Do You Know You Can Die From Drinking Too Much Water?

In January 2007, hours after competing in a radio
station contest to win a Nintendo Wii, 28-year-old
Jennifer Strange was found dead in her California
home. The station's "Hold Your Wee for a Wii"
challenge awarded the game system to the
contestant who could drink the most water without
having to take a trip to the bathroom. According to
preliminary autopsy reports, Ms. Strange apparently
died from drinking too much water too quickly,
resulting in a condition called water intoxication.
At its most basic, water intoxication occurs when a
person drinks so much water that the other nutrients
in the body become diluted to the point that they can
no longer do their jobs. You've probably heard the
term electrolyte before, whether in reference to
sports drinks (which provide electrolytes in addition
to fluids) or to certain conditions, such as bulimia or
diarrhea, that cause dangerous "electrolyte
imbalances" in the body. Electrolytes are simply salt
ions ( atoms with an overall positive or negative
charge) that cells use to move fluids and nerve
messages into and out of cells and throughout the
body. Without electrolytes, the body can't function
(see What are electrolytes? for a more detailed
description). Water intoxication causes an electrolyte
imbalance that affects concentrations of the ion
sodium, and it leads to a condition called
hyponatremia.
In cases of water intoxication, it is extreme
hyponatremia that can ultimately cause coma and
death. If it's caught early, treatment with IV fluids
containing electrolytes can lead to a complete
recovery; but untreated, hyponatremia is fatal. Water
intoxication is basically one form of hyponatremia --
the condition can also be caused by excessive
sweating, severe burns, prolonged dehydration and
certain liver and kidney problems, among other
diseases and conditions.
When a person dies from hyponatremia as a result of
water intoxication, the initiating factor is a severe
sodium imbalance that causes massive cell
damage. Sodium is a positively charged ion, and its
role in the body is to circulate the fluids outside of
cells. As a result, sodium helps regulate blood
pressure and maintain the signals that let muscles
operate properly, among other things. Cells actively
maintain a precise sodium concentration in the body.
Inside the cell, there are more electrolytes; outside
the cell, there is more water. Cells keep sodium
levels healthy by moving water and electrolytes into
and out of the cell to either dilute or increase sodium
levels in body fluids. But when someone drinks a
tremendous amount of water in a short period of
time, and the water does not contain any added
electrolytes, the cellular maintenance system can't
handle the level of sodium dilution that occurs.
The result is that cells desperately try to increase the
sodium concentration in body fluids by taking in
tremendous amounts of water. Some cells can swell a
great deal; others cannot. Brain cells are constrained
by the skull and can end up bursting with the
pressure of the water they are taking in.
The exact amount of water intake that can lead to
water intoxication is unknown and varies with each
individual. Symptoms of water intoxication actually
look a lot like the symptoms of alcohol intoxication,
including nausea, altered mental state, and vomiting.
Other symptoms include headaches, muscle
weakness and convulsions. In severe cases of water
intoxication, coma and death come fairly quickly as a
result of brain swelling. The condition is quite rare
in the general population, but in distance athletics,
it's a known risk and is often avoided by drinking
sports drinks instead of water during training and
events.