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From time to time an athlete dies from guzzling water right after a race. From what I understand the rapid influx of water overwhelms the cells and causes them to burst.

For those of us who have guzzled after a race but did NOT die is it possible/likely that we have sustained significant cell damage but because it didn't kill us we don't realize it?

And if that is the case (which seems like it might be) then what systems would be the most likely to be affected?

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  • Cells bursting isn't the mechanism of death in water intoxication. Also, drinking large amounts of water after exercise isn't a problem unless you go way overboard. It takes far more water than the typical athlete will drink to reach toxic levels.
    – Carey Gregory
    Apr 16, 2019 at 0:00
  • Okay, thanks. Do you think I should delete this question then @CareyGregory?
    – Ruminator
    Apr 16, 2019 at 0:08
  • 1
    You can delete it if you wish, but answers that correct incorrect information are some of the most valuable. I would give it another day or two. I might answer myself if I find a few minutes.
    – Carey Gregory
    Apr 16, 2019 at 0:22

1 Answer 1

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In water intoxication, cells do not burst but swell. This can lead to swelling of the entire organs; the most dangerous is brain swelling, which is the usual cause of death.

Transitional cell or organ swelling is not already a damage. Brain swelling is different because the swollen brain presses hardly against the skull, which can cause damage.

When you drink excessive amounts of water and do not experience any symptoms within the next 24 hours, it is very unlikely that any permanent damage has occurred in your body. But if you experience symptoms, such as headache, vomiting, confusion, seizures or impaired consciousness, you might later have chronic symptoms related to the brain damage, for example, depression and loss of appetite (PubMed, 2016).


Drinking large amounts of water is dangerous only if it results in dilutional hyponatremia - a drop of sodium in the blood, which results in the flux of water from the blood into the cells. This more likely happens if you:

  • are already well hydrated and drink excessive amount of water several hours in the row (so the kidneys have no time to excrete it)
  • do not consume any sodium from foods or beverages (but common commercial sport drinks, such as Gatorade, may not contain enough sodium to prevent hyponatremia)
  • have low body weight (children and women are at higher risk)
  • exercise, which, in some people, increases secretion of the antidiuretic hormone (which causes water retention)
  • sweat only little

From the above reasons, the amount of water that causes water intoxication is not a fixed number. Examples:

  • A 22-year old man drinking 6 liters in 3 hours, was in coma, survived after treatment (PubMed, 2013)
  • A 40-year old woman drinking over 4 liters in less than 2 hours, died (BBC News, 2008)

According to Current U.S. Military Fluid Replacement Guidelines (2003), an adult person should not drink more than 1.5 liters of water per hour during exercise.

Sources:

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