Active Recovery & Hydration – What Happens in Dehydration?

HydrationIt’s a well-known fact that the human body is 80% water. The body loves water. However, unlike camels in the dessert, human beings are not very good at conserving it. In fact, we lose water quite easily. The quickest way to restore hydration is via intravenous administration. This is why if you go to the Emergency Room when you are throwing up or have diarrhea, you are given intravenous fluids containing water and salt (saline). After a workout or race, the fastest way to restore your body’s fluid status is to get IV fluids. The fluid is even better when antioxidants and vitamins are added to it! Read more about Vitamin Infusions for Active Recovery.

What happens with excessive water loss (dehydration)?

Initially, your heart is not able to pump out as much blood since your total blood volume is decreased by the lack of water available. The heart is a pump, and it can only pump what it receives. If it receives less blood, it pumps less blood. When blood flow decreases, you develop symptoms of severe fatigue and thirst. As the dehydration progresses, you will STOP sweating. Lack of sweating when exercising (or working) is a very ominous and dangerous sign. Seek help immediately!

As dehydration progresses, the body clamps down blood flow to the kidneys in order to stop losing water as urine. The natural breakdown products of muscle tissue begin accumulating in your bloodstream. These levels are measured by a laboratory in order to determine the severity of dehydration (BUN and Creatinine).

As dehydration progresses further, the body begins shunting blood away from the skin, muscles, bones, and GI tract in order to provide blood flow to the vital organs (heart, lungs, liver, and brain). As your muscles starve for nutrients carried by the bloodstream, they begin breaking down. During cellular death, they release a protein called CPK that can be measured in your blood stream to determine the extent of muscle damage.

Untitled2Eventually, your heart will not be able to pump enough blood to keep cellular function alive. Your suffocating tissues create lactic acid without oxygen. The lactic acid turns your blood acidic. By this point, you have most likely lost consciousness and are overheating without the ability to sweat. Your temperature is rising above 104F. Treatment is emergent as you will die without life-saving intravenous fluids. Once intravenous fluids are given, your body returns to life, re-establishing its normal balance or homeostasis.

Sensible Water Loss:

Most people realize when they’re losing water: sweating, urinating, diarrhea, vomiting, drooling, runny nose, or bleeding.

Insensible Water Loss:

There’s an additional element of water loss that we refer to in medicine called “Insensible Water Loss.” We insensibly lose water through our respiratory tract and skin.

Respiratory Tract Water Loss:

This is the water required to hydrate the air we breathe. Every animal’s lungs on the planet require humidified air. With every breath, we infuse water into it to the desired humidity. Many animals reabsorb the water as they exhale, but humans do not. We exhale the humidity. The water that we add to the air to breathe is lost.

Untitled3Skin Water Loss:

Since most humans do not have fur to cover our outer skin, we constantly leak water into our environment. This water is immediately dehydrated. The humidity in the air determines the rate of dehydration. This is different than sweat since it is does not contain electrolytes, and it is not intentional.

Humidity plays an important role in both sensible and insensible water loss. It is important to pay attention to the environment that you are working in. If you are in high humidity working or exercising outdoors, you will have a great gauge of how much water you’re losing based on the buckets of sweat that are accumulating. However, in dry weather, you will not see sweat accumulating yet you will be losing water at a faster pace!

Inappropriate Fluids for Rehydration

Caffeine is a Diuretic:
Untitled4I frequently see patients in the ER because they have been working in the dry air, drinking Coca-cola, tea, and coffee for hydration. Although all of these liquids are majority water, they contain high amounts of caffeine, which acts as a natural diuretic. Your body is trying to conserve water, but the caffeine is forcing the body to urinate out more than it should. When you are in the heat, you must be able to drink (and keep) more water than you are urinating.

Endurance athletes must take note of the products that contain caffeine in order to not fall behind on their prolonged workouts. Many gels, bars, and drinks contain caffeine to give you a boost of energy. Be mindful of the amount of caffeine you’re consuming, especially if you’re drinking a pre-game caffeinated beverage!

Diabetes Causes Excess Water Loss:
If you are a diabetic, you also have the potential for losing more water. When your blood sugar gets too high, your kidneys cannot reabsorb it fast enough. Once your blood sugar goes over this threshold, it acts as a natural diuretic. Just like caffeine mentioned above, you must be able to absorb more water than you are losing.

Active Recovery & Hydration part 1

Active Recovery & Hydration part 2

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Active Recovery & Hydration II – Staying Hydrated

How do I stay hydrated?

gatorade sweatYour body can only maintain hydration if you are consuming more water than you are losing. In order to improve hydration, your body needs water … duh!
But, did you know that staying hydrated requires more than water??? It needs water in the presence of salt and sugar. This is the theory behind why Gatorade, Powerade, and other electrolyte drinks are better at restoring your fluid status than water alone.

Advantages of IV Fluids After Exercise or Post-Race

IV fluid goes straight into veins, which all lead to the heart. Once the fluid gets to the heart, it is disseminated throughout the body. Your body decides where the majority of nutrients are directed by dilating the arteries that lead to areas in need. In contrast, your body constricts and limits blood flow to areas that don’t need as much emergent blood flow.

Without appropriate hydration, your body restricts blood flow to vital organs until it becomes a problem. If the muscles are begging for blood, the arteries will dilate to the muscles while constricting blood flow to the bowels and kidneys. If you have less blood flowing through your digestive tract, you can consume as many protein bars as you want, but your body will not be able to receive those nutrients without appropriate blood flow. In addition, your body will be shunting blood away from the kidneys, which causes a build-up of toxins when there is inappropriate kidney blood flow. Dehydration causing kidney damage is called “Acute Kidney Injury” in medicine. The kidneys cannot filter without enough blood flowing through them.

With rapid rehydration using IV fluids, you are able to give your body the fluid that it needs to pump blood to your muscles and vital organs without starving any of them. It gives the kidneys ample fluid to filter, and it gives the muscles enough nutrients and water to regenerate.

Active Recovery & Hydration

This is Dr. Oubre and his team performing IV hydration with vitamin infusions at the Jack’s Generic Triathlon for competitors post-race.

Sweet and Salty – The Cure to Dehydration

sweet and saltyThe body’s cellular pumps that absorb water require a small amount of sugar and salt in order to adequately pull in the water. Your body is not very good at absorbing water. In fact, it rarely moves water around; instead, it absorbs salt and due to the laws of osmosis – water follows the salt. However, sugar is needed in order to power the salt pumps. Salt is also needed to hold onto that water that you just absorbed. Without salt, your body just makes dilute urine.

It is important to remember that sweat is the loss of water and electrolytes. This is why animals lick us when we are sweaty – they like the taste of salt. If you are replacing your fluid with water only, you are losing electrolytes without replacing them. This is why marathon runners and other endurance athletes can die during a prolonged race. Their salt levels can drop to dangerous levels without adequate replacement. This is called Hyponatremia.

How can I tell if I am hydrated?

urine hydrationYour urine is the best gauge of hydration status. If your kidneys are trying to preserve water, your urine turns dark orange like orange juice. They are telling you that you need to drink more water. If your urine is light yellow like lemonade, then you are adequately hydrated. You are keeping up with your water level.

How can I tell if I have enough salt?

There is no good way to determine salt levels on the go. It is important to speak with a professional before embarking on endurance races for prolonged periods of time in order to ensure adequate electrolyte intake. Too much salt can cause abdominal cramping, which will also put you out of the race.

How can I tell if I have enough sugar?

This one is fairly easy. You normally feel like crap if you don’t have enough sugar! This is called “bonking” or “hitting the wall” by most athletes. Luckily, your body can create its own sugar on the fly. If you are exercising beyond your body’s sugar production, you will ultimately develop cramps and muscle pains that require you to quit exercising. Then, your body’s sugar production will catch up to your sugar consumption.
You can also check your blood sugar level with a glucometer (or test strip), but if you are not diabetic, it is unlikely to be very useful. Your body normally feels symptoms of low blood sugar before the level drops.


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Active Recovery & Hydration – Part 1 of 3

Why is Hydration Important?


We all know that hydration is important. We hear about it all the time. So, what is it exactly that makes hydration so important? Why does our body need water anyway?

Let’s go over it by breaking it down into several categories:


Blood Viscosity:

HydrationOur body requires water in order to pump blood throughout our body. The majority of our blood volume is water mixed with proteins and electrolytes. We call this plasma. When water levels decrease, the blood becomes thicker and more viscous. It is unable to squeeze through our tiny pipes as quickly.   Would you rather water or molasses pumping through your body?   How do you expect lactic acid, broken down cellular components, and other toxic byproducts to get out of the fatigued muscle if it cannot get blood flow through it? Moreover, how do you expect fresh oxygen, clean water, and nutrients to get to fatigued muscle if blood is not flowing quickly to it?


Cellular Metabolism:

Chemical reactions are occurring in every cell of your entire body. Producing energy is simply taking a Hydrationmolecule with hydrogen atoms, popping them off, and forcing their electrons through a series of events that churns a pump which phosphorylates a molecule (called ATP). Okay, so maybe it’s fairly complicated, but it’s still a series of chemical reactions.


Water is crucial to chemical reactions because it is the solvent that allows molecules, proteins, and organelles (cellular structures) to float through the cell. If the cell is dehydrated, then it is shrunken and its gelatinous cytosol is more like Jell-O after a night in the fridge than Jell-O when you first mix it.



The body is not very good at removing fat-soluble toxins; therefore, its detoxification processes usually involve sticking water-soluble molecules onto the toxin. Once a toxin is made water-soluble, it is easily eliminated from the kidneys. When you are dehydrated, the kidneys conserve water by reabsorbing it after it has been filtered. Without appropriate hydration levels, the kidneys are not able to adequately excrete water-soluble toxins, so the toxins get recycled as the kidneys try to conserve water. Thus, the toxins continue to circulate through your body.

Although we typically think of “toxins” as things that we eat, drink, and touch, it is important to realize that our body makes its own toxins and byproducts. We are just

Human Skin.

like your car’s combustion engine. When making energy, there are always byproducts that need to be removed in order to continue making energy. Common byproducts are heat, carbon dioxide, nitrogen, and acid.

Heat: This is why your body gets warmer during exercise.

Carbon dioxide: This is why you breathe faster during exercise.

Nitrogen: This is the breakdown product of protein, and it is turned into urea, which is excreted by the kidneys as urine.

Acid: This is created during exercise as lactic acid during anaerobic metabolism.

Without adequate hydration, your tissue is not able to dump its toxic metabolites into the circulation. If the garbage truck is full every time it swings by your house, it does not matter how often it stops by.

As you can see, hydration is paramount for optimal cellular function. For athletes, it’s even more important. The longer you stay in the dehydrated state, the longer that will take to fully recover and make gains.

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