Seasoned medical experts have identified categories of individuals at risk of overhydration, warning that excessive water intake, though often encouraged, may pose health risks under certain conditions.
The experts explained that people with certain kidney or hormonal conditions, and those taking medications that affect fluid balance, are particularly at risk of overhydration.
They stressed that while hydration is essential for maintaining bodily functions, the body’s ability to regulate fluid balance depends largely on kidney function and other physiological mechanisms.
They, however, warned that consuming too much water within a short period can dilute vital electrolytes in the blood, leading to a condition known as hyponatraemia.
Hyponatraemia occurs when the level of sodium in the blood is too low, according to the Cleveland Clinic.
There have been several awareness campaigns on social media promoting adequate water intake, particularly championed by popular Nigerian health advocate, Dr Chinonso Egemba, which raised Nigerians’ consciousness on the importance of hydration.
However, the move generated debate recently when a man on X argued that excessive water intake could overwork the kidneys.
“When we need water, our body will tell us. Don’t give the kidneys excess work to do. Doctors and nurses are failing Nigerians. That information is wrong; don’t drink water anyhow. If you need water, your body will tell you; you’d feel thirsty. Why are we deceiving ourselves? And why are these doctors deceiving you? And they know,” the man, dressed in a lab coat in the one-minute-38-second video, said.
But responding, Egemba, popularly known as Aproko Doctor, explained that drinking adequate water is a form of protection for the kidneys.
“The primary job of your kidneys is to collect all the toxins in your body, waste from your blood, and flush them out as urine. And for them to do it effectively, they need something to work with. And that thing it needs to work with is water. Telling you to drink water is not spoiling your kidneys. It is actually protecting your kidneys from forming stones,” he said.
Giving expert insight while speaking exclusively with PUNCH Healthwise, a Professor of Medicine (Nephrology) at the Lagos State University College of Medicine, Ikeja, Jacob Awobusuyi, said overhydration is uncommon in individuals with healthy kidneys.
He explained that the body typically eliminates excess water through urination when kidney function is normal.
“When you take water, and you have a normally functioning kidney, you are not likely to get overhydrated because your kidneys eliminate the excess water and fluid. That’s it,” the nephrologist said.
Awobusuyi, however, noted that the situation differs for individuals with impaired kidney function, who may struggle to excrete excess fluid.
“Now, there are certain conditions in which the kidneys are not functioning very well, and if such an individual takes a lot of water, they accumulate fluid, and their legs and face get swollen, and they may even have fluid accumulation in their chest and lungs,” the don said.
He added that people with certain psychological conditions may also be at risk due to compulsive water consumption.
“Now, some people with psychological problems have this compulsive drinking habit. So they just keep on drinking and drinking more than what their kidneys can handle. And when that happens, and fluid accumulates, the sodium concentration in the body drops slightly,” the nephrologist said.
He noted that signs of overhydration in vulnerable individuals include swelling in various parts of the body.
Awobusuyi, who is the immediate past president of the Nephrology Association of Nigeria, said, “Well, the first thing that happens is that they develop swelling in dependent areas. So if they have been going about all day, their legs start getting swollen. When they lie down, their eyes become swollen; they have this bagginess, and their face may also be swollen.”
He added that as fluid accumulation worsens, more serious complications may develop.
“As more and more fluid accumulates in the body, the swelling starts extending. So they may develop what you call ascites. And as the fluid accumulates further, it can also collect in the lungs. These are not good clinical conditions,” the nephrologist said.
Despite concerns about overhydration, the expert emphasised that water intake remains essential for preventing dehydration and supporting bodily functions.
He said, “The basic thing is that when you drink water, you prevent dehydration, and that helps you a lot. But you should not become dehydrated. If dehydration becomes moderate, it can reduce blood flow to vital organs, including the kidneys.”
Awobusuyi noted that a common mistake people make is failing to drink enough water, especially in physically demanding conditions.
“The most common one is that people do not take enough water, especially if their job is demanding, like working under the sun, doing manual labour, or jobs where people sweat a lot,” he said.
Awobusuyi, however, cautioned against excessive water consumption, particularly among individuals with underlying health conditions or impaired kidney function.
“If you have a normal functioning kidney, water intake poses no significant problem because your body can handle it. But if you do not have a normal working kidney, or if certain drugs affect that thirst mechanism, then you may have issues with water intake,” he said.
On his part, a Professor of Endocrinology at the Lagos University Teaching Hospital, Idi-Araba, Mushin, Olufemi Fasanmade, explained that people with kidney impairment are mostly affected by overhydration.
“Drinking excessive water can lead to water intoxication, especially in those with kidney impairment,” he said.
The don listed the first warning signs of drinking too much water, including dizziness, headache, and altered consciousness.
The endocrinologist advised Nigerians to take about 12 glasses of water daily.
“Eight glasses is about 3 litres. In a hot tropical climate, 10–12 glasses may be required. Drink enough to ensure your urine is very light amber. Dark amber, brown, or deep orange-coloured urine indicates dehydration,” Fasanmade said.
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