Is thirst a good predictor of dehydration?
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Water is essential for daily functioning and health, and we can only survive a few days without it. Yet we constantly lose water through sweat, urination and even evaporation when we breathe.
This is why we have evolved a way to regulate and maintain water in our bodies. Like other animals, our survival relies on a strong biological drive that tells us to find and drink water to balance fluid loss.
This is thirst – a sensation of dryness in the mouth signalling we need to have a drink. This basic physiological mechanism is controlled mainly by part of the brain’s “control centre”, called the hypothalamus. The hypothalamus receives signals from various regions of the body and in return, releases hormones that act as a messenger to signal the thirst sensation.
What is dehydration?
Staying hydrated (having enough water in our bodies) is important for several reasons, including:
- regulating body temperature through sweat and respiration
- lubricating joints and eyes
- preventing infections
- digesting and absorbing nutrients
- flushing out waste (via the kidneys)
- preventing constipation
- brain function (including memory and concentration)
- mood and energy levels
- physical performance and recovery from exercise
- skin health.
Dehydration occurs when our body doesn’t have enough water. Even slight drops in fluid levels have noticeable consequences, such as headaches, feeling dizzy, lethargy and struggling to concentrate.
Chronic dehydration can pose more serious health risks, including urinary tract infections, constipation and kidney stones.
What does the evidence say?
Despite thirst being one of the most basic biological drivers for good hydration, science suggests our feelings of thirst and subsequent fluid intake don’t always correlate with hydration levels.
For example, a recent study explored the impact of thirst on fluid intake and hydration status. Participants attended a lab in the morning and then later in the afternoon to provide markers of hydration status (such as urine, blood samples and body weight). The relationship between levels of thirst in the morning and afternoon hydration status was negligible.
Further, thirst may be driven by environmental factors, such as access to water. For example, one study looked at whether ample access to water in a lab influenced how much people drank and how hydrated they were. The link between how thirsty they felt and how hydrated they were was weak, suggesting the availability of water influenced their fluid intake more than thirst.
Exercise can also change our thirst mechanism, though studies are limited at this stage.
Interestingly, research shows women experience thirst more strongly than men, regardless of hydration status. To understand gender differences in thirst, researchers infused men and women with fluids and then measured their thirst and how hydrated they were. They found women generally reported thirst at a lower level of fluid loss. Women have also been found to respond more to feeling thirsty by drinking more water.
Other ways to tell if you need to drink some water
While acknowledging some people will need to drink more or less, for many people, eight cups (or two litres) a day is a good amount of water to aim for.
But beyond thirst, there are many other ways to tell whether you might need to drink more water.
1. urine colour: pale yellow urine typically indicates good hydration, while darker, concentrated urine suggests dehydration
2. frequency of going to the toilet: urinating regularly (around four to six times a day) indicates good hydration. Infrequent urination can signal dehydration
3. skin turgor test: gently pinching the skin (for example, on the back of the hand) and observing how quickly the skin returns to its normal position can help assess hydration. Slow return may indicate dehydration
4. mouth and lips: a dry mouth or cracked lips can be early signs of dehydration
5. headaches and fatigue: frequent headaches, dizziness, or unexplained fatigue can be signs of inadequate hydration
6. sweating: in physically active people, monitoring how much they sweat during activity can help estimate fluid loss and hydration needs. Higher levels of sweat may predispose a person to dehydration if they are unable to replace the fluid lost through water intake
These indicators, used together, provide a more comprehensive picture of hydration without solely depending on the sensation of thirst.
Of course, if you do feel thirsty, it’s still a good idea to drink some water.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Kiara Too, PhD candidate, School of Human Movement and Nutrition Sciences, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Thinking about trying physiotherapy for endometriosis pain? Here’s what to expect
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Endometriosis is a condition that affects women and girls. It occurs when tissue similar to the lining of the uterus ends up in other areas of the body. These areas include the ovaries, bladder, bowel and digestive tract.
Endometriosis will affect nearly one million Australian women and girls in their lifetime. Many high-profile Australians are affected by endometriosis including Bindi Irwin, Sophie Monk and former Yellow Wiggle, Emma Watkins.
Symptoms of endometriosis include intense pelvic, abdominal or low back pain (that is often worse during menstruation), bladder and bowel problems, pain during sex and infertility.
But women and girls wait an average of seven years to receive a diagnosis. Many are living with the burden of endometriosis and not receiving treatments that could improve their quality of life. This includes physiotherapy.
Netpixi/Shutterstock How is endometriosis treated?
No treatments cure endometriosis. Symptoms can be reduced by taking medications such as non-steriodal anti-inflammatories (ibuprofen, aspirin or naproxen) and hormonal medicines.
Surgery is sometimes used to diagnose endometriosis, remove endometrial lesions, reduce pain and improve fertility. But these lesions can grow back.
Whether they take medication or have surgery, many women and girls continue to experience pain and other symptoms.
Pelvic health physiotherapy is often recommended as a non-drug management technique to manage endometriosis pain, in consultation with a gynaecologist or general practitioner.
The goal of physiotherapy treatment depends on the symptoms but is usually to reduce and manage pain, improve ability to do activities, and ultimately improve quality of life.
What could you expect from your first appointment?
Physiotherapy management can differ based on the severity and location of symptoms. Prior to physical tests and treatments, your physiotherapist will comprehensively explain what is going to happen and seek your permission.
They will ask questions to better understand your case and specific needs. These will include your age, weight, height as well as the presence, location and intensity of symptoms.
You will also be asked about the history of your period pain, your first period, the length of your menstrual cycle, urinary and bowel symptoms, sexual function and details of any previous treatments and tests.
They may also assess your posture and movement to see how your muscles have changed because of the related symptoms.
During the consultation, your physio will assess you for painful areas and muscle tightness. Netpixi/Shutterstock They will press on your lower back and pelvic muscles to spot painful areas (trigger points) and muscle tightness.
If you consent to a vaginal examination, the physiotherapist will use one to two gloved fingers to assess the area inside and around your vagina. They will also test your ability to coordinate, contract and relax your pelvic muscles.
What type of treatments could you receive?
Depending on your symptoms, your physiotherapist may use the following treatments:
General education
Your physiotherapist will give your details about the disease, pelvic floor anatomy, the types of treatment and how these can improve pain and other symptoms. They might teach you about the changes to the brain and nerves as a result of being in long-term pain.
They will provide guidance to improve your ability to perform daily activities, including getting quality sleep.
If you experience pain during sex or difficulty using tampons, they may teach you how to use vaginal dilators to improve flexibility of those muscles.
Pelvic muscle exercises
Pelvic muscles often contract too hard as a result of pain. Pelvic floor exercises will help you contract and relax muscles appropriately and provide an awareness of how hard muscles are contracting.
This can be combined with machines that monitor muscle activity or vaginal pressure to provide detailed information on how the muscles are working.
Yoga, stretching and low-impact exercises
Yoga, stretching and low impact aerobic exercise can improve fitness, flexibility, pain and blood circulation. These have general pain-relieving properties and can be a great way to contract and relax bigger muscles affected by long-term endometriosis.
These exercises can help you regain function and control with a gradual progression to perform daily activities with reduced pain.
Low-impact exercise can reduce pain. ABO Photography/Shutterstock Hydrotherapy (physiotherapy in warm water)
Performing exercises in water improves blood circulation and muscle relaxation due to the pressure and warmth of the water. Hydrotherapy allows you to perform aerobic exercise with low impact, which will reduce pain while exercising.
However, while hydrotherapy shows positive results clinically, scientific studies to show its effectiveness studies are ongoing.
Manual therapy
Women frequently have small areas of muscle that are tight and painful (trigger points) inside and outside the vagina. Pain can be temporarily reduced by pressing, massaging or putting heat on the muscles.
Physiotherapists can teach patients how to do these techniques by themselves at home.
What does the evidence say?
Overall, patients report positive experiences pelvic health physiotherapists treatments. In a study of 42 women, 80% of those who received manual therapy had “much improved pain”.
In studies investigating yoga, one study showed pain was reduced in 28 patients by an average of 30 points on a 100-point pain scale. Another study showed yoga was beneficial for pain in all 15 patients.
But while some studies show this treatment is effective, a review concluded more studies were needed and the use of physiotherapy was “underestimated and underpublicised”.
What else do you need to know?
If you have or suspect you have endometriosis, consult your gynaecologist or GP. They may be able to suggest a pelvic health physiotherapist to help you manage your symptoms and improve quality of life.
As endometriosis is a chronic condition you may be entitled to five subsidised or free sessions per calendar year in clinics that accept Medicare.
If you go to a private pelvic health physiotherapist, you won’t need a referral from a gynaecologist or GP. Physiotherapy rebates can be available to those with private health insurance.
The Australian Physiotherapy Association has a Find a Physio section where you can search for women’s and pelvic physiotherapists. Endometriosis Australia also provides assistance and advice to women with Endometriosis.
Thanks to UTS Masters students Phoebe Walker and Kasey Collins, who are researching physiotherapy treatments for endometriosis, for their contribution to this article.
Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney and Caroline Wanderley Souto Ferreira, Visiting Professor of Physiotherapy, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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An Addiction Expert’s Insights On Festive Drinking
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This is Dr. Christopher Kahler. He’s Professor of Behavioral and Social Sciences, Director of Alcohol and Addiction Studies, Professor of Psychiatry and Human Behavior, all at Brown University.
What does he want us to know?
It’s the trickiest time of the year
Per stats, alcohol sales peak in December, with the heaviest drinking being from mid-December (getting an early start on the Christmas cheer) to New Year’s Eve. As for why, there’s a collection of reasons, as he notes:
❝The main challenge is there’s an extra layer of stress, with a lot of obligations and expectations from friends and family. We’re around people who maybe we’re not usually around, and in larger groups. It’s also a time of heightened emotion and, for some people, loneliness.
On top of that, alcohol use is built into a lot of our winter holiday traditions. It’s often marketed as part of the “good life.” We’re expected to have alcohol when we celebrate.❞
As for how much alcohol is safe to drink… According to the World Health Organization, the only safe amount of alcohol is zero:
Dr. Kahler acknowledges, however, that many people will wish to imbibe anyway, and indeed, he himself does drink a little, but endeavours to do so mindfully, and as such, he recommends that we…
HALT!
Dr. Kahler counsels us against making decisions (including the decision to drink alcohol), on occasions when we are one or more of the following:
- Hungry
- Angry
- Lonely
- Tired
He also notes that around this time of year, often our normal schedules and habits are disrupted, which introduces more microdecisions to our daily lives, which in turn means more “decision fatigue”, and the greater chance of making bad decisions.
We share some practical tips on how to reduce the chances of thusly erring, here:
Set your intentions now
He bids us figure out what our goal is, and really think it through, including not just “how many drinks to have” if we’re drinking, but also such things as “what feelings are likely to come up”. Because, if we’ve historically used alcohol as a maladaptive coping mechanism, we’re going to need a different, better, healthier coping mechanism (we talked more about that in our above-linked article about reducing or quitting alcohol, too, with some examples).
He also suggests that we memorize our social responses—exactly what we’re going to say if offered a drink, for example:
❝It’s important to know what you’re going to say about your alcohol use. If someone asks if they can get you a drink, good responses could be: “A glass of water would be great” or “Do you have any non-alcoholic cider?” You don’t have to explain yourself. Just ask for what you want, because saying no to someone can be difficult.❞
See also:
December’s Traps To Plan Around
Mix it up and slow it down
No, that doesn’t mean mix yourself a sloe gin cocktail. But rather, it’s about alternating alcoholic and non-alcoholic drinks, to give your body half a chance to process the alcohol, and also to rehydrate a little along the way.
We talk about this and other damage-limitation methods, here:
How To Reduce The Harm Of Festive Drinking (Without Abstaining)
Take care!
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No Equipment Muscle Gain Routine for Ages 50+
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Sarcopenia, the loss of muscle mass commonly associated with aging, can be a big problem as it leaves us vulnerable to injury (and also isn’t great for the metabolism—keeping adequate muscle mass ensures keeping the metabolism ticking over nicely). Will Harlow, over-50s specialist physiotherapist, is here to share a routine that works without weights:
Where it counts
There’s a fair amount of emphasis here on the lower body and core. That’s because in practical terms, this is what matters more for our health than having bulging biceps:
- First exercise: donkey calf raises to build strength in the calves using a chair.
- Second exercise: single-leg elevated lunge to work the quads and glutes, using a step or books for elevation.
- Third exercise: slow sit-to-stand for quads, glutes, and core strength, focusing on a slow descent.
- Fourth exercise: wall press-up to strengthen the chest, shoulders, and arms, with a variation using towels for increased resistance.
- Final exercise: shoulder raises using bottles or similar weights to target the shoulders and rotator cuffs.
Ok, so that last one was a slight cheat on his part as it does require grabbing a weight, but it’s not specialist equipment at least, and can just be something you grabbed at home. It’s also the least important of the five exercises, and can be skipped if necessary.
For more on all of these plus visual demonstrations, enjoy:
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Want to learn more?
You might also like to read:
Take care!
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Love Sense – by Dr. Sue Johnson
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Let’s quickly fact-check the subtitle:
- Is it revolutionary? It has a small element of controversy, but mostly no
- Is it new? No, it is based on science from the 70s that was expanded in the 80s and 90s and has been, at most, tweaked a little since.
- Is it science? Yes! It is so much science. This book comes with about a thousand references to scientific studies.
What’s the controversy, you ask? Dr. Johnson asserts, based on our (as a species) oxytocin responsiveness, that we are biologically hardwired for monogamy. This is in contrast to the prevailing scientific consensus that we are not.
Aside from that, though, the book is everything you could expect from an expert on attachment theory with more than 35 years of peer-reviewed clinical research, often specifically for Emotionally Focused Therapy (EFT), which is her thing.
The writing style is similar to that of her famous “Hold Me Tight: Seven Conversations For A Lifetime Of Love”, a very good book that we reviewed previously. It can be a little repetitive at times in its ideas, but this is largely because she revisits some of the same questions from many angles, with appropriate research to back up her advice.
Bottom line: if you are the sort of person who cares to keep working to improve your romantic relationship (no matter whether it is bad or acceptable or great right now), this book will arm you with a lot of deep science that can be applied reliably with good effect.
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Allen Carr’s Easy Way to Quit Emotional Eating – by Allen Carr
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We’ve reviewed books before on quitting drinking; is this book about emotional eating so different?
There are overlaps, but important points of contrast, too. After all, alcohol and junk food are both often unhealthy coping mechanisms for other things, though:
- Alcohol has in principle the stronger grip (making it harder to give up)
- Junk food is so much easier to justify (making it harder to give up)
Author Allen Carr is of course most well-known for his debut book about quitting smoking, and he brings a lot of that expertise to bear on the slightly different beast that is emotional eating.
Focused on reframing quitting as being less about self-denial and more about self-liberation, he helps readers to understand that giving up a substance (in this case, junk food) does not mean giving up happiness—rather, it means finding happiness beyond it.
If this book has a downside, it’s that some parts can be a little repetitive, and it can sometimes seem like one of those “this book could have been an article” situations.
On the other hand, many people benefit from repeated messages to truly inculcate an idea, so this could be a positive for a lot of readers.
Bottom line: if you’ve tried to eat more healthily but find that you keep reaching for an unhealthy comfort food, then this book may make a difference that other methods didn’t.
Click here to check out The Easy Way To Quit Emotional Eating, and find your own freedom!
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16 Overlooked Autistic Traits In Women
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We hear a lot about “autism moms”, but Taylor Heaton is an autistic mom, diagnosed as an adult, and she has insights to share about overlooked autistic traits in women.
The Traits
- Difficulty navigating romantic relationships: often due to misreading signs
- Difficulty understanding things: including the above, but mostly: difficulty understanding subtext, when people leave things as “surely obvious”. Autistic women are likely to be aware of the possible meanings, but unsure which it might be, and may well guess wrongly.
- Masking: one of the reasons for the gender disparity in diagnosis is that autistic women are often better at “masking”, that is to say, making a conscious effort to blend in to allistic society—often as a result of being more societally pressured to do so.
- Honesty: often to a fault
- Copy and paste: related to masking, this is about consciously mirroring others in an effort to put them at ease and be accepted
- Being labelled sensitive and/or gifted: usually this comes at a young age, but the resultant different treatment can have a lifetime effect
- Secret stims: again related to masking, and again for the same reasons that displaying autistic symptoms is often treated worse in women, autistic women’s stims tend to be more subtle.
- Written communication: autistic women are often more comfortable with the written word than the spoken
- Leadership: autistic women will often gravitate to leadership roles, partly as a survival mechanism
- Gaslighting: oneself, e.g. “If this person did this without that, then I can to” (without taking into account that maybe the circumstances are different, or maybe they actually did lean on crutches that you didn’t know were there, etc).
- Inner dialogue: rich inner dialogue, but unable to express it outwardly—often because of the sheer volume of thoughts per second.
- Fewer female friends: often few friends overall, for that matter, but there’s often a gender imbalance towards male friends, or where there isn’t, towards more masculine friends at least.
- Feeling different: often a matter of feeling one does not meet standard expectations in some fashion
- School: autistic women are often academically successful
- Special interests: often more “socially accepted” interests than autistic men’s.
- Flirting: autistic women are often unsure how to flirt or what to do about it, which can result in simple directness instead
For more details on all of these, enjoy:
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Related reading:
You might like a main feature of ours from not long back:
Miss Diagnosis: Anxiety, ADHD, & Women
Take care!
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