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  • Writer's pictureDr. Kogan

Holistic focus this summer – Hydration


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So many of you have experienced this: you juggle a million things and get it all done. You live on takeout and Diet Coke or another diet soda – too busy to cook! Then suddenly, things start falling apart. You start forgetting things, gain weight, and feel fatigued despite getting enough sleep at night. Believe it or not, this is a common presentation of mild dehydration in my office. “Dehydration?” you will protest. “How can that be? I am drinking tons of diet soda—isn’t it just a flavored seltzer?” The answer is: not at all. It is well established that most sodas have caffeine, which acts as a diuretic. But Diet Coke and all other diet sodas pack a double whammy: they contain caffeine and zero-calorie sweeteners, and both act as diuretics.


Most common sweeteners like Aspartame, Splenda, and NutraSweet, work like magnets on water molecules, drawing fluid from the body’s cells. My advice to these folks complaining of brain fog and tiredness: quit soda, drink six to eight cups of filtered tap or bottled spring water daily, and balance your diet with fresh fruits and vegetables as they are all high in water content. You will feel the difference in your energy and concentration within seven to ten days. And your extra pounds and bloating will be gone within a month.


Truth be told, dehydration is especially common in the summer, and it comes in many “flavors” – brain fog and fatigue are just some of the symptoms I frequently encounter in the office. I also see many patients with constant joint and muscle aches. These folks come in asking for arthritis and autoimmunity testing but after a careful evaluation, I often diagnose them with moderate dehydration. And for good reason: aging desensitizes the brain to thirst signals. Research shows that after thirty years of age, thirst sensors in the brain’s hypothalamus and pituitary gland become less responsive. Factors like chronic stress and low intake of Omega-3 fatty acids found in foods like salmon and sardines can further impair those sensors. People with this type of moderate dehydration should drink about eight to nine cups of filtered tap or spring water daily. Mineral water is not a good option because it has too much salt and electrolytes and that is not an issue here. Shortage of water is what needs to be addressed ASAP though. If you are an athlete who engages in rigorous physical exercise, consult with your doctor regarding the use of sports drinks and electrolytes in your regimen.


Dehydration can sneak up on you also when you are taking antihistamine medications. Claritin (loratadine), Allegra (fexofenadine), and Zyrtec (cetirizine) work by suppressing the action of histamines, inflammatory biochemical that produces symptoms like sneezing, itching, or watery eyes. Ironically, histamines normally also serve as a safeguard against dehydration. If water intake dips, histamine levels rise slightly to slow fluid loss from the body. To stay optimally hydrated during allergy or mosquito bite itchy season, use antihistamines only when needed, rather than automatically taking one every day.


As you can see, the body can become dehydrated without even registering thirst. To avoid developing symptoms like fatigue, brain fog, and body aches, it is important to sip water throughout the day, especially in the summer. To have a better idea of how much water you need to stay well-hydrated, divide your weight (in pounds) by two. This is approximately the amount of water (in ounces), that your body needs daily. For example, a 160-pound person should drink 80 ounces of water per day. This may seem like a lot, but this is more appropriate in the summer and includes your tea and coffee, and juice—don’t forget to count them in. When you add the overheating in the sun combined with increased sweating and losing fluids that way, you realize that we need to exercise caution and common sense to avoid getting hurt.


When spending time in outdoor heat, take mini breaks to drink water in the shade. This will help cool the body and prevent sweating off too much water. Some people just don’t do well in the bright midday sun—period. I’ve had patients who would feel dizzy and even get “sunstroke” from being out on the boat at sea for a prolonged period. I have also had patients who would get chest pains from heavy-duty chores in the garden or out in the backyard in the heat of the day. The bottom line is that the safest time for you to be outdoors in Florida is early in the morning and until 11 a.m. and after that after 5 p.m.

Now that you are equipped with more information, have a safe and healthy summer!

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