Dilutional Hyponatremia or Water Intoxication

Dilutional hyponatremia, also known as water intoxication, is a life-threatening condition that occurs when a person consumes excessive water without replenishing sufficient electrolytes, particularly sodium. This imbalance causes water to accumulate within the body's cells, leading to swelling and disruption of normal cellular functions. The brain is particularly vulnerable to these effects, making hyponatremia a serious medical concern.

Individuals at Risk for Hyponatremia

While most people are not at significant risk of developing hyponatremia, certain individuals are more susceptible:

• Stimulant Drug Users: Stimulants, especially when combined with prolonged periods of dancing, can cause rapid fluid and electrolyte loss. This is common at raves and dance parties, where individuals may consume drugs like meth, cocaine, MDMA (Ecstasy), bath salts, or low doses of MXE or ketamine to maintain energy levels.

• Individuals Purging After Drug Use: Some individuals may attempt to "flush" drugs from their bodies by consuming excessive amounts of water, potentially leading to hyponatremia.

• Addicted Exercisers: Individuals who engage in excessive exercise for several hours daily and solely rehydrate with water are at risk of developing hyponatremia.

• Individuals with Eating Disorders: Individuals with anorexia nervosa may use large amounts of water in an attempt to lose weight, increasing their risk of hyponatremia.

• Newborns: Newborns whose mothers avoid breastfeeding and feed them diluted formula or water, including drug-using mothers, are also at risk.

• Endurance Athletes: Athletes engaged in prolonged endurance activities may experience significant fluid loss and require proper hydration strategies to maintain electrolyte balance.

• Individuals with Psychiatric Conditions: Certain psychiatric conditions, such as depression, schizoaffective disorder, and bipolar disorder, may increase the risk of hyponatremia.

Prevention

To prevent water intoxication and maintain proper hydration, it is crucial to address the factors that contribute to hyponatremia:

For Stimulant Use:

• Encourage individuals to consume water throughout the night rather than excessive amounts at once.

• Emphasize the importance of consuming sufficient salt to prevent water intoxication.

• Recommend the use of rehydration fluids, salty snacks, or a small amount of salt added to water (approximately half a teaspoon per liter).

• Avoid high doses of caffeine, especially from energy drinks, as they can act as stimulants and contribute to dehydration.

For Alcohol Consumption:

• Encourage individuals to alternate between alcoholic and non-alcoholic beverages to prevent dehydration.

• Incorporate fruit juices and mixers containing salt into drinks.

For Weight Loss:

• Advise individuals to rehydrate with water or electrolyte-containing drinks during exercise.

• Recommend consuming small amounts of fluid frequently rather than large volumes all at once.

• Exercise caution with compulsive water drinking, which can occur in stimulant users, over-exercisers, and individuals with eating disorders.

For Newborn Feeding:

• Educate mothers on the proper preparation of formula, following package instructions precisely.

• Emphasize the importance of breastfeeding, as breast milk provides an ideal balance of electrolytes and water.