Dehydration Looks Like a Lot of Things.
Here Is What Chelsea Sees.

Some of the most common things I hear, “I’m exhausted by 2 p.m.,” “I get headaches most afternoons,” “I just can’t focus,” have many possible causes. Hydration is one of the simplest to check, and one of the most often overlooked.

Water makes up more than half of an adult’s body weight and is involved in almost everything the body does. It helps regulate temperature, cushions joints, carries nutrients, helps the kidneys clear waste, and keeps blood volume steady so the heart does not have to work harder. In the MySWANS™ framework, Water is the W: the forgotten essential.

Mild dehydration is easy to miss

You do not have to be severely dehydrated to feel it. In a controlled study, healthy young women who lost just over 1 percent of their body weight in fluid reported lower mood, more fatigue, more headaches, and more trouble concentrating.¹ That level of fluid loss can happen on an ordinary busy day: a morning of coffee, a long meeting, a warm afternoon, and no water bottle in sight.

What dehydration can look like

How much water do you need?

The National Academies report on water needs found that women who were well hydrated took in about 2.7 liters (91 ounces) of total water a day and men about 3.7 liters (125 ounces), counting all beverages and foods. About 20 percent of that typically comes from food. The report also noted that most healthy people meet their needs by letting thirst guide them, and that people who are very active or in hot climates need more.²

That is why I do not hand every patient the same number. Your needs change with heat, exercise, illness, pregnancy or breastfeeding, and some medications. North Texas summers are a real factor for our Carrollton patients. Some conditions, such as heart failure or advanced kidney disease, may require a fluid limit, so always follow the plan your own provider gives you.

Who is more likely to run low

• Older adults, because the sense of thirst tends to weaken with age.
• People who exercise hard or work outdoors, especially in heat.
• Anyone with vomiting, diarrhea, or fever, which increase fluid losses quickly.
• People taking diuretics (water pills) or certain other medications.
• People in medical weight loss programs. Some weight loss medications reduce appetite and thirst, and side effects like nausea can add to fluid loss, so hydration is part of every weight loss conversation.
• Busy caregivers and professionals who simply forget to drink until the end of the day.

Simple ways to make hydration a ritual

• Start the day with a glass of water before coffee or tea.
• Keep a bottle you like within reach at your desk, in the car, and by the couch.
• Pair water with habits you already have: every meal, every bathroom break, every time you refill your coffee.
• Eat water-rich foods such as cucumbers, watermelon, oranges, berries, lettuce, and soups.
• Flavor it naturally with citrus, cucumber, berries, or mint if plain water feels boring.
• Drink more in heat, during exercise, and when you are sick. If you are sweating heavily or have vomiting or diarrhea, a drink with electrolytes can help; most people do not need electrolyte drinks every day.

Coffee and tea in moderate amounts still count toward your daily fluids. Alcohol, on the other hand, increases fluid loss, so alternate alcoholic drinks with water.

Hydration is one of the kindest, simplest things you can do for your body, and it is often the first step that makes the others feel possible.

Chelsea Asante, FNP-C  ·  Orchid Wellness

Where IV hydration fits in

For most people, drinking fluids and eating water-rich foods is all that is needed. IV fluids are a tool for specific situations. At Orchid Wellness, IV therapy is offered by appointment in our Carrollton office after a review of your health history. It is not a replacement for daily hydration, and severe dehydration is a reason for urgent or emergency care.

Water works hand in hand with the other pillars. Being well hydrated supports activity, can make it easier to tell thirst from hunger, and may help you feel more focused when stress is high. The MySWANS™ Lite tracker in our web app lets you check in on all five pillars each day, so you can see patterns over time instead of guessing.

Hydration myths, cleared up

“Everyone needs exactly eight glasses a day.” Needs vary with your size, activity, climate, and health. Eight glasses is a reasonable starting point for many people, not a universal rule, and food provides a meaningful share of your water too.

“Coffee dehydrates you.” In moderate amounts, coffee and tea still add to your daily fluids. If caffeine affects your sleep or makes you jittery, that is a better reason to cut back.

“Clear urine is the goal.” Pale yellow is the sweet spot. Forcing large amounts of water beyond thirst is not helpful, and in rare cases, such as long endurance events, drinking far too much plain water can dangerously lower sodium levels.

What a hydrated day can look like

Here is one example, not a prescription: a glass of water when you wake up, coffee or tea with breakfast, a refillable bottle at your desk that you finish by lunch and refill for the afternoon, a piece of fruit or a salad with a meal, a glass with dinner, and extra water before and after any workout or time outside. Small, repeated moments add up without much effort.

This article is for general education and is not medical advice. Talk with your healthcare provider about your own health. In an emergency, call 911.

Chelsea Asante, FNP-C, APRN, MSN

Board-Certified Family Nurse Practitioner  ·  Founder, Orchid Wellness  ·  Author, MySWANS™: A Graceful Return to You

Chelsea Asante is a board-certified Family Nurse Practitioner and the founder of Orchid Wellness in Carrollton, TX. She provides whole-person primary care, medical weight loss, hormone therapy, and wellness services in person in Carrollton and by telehealth in Texas, New York, Virginia, and Washington, DC. She created the MySWANS™ framework and wrote MySWANS™: A Graceful Return to You.