Talk:Dehydration

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2.5 Litres[edit]

The BBC report talks about the 2.5 Litres of water lost - perhaps it should be noted that it is not necessary to drink this much per day as we get water from other sources? http://news.bbc.co.uk/2/hi/health/7326437.stm —Preceding unsigned comment added by 115.147.69.133 (talk) 02:29, 8 April 2009 (UTC)

Loss of water[edit]

ok, i'm probably going about bringing this up the wrong way, but in the Avoiding dehydration section it says "Drinking water beyond the needs of the body entails little risk" but (even though I don't have an online source, I'm sure you could find one) you can die from drinking too much water, and I wouldn't call that little risk...

In Seattle, a radio station held a water drinking contest for a Nintendo Wii console. Jennifer Lea Strange, a 28 year old mother of 3, entered, won, & died from "water intoxication" or Hyponatremia & the staff was fired. Marry Christmas kids, I hope your mom wasn't single. http://seattletimes.nwsource.com/html/nationworld/2003529990_water18.html

This is true, but this wikipedia article addresses this appropriately by saying that the kidneys have a large capacity to excrete free water. In the euvolemic state, the kidneys can clear something like 18 L of free water in a 24 hour period. That means that the kidneys can clear 3/4 of a liter per hour. Drinking water at a higher rate than that would start to lower serum sodium, although it would take a much much higher rate to cause clinically significant hyponatremia. It does happen, but it's not common unless you're actually trying to consume massive amounts of water. It is the hypovolemic state where excessive water consumption is particularly hazardous. Hypovolemia impairs renal free water clearance (combination of decreased distal water delivery and ADH secretion in response to hypovolemia), so much lower rates of water consumption can cause hyponatremia. This is why marathons have started to have water stations every 2 miles instead of every mile, to decrease risk of hypovolemic hyponatremia.--Nibblesnbits (talk) 04:21, 24 February 2011 (UTC)

Salted foods are OK, but Salted water (i.e. Seawater) not OK? How can that be?[edit]

I'm not disputing it as a fact, I'm just a little confused. How can it be a bad idea to drink seawater, yet having some salty foods with your "regular" drinking water is fine. When you see in films, people in a rescue boat in the middle of the ocean dying of thirst, I can't help thinking drinking the seawater has to be better than drinking nothing.

When you drink a high concentration salt solution, as you would from the ocean, your body would become more dehydrated. This occurs because the ocean has a higher salt concentration than your body, and it will cause the water to leave your cells in attempt to equalize the concentrations. (D.c.camero (talk) 04:50, 7 November 2008 (UTC))

How can there be no data anyhwere in wikipedia on this?[edit]

How much days can one survive without drinking?, how many without eating? without breathing? The answer is borderer but not treated.Undead Herle King (talk) 03:57, 19 March 2008 (UTC)

Probably because it is highly dependent. How long you can live without eating depends on a combination of how much energy you expend and how much reserve you began with (fat), similarly how long you can go without water or oxygen depends on activity level and initial hydration level, and activity level and basal metabolic rate, respectively. Certainly a person can go the longest without food, then water, and only a very short time without oxygen, but the exact numbers will vary from person to person and from situation to situation. For instance a person who falls in a pool in the summertime will die much sooner than a person who falls into that same pool in the winter.(D.c.camero (talk) 04:55, 7 November 2008 (UTC))
   Don't take this too seriously, we're indeed just talking orders of magnitude:
You can bleed out in seconds,
smother in minutes,
die of exposure in hours,
die of dehydration in days, and
starve in weeks.
   One thing that few people adequately consider, tho, is that if the temperature is high or you're working hard enuf or the air is dry enuf (e.g. in winter even if you are adequately clothed for the conditions, since the dry air keeps sucking moisture out of your lungs), without water you'll get cranky, clumsy, and stupid within hours, and run a high risk of falling badly enuf or mis-assessing your situation badly enuf to result in either
quick death from a severed femoral artery, drowning or a massive head injury,
slower death from a thoracic injury,
or further loss of capabilities from a closed-skull head injury, or lower-limb injury, and thus further heightened risk of not being found within hours, days, or weeks, resulting in death from
a septic wound, or
one of the lacks that began this discussion.
Hence the slogan: Hydration is everything. (And hence the role of hydration systems as hiking, rock-climbing, and military equipment.)
--Jerzyt 07:51, 9 November 2010 (UTC)

DRINK WATERIO WATER, THE MOST WATERY OF THEM ALL[edit]

Ideally, at least two litres (approximately eight glasses) of pure water should be consumed per day. This is in addition to other fluids,such as alcohol, tea, coffee and many soft drinks, that may increase loss of or need for water.

roflmao This sounds like some kind of bottled water advertisement. In most places no sane person ever drinks that much water. The first approximation of daily water requirements, as found in most medicine textbooks, is about 550 ml (gain with metabolism - loss with respiration - loss with perspiration) + loss with urine (without excessive heat, physical effort etc.), with the latter variable in a very wide range.

Most of the food contains a lot of water. About any common drink, except for those with extremely high alcohol content, provides much morewater than it causes to loss with increased urination. So usually you don't need to drink any "pure water" at all, and only a limited amount of other drinks – much less than the 2 litres a day. Taw 10:42, 2 Sep 2004 (UTC)

I disagree. First off, it doesn't mention bottled water, you can get it from your tap (though I prefer to filter it first). The main confusion is that with increased water consumption, there is increased urination, so you can't use the amount of urine as a determinant of your water needs. I definately agree with you though: all water content, including that in foods and other beverages should be taken into account. We should definately modify this if it is not reflected. Assuming it is 8 glasses, you may only need to drink 4 if you get 4 from the rest of your diet. The reason I think they say in addition to alchohol/tea/coffee/pop is that there is this paranoia about them being diuretics, which from what I've seen so far is blown out of proportion, considering pure water itself is a diuretic (being something that makes you urinate).Tyciol 06:56, 6 March 2006 (UTC)

I've always thought that caffeine causing dehydration was a myth, based on my own experience. Checking it out I found this: *[1] and this *[2]. It would seem that normal amounts of caffeine intake do not cause dehydration. Peter Harriman 16:43, 4 July 2006 (UTC)

Most people don't drink that much, and most people experience frequent headaches which they attribute to 'stress' and not drinking gallons of coffee and no water. Caffiene doesn't 'cause dehydration', but it does dehydrate you to a small degree; it is a diuretic: http://en.wikipedia.org/wiki/Caffeine for more info. That means that it blocks the mechanism in the body that draws water out of the urine, causing urine to be dilute, which therefore causes the body to lose an excess amount of fluids in the urine. Alcohol is also a diuretic. It is not a myth that it makes you pee more either! Though structurally not at all related, they affect water retention by the same mechanism. —Preceding unsigned comment added by 24.108.93.159 (talk) 05:56, 4 July 2008 (UTC)

Treatments for dehydration[edit]

Drinking seawater, yes bad idea. Drinking urine...There seems to be less concenus (maybe 95% say its a bad idea with 5% saying its a good idea) - anyone know of any studies? And as for avoiding alcohol - all alcoholic drinks? Or just vodka? I can understand high alcohol content beverages but what about <=5% drinks? And what about blood? Tyciol 06:56, 6 March 2006 (UTC)

What is your concern exactly? The best treatment is to drink normal water. If you are not able to access it, yes, drink your urine, unless you consumed something toxic recently, in which case it's less of a good idea. Never drink your own blood. If you have access to flesh and no water, then drinking an animal's blood would be a way of increasing the water content of your diet, even if it does carry increased risk of disease. If you mean human blood, that would be up to the dilemma of cannibalizing others for survival (there's a Tom Connors song about it...). I am unsure about alchohol, generally I think it would be good to drink it if you were dying of dehydration, supposed diuretic or not. Tyciol 06:56, 6 March 2006 (UTC)

Hey, I was wondering, where it says the average person can go months or whatever drinking like .2 ml of salt water or something like that, going a year doing that without kidney failure. Is that actually true, or is that if you drink a glass of normal water or something. How long can somebody go by drinking salt water, and drinking no water is better than drinking salt water, correct? Predator106 (talk) 03:26, 13 January 2008 (UTC)

On Hypovolemia[edit]

I combined the sentence and fragment into something like:

"Hypovolemia, a depletion of blood volume is similar to dehydration, but it refers to the loss of salts as well as water."

The article on hypovolemia states that it can be caused by dehydration, so "similar" seems to be an odd word to use. I moved it to the "See Also" section just to be safe. Can someone better informed take a look? Hpdw 00:24, 29 August 2006 (UTC)

Hypovolemia is not similar to dehydration because free water loss is intracellular water loss (osmotic forces will replace free water losses from the extra cellular compartment) while hypovolemia is extracellular water (and salt) loss. Sardmeta1 (talk) 01:44, 14 November 2012 (UTC)

I am an internal medicine physician and a nephrology fellow. Dehydration is the clinical entity characterized by loss of free water (pure water with no salt or solutes on it). Dehydration therefore always is accompanied by high sodium concentration in the blood or hypernatremia. Conversely, volume depletion or hypovolemia is produced by loss of a salt and water solution that has the same osmolarity as the plasma, i.e. a isotonic solution. The sodium concentration does not change. The treatment for dehydration is water or D5W and the treatment for hypovolemia is 0.9%NaCl.—Preceding unsigned comment added by 136.142.242.53 (talkcontribs) 21:14, 30 November 2006

Note the above comment! This page is improperly named, or it should not be redirected to from "Volume depletion". Volume depletion and dehydration are two different things! The relationship to sodium concentration is key, and is not clearly explained in this page. Volume depletion should get its own separate page. Wwallacee 16:12, 21 February 2007 (UTC)

I've redirected volume depletion to hypovolemia. WhatamIdoing (talk) 19:28, 11 January 2008 (UTC)

The above comments are really really important and need to stop being ignored. Most of this article is not actually about dehydration, it's about hypovolemia, and many of the statements are just incorrect. For example, the statement that the most common type of dehydration in humans is isonatremic is not correct. As the renal fellow mentioned above, dehydration, by definition, is hypernatremia. The article needs to be rewritten.--Nibblesnbits (talk) 04:26, 24 February 2011 (UTC)

Goodness!!! my changes today were undone despite this discussion being ongoing for six years - Why are the editors of this page ignoring the reality and not allowing a re-write of the page? I re-wrote the page (because the heading says re-write) and was immediately undone. Also, the re-direct should be to hypernatremia and volume depletion and hypovolemia have nothing to do with dehydration. Sardmeta1(talk) —Preceding undated comment added 00:21, 14 November 2012 (UTC)

Muscle Cramps?[edit]

Arn't muscle cramps also a sympton of dehydration? I just completed a 100 mile bicycle ride without enough water and I experienced severe cramps in my lower legs and feet, as well as headaches. --Allyn 04:19, 29 May 2007 (UTC)

No, I don't believe cramps are, it was probably just because you rode so far :P —Preceding unsigned comment added by 69.40.172.104 (talk) 04:02, 17 February 2008 (UTC)

Might want to look into this one - muscle cramps are commonly associated with dehydration in the athletic world. —Preceding unsigned comment added by 65.98.138.53 (talk) 23:09, 7 August 2008 (UTC)

I think the muscle cramps are due to lactic acid buildup in the tissue. At low levels of activity, your body is able to send nutrients to the muscle, and remove toxins from the muscle adequitely, but under higher levels of activity the body is unable to keep up, so the muscles start to burn their internal stores of energy, and this process causes a buildup of lactic acid in the muscle cells.(D.c.camero (talk) 05:01, 7 November 2008 (UTC))

removed blurb about vilomensitis[edit]

I just removed a blurb about a disease called "vilomensitis" that was added by an anon a few months ago. Right now, I suspect that this is medical-sounding gibberish. Please re-add the content if this is valid information. Thanks, Lisatwo 21:10, 15 October 2007 (UTC)

Removal of "causative" item[edit]

I removed this from the article, as a cause of dehydration:

Consumption of alcohol, caffeine or other diuretic substances.

As noted in a comment above (with links provided), caffeinated drinks do not cause dehydration. (similar source: Nutrition Action Health Newsletter, Jan/Feb 2008, page 6.) Nor - I believe - does drinking alcoholic beverages, which are mostly water.

If someone wants to put this back in, please provide a reliable source. -- John Broughton (♫♫) 20:03, 23 January 2008 (UTC)

I'm in a bit of a rush at the moment, so I can't edit in my source until later, but I've re-added alcohol consumption on the grounds that alcohol is a diuretic. A quick Google provides fairly reliable sources outside my medical text, such as http://www.alcohol.org.nz/BodyEffect.aspx?PostingID=671 —Preceding unsigned comment added by 65.98.138.53 (talk) 23:12, 7 August 2008 (UTC)

This is an important point about alcoholic beverages and dehydration, that many people misunderstand. Ethanol does contribute to dehydration, despite most alcoholic beverages being mostly water. A heavy drinker may have apparently normal urine output, yet become severely dehydrated. Chronic insufficient hydration is associated with consumption of caffeinated drinks and alcoholic drinks. See PMID 15936302 and PMID 9972188. --Una Smith (talk) 19:19, 18 June 2009 (UTC)

Perspiratio insensibilis[edit]

To the author. I admit some typos - sorry for that. But otherwise perspiratio insensibilis is a fact and important way for loss of water - about 300 ml through the skin and about 500ml through breathing per day. So what´s the problem ? —Preceding unsigned comment added by Jmak (talkcontribs) 06:20, 5 April 2008 (UTC)

Excess Diuretic Foods Cause Dehydration[edit]

You may want to discuss how excessive consumption of diuretic foods (e.g. parsley) can cause or contribute to dehydration. —Preceding unsigned comment added by 68.238.228.149 (talk) 11:39, 9 November 2010 (UTC)

Antidiuretic Hormone[edit]

You may want to mention how dehydration can result from a lack of the antidiuretic hormone (vasopressin). The medical condition is known as diabetes insipidus. —Preceding unsigned comment added by 68.238.228.149 (talk) 11:46, 9 November 2010 (UTC)

Article Requires Rewrite[edit]

This article is mainly about hypovolemia, which is very different from dehydration. While this is often a muddied topic, even among physicians, dehydration is distinct from hypovolemia. Dehydration is a loss of free water, and manifests as hypernatremia. There is no such thing as hyponatremic dehydration. Hyponatremic hypovolemia definitely exists, but not hyponatremic dehydration. Most of the signs and symptoms described are the signs and symptoms of hypovolemia, not dehydration. The described causes are also pretty much a description of causes of hypovolemia. Part of the prevention section is accurate, but the treatment section describes the treatment for hypovolemia, not dehydration/hypernatremia, which is in many respects different. So I think this article needs to be rewritten in its entirety. I can try to help with it, but I don't have much time right now. I just wanted to make sure it was flagged so that maybe people will stop learning this incorrectly.--Nibblesnbits (talk) 04:50, 24 February 2011 (UTC)

I'm not sure people should be allow to mark an article as "needs rewriting" wikipedia is full of people who say articles need rewriting but can't be bothered to do it. If you know the subject you should be able to set aside an hour or two to do it - and if not, well perhaps one shouldn't criticize what others have been doing.--IceHunter (talk) 16:23, 23 March 2011 (UTC)

I re-wrote it and guess what - not only was it was undone, but I was also accused of vandalism! I agree, not only is this page about hypovolemia, it is also scientifically wrong and confusingly mixed up with various other concepts such as hypo/hypernatremia and dehydration. This comment was a year ago - why is there a resistance to change what is clearly wrong?? This page should be a definition stub and linked out to hypernatremia because esentially dehydration is the non-technical name for hypernatremia and that page is accurate. The pages should not be merged as there is nothing of much use on this page. Thanks Sardmeta1 (talk) 01:25, 14 November 2012 (UTC)

Treatment section: hypertonic or hypotonic ?[edit]

I think there may be an error in the Treatment section, which says intravenous treatment should be with a hypotonic (or isotonic) solution. I think this may be backwards, as the following sentence says pure water (very hypotonic, yes?) in the veins causes red cells to lyse. I believe that cells in a hypotonic solution gain water by osmosis, until they burst in extreme cases, but I am not perfectly enough familiar with this to be certain. It seems conceivable (unlikely, I hope) that this could cause a treatment error somewhere, so if it is wrong, it really needs to be fixed. The statement was introduced in early September 2010, so it has been there for a while. Unfortunately I have seen spectacular errors lie fallow in Wikipedia for much longer, so that is no guarantee of correctness. Thanks, Wwheaton (talk) 00:15, 4 June 2011 (UTC)

Okay, a friend has straightened me out, I think. False alarm. Wwheaton (talk) 04:17, 4 June 2011 (UTC)

Dehydration (hypernatremia) is treated with hypotonic solutions. Isotonic solutions have no free water and hypertonic solutions (eg sea water) will simply worsen dehydration. Sardmeta1 (talk) 01:38, 14 November 2012 (UTC)

A symptom of dehydration is dry skin??? as in Xeroderma?[edit]

Initially, one experiences thirst and discomfort, possibly along with loss of appetite and dry skin.

How is possible that the water content inside my body affects how dry the outside of my skin is? Seems like that's more weather dependent.

I'm pretty sure dry skin is genetic.

Is there a reference to a study or something that shows the connection between dry skin and dehydration. — Preceding unsigned comment added by 184.145.112.8 (talk) 23:08, 2 November 2011 (UTC)

Dry skin as in not sweating. • • • Peter (Southwood) (talk): 09:03, 7 October 2016 (UTC)

Deletion on the parah on moral grounds[edit]

The Article states;

In numerous studies of terminally ill patients who have chosen to die, it has been shown that deaths by terminal dehydration are generally peaceful, and are not associated with suffering when supplemented with adequate pain medication.

I believe that can lead people to suicides, so must not be told on public forums like wikipedia. So I propose deletion, rather I will go ahead delete it and we can discuss it whether we can put it back.

Thanks, --Mutawassam (talk) 10:49, 13 May 2012 (UTC)

Your removal of this referenced information on the grounds stated is in conflict with Wikipedia policy, so I have reverted. Please do not remove what appears to be factual and encyclopedic information for reasons of personal disagreement. Your "moral grounds" are not shared by everyone. Wikipedia is required by consensus to retain a neutral point of view. Peter (Southwood) (talk): 06:17, 14 May 2012 (UTC)
While Wikipedia is not censored, I'm wondering if the information belongs there. It seems to be more appropriate at Terminal dehydration, because the information in question does not fall under "Signs and symptoms", and seems out of place in this article. - SudoGhost 08:21, 14 May 2012 (UTC)
Well, the sentence in question does link to "terminal dehydration", and it actually does say about "signs and symptoms"; in fact it is the purpose of the sentence. Staszek Lem (talk)
It is neither a sign, nor is it a symptom; it is outside the scope of that section, going into something already covered by another, more appropriate article. - SudoGhost 01:14, 15 May 2012 (UTC)
On the other hand it does sound like propaganda: if "supplemented with adequate pain medication", then even chopping off the head is peaceful. So I would suggest to remove the phrase from this article and put "terminal dehydration" into "See also" aection. The latter article has better chance of presenting balanced POV on the sensible issue. Staszek Lem (talk) 01:18, 15 May 2012 (UTC)
It's already in the see also section, but maybe it would be better to include terminal dehydration in the lede, something along the lines of "dehydration to the point of death is known as terminal dehydration", to note that this article's scope covers general dehydration, and that the other article exists which covers the terminal aspects specifically? - SudoGhost 01:21, 15 May 2012 (UTC)

as you said; "Your "moral grounds" are not shared by everyone" Dear that can be said about your moral values, too. But having said that the sentence does seems like "giving ideas" to people who want to commit suicide. Nobody, nobody in his/her right minds, would want to be a reason a man died. Anyhow, you have put it back, while I would have preferred if you had had finished your discussion with Mr. SudoGhost regarding this and then you had put it back.

Good Luck and wish no body takes ideas from this article. --Mutawassam (talk) 08:48, 19 May 2012 (UTC)

Quite so, my "moral values" are not shared by everyone. That is not relevant to this point, which was that you deleted the entry on your moral grounds, which is in conflict with Wikipedia policy. Whether a person has a right to kill themself by the means of their choice is not at issue here, nor is whether they can be induced to commit suicide by knowing the relative discomfort of different causes of death. The later comment by SudoGhost was not about whether the entry was suitable for inclusion in Wikipedia, but on which specific section or article it is most appropriate for it to be in, a subject on which I have no strong opinions, as this is not my field of expertise. In short, It is fine by me if it stays in this article, or if it is moved to the Terminal dehydration article, or is used in both. It is also fine if it is removed because it is shown to be factually incorrect, providing the person who does so can provide references showing that to be the case. Peter (Southwood) (talk): 09:26, 19 May 2012 (UTC)

Dehydration[edit]

This page is totally wrong in it entire scientific conceptualization. There is no such thing as hypotonic or hyponatremic dehydration because dehydration is synonymous with hypernatremia. Also, the symptoms presented are those of hypovolemia and not dehydration. What this page has done is mix up hypovolema and dehydration in a way that cannot be salvaged. I would strongly recommend that all the members who undid my post read the papers I posted - the real problem is this page as it exists, not my post Thanks Sardmeta1 — Preceding unsigned comment added by Sardmeta1 (talkcontribs) 23:24, 13 November 2012 (UTC)

Surely some authorities disagree with you about what kinds of dehydration may be distinguished. Please work with the article in a gradual way:

  • state your objections to particular statements, so that other may discuss them
  • Add text supported by solid references
  • Familiarise yourself with wikipedia editing guidelines. Staszek Lem (talk) 23:39, 13 November 2012 (UTC)

The above does not mean that the article is not without problems. Let us solve it one by one. Staszek Lem (talk) 23:49, 13 November 2012 (UTC)

Agree - I just got heated up when someone called me a vandal somewhere on the site. Anyway, I have deleted that term from my post above. Everything said and done this mixup of hypovolemia and dehydration has been going on for years so cannot expect to rectify it in a day as I was thinking.

I think the starting point for the rectification has to be a very clear discrimination between hypovolemia and dehydration and I propose the to start off by discussing the pathophysiology as indicated in this online paper[1] Sardmeta1 (talk)

One very important factor to keep in mind is that ALL mention of hyponatremic dehydration in the literature has been by non-experts who are actually referring to hyponatremic hypovolemia. Again, this is a very common mix-up in the medical literature[2] The rule of thumb is very simple: If a subject is not hypernatremic s/he is not dehydrated. Anyone who disagrees, kindly place a reference here to support your statement. Sardmeta1 (talk) 02:17, 14 November 2012 (UTC)

Please also keep in mind that the vast majority of wikipedia, as I suspect, is written by non experts, since, again, I suspect, most experts are busy either with aking money from their expertise or busy bashing wikipedia. Still, contrary to busily propagated misconception, wikipedia is not hostile towards experts. Wikipedians may be hostile to arrogant experts which assume that their words must be taken on faith. For a number of age-affirmed reasons, wikipedia requires all statements in its articles be supplied with solid references (WP:CITE policy). The opposite side of the coin, wikipedians do not take lightly any deletion of text supplied with references. The latter we see in our case. That said, here is my plan what to do with this article.

  • Start with basic definition of 'D'.
  • State that 'D' per se is a physiological state of a body which may be either a symptom or a cause of one of several medical conditions.
  • Put the term "water loss" into circulation. Draw distinction between intra- and extracellular water loss and their possible interaction.
  • (Now, assuming that you are right and you may confirm this by references to books or articles of reputable authors, preferrably the ones which have wikipedia bios, so that their authority will not be questioned outright):
    • State (with references) that some of the above medical conditions may be informally referred to as "dehydration", either informally or sloppily or for historical reasons when in olden times there was no clarity in medicine and hysteria was a disease. -- This part is important, because common misconceptions are just as encyclopedic information as correct information.
  • According to Wikipedia:Summary style, this article may have summary sections for all "real" ailments associated with dehydration:
  • Browse around and fix all wikipedia articles directly associated with dehydration.

I hope now you understand that simply writing an "it is all bullshit" paragraph in this article is not enough to cover the issue properly, even if you are basically right. Staszek Lem (talk) 03:11, 14 November 2012 (UTC)

Cannot be done this way because dehydration is the state associated with hypernatremia and the latter has a reliable page. However, if that is the path the editors prefer, please go ahead. My view is that this page needs to be re-written from scratch and main page indicated as hypernatremia just as I had done. Diarrhea and hypovolemia are conditions in their own right and need not be mixed up with dehydration and are already referred to on the hypernatremia page which can be tweaked. The references on this page may seem authoritative but this is a very misunderstood topic and even specialists can get it very wrong[3]. Kahn is referring to hypervolemia here but interprets it as "without water depletion". These are the sorts of references all over this page, and despite warnings about this dating back to 2006, nothing has been done. The experts have tried to help, (my post had all the key references in place, so was not personal opinion)) but unfortunately most editors on this page have been busy ignoring the experts - does not do much for the image of wikipedia to have them ignored for 6 years. Sardmeta1 (talk) 10:53, 14 November 2012 (UTC)

Obviously you are not reading what I wrote. You say: "even specialists can get it very wrong". All the more the article must be very careful in explaining what is wrong and what was meant. You are a specialist and you may as well be very wrong by yourself. "Dehydration" is a generic term meaning depletion of water content. Period. As a layman, I believe diarrhea leads to depletion of water content. Therefore they say "drink-drink-drink". Therefore I fail to see truth in your statement that diarrhea need not be mixed with hehydration. I am not suggesting to mixing it with dehydration, I am suggesting to explain their relation. Also one of causes of hypervolemia is dehydration (according to wikipedia page). Again, I am not suggesting to mixing it with dehydration, I am suggesting to explain their relation. Yes I agree it must be rewritten from scratch, and I was proposing a plan. I disagree that it cannot be done. Existence of one article does not prevent writing another one on a related subject. YOur version of the text says "None of these are seen with dehydration" (including "dry tongue") . Man, when I play volleyball 6 hours, my tongue is dry. Are you telling me that this is not because of water loss due to sweating? Instead of whining about "experts trying to help", please take suggestions from laymen seriously, because wikipedia is written for laymen, not to teach other experts that they are mistaken. I looked up one book which seems to follow your point of view. Still it is very careful and does not say that all are idiots. It just says that the term "denatration" may provide a more accurate depiction. But is does not say forget "dehydration", wrong word, you all are using wrong terminology. And most certainly wikipedia cannot do this either. Wikipedia's goal is to describe the current word usage, possbly criticize, but not to enforce a "better language" before it is enforced in all medical community. Staszek Lem (talk) 01:05, 15 November 2012 (UTC)
P.S. Earlier I mentioned the term "hysteria" in a mildly humorous context. Now I am seriously suggesting you to read this article carefully and learn how to deal with obsolete and inexact medical terms in an educational way. Staszek Lem (talk) 01:09, 15 November 2012 (UTC)


You say "Dehydration" is a generic term meaning depletion of water content. Period.. This is the main issue under debate here. Medics on the other hand need to separate "only water" and "sodium + secondary water losses" otherwise a patient cannot be treated. This is further complicated by the fact that both can occur in the same person at the same time and require different treatment NOT drink-drink-drink. Have you heard of ORS in diarrhea? Why is simple water not used for example? Because it kills the person. Why can stranded at sea persons not drink sea water and why does it kill them? If a patient appears in ED with generic dehydration which means loss of body water of any sort (as you have suggested) is there a simple fix for them ie drink-drink-drink as you put it (either orally or IV)? The answer is a resounding NO.

The page says: There are three types of dehydration: hypotonic or hyponatremic (primarily a loss of electrolytes, sodium in particular), hypertonic or hypernatremic (primarily a loss of water), and isotonic or isonatremic (equal loss of water and electrolytes).[2] This is misuse of terminology with an author who refers to volume depletion as dehydration. This will be understood by residents with their background knowledge of AVP and RAAS, but is not appropriate for a page addressing medical dehydration. I am begining to understand why wikipedia is being shunned by specialists - many pages cannot be corrected because they get written by persons who simply do not know that they don't know and editors lack the expertise to make changes on their behalf. Sardmeta1 (talk) 11:14, 15 November 2012 (UTC)

  • What's your problem, man? I am not saying that you are wrong. I am saying that the text you suggested is completely useless. You may be an expert, but surely you have no faintest idea how to write something useful for education of an average reader. Many pages cannot be corrected because experts are too busy brandishing their expertise and bashing wikipedia. I made an outline of what can be a useful article. What was wrong with it? Instead of bickering, why don't we start cooperating? For the Nth time, it is not enough to write "they all have it wrong" based on 1-2 references to random articles. In this talk page you wrote a number of useful things. When a long-standing page cannot be corrected, a proper way is to start writing a draft, with discussions. Please do so in this page.
  • You wrote "misuse of terminology with an author who refers to volume depletion as dehydration" - who is the "author" here? - A wikipedian or the author cited by a wikipedian? Where is the proof that it is misuse of terminology? Can you cite a book or an article which explicitely say so: "many texts confuse hypervolemia with dehydration"?
  • Is is correct to say that "hypervolemia, among other resons may be caused by dehydration"?
  • Is my sketch definition you quote "Dehydration" is a generic term meaning depletion of water content. Period. basically correct? I mean what is the meaning of your phrase "This is the main issue under debate here." Do you mean I am wrong or do you mean I am right, therefore the whole article is nonsense?
    • Quite a few medical texts and dictionaries write that "dehydration is "loss of water plus salts/electrolytes/whatever" or "loss of body fluids". It is a widespread parlance, and it must be explained, unless it is used only by sloppy/uneducated writers, which I doubt. Your definition is "the excessive loss of free body water". Can you cite impressive scholarly references? I may see that defining dehydration as "excessive loss of body fluid" is sloppiness: bleeding is loss of "body fluid", but it is hardly called dehydration.
  • What's your point with ORS in this context? R is for "rehydration". This is just shows that this "hydration" terminology permeates the medical literature and you cannot simply say "wrong terminology". YOu have to explain how to "read between lines" and understand what is actually written about in other sources, because of course not all of us are residents (although some of us are permanent residents; why don't we start a campaign in wikipedia and say that "resident" is wrong medical terminology?).
  • I am perfectly aware that water loss by itself may be harmless even in huge quantities, e.g., if I had it too much in the first place. Can you explain this in the article? I even heard somewhere that the "I lost 25 pounds in 2 weeks" adverts are about harmless "dehydration" of excess water. Am I right? Can we write about this here as an example of harmless water loss?
  • I am aware that in most cases water loss cannot be isolated from other losses, and this is why people try to classify whatever thay call "dehydration" into different combinations. Staszek Lem (talk) 23:32, 15 November 2012 (UTC)

Can you work to mutual agreement step by step to improve wikipedia or you are just happy with the fact that you are "begining to understand why wikipedia is being shunned by specialists? Staszek Lem (talk) 23:19, 15 November 2012 (UTC)

Another issue I mentioned and you seem to forget is that we have to work with the whole range of articles on connetc3d topics, to maintain overall consistency of coverage:

May be the following idea will convince you better: It is insufficient to write a correct wikipedia text in the environment, where, as you say, many sources are confused and propagate misconception. YOu have to write a wikipedia article in such a way that next year when you got bored with editing, a random dude cannot come and expand (or even replace) your perfect, but brief text, with something cited from these numerous incorrect sources. (In perfectly good faith, unaware that it was a text by an expert and not by another equally random dude.) Staszek Lem (talk) 01:45, 16 November 2012 (UTC)


I was about to vanish from the scene, but OK, I see your point. Let me see if I can convince you and if that works then might be worthwhile to work on the page. Over the next few days, I will take it in steps here. So to start with step 1: Definition. This is paramount as thats where all the confusion lies. Humans can lose water from the body - of any aetiology - but that loss can only manifest itself in two ways:

  • a) Loss of blood volume
  • b) Loss of tissue water

Not only can it only manifest in two ways, the mechanism of the water loss that leads to a) or b) is distinct. a) can only occur if sodium is lost and the water loss is secondary to this sodium loss. b) can only occur if water loss is independent of sodium loss. Both can co-exist ie sodium and water loss that is not balanced ie more water loss than expected for sodium loss. Now as you have guessed, dehydration refers to tissue water loss and hypovolemia to loss of blood volume. This is the correct and pure definition but unfortunately gets wildly mixed up. Very interestingly the opposite can also occur ie overhydration as well as hypervolemia. Finally they do not need to move in the same direction ie a person can be overhydrated and hypovolemic at the same time and any combination of these six states can coexist. Yes six states, if you count euvolemia and normal hydration. Now you can fire away any objections and I will respond before moving on to step 2. Sardmeta1 (talk) 05:30, 16 November 2012 (UTC)

Step 2 - Relationship of hydration states to hyponatremia and hypernatremia: Dehydration is synonymous with hypernatremia, if we agree with the definition of dehydration above. Thus, any loss of free water from the body raises serum sodium. Symptoms are not present (except thirst) until a complication occurs when dehydration is severe (seizures or respiratory arrest). Decreased skin turgor, low blood pressure and dry tongue are signs of hypovolemia, not dehydration and thus do not occur. there is not much change in blood volume even in severe dehydration because most of the water loss is intracellular based on osmotic gradients. In the same way, overhydration is synonymous with hyponatremia (except when pseudohyponatremia is present and that is why hypotonic hyponatremia is considered true hyponatremia). Now it becomes clear why the concept of isotonic or hypotonic dehydration is impossible to concieve: One can only have hypertonic dehydration since by definition, dehydration = hypernatremia = hypertonicity. Sardmeta1 (talk) 08:37, 21 November 2012 (UTC)

References[edit]

  1. ^ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2275758/
  2. ^ Mange K, Matsuura D, Cizman B, Soto H, Ziyadeh FN, Goldfarb S, Neilson EG. Language guiding therapy: the case of dehydration versus volume depletion. Ann Intern Med 127:848–853; 1997
  3. ^ Kahn T. Hypernatremia without water depletion. Clin Nephrol. 76(2):130-5; 2011

Rewritten[edit]

I have attempted to rewrite with the above concerns and relevant sources in mind. Please find and fix any remaining errors. FiveColourMap (talk) 23:33, 10 June 2014 (UTC)`

REFERENCES INADEQUATE; INFORMATION INCORRECT[edit]

By my count, at least 17 of the 28 references for this page are non-peer reviewed sources, such as online sources and lay newpapers/magazines, including the incorrect definition of dehydration. I plan to delete all but peer reviewed references; and rewrite this article to conform with universally accepted scientific knowledge about this important subject in biology and medicine. I invite critique and debate on this Talk page; not deletions and reversions without comment and justification. IiKkEe (talk) 11:29, 11 November 2014 (UTC)

I agree. I really do not understand why this page keeps being re-written with completely wrong information. All the work I did on this page has disappeared and we are back to square one. Rather than re-write this page, what we need is an investigation into why it keeps being returned to this state? Who is reverting the content and deleting the scientific references? And why? Sardmeta1 (talk) 05:16, 23 October 2015 (UTC)

Okay, have addressed summary and definition again - 3 yrs after my first attempt. Will address the next section when next I am free. (All the necessary justification has been referenced with the edits and justified above in 2012 so will not be repeating this on this talk page) Sardmeta1 (talk) 08:45, 24 October 2015 (UTC)

Stopping my edits at Cause. Will deal with the next two sections later - lets see what happens to this page in the next couple of weeks! Fingers crossed! Sardmeta1 (talk) 00:30, 25 October 2015 (UTC)

Language revision as of 18/1/16[edit]

I went through and corrected the way certain things are phrased so as to not seem like the text has some thesis to prove, where it should have merely been a summary of information. The Causes section really makes no sense to me. Now, I am not educated in biology but I have read a few articles and such, and I have no clue how "endurance athletes, elderly adults, infants and children, and people living with chronic illnesses" can be risk factors. Let me quote from the Multiple sclerosis: "Smoking has been shown to be an independent risk factor for MS. Stress may be a risk factor although the evidence to support this is weak. Association with occupational exposures and toxins—mainly solvents—has been evaluated, but no clear conclusions have been reached. Vaccinations were studied as causal factors; however, most studies show no association. Several other possible risk factors, such as diet and hormone intake, have been looked at; however, evidence on their relation with the disease is "sparse and unpersuasive"." See what I mean? Quite different. Ramthecowy (talk) 15:34, 18 January 2016 (UTC)

I understand your point but I don't think the language is too technical. Some editing / rephrasing may be desirable however we shouldn't be dumbing down Wikipedia into something where every article must be understandable to every random person per se. There are plenty of articles on specific subjects - medical, mathematical, chemical, linguistic - you name it; we can't expect each and every article to be written in such a way that any layman can understand it. That said, this article specifically should indeed be at least somewhat 'accessible' to non-medical / scientific readers. I'm on holiday now so I can't spend time on it myself. --Piz d'Es-Cha (talk) 21:30, 8 February 2016 (UTC)
@Piz d'Es-Cha: Sorry, I think I didn't make my point clear. The language is fine, the point of the encyclopedia in the end is to acquire knowledge like that. But, I digress. What I meant was that the article seems to base itself upon some research paper. That piece originally was probably trying to support some hypothesis through research. This article comes in much the similar way. However, the problem is that it's alright if Wikipedia states that there is research that claims so and so, but it mustn't try to make its own point, right? Correct me if I'm wrong.
The bigger problem I wanted to point out is the Causes section. Let me paraphrase: your own Wiki on Risk Factors reads "a risk factor is a variable associated with an increased risk of disease or infection." Please explain to me how "endurance athletes, elderly adults, infants and children, and people living with chronic illnesses" are classed as risk factors.
X) If I'm making a fool of myself, please do tell me to shut up. I won't mind. Cheers, Ramthecowy (talk) 12:29, 24 March 2016 (UTC)
Sorry for the delayed reply. No, this is common medical language. Would you disagree if I wrote that risk factors for coronary artery disease include "being male, elderly, smoking, obesity"? Of course those are risk factors. Same here. These types of people are more at risk than others, due to either their activities, their general physical or medical condition, choices of lifestyle, and many other reasons. I don't see anything wrong with the way that's written. --Piz d'Es-Cha (talk) 08:36, 4 April 2016 (UTC)
No worries. No, I would not disagree at all, but I feel like the wording in this article is a little dodgy there. Never mind me, then. Have a good one! Ramthecowy (talk) 17:57, 13 April 2016 (UTC)