This is an important topic and clearly very relevant to your overall health and potentially your urological symptoms. In addition, there is a great deal of false information circulating regarding what is recommended for fluid intake.
by Mr J. Graham Young, Consultant Urological Surgeon
So, how much water do I actually need per day?
Your basic fluid requirement per day is only about 1.2-1.5 litres (plus water you get from food intake). That’s about six to eight glasses of water.
That doesn’t sound like very much – is that healthy?
That is just your basal requirement – if it is a hot day or you are exercising, for example, you will lose more fluid through sweating and will need to drink more.
Are there any other people who should drink more than that?
Pregnant and breastfeeding women will need more-about 300ml in pregnancy and about 700ml when breastfeeding.
How about in some illnesses?
The evidence on fluid intake and illnesses isn’t very strong – except for people who have had problems with kidney stones. We
know that people who have had kidney stones should drink more – we want them to produce about two litres of urine per day. In practice, that means drinking about 2.5 litres of water.
Some illnesses can also cause dehydration in themselves, such as diabetes, and in this case, you should be aiming to increase intake to take account of increased fluid losses in urine. In other illnesses also, such as if you are running a high temperature from flu, you should also increase your water intake.
What happens if I drink more?
In normal healthy individuals, your kidneys will simply compensate by increasing the amount of urine you produce. Occasionally, for some people this can be a problem if they have got into a habit of drinking several litres per day for alleged health reasons and find they have to empty their bladder more often than is convenient!
What should I drink?
The perfect drink is probably water – that makes sense as that is what we evolved to drink long before we had fruit juices, fizzy drinks, tea, coffee and the rest! Water has zero calories as well!
For kidney stone formers, there may be some benefit from adding in fluids rich in citrate, such as lemon juice, to water. Citrate can act as an inhibitor of stone formation. However, take advice f rom your doctor first about this.
Is there anything I shouldn’t drink?
The upper limit for alcohol consumption has decreased recently – for adults this is now only 14 units per week. Alcohol also has the effect of actually causing dehydration – most of us have the experience of a very dry mouth the morning after drinking too much! That’s because ethanol itself makes your kidneys excrete more water than they should.
Another drink that you should be aware can be potentially harmful is grapefruit juice, because grapefruit can interfere with metabolism of a number of common drugs, including many of the drugs used to thin your blood after a heart attack, as well as statin drugs to lower cholesterol.
For a full list, check www.nhs.uk/common-health-questions/medicines/does-grape-fruit-affect-my-medicine.
Ask your doctor if you are in any doubt.
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