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Water Intoxication


Ma Kuang’s Life Care magazine


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JIE JUN DONG—Senior Physician


Singapore, situated near the equator, has a typical tropical climate. Most people love the feeling of chilled air and the taste of ice water. Excessive air-conditioning and ice water can weaken the Yang energy in human body. If the Yang energy is compromised, our ability to process and mobilize fluid decreases. When excess water accumulates in the body, it causes water intoxication. It commonly presents as excessive thirst, oliguria, excessive sweat, vomiting, diarrhea, dizziness, headache, palpitation, and swelling, etc.


Water intoxication is also termed “water reversal syndrome” in TCM. It was documented in the Treatise on Cold Injury written 2000 years ago. It describes that the syndrome presents as excessive thirst not relieved by water intake, and oliguria. Now you may ask where the water went? If water intake does not quench the thirst, and it’s not leaving the body through urination, then where did the water go? In fact, the water has become a waste that stagnates in the body. It eventually leaves the body in several ways:

  1. Vomiting. It presents as frequent thirst, and vomiting shortly after water intake. Since the person would still be thirsty, he would continue to drink and vomit large amount of water afterwards. This is a vicious cycle.
  2. Water retention. In this case, the body is not utilizing the water, but is not able to mobilize it and excrete it in the form of urine, either. It leads to swelling and edema of the face and distal extremities.
  3. Sweats. This can present as excessive sweating or other skin conditions, such as eczema. These are all body’s attempts to excrete excessive water.
  4. Diarrhea. The body excretes the water through the gastrointestinal tract and causes watery diarrhea.
  5. Flow to other cavities, such as the chest, abdomen, joint spaces, and the cranium, to form pleural effusion, ascites, joint effusion, and hydrocephalus. It presents as chest tightness, bloating, joint pain and swelling, dizziness, headache, glaucoma, otitis media, and sinusitis, etc.
  6. Water retention in the stomach. In this case, the water stagnates in the stomach. The person is not vomiting or having diarrhea, but experience bloating and belching.
  7.  Overflow to superficial fascia and lead to obesity, muscle pain and soreness, such as neck and shoulder pain.


I had a patient who was a high school student. She came to me for severe joint pain and swelling in all fours, and excruciating low back pain. Prior to her visit, she had been diagnosed and treated for glaucoma, migraine, and irregular menstruation for 3 years. While taking her medical history, I learned that she loved ice water since she was a kid. She would often have several gasses of ice water a day. Since she got sick, she had gained over 10kg. When she had a headache, she would be seeing stars and vomiting. At the time of her visit, her joint pain was excruciating. Taking into consideration of all her symptoms, I diagnosed her with water intoxication syndrome. After treating with warm-natured and diuretic herbs, she gradually improved. Her joint swelling decreased. She lost weight. Her periods returned. Her headaches and glaucoma also resolved spontaneously.


The body is prone to dehydration in hot weather, so adequate hydration is important. However, one must remember, “the water that floats a boat can also sink the boat”. Excessive water intake can cause water intoxication. I had another female patient who is extremely health conscious, and would drink 2-3 liters of water a day. This would not be a problem for outdoor labor workers or those who exercise on a regular basis, but she had a sedentary lifestyle. She sat in an air-conditioned office all day. With increased stress from work, she started to experience headaches, anxiety, palpitation, and insomnia. Sometimes, she just completely lost it emotionally. From a TCM perspective, she has a weak and sensitive constitution that contributes to a weaker kidney system. The burden from excessive water intake overwhelmed her system and led to emotional liability. After treating with diuretic and tranquilizing herbs, her condition improved.


Depending on the locations of water retention and its excretion, water intoxication can affect each person differently. Consider if you have the following symptoms: water sounds when lightly tapping the abdomen, abdominal bloating and heaviness, swelling in the lower extremity, bags under eyes, double chin, stiff tongue, migraine headache, diarrhea, vomiting, and extremely fatigue. If you are experiencing any of the symptoms above, you might be water intoxicated.


In short, the body does not always excrete excess fluid properly. Diuretics alone don’t always solve the problem, either, as most diuretics are cold in nature, which can be counterproductive. Treatment protocols include facilitating sweating, nourishing Qi and YinYang, and improving circulation. Basically, keeping the body warm and maintaining an optimal circulatory system are the rules of thumb to prevent water retention. Regular exercises, and ginger brown sugar tea are also helpful in promoting good circulation.


Credit: Ma Kuang’s Life Care magazine  

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