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9 surprising signs of dehydration

By Dr. Sharon Stills, NMD

You’re feeling tired all the time, your skin is dry, your digestion is poor and other strange symptoms keep popping up — like bad breath. Of all the explanations that have crossed your mind for what could be the matter, have you ever considered that the root of your problems could be dehydration?

A woman drinking water to relieve her dehydration

Dehydration isn’t just a hot weather concern. In winter, dehydration can be even more common — and sneaky. Outside, cold air is much dryer than warm humid summertime air. The simple act of breathing outdoors can increase fluid loss as your airways are forced to moisten the air before it hits your lungs. Once you exhale, that warm humid air is gone — taking its moisture with it. Your body also undergoes certain processes when it’s cold out in its attempt to keep you warm. One of the side effects of these is fluid loss.

Inside, breathing in the dry warm air is equally drying. Spending so much time inside keeps you exposed to this dry heat for much of your day (and night), leading to excess fluid loss and dehydration. If you spend your winters fighting fatigue and dry skin — the real culprit could be dehydration.

Are you dehydrated?

Symptoms of chronic dehydration can be surprising — and even a little strange.

1. Bad breath. Natural antibacterial properties in saliva help to keep your breath smelling fresh. When you’re dehydrated, production of this natural “mouthwash” falls. And in a dry mouth, stinky bad bacteria thrive. Have people suddenly started offering you mints? It could be that all you really need is more water.

2. Carb cravings. When you’re dehydrated and you exercise, your body uses up stored glucose (glycogen) in your liver at a much faster rate. Post-exercise, your body will attempt to quickly stock back up on glycogen — and this can lead to carb cravings for sugary foods. If strong food cravings strike after you exercise, increase your water intake throughout the week and before and during your workout. Infusing your water with citrus slices or berries can give it a sweeter taste.

3. Dry skin. Hydrated skin cells are supple and plump, so if your skin has become dry and flaky, or has taken on a dull, lifeless appearance, think about upping your water intake. A quick check for dehydration is to pinch the skin on the back of your hand hard for a few seconds. If the skin remains “tented” for more than a couple of seconds after you let go, your skin cells are probably very thirsty!

4. Headaches. Water is so essential to your brain that when you become dehydrated, brain tissue can temporarily shrink from fluid loss and pull away from the skull. If this sounds painful — it is! Headaches and even migraines can be signals from the brain that you need to boost your fluid intake.

5. Fatigue and foggy thinking. Dehydration can trigger blood pressure to drop and blood flow to the brain to slow down — leaving you feeling fatigued and unfocused. But before you reach for a cup of coffee to perk up, consider this: caffeine in coffee is actually a mild diuretic — meaning that by drinking coffee, you can lose more fluids, worsening your dehydration even more. Instead of coffee, try a brisk mug of ginger tea to start your day and see if it also improves your energy and focus.

6. Constipation: When you are dehydrated, your body goes on the hunt for extra water sources — and often finds one in the form of food waste sitting in your lower digestive tract. If you are not drinking enough water, your body will steal it from your large intestine, putting you at risk for constipation.

7. Digestive issues. A body that’s dehydrated will produce fewer digestive juices, leading to digestive problems ranging from acid reflux to gas and bloating. Increasing your water intake can help with your digestive issues— but make sure the water you drink is room temperature. Cold water “freezes” enzymes in your gut and constricts your blood circulation, making it even more difficult to digest and absorb nutrients from your foods.

8. Worsening of allergy, asthma and arthritis symptoms. Dehydration triggers the body to produce higher histamine levels, which can worsen symptoms related to allergies, asthma, rheumatoid arthritis and other immunological disorders. Is allergy season particularly rough for you this year? Up your water intake and see if things improve.

9. Dark urine. When you’re dehydrated, your body tries to conserve water wherever it can, and this means less water is excreted in your urine. As a result, urea and other waste products give the lower water content urine a darker hue. Check your first morning urine. Pale yellow is a good sign that you are hydrated, dark yellow can be a prime sign that you need more water.

Here’s the thing. Almost every symptom listed above can also be a sign of some other health issue — from low thyroid to hormonal issues related to menopause. So when patients come to me for help, I want to know what we’re dealing with — and one easy way to do this is to eliminate any amount of dehydration. If you are having constipation, I might say, let’s increase your water intake and see what happens. If the constipation continues and I know that you’re well-hydrated, we’re better able to pinpoint the true cause. (In this case, continued constipation could be a sign of low thyroid.)

3 fun and easy ways to get more water

Need help staying properly hydrated? Try these ideas:

1. Add some flavor! Jazz up the taste — and appearance — of plain water by infusing water with chunks of fruit. Flavorful additions include watermelon chunks, orange slices, raspberries, blueberries, cucumber slices and lemon wedges. Experiment with fun flavors by pairing different fruits together. Bonus: Freeze fruit in ice cube molds beforehand to use instead of ice cubes.
2. Skip the soda. For a fizzy alternative to sugary soft drinks, add a splash of juice to plain sparkling water. Our favorite recipe is a triple threat of cranberry, orange and tart cherry juice. Pro Tip: Choose juices that are free from added sugar.
3. Spice it up with added herbs! Give water a zesty flavor boost with a simple herbal infusion using natural ingredients like mint, basil, thyme, rosemary or ginger.

This tasty recipe for Mint Citrus Water will definitely have you coming back for refills!

Mint Citrus Water

2 quarts filtered water
1 lemon, sliced
1 lime, sliced
1/2 cup mint leaves
Pour water into a pitcher or half gallon size mason jar. Stir in lemon-lime and mint. Refrigerate mixture overnight. Pour yourself a glass and enjoy!

Pour yourself a glass of good health

Here’s what I tell my patients: work your way up to drinking half your weight in ounces of water every day. If you weigh 150 pounds, then gradually increase your water intake to 75 ounces a day. Does this seem like a lot? I look at my water drinking as a daily job. Just like working out, at the end of the day, I think “I’m a hydrating superstar and happy to be finished with my water intake!”

Finish your water intake 3 hours before bed. Use this cut off to help you pace your water intake throughout the day.

And one last tip, add a pinch of Celtic salt to your water jug — it helps to increase absorption.

Hydration is a foundation of health, so let’s raise a glass to the power of water.

Here’s why I write the prescription: “You need to drink water!”


Last Updated: November 22, 2023
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