Hi, I’m Jen Aniston and I’m here to talk to you about Smart Water. We have 2 kilos, 5 kilos and 10 kilos. If you know me, then you know that water is like my favorite drink. I love drinking water all day. I’m excited to have that like Halle Berry skin where I look 12, but I’m really 70. Oh water is the drink that you can trust, no-one’s ever…. Hey guys. I’m Siobhan, a second year medical resident. We constantly see ads telling us that drinking more water is really healthy for you. But the question is: Can you take that too far? Can you actually overdose on water? Before we start, I do want to warn you that we will be talking about a real case where someone passed away. And the goal of this is to learn a bit about the body and the medical conditions, not to be providing medical advice. So definitely see your doctor if you have any specific concerns. Jennifer, I heard that it’s not… You’re not doing too. Well, my head hurts. In 2007 a California radio station held a competition called ‘Hold your wee for a Wii’. And contestants came in and drank as much water as they could without urinating. A 28 year old woman participated in this and she drank a shocking 7,5 liters of water in just 3 hours. She came in 2nd prize for this and she ended up winning two tickets to the Justin Timberlake concert that night. But when she was leaving the radio station, she apparently wasn’t feeling well and was saying that she had a headache. They keep telling me that it’s the water, that it’s my… It’ll tell my head to hurt and then it’ll make me puke, but… Who told you that? The intern? Yeah. It hurts, but it makes me feel light-headed. So she called her work and called in sick for that day. Just hours later she was found dead at home. Shocking, I know. Such a tragedy and especially over a competition like that. I mean… I bet you are wondering: How does someone healthy and young die that quickly from just drinking water? So let’s take this step by step and figure it out. So when you drink a glass of water, it goes down into your stomach, gets absorbed by the small intestine and then it makes its way into the blood vessels. At that point it just starts to automatically distribute throughout the body and through a process called osmosis it gets into the cells. Osmosis is when water moves from an area of low solute concentration to an area of high solute concentration. One of the most important electrolytes in the body is called sodium and we measure it all the time in the hospital. When you drink lots of water, your blood starts to get a bit diluted out and so does the sodium. Low levels of sodium is called hyponatremia and that can cause lots of different symptoms. Things like headache, nausea, vomiting, even confusion. And with that low level of sodium, it causes more water to shift over into the cells through osmosis. And that’ll actually cause the cells to swell and to even get a little bit bigger. In most parts of the body it doesn’t really matter if you have just a little bit of swelling. But if it happens at the brain, it’s actually quite serious, because there’s not a lot of extra room in the skull. As brain starts to swell, it starts to push against the skull and then it creates this high pressure in the brain. And doctors will call that high ICP or elevated intracranial pressure. The skull only has one hole and that’s at the bottom, that is called the foramen magnum. And you can imagine as that pressure gets bigger, the brain will actually start coming down through that hole and that’s called brain herniation. You do not need a medical degree to know that that is bad. It means you’re not getting blood flow to the brain. It can cause seizures, coma and it can even be fatal. So you’re probably thinking: Okay well, just pee out a whole lot more and then you’ll just get rid of the water and it’ll be okay. And on a typical day if you drink a bit too much water, that’s what happens and it’s no problem. But the problem is the kidneys cannot just pee out water, it’s just the way they are. They cannot just pee water, you always have electrolytes that go into the urine and that includes sodium. So when you drink a whole bunch of water, you’ve diluted out the blood and then on top of that you’re peeing a whole bunch, because you drank all that water. And then you’re getting rid of sodium in the pee. So all of a sudden your sodium level just keeps dropping and dropping and dropping and all of a sudden you have really profound level of hyponatremia. And it could be life-threatening. So this is what happened to the woman in the radio challenge. Drinking 7,5 liters of water caused the sodium in her blood to get diluted. Leading to swelling in the brain, which was likely the cause of death. Luckily, we don’t often see people coming in after a competition like this. But there is a condition called psychogenic polydipsia, where someone will feel a compulsion to drink tons and tons of water and they will come in very ill with low sodium. I think it’s really important to mention that this is just one cause of hyponatremia. There are actually a ton of medical conditions that will also cause hyponatremia for different reasons and they get treated differently. So when I’m on call for internal medicine, I almost always admit at least a few patients with hyponatremia. And that could be low thyroid, adrenal gland problems, heart problems, liver problems, kidney problems, certain types of cancers, the list just goes on and on. So it is so important to see your doctor and allow them to look at the whole picture and figure out what is causing the hyponatremia and then finding the right treatment option. So it’s not a one-size-fits-all situation. Okay, but guys I do not want you walking away from this video terrified to drink water. That is not the message here. Water is healthy, we’re 60% made up of water. But the question is: How much is the right amount to be drinking? And the answer is: It depends. Don’t you just love that?! It depends on whether you have a fever, how much you’re sweating and how active you’re being. Do you have any underlying conditions? Do you have things like diarrhea? Are you pregnant? All of that stuff goes into it. But for the average individual, the National Academies of science has said that men require about 3.7 liters of fluid per day and women need about 2.7 liters of fluid. And that’s everything together; your food, your water, any juices, any caffeinated beverages, everything together. But to be honest, if you just just listen to your body and when you notice that you’re thirsty and if you drink at that point, you’re probably gonna be okay. Although if you’re me and when you’re on call and you always forget to drink water, it’s sometimes just important to remind yourself. Just remember that things that are natural don’t necessarily mean there are no side effects or that you can have as much of them as you want. So my grandfather always tells me that too much of a good thing isn’t good, but a little bit of a bad thing can sometimes be good. Get your head around that one. Anyway, if you like this new type of a video, let me know in the comments below and if you want to see more like this, don’t forget to subscribe. Otherwise I’ll be chatting with you guys next week. So bye for now.