“Drink more water” is as old a statement as humanity.

Not too many people know what that means and how dangerous that can be. Even TV show hosts, who are doctors, call for clear urine as the goal. The general population is following whatever this Dr. says on TV even if it is dead wrong. Pun intended.

Clear urine can lead to death. I bet you did not know that!

Urine has a reason to be colored. It takes toxins out of our bodies and toxins are not transparent. A healthy urine is light yellow that you can see through and smell like… well… healthy urine! Not like water. Why is clear urine bad for you? Can too much water hurt you? How and why?

First, let’s look at what urine is and why it needs to have color: urine is used water from our cells that contains toxins from leftover medicines, vitamins, foods, whatever the body used and considers trash or whatever it could not use and considers harmful. Thus urine has a biologically very important function! Clear urine implies that the body is not working! If urine is too dark, it means that there is not enough water to wash all the toxins out so one better drink more water. But how much water? And how does water get to clear toxins?

Cellular biology tells us that cells have little pumps that allow certain nutrients inside, such as sodium, potassium, magnesium, glucose, etc. Water can go through little water channels that need no pumps. Water flows wherever there is less water by osmosis, via the osmotic gradient such that if inside the cell there is more water than outside, water will leave the cell. If there is more water outside than inside the cell, water will head inside. It balances to equalize the two sides in water. In order for it to stay stuck in either side, something must grab a hold of it. It is also important to note that water goes in and out freely because it has no electric charge. But other elements inside the cell, such as sodium, which is positive, cannot use the osmotic gradient. They need electricity to be pushed against density!

Inside the cell sodium (Na+) holds onto water thereby keeping the cells nice and plump–volume hydrated. However, the more water a person drinks, the more water will also enter the inside of cells because of water’s osmotic balancing. Each cell has a certain size that is flexible but not the cells in a person’s head! There is a bone (skull) that encloses all cells and so cell size is limited. Drinking too much water thus puts pressure on the skull. The skull is bone and has no pain sensors. The brain has no pain sensors either. However, there is a little layer of tissue called the meninges that is between the skull and the brain. All brain pain sensors are on the meninges, which is squeezed to death by the pressure of the water building up in the brain, pressing the brain against the skull. This causes headaches and for those who are migraineurs, migraines.

There is another problem, which is called hyponatremia. “Hypo” means not enough and “natria” means sodium (Na+). As more and more water enters the cells, less and less sodium is available to grab water and keep water inside the cells. This ends up in a potential fatal condition of hyponatremia. Sodium has a vital role in brain and other cell health. Sodium is positively charged and is part of sodium chloride (salt) in which chloride (Cl-) is negatively charged. Sodium is inside the cells and chloride is outside. The two create voltage differential such that the cells are able to generate voltage power to function.

Hyponatremia thus also means lack of enough voltage and so the brain and other cells (heart for example) that use voltage stop producing voltage and cell death may follow. When a person goes this far, it becomes known as water toxicity! It is particularly dangerous for athletes since hormones participate in preserving fluids, placing a block to fluid release, thereby further increasing hyponatremia. It is not unheard of that athletes die from too much water; it is also not unheard of that water challenge participants also die of water toxicity. What is less known is that hyponatremia is also responsible for migraines.

Migraine brains have more sensory neuron connections than regular brains and so they use more voltage to run the brain. More voltage use requires more voltage need! However, since the standard of salt intake heads to the “lower is better” dogma, migraineurs pay the price! No wonder we have a migraine epidemic!

So how much water should you drink? And how much salt and other electrolyte minerals/nutrients should you also take a day?

There are a variety of water calculators on the internet. In general the recommended water intake in ounces is half your weight in pounds. So if you weigh 130 lbs, your water intake should be 65 oz or 8.125 glasses of 8 oz water. But this is not totally correct.

Weighing 130 lbs in 120F with 90% humidity, or weighing 130 lbs in -40F with 10% humidity or after a heavy exercise or a sick-day with diarrhea will each lead to a slightly adjusted water intake. A person weighing 130 lbs in 7000 feet elevation needs more water than the same person at sea level! There are many variations. But at least you have a guideline: half your weight in ounces is the minimum you must drink every day in pure water and must also replace salt loss.

Soft drink, coffee, tea, milk, soups, alcohol, smoothies and shakes do not count into this!!! Be aware that water is water and not coffee–coffee is blood vessel constricting and it prevents water from entering your cells. Tea is diuretic (all teas! Even herbal!). All the rest are sugar filled even if you do not add sugar–alcohol is fermented sugar too. The only thing that may matter is soup but how much soup do you eat a day?

What about salt and potassium? The FDA guideline is 4700 mg potassium and between 1500 to 2350 mg sodium. Migraineurs need about 50% more sodium than non-migraineurs so if you are a migraineur, go for the 2350 mg to start with! That is one level teaspoon! If you eat less salt or drink less water, you will get a migraine if you have a migraine-brain, guaranteed!

When you get a migraine, contact me!

Comments are welcome!

Angela

Sources:

Schwedt, T.J., Multisensory Integration in Migraine. Current Opinion in Neurolology, 2013: p. 248-253.

Tso, A.R., et al., The anterior insula shows heightened interictal intrinsic connectivity in migraine without aura. Neurology, 2015: p. 1043-50.

Campbell, D.A., E.M. Tonks, and K.M. Hay, An Investigation of the Salt and Water Balance in Migraine. British Medical Journal, 1951: p. 1424-1429.

Longo, D.L., et al., Harrison’s Manual of Medicine 18th Edition. 2013, New York: McGraw Hill Medical.

Liu, H., et al., Resting state brain activity in patients with migraine: a magnetoencephalography study, in The Journal of headache and Pain. 2015. p. 16-42.

Peter Whoriskey More scientists doubt salt is as bad for you as the
government says April 6 at 8:24 PM, The Washington Post

Cogswell, M.E. et al., Sodium and potassium intakes among US adults: NHANES
2003–2008 American Journal of Clinical Nutrition. 2012.

Gautam Bhave, M.D., Ph.D. and Eric G. Neilson, M.D. Volume Depletion versus Dehydration: How Understanding the Difference Can Guide Therapy. American Journal of Kidney Disease 2011 August ; 58(2): 302–309

Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Institute of Medicine. The National Academic Press. 2005