[HN Gopher] Water drinking acutely improves orthostatic toleranc...
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       Water drinking acutely improves orthostatic tolerance in healthy
       subjects (2002)
        
       Author : pizza
       Score  : 105 points
       Date   : 2021-12-23 10:28 UTC (12 hours ago)
        
 (HTM) web link (pubmed.ncbi.nlm.nih.gov)
 (TXT) w3m dump (pubmed.ncbi.nlm.nih.gov)
        
       | vstm wrote:
       | It's the study that laid the groundwork for /r/hydrohomies
        
       | GoodOldNe wrote:
       | Cold water helps even more!
       | 
       | Fun thing to find on HN. I just cited this study in a
       | presentation given to our local paramedics on syncope / passing
       | out.
        
       | mensetmanusman wrote:
       | During intermittent fasting, an hour after my morning coffee,
       | sometimes I set a recurring hour timer and drink a full water
       | bottle on the hour. After about the fourth or fifth hour I get
       | this really interesting sense of being hyper alert/awake.
       | 
       | It's essentially the opposite of how I felt when I used to eat
       | lunch and would get tired/slow.
       | 
       | This is more doable during WFH since I wouldn't get noticed going
       | to the restroom so often...
        
         | jmnicolas wrote:
         | A lot of water is probably not a good thing while fasting.
         | 
         | The easiest fasts I ever done were dry fasts. The hardest was
         | with a lot of water.
         | 
         | However since I got a kidney stone after dry fasting (I have no
         | 100% proof it's correlated but it was close to a fast and it
         | never happened before or after) I now drink a little bit of
         | water while fasting (something like 300 ml per day, I do
         | several days fasts, not intermittent).
        
           | mensetmanusman wrote:
           | It's not intense fasting, just the 'only eat from 5-9pm'
           | daily type. I definitely feel better drinking water than not
           | though, so it may vary by body type.
        
           | LiquidPolymer wrote:
           | My doctor told me kidney stones are very closely associated
           | with mild dehydration. I've upped my water consumption and
           | never had another (yet).
        
           | entropie wrote:
           | Water is almost never bad for you, except in very large
           | amounts.
           | 
           | You absolutely need to drink more water/tea than usual while
           | fasting and this is pretty much recommended at least by most
           | professionals is the survival sector (probably by more, but
           | in this case I know for sure). Especially if you need to get
           | things done; while having no food drinking is even more
           | important.
        
           | ford_o wrote:
           | I have never heard of dry fasting. It sounds pretty
           | dangerous.
        
       | bobthechef wrote:
       | "ingested 500 mL and 50 mL of mineral water "
       | 
       | Try drinking water with a bit of salt dissolved in it (sole water
       | some call it), best prepared using rock or sea salt which is
       | richer in minerals than refined tabled salt. (The categorical
       | fear of sodium is very simplistic; it's the ratio of water to
       | sodium that matters.) Distilled water can flush electrolytes from
       | your body which is not what you want.
        
         | spuz wrote:
         | Do people actually drink distilled water? If you want to
         | increase your water consumption, I believe unadulterated tap
         | water will contain sufficient electrolytes. No need to
         | complicate your life by supplementing with additional salt.
         | Obviously, drinking too much tap water _will_ deplete the
         | electrolytes in your blood but it 's probably still wise for
         | more people to drink a little more water than they already do
         | even if it doesn't have the perfect salt balance.
        
           | hammock wrote:
           | Yes, adding to the existing comment, all water I use in the
           | kitchen for internal consumption comes from either an RO
           | filtered tap or a water filter pitcher, both of which remove
           | electrolytes. The purpose of this is to avoid lead and other
           | contaminants.
        
           | dade_ wrote:
           | Many cities, such as Toronto where I live, still have lead
           | pipes for drinking water. The levels are extremely low, and
           | they have various additives in the water supply to minimize
           | risk, but the safe level of lead consumption is zero. So
           | yeah, I drink distilled water. It's also handy to have
           | distilled water around for various uses, such as steam irons.
           | 
           | There are many sources of electrolytes, bananas, our endless
           | array of processed food, salt, etc. I can't imagine anyone in
           | North America needs to worry about their electrolytes, beyond
           | those that do anyway due to medical issues or due to
           | strenuous physical activity.
           | 
           | Our lackadaisical attitude toward pollutants in our drinking
           | water, especially lead never ceases to amaze me. Though we
           | shouldn't be dumping such large amounts of a pollutant in our
           | waterways, it is wild to see the traction fluoride gets with
           | the paranoid.
        
         | podgaj wrote:
         | >Distilled water can flush electrolytes from your body which is
         | not what you want.
         | 
         | This could be a good thing, like for people with hyperkalemia
         | and hypernatremia. Distilled water is usually given to patients
         | with hypernatremia.
         | 
         | https://aspenjournals.onlinelibrary.wiley.com/doi/abs/10.117...
         | 
         | It is always best to know your body chemistry before listing to
         | such blanket advice. (I suffer mild hyperkalemia and
         | hypernatremia which is why I know this.)
        
         | abrowne wrote:
         | Note that in the US, all salt can be labeled "sea salt". Other
         | places, like Canada, mined salt can't be.
        
         | cloudcalvin wrote:
         | Use Sodium Bicarbonate or Potassium Bicarbonate instead, it
         | helps as antiacid as well
        
         | TheBlerch wrote:
         | For any person consuming a healthy balanced diet, how would
         | distilled water flush electrolytes from their system? Their
         | food would be providing them with plenty electrolytes, such as
         | sodium, potassium, etc. Electrolyte supplements are unnecessary
         | for all but more intense longer endurance exercise (same for
         | energy bars). RO (reverse osmosis) water filtration systems are
         | best in class - far better at removing contaminants than
         | pitcher filters - some RO models have a calcium cartridge which
         | is purely meant to improve taste, not save anyone from
         | electrolyte flushing.
        
           | l33tbro wrote:
           | Do RO water systems still waste the vast majority of what
           | comes out of the tap? I've wanted to get one, but they seem a
           | bit environmentally gnarly.
        
             | lathyrus_long wrote:
             | The usual cheap RO systems operate from household water
             | pressure only. They fill a pressure tank at the output,
             | allowing the purified water to be dispensed from a faucet.
             | The pressure across the membrane is that input pressure
             | minus the tank pressure. That's relatively low, so the
             | efficiency is poor, wasting perhaps four gallons for every
             | gallon of pure water.
             | 
             | You can improve the efficiency with an electric booster
             | pump, or with a "permeate pump" that recovers energy from
             | the exiting waste water, or by simply filling a pitcher
             | with no pressure tank. I'd expect that even the most
             | wasteful systems are still a small share of a typical
             | household's total water consumption though, assuming
             | they're used only for drinking and cooking water.
        
       | ta988 wrote:
       | I can confirm that, always had issues of orthostatic hypotension.
       | On days with too much coffee and not enough water it comes back
       | (not as bad as it was when I was a kid though)
        
       | fredley wrote:
       | Orthostatic tolerance, I think, means your ability to stand up
       | without passing out. Basically drinking water means that markers
       | of othostatic intolerance improve dramatically in healthy
       | subjects.
       | 
       | https://en.wikipedia.org/wiki/Orthostatic_intolerance
        
         | davelacy wrote:
         | Interesting conclusion... though I wish I didn't have to go
         | down a rabbit hole to understand orthostatic tolerance I saw
         | your comment too late but it's appreciated!
         | 
         | It's too bad this couldn't be briefly explained in the abstract
         | by the researchers. Such small efforts go a long way in making
         | research findings more easily understood to the general public.
         | Overly highfalutin abstracts are a bit annoying
        
           | Ensorceled wrote:
           | > It's too bad this couldn't be briefly explained in the
           | abstract by the researchers.
           | 
           | Where would you stop? It's a medical abstract that is full of
           | terms and phrases that, for instance, my parents wouldn't
           | understand. How long would this abstract be if aimed at a
           | Grade 10 reading level?
           | 
           | I counted at least 15 medical, diagnostic or clinical trial
           | terms that would need to be explained to the average person,
           | but would be the correct and concise terminology for a
           | practitioner in the field.
           | 
           | "Orthostatic symptoms and syncope", "severe autonomic
           | dysfunction", "randomized, controlled, crossover fashion",
           | "brachial blood pressure", "thoracic impedance", "blood flow
           | velocity", "brachial artery", "middle cerebral artery",
           | "presyncope", "supine mean blood pressure", "(P<0.01)",
           | "stroke volume", "Cerebral blood flow regulation", "acute
           | hemodynamic response", "cerebrovascular regulation"
        
             | furyg3 wrote:
             | On the one hand, I think you're right, it's more the job of
             | science journalists to summarize scientific literature and
             | communicate its significance based on research methods and
             | potential impact.
             | 
             | At the same time, this goes wrong so often that you could
             | make an argument for a 'plain English' summary of an
             | article to help facilitate both journalists and the
             | curious.
             | 
             | Presumably researchers explain their research to non-
             | experts all the time, so this is not some unbelievable
             | request.
        
               | Ensorceled wrote:
               | I guess I kind of feel like we are barging into a
               | conversation between scientists and doctors and demanding
               | that they write down to our level because we are
               | "curious" and someone linked to it from HN.
               | 
               | I would expect a journalist writing about this kind of
               | article to actually be able to understand the abstract,
               | at a minimum, or they shouldn't be writing about this.
               | 
               | I know I'd be annoyed if a bunch of doctors started
               | reviewing my architecture documents and criticized me for
               | not explaining s3 or etl or snowflake or redshift.
        
               | austinjp wrote:
               | Some publishers do indeed try to provide a plain-language
               | summary where possible. See Cochrane reviews, for example
               | this one:
               | 
               | https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858
               | .CD...
        
             | gumby wrote:
             | Where this required (package labeling on OTC medications,
             | for example) the FDA requires that it be written at a fifth
             | grade level.
             | 
             | OTOH the so-called "label" (package insert) is written for
             | doctors and pharmacists.
             | 
             | I would hate it if I had to break out words like "page
             | table", "TLB", "pointer swizzle", etc when writing a paper.
             | I have to assume the reader has some basic knowledge of the
             | topic at hand else they are unlikely to understand what I'm
             | talking about anyway.
             | 
             | You see this in the uproar over "Critical Race Theory" or a
             | lot of the Covid misinformation sites: the basics are not
             | misunderstood or ignored so the argument goes in strange
             | and incomprehensible directions. The problem is deeper than
             | a little vocabulary.
        
               | anoncow wrote:
               | Leaflets meant for patients are to be written in lay
               | language. Prescribing information meant for physicians
               | aren't. I would consider scientific literature to be the
               | same as prescribing information as they are aimed at the
               | scientific community and not the lay public. Science
               | journalists perhaps are meant to fill the gap here.
        
               | gumby wrote:
               | Indeed but the origin of this thread was someone
               | complaining that abstracts of technical papers aren't
               | written in language that anyone could understand.
        
           | drnonsense42 wrote:
           | The entire purpose of an abstract is for fellow experts in
           | the field to grok the paper quickly, not for the general
           | public to get a hand-wavy interpretation of jargon.
           | 
           | And quite frankly, absurd practicalities aside, there is a
           | lot of harm in having every paper accessible to all. There's
           | a wide divide between papers that have been accepted to a
           | venue vs. important theory that has been debated and accepted
           | by a scientific community and is worth presenting to the
           | general public. And, the general public certainly cannot tell
           | the difference.
        
           | nautilius wrote:
           | I had to look up 'highfalutin' to understand your comment on
           | a general message board.
        
         | cik2e wrote:
         | I'm susceptible to dizzy spells upon standing myself. Not sure
         | if this is an issue of orthostatic tolerance or something else.
         | I did a little research a while back and read that this is
         | associated with significantly higher all-cause mortality. Yay
         | for me.
         | 
         | I do drink plenty of water, maybe too much even, am in good
         | shape, and have no medical conditions of any kind. Weed greatly
         | exacerbates this issue for me, probably from the fact that it
         | reduces blood pressure, but this can still happen when I'm not
         | smoking for extended periods.
         | 
         | Recently, I figured out a way to short circuit the onset of a
         | dizzy spell. Hyperventilating completely nips this in the bud,
         | likely because it increases blood pressure [1]. I'd recommend
         | trying this technique to anyone that's otherwise healthy (I am
         | not a doctor) and coping with this issue.
         | 
         | [1]
         | https://www.ahajournals.org/doi/full/10.1161/01.HYP.00000523...
        
           | stefan_ wrote:
           | If you are lean and regularly do endurance exercise, it's a
           | known phenomenon. It's not of any concern since it won't go
           | to the point of passing out, it's just a curious insight into
           | the control loop that regulates our blood pressure and
           | heartrate and that it's possible to leave the stable area,
           | though not to the point of divergence :)
        
             | tomxor wrote:
             | I do a lot of climbing, am fairly lean, healthy, and have a
             | low resting heart-rate. I've also always had the problem of
             | nearing "blackout" occasionally if I stand up very quickly
             | from zero physical activity - I've never actually passed
             | out, but you have this weird sensation where your vision,
             | balance, and in extreme cases even hearing, fades to
             | various degrees until the pressure stabilises.
             | 
             | I wondered if it would be a similar effect to what happens
             | when a pilot pulls a high-g manoeuvrer.
        
           | md2020 wrote:
           | Another technique you can try to cut off the dizziness upon
           | standing is flex your abdominal muscles as soon as you feel
           | it coming on. Works 100% of the time for me. Probably works
           | for the same reason (blood pressure), but easier than
           | hyperventilating :)
        
             | lukas099 wrote:
             | Yep, the valsalva maneuver against a closed glottis works
             | great for this.
        
               | simonswords82 wrote:
               | This is the most HN comment ever. Love it. Merry
               | Christmas :)
        
               | WillPostForFood wrote:
               | _During the Valsalva maneuver (i.e., exhaling against a
               | closed glottis or bearing down as though to defecate),
               | intrathoracic pressure increases and leads to increased
               | arterial pressure as a result of increased afterload. It
               | is easily done by having the patient take a deep breath,
               | put their thumb in their mouth with closed lips, and
               | attempt to exhale without expelling any air._
        
             | c54 wrote:
             | Thanks for this suggestion, I have the same experience of
             | lightheadedness upon standing up (very often) and will
             | definitely be working this into a habit.
        
           | mancerayder wrote:
           | That happens to me after 10m in a hot bath.
        
           | foobarian wrote:
           | Interesting, I found that hyperventilating is actually pretty
           | much guaranteed to cause a fainting for me. The method is to
           | sit down as low as feasible, maybe even lie down,
           | hyperventilate for about a minute, and then rapidly stand up.
           | I used to do this to faint on command until I hurt myself
           | falling on a concrete patio. Now I know this effect has a
           | name and a possible mitigation, yay!
        
             | MetallicCloud wrote:
             | Same thing for me. I used to do it with friends when I was
             | a teenager. Until they got the idea I was faking and let me
             | hit the deck, expecting me to catch myself.
        
             | CoastalCoder wrote:
             | Very tangential, but your comment reminded me of this...
             | 
             | I have this weird trick where I can put the back of my
             | tongue against the roof of my mouth, and exhale I'm a
             | certain way that causes a whistling sound, I think where my
             | sinuses reach my throat.
             | 
             | That often makes me light-headed very shortly after for
             | some reason.
        
         | Leary wrote:
         | I'm young but this happens to me sometimes in the evening when
         | I experience caffeine withdrawal.
        
           | kozak wrote:
           | Are you sure this is caffeine withdrawal and not a sugar
           | crash (https://en.wikipedia.org/wiki/Reactive_hypoglycemia)?
        
       | cblconfederate wrote:
       | interestingly when people faint they are usually given water
        
       | 01100011 wrote:
       | Weird to see this on the front page. I wouldn't think the average
       | HN reader would care.
       | 
       | I have occasional orthostatic hypotension. For some reason it
       | mostly only happens after I get out of my car. I'll get halfway
       | across the parking lot and then it hits. I've never gone down
       | from it, but come awfully close. It helps to contract my leg and
       | core muscles.
        
       | refurb wrote:
       | Random orthostatic tolerance experience. I donated blood, then
       | jumped on a flight the next day, didn't drink much then worked
       | out after arriving at the hotel.
       | 
       | Suffice to say struggling to see your hotel room number through
       | tunnel vision isn't fun.
        
         | chillingeffect wrote:
         | next time add in a 15-minute hot tub stay -- - -
         | 
         | it's an orthostatic decathlon!
        
       | yalogin wrote:
       | This is very interesting. Even though I know nothing about this
       | and had to google what orthostatic means, I wonder how they came
       | up with the idea to do this study. Why drinking water? Why not
       | roll on the bed for 10 mins before getting up? What prompted them
       | to think water drinking would be effective?
        
         | xpe wrote:
         | It is interesting to seek out inventors and scientists and ask
         | "Do you remember the spark (i.e. an idea or question) that got
         | you started?"
         | 
         | The rigor of science is almost always emphasized, because the
         | core of the scientific method is empirical validation. Still,
         | we should not discount the creative spark that sets it in
         | motion. What inspires and motivates people to test an idea? Not
         | a small number of scientific theories arise from unexpected
         | places -- patterns, connections, metaphors, even dreams.
        
         | crawfordcomeaux wrote:
         | Maybe one of them was in marching band and experienced
         | difficulty standing at attention for long periods until they
         | started drinking water?
         | 
         | Looking back, this was probably something I experienced without
         | realizing it.
        
           | giardini wrote:
           | Maybe one of them had a Mom:
           | 
           | https://news.ycombinator.com/reply?id=29660885&goto=item%3Fi.
           | ..
        
       | jmnicolas wrote:
       | When I was in the army 23 years ago (ouch!), when there were some
       | kind of speeches or other events where we were supposed to stand
       | to attention for a long time there always was 1 or 2 guys that
       | would pass out.
       | 
       | It was considered normal by the hierarchy. I never understood
       | why, and the guys weren't able to explain why neither.
       | 
       | Maybe we should have given them plenty of water (but then they
       | would have run the risk of pissing themselves, choices choices :)
        
         | casion wrote:
         | Most of the time it's from locking your knees, which reduces
         | circulation a surprising amount.
        
       | amelius wrote:
       | Can this help jet fighter pilots and F1 drivers?
        
       | inamberclad wrote:
       | Wouldn't being dehydrated reduce your blood pressure -> being
       | properly hydrated restores blood pressure.
        
         | hashmymustache wrote:
         | It's not that simple. Physiology is a very dynamic system so I
         | appreciate any corrections. But, basically the venous system
         | has a lot of compliance and capacitance holding 70% or so of
         | your blood volume in a euvolemic state. You can easily maintain
         | blood pressure and arterial volume while dehydrated.
         | 
         | Orthostatics refers to change in blood pressure when standing.
         | Every time you stand up you lengthen a large column of blood
         | that gravity wants to pull to the bottom of your feet. Pressure
         | sensors in your neck (where blood goes to the brain)
         | immediately tell the autonomic nervous system about the sudden
         | drop which sends a response to increase heart rate and increase
         | resistance in the arterial system to maintain output and
         | arterial pressure so you don't pass out. To accommodate this
         | you pull extra volume from the large venous pool to continue
         | optimally filling the heart with each stroke. If your venous
         | pool is low, the extra refill volume and venous pressure isn't
         | available to keep up with the sudden demand and the arterial
         | pressure drops.
         | 
         | We have different medication classes that can selectively slow
         | the heart down or decrease blood pressure by preventing
         | increased resistance in the arterial system and those folks are
         | also at risk of orthostatic hypotension because of blocking
         | those compensatory mechanisms.
        
       | srean wrote:
       | @pizza I am curious about the context in which you found this
       | interesting, given this is a publication from 2002.
       | 
       | Being able to stand for long hours, or being able to stand up
       | from a sitting or a supine position (without passing) is a
       | difficulty that some in my immediate family has to deal with. The
       | 'healthy subject' precondition does limit the scope somewhat.
       | Regardless, just from empirical and anecdotal observations,
       | enough water and right electrolyte balance does help.
        
         | geek_at wrote:
         | I always have the feeling that old research articles like these
         | on top of hn are the result of a disagreement between two
         | individuals and one is right and rubbing it in in a public
         | fashion
        
         | pizza wrote:
         | My mom is suffering from a lot of knee pain. Recently we went
         | on a long drive and the following day her knees were swollen up
         | like canteloupes.. it makes me sad how much she is unable to go
         | on her daily walks, or go on hikes with the rest of the family,
         | or even struggle to stand up from my couch which is
         | particularly low to the ground. So I heard that she might have
         | a circulation issue, something I suspect might be a bit wonky
         | in myself as well. So last night I just googled "circulation
         | changes due to drinking water" as kind of a hail mary and, lo
         | and behold, found this
        
       | tshanmu wrote:
       | dehyrdation is the root of all bodily problems - Mum was always
       | right ;)
        
         | bitwize wrote:
         | I thought it was inflammation? Or gut bacteria?
        
         | joejohns wrote:
         | I agree, thus the reason to drink water all day.
        
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       (page generated 2021-12-23 23:01 UTC)