Hep C Discussion Forum

LanaiSurferGirl · Senior Member

RE: Daily fluid requirement

mallani · Guru

Thanks guys. Lanai, translating from US, 64 oz= 1.9 litres (?correct). With fluid from soup, fruit, cereal and food, that gives me a daily fluid intake of 2.5 litres. I can cope with this. I just wanted to make sure there was no scientific basis for the vast fluid intakes some members are doing. Sure, sips of water or mouth gel helps the dry mouth and if folks find drinking extra water helps the Sx, great. I found extra water did not help me, and caused extra Sx. I think it is important to realize the dry mouth and skin are direct effects of the drugs, rather than a sign of dehydration. For those drinking over 3 litres/day, it may be worth reducing fluid intake by a litre, to see if this helps.

LanaiSurferGirl · Senior Member

oh...when I said I normally don't recommend this in the previous post I was referring to the drinking of soda :) But hey, you gotta do what you gotta do and if this will get you more water intake than do it! :)

LanaiSurferGirl · Senior Member

Dave has some good points. I have a master's in exercise science so have extensive courses in nutrition. The "8 glasses of water per day" rule we all hear is based on the 2,000 calorie diet. Basically if you are consuming 2,000 calories per day you should consume 64 oz of fulid. HOWEVER, it does vary with activity level, sweating, and medication intake. I always err on the conservative side in that you should drink a little more water than you think you will need. Overdoing it with water (hypernatremia) is difficult to do but does happen, mainly this time of year on the football field in 100+ temperatures and is also attributed to not ingesting enough electrolytes with the ratio of water intake.

Try getting water from other sources....soups, eating fruit, drinking milk, juices, soda (i normally don't recommend this but it will help you hydrate then do it), eating things like salsa..... Your water intake does not have to be from water. As long as there is water in it you are hydrating yourself.

Again, if you just can't get it down then eat foods with high liquid content. :)

Hope this helps,

Meghan

JoAnneh · Guru

Angelwish thanks for mentioning the juicer. I need to start back tomorrow.
It is so good for us. Captain 12 step I love the joy and laughter u give us.
Thank you! I am like Dave just want to read ur writings.
U r hilarious
JoAnne

angelwish · Member

My husband marks off the glasses of H2O everyday plus gingerale and gatoraide. He has very little skin irritation. The water never helps the metal taste in his mouth.

He also does jucing mostly greens after injection for a few days. Still feels tired and achey.

Blessings to all -- bottoms up.

davesf · Senior Member

Vern, I'll be the straight man in your routine any day. biggrin

Heck, I'd come on this forum if I didn't have HCV just to read your posts.

Thanks for the day brightener as always.

12Step Guy · Senior Member

Waterboarding? I thought we only did this in the USA? Yes, I admit it, I'm powerless over water and can't stop drinking. I wasn't always a heavy water drinker. I didn't start out to be. Water was everywhere, bottles, cans, pitchers, hoses. Once I started I coudn't stop. I'm a waterholic. Drinking, drinking drinking.

I have three main rules for living.

# 3 is: If you see a bathroom use it.

Phil G · Senior Member

I could not possibly force myself to drink even a liter of water prior to tx. I would try to drink it all at once to get it over with. Its amazing how much you can drink when sipping constantly, and I'm trying to continue that. A lot of problems I had before, like leg cramps, are gone for the most part. I think over-hydration is only a problem for folks like marathon runners who consume large volumes in a very short time after a race.

hrsetrdr · Guru

Malcolm, looks like Dave's post sums up the technical aspects of drinking extra water while on tx. I think that in your case, being an 80kg male that's not having pronounced skin problems, the 2L/day you're consuming should be quite adequate.

In my case, just in the last 2weeks(#13-15) my skin rash has become worse; in spite of of having increased my water intake by [about] 1L/day my skin condition has not improved. Today I am increasing my H2O intake, hoping to stave-off the nasty itchy insanity.

davesf · Senior Member

Great questions on this topic. I can't reference anything specific on the need for massive amounts of water or more importantly, the "right" amount of water. But here are my own thoughts on the matter:

We don't metabolize all the drugs we consume and some part is eliminated renally (through kidneys/urine). About 5-15% for Ribavirin which I think is the primary culprit. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014952/

The more stuff our kidneys process, the more water they require for the additional urine. So we require "More" water than our "Normal" amount. The problem is it's really hard to quantify those two amounts. The "Normal" baseline has a pretty wide range as you already mentioned. Some factors which affect a person's individual requirement:

Weight- Heavier people have more tissue mass and require more water to maintain it

Activity- Active people require more water than sedentary people

Environment- Hotter drier climates require more water intake

Diet- More caloric intake as well as larger amounts of salts/sugars all require more water to process

So it's diifficult to come up with a number. Some people use 2 fluid oz of water per pound of body weight. I think that is about 36ml per Kg. Here is a baseline calculator: http://www.csgnetwork.com/humanh2owater.html

The water requirement refers to all dietary intake not just drinking water which give you another variable to consider. Other fluids (juices, soup) have a large amount of water in them already.

So where does that leave us? Your "Normal" water need is a rough approximation and you will require "More" during treatment.

I think the goal is to make sure you have adequate water so your kidneys can do their job and to mitigate side effects that are more common with dehydration (rash, itching, headaches). Aim for your estimated baseline plus a bonus amount of water that feels right by listening to your body. For me drinking adequate water aleviated general feelings of crappiness. For me that was approx. 25-50% more water than usual. Some days the dry mouth made it easy and other days feeling crappy reminded me to force a little more down.

Of course if you do overdo it, you have to worry about overhyrdration issues. I laugh at the symptoms mentioned for this:

Nausea
Headache
Confusion
Lethargy
Fatigue
Appetite loss

Sounds like I'm either dehydrated or taking drugs for Hep C

But I tried to have a banana for Potassium or a sports drink for electrolytes every couple days in case I was overdoing it on the water.

mallani · Guru

I am having great trouble drinking water. I hate the stuff, have tried all added cordial, flavours, juices. I just gag and by sipping, I guess I currently drink about 2 litres/ day. I don't have a rash or skin itch, have some skin dryness, have a dry mouth sometimes but my urine output is normal, and of normal concentration. For about 2 weeks, I forced myself to drink about 4 litres/day. I felt nauseated, had to get up several times a night so slept poorly and felt even more fatigued. My skin and mouth were no different. I am amazed at posts about the amount of water people drink (up to 6 litres/day). This would be in addition to the fluid ingested as food. I have stopped all caffeine as I can't stand the taste anymore.

I know dehydration causes dry skin, dry mouth and dry eyes. I know the triple Rx drugs make this worse, by direct effect. Do we really need to overload our bodies to the extent some are obviously doing? Fluid overload can cause it's own problems. Normal fluid requirement in an 80 kg male is between 1.5 and 2 litres/day (assuming you're not in the Tropics, doing manual labour etc). I also realise that some are working outdoors in a hot U.S. Summer, and require more fluid. We are in a cool Winter, and I am unable to exercise due to fatigue. The fatigue is due to anaemia, not dehydration. The HCV Advocate , in the Side Effects Section, talks about maintaining adequate fluid intake. It gives a figure of between 1.9 litres and 3.7 litres. There is no mention of additional fluid intake in the Victrelis Information Sheet, and when I asked my doc., he said to watch my urine concentration.

Am I missing something? Does anyone have any reference from a recognised authority, explaining why such massive fluid intakes are beneficial?

-- Edited by mallani on Sunday 29th of July 2012 07:26:39 AM

Hep C Discussion Forum

Legal Disclaimer: