte balances, and creating a host of unwanted side effects detrimental to one's health. Whereas high blood pressure can be deadly in the short term, overuse or misadministration of circulatory medications can be dangerous and life shortening in the long term.

Diuretic/hypertensive medications should not be prescribed (excepting emergency cases) without first ascertaining the following data:

When the above factors are considered, the author estimates that as much as 80% of today's BP medications would be eliminated, and medications would be more used in the short-term, during crisis, or while other more efficacious treatment is pursued. In other words, diuretics as prophylaxis would rarely be the prescribed course.


  1. Chronic semi-dehydration
  2. High sodium/low potassium diet
  3. High LDL cholesterol, triglycerides
  4. Renal/circulatory decline
  5. Contributive psychosocial/stress factors

When underlying causes of blood pressure are not considered, especially chronic semi-dehydration, caffeine intake, and other dietary factors, are not considered, we may lower BP in the Macro System, while starving the Micro System. In the process, we cause more hearing loss, louder tinnitus, more episodes of vertigo, advancing dementia, depression, a host of secretory deficiencies, and declining health of the heart.

The key is to reduce dependency upon diuretic/ hypertensive medications as quickly as possible, while addressing underlying causes. We must acknowledge that artificially low blood pressure can also be undesirable. By so doing, we will find much happier patients, living longer and healthier, and far fewer communicative/cognitive disorders.

Note: This monograph is offered only as public education, and is not intended to be construed as medical advice.

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