The Consequences of Excessive Water Consumption

One woman has died and another was hospitalized as a result of drinking too much water, according to recent news reports.

The events show that, while hydration is important to health, it is possible to drink too much water.

TikTok user Michelle Fairburn shared her experience of being hospitalized for 'water poisoning' on the platform in July, after 'drinking an excessive amount of water as part of the '75 Hard' challenge, which requires people to drink a gallon of water a day.

According to Fairburn, she began feeling nauseated and weak on day 12 of the challenge. She also had 'major diarrhea' and a 'band of fire...in [her] abdomen and [her] lower back.' Those symptoms sent her to her doctor, who eventually diagnosed her with a 'severe sodium deficiency.'

Though Fairburn has since recovered, another woman—an Indiana mother of two named Ashley Summers—died from water toxicity last month.

Summers, 35, reportedly told family members she felt like she 'couldn't drink enough water' and ended up drinking four bottles of water in 20 minutes. She later passed out in her garage and never regained consciousness.

Though fatal water intoxication is rare, it can happen—here's what to look out for.

The biggest concern of drinking too much water is developing a condition called hyponatremia, which may also be known as water intoxication, water poisoning, or overhydration.

Hyponatremia occurs when a person drinks so much water that the electrolytes in the blood become diluted, Natasha Trentacosta, MD, pediatric and adult sports medicine specialist and orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, told Health.

 “A generally healthy person’s kidneys are going to be able to regulate that water balance,” Eric Adkins, MD, an emergency room physician at The Ohio State University Wexner Medical Center, told Health. “But once the kidneys can’t keep up with excreting water, the body’s sodium levels become more and more diluted. It’s progressive and can be dangerous.”

Sodium, one of the body’s key electrolytes, helps control blood pressure, nerves, and muscles. It also plays a crucial role in balancing the body’s fluids. If sodium levels fall too low—below 135 milliequivalents per liter (mEq/L)—extra water can enter cells and induce swelling, which can cause severe symptoms.

“Hyponatremia may present with lethargy or altered mental status as the brain is sensitive to sodium levels in the blood,” said Trentacosta. “Nausea and vomiting and loss of coordination may occur as well.” 

According to the National Kidney Foundation, other potential symptoms include:

If someone continues to drink too much water, they can even develop seizures or fall into a coma, said Trentacosta. 

There are no uniform guidelines on excessive water intake. Rather, the U.S. National Academies of Sciences, Engineering, and Medicine recommends an amount of fluids that people should aim to consume: 15.5 cups for men and 11.5 cups for women. That includes fluids from food—not just water. (75 Hard's recommended gallon of water a day equates to 16 cups, at least 4.5 cups more than the recommended amount for Fairburn.)

“Too much water is going to be somewhat proportional as far as the size of the person,” Adkins said. Everyone’s body composition and hydration needs are slightly different, he added.

Adkins recommended paying attention to the color of your urine to determine if you’re drinking too much water. “If it looks dark—orange or dark yellow—it’s an indication that you’re not getting enough water. You want to make sure it’s closer to light yellow,” he said.

But if you find that you’re “drinking so much that it looks like you’re constantly urinating out water” and you’re having other symptoms, it’s “probably a sign that your water intake is too aggressive,' he said.

If you’re doing a hard workout, he suggested having a drink that contains electrolytes, like a sports drink or coconut water, to help balance out sodium levels.

According to Adkins, the average person doesn’t have to worry about hyponatremia. On the flip side, most people don’t drink enough water.

“We don’t see a ton of people coming into the emergency department with this, but there are rare scenarios where people are being aggressive with their water intake,” he said.

Trentacosta said hyponatremia more often affects athletes. People in the intensive care unit or elderly patients are also more likely to develop hyponatremia, according to Adkins, because the condition can result from excessive water intake but also other factors, such as diarrhea, extreme sweating, and vomiting. 

Treatment depends on the severity of the condition, said Adkins. If doctors suspect you have sodium deficiency, they usually do blood and urine tests to determine your levels.

“If it’s a mild case, the kidneys will help return the balance to normal if you can limit the amount of water intake by the person,” Adkins said. But doctors will give you medication or an IV to slowly raise sodium levels in more severe cases.

“We have to have really tight control around the correction of the sodium in the body,” Adkins said. If doctors “overcorrect” the imbalance too quickly, it can impact the brain by destroying the protective sheath around nerves called myelin, he said.

If someone has a mild imbalance, sodium levels may become normal within a few hours after limiting water intake, according to Adkins. It may take several days in more severe cases.

Fortunately for Fairburn, she felt much better after her hospital visit, saying she went from feeling 'like a negative ten' the previous day to a six. While Fairburn revealed plans to continue 75 Hard, she said she'd no longer be participating in the water portion of the challenge.