In fact I think teaspoons are reasonable for those if it's something you'd prepare at home. Faster to measure with a teaspoon than using a scale or measuring cup, I'd think.
With those things it doesn't have to be exact.
I can imagine how much 6 teaspoons or 2 tablespoons are. But I can't really do anything with 25g without a scale.
I was curious because I sometimes estimate recipe ingredients so I and compared my intuitive notion of a teaspoon and tablespoon to their measured amounts using table salt and found it to be off by a larger margin than I expected.
I can weigh an amount of water that fits my coffee pot.. but that is learned over 20 years.. I can add amounts to warm cups or make oatmeal but I would need a food scale and I dont have one.
> Thank you for that, I wish more articles would use SI units of measurement.
As someone who only uses traditional units, I wish that more articles would use them. Perhaps a good compromise between us would be for articles to use both!
There was a program that taught women in developing countries to make oral rehydration solution for their children - the result was decreasing deaths due to cholera by an order of magnitude. Many of these women didn't have tools for measuring the ingredients, and the program didn't distribute them - requiring such tools would restrict the spread of the program.
The heuristic is a liter of water, a handful of sugar and a generous pinch of salt. The result may not be exactly the optimal concentration, but it's essentially always close enough to have the desired effect. This heuristic has saved millions (probably tens of millions) of lives.
Right. The formula is for rapid absorption. If you are a little off you will still absorb it eventually. This is a big deal in the ultra running world. You will inevitably dehydrate or get to a bad place unless you learn some electrolyte blend that works well for you. Plain water can work for a short time but most runners will suffer in their later hours (10+).
> Better yet, we’ve learned since that you can still get most of the benefit without WHO-approved stockpiles of ORS. You can use a number of widely available commercial products that essentially replicate ORS, from sports drinks to Pedialyte. You can also make good oral rehydration solutions yourself at home for pennies: Just take 32 ounces of water and add 6 teaspoons of sugar and a half-teaspoon of salt. There are just two pitfalls to avoid, according to my colleague Regan Marsh, an emergency physician at Brigham and Women’s Hospital and a medical director for Partners in Health. First, fight the urge to sweeten it too much. “People want to make it more sugary because of the taste, but that proportion of salt and sugar is important.”
I did this several years ago, after dehydrating myself while working outside on a hot day. Water didn't touch my thirst, then I realized I needed electrolytes. I used lemon juice, sugar, and a good amount of salt. It was delicious.
Disregarding the sweetness angle, what's interesting is that we perceive the saltier solutions as tastier when we are dehydrated. If you try drinking an ORS product when you're not dehydrated it will taste worse than when you are in that run down sweaty state on a hot day.
It's offered as a service in Denver - IIRC the ads are focused on helping you feel better when you're low on energy or whatever, but I know people who have gone for hangovers.
When I was in the army we did this regularly. My barracks roommate was our platoon medic and would stockpile as many IV bags as he could without causing suspicion. Anytime we had a late night of heavy drinking, before morning PT he’d hook up a bag and 20 minutes later we’d be feeling great and good to go,.
Which makes me always wonder: IV carries always the risk of thrombosis so I'd expect especially medical personnel staying away from it. But maybe they take also good dose of Warfarin with it...
Even if the person has nausea, they can drink a bit at a time
> Second, she says, is to resist the temptation to drink at a normal rate—let alone chugging the stuff. An ounce at a time every few minutes decreases the odds that the liquid will, um, return from whence it came.
> Even if the person has nausea, they can drink a bit at a time.
Not necessarily. Sometimes the nausea is so severe that even a teaspoon of water gets sent back the way it came in… a most unpleasant feeling when the body refuses to take anything and ends up vomiting fluids beyond the stomach—e.g. bile.
Thanks to some bad luck my father has been in the hospital more than half a dozen times in the last couple of years. He has always been given IV fluids. This week he went in for pneumonia, just coughing and shortness of breath, and they put him on an IV. I never thought twice about it until today.
Having a needle in your arm for hours is not pleasant. My dad doesn't heal so quickly these days, so he's going to have bruising and tenderness for a week where they put the needle in. Watching my dad go through this, and my girlfriend's brother who has mental disabilities a couple of years ago, and now realizing it would have been a lot more comfortable for them if they'd just let them sip on some Gatorade seriously pisses me off.
I can confirm. When I had food poisoning, I couldn’t drink any amount of water without vomiting immediately after. After 8 hours, I went to the ER and got 2 IV bags, and immediately stopped throwing up.
> You can also make good oral rehydration solutions yourself at home for pennies: Just take 32 ounces of water and add 6 teaspoons of sugar and a half-teaspoon of salt.
> resist the temptation to drink at a normal rate... An ounce at a time every few minutes
This should be something everyone learns. Many common headaches are just dehydration. When you've got a cold or flu, dehydration is common and makes you feel even more miserable. Got a hangover? This will make things better for you.
The only part of this I've never realized was how much sugar is needed to optimize it. Good to know for next time.
> for rehydration, glucose is basically as important as sodium. The two compounds work together to pull water into shriveled cells that have been deprived of ample water.
IIRC it's mostly a factor for gut absorption: when gut cells absorb glucose, sodium is cotransported (goes along for the ride) and thus pass through the gut and into the bloodstream at a much greater rate, and the greater sodium gradient increases the rate of water absorption: https://www.ncbi.nlm.nih.gov/pubmed/11193601
And the sodium also (and originally) serves to combat hyponatremia, as lost fluid generally brings sodium along for the ride if you rehydrate with non-electrolytic water you find yourself with mild to severe low sodium levels.
It drove me a little bit crazy to hear a mom complaining about how she couldn't find sugar-free Pedialyte for her child. It is difficult to explain that to a person who has spent their whole adult life demonizing artificial colors, artificial flavors, and of course sugar.
There's many a time, I believe, I've mistaken a loss of appetite control for some "emotional event" when it's been mere dehydration.
I recently traveled for several days without drinking much and sugar binged when getting home. I assumed the travel had stressed me, rather, I was just severely dehydrated.
Hmm, that's going to need some study - particularly that the article says osmolarity allows for water to flow down the gradient, but then the final paragraph says that water can flow contrary to the gradient too.
Potassium is also important, whatever mechanism you are losing Sodium (Sweat, urine, diarrhea, vomiting), there's a good chance you're losing Potassium too. Some ORS products also include Zinc because in the developing world it has been shown to reduce the duration and severity of acute and persistent diarrhea. Source: https://www.ncbi.nlm.nih.gov/pubmed/11101480
A lot of the hangover effect comes from acetaldehyde, a somewhat toxic product of the metabolism of alcohol.
A big part of the hangover is waiting for your body to get rid of acetaldehyde. Drinking more reduces your awareness of the effects of acetaldehyde, but increases the total amount of it in your body, prolonging the hangover.
Aldehyde dehydrogenase enzymes employ the sulfur chemistry of cysteine. Taking n-acetyl cysteine before you drink helps your body to synthesize the ALDH. Glutamate (easily available from monosodium glutamate) is required, along with water, for the enzyme to process aldehydes into carboxylic acids. The reaction is powered by NAD+/NADH, so adequate niacin and tryptophan in your diet would help you have enough of that, but that system also powers the alcohol dehydrogenase that is producing the aldehydes.
Whether you get hangovers or not largely depends on the relative efficiency of your ADH versus your ALDH enzymes. If you clear aldehyde faster than you can metabolize the alcohol, you never get hangovers unless you have some odd sulfur-based chemistry happening in your body. If you clear aldehyde slower than you metabolize alcohol, you get hangover effects. If you have an ALDH defect, or are taking a drug that antagonizes it, you might experience "Asian blush", with immediate unpleasant reactions to drinking alcohol.
Dehydration has its own unpleasant symptoms, and since alcohol is a diuretic, it can dehydrate you. Drinking water or electrolyte rehydration solutions will help with that. You can be fully hydrated and still have a hangover, but at least you won't have a hangover and be dehydrated too.
I have never had a hangover, but the chemistry suggests that if you get them routinely, supplementing your diet with NAC might help. Eating tofu and shiitake (high in tryptophan/niacin) with MSG as you drink or after you drink might also help. It's mostly your genetics, though. If you get bad hangovers, there's no easy cure for it other than to drink less alcohol.
Yes, but likely unnecessary. Though unless you're drinking alone you're probably having some salty nuts or other snacks while you drink so really water will be fine. These solutions are for people who are in serious acute dehydration, which you won't be after a night of drinking unless there are other factors.
Simply drinking a large glass of water before going out, and having a glass of water after each alcoholic drink, is a pretty good way to avoid a hangover.
(also the water will help you pee out a lot of toxic crud that your kidneys have kindly removed from your bloodstream for you).
The most effective time to consume oral rehydration solution would be after drinking. Alcohol is a diuretic causing you to lose more water than normal through urine, and eventually also electrolytes (although at first, your body will make an effort to retain them). So if you drink the ORS whilst still in diuresis, it won't have any negative effects, but you're more likely to urinate away the contents. After drinking, but before sleeping is anecdotally the optimal way to use ORS products for the hangover use case.
At the start of my bachelor party (and possibly later on that night? It gets blurry) we brought workout hydration powder, the kind you use during and after a gym session. Drank a lot of it ideally to prevent or reduce hangovers.
I have no idea how much it helped, because I was still hungover the next day.
As J_Sherz noted above, hydration before or during drinking isn't very helpful as alcohol is diuretic, so chances are you'll literally be pissing it away. You want to rehydrate afterwards, after you've stopped drinking and when you wake up (during the night if you wake up to piss, and the day after).
Salt freezes at 801°. If the temperature is too high for the salt to freeze, it's way too high for the water or the salt–water eutectic to freeze. Also, you are going to have worse health problems than dehydration pretty quick.
Some quick googling estimates 6 tsp of sugar is about 25 grams or 100 calories. For comparison, a 32oz bottle of Gatorade G2 (low calorie) has about 19 grams of sugar, and a 32oz bottle of normal Gatorade has about 56 grams.
Adding - 1/2 tsp of salt is 2.5 grams of which it is 1 gram of sodium. G2 - 435mg sodium, 120mg potassium; normal - 400mg, 100mg.
As a third point of reference, the Strawberry Lemonade 32oz Powerade I have here next to my keyboard (now filled with water) contains 56g sugar, 400 mg sodium, 93 mg potassium.
Note that the label says it contains 21g sugar, 150mg sodium, 35 mg potassium - per 12 fluid ounces. Multiply by 2.66 if you drink the whole bottle.
It's striking how similar the regular Gatorade and Powerade are. Also, the powerade.com nutritional info site is "down for maintenance", had to search elsewhere: http://archive.is/2018.02.22-160258/https://www.powerade.com.... They have the Coca-Cola logo.gif on the site, but unfortunately no animated orange construction barrels.
All three manufactured/retail products listed also contain a non-insignificant amount of potassium, particularly the Pedialyte, to which the homemade solution matches best. Is the value added by potassium minimal enough to not include it? Or is availability in a common household more of an issue?
I have seen in stores sodium-free salt, and reduced-sodium salt, which both substitute potassium for the "missing" sodium, which can be a source of potassium if the added benefit is worthwhile.
This entire thread is reminding me of my Marine Corps days. Super hung over? Hey doc, we need to practice our IV skills... sweet cold hangover relief. About to do an extra hard day of training? Drink a bottle of pedialite and grab the other camelback you put Gatorade in.
To make kids drink something...would juice /soda and some type of salty chips or crackers work? They get some sugar and water from the drink and some salt from the crackers, potato chips.
Simply because they are probably more likely to drink and eat that :)
I am curious but I suspect the sugar would still be fine to keep a diabetic from entering Diabetic ketoacidosis (DKA) which occurs from dehydration. this hits particularly close to home as this is what happens to my own mother when she gets sick, she stops drinking and being diabetic it can escalate.
example, while sick and headed to hospital her blood sugar being pass two hundred. This is having only eaten once in three days. Two hours later it hit seven hundred plus in emergency. They got her out of it but the simple reason is, you dehydrate and toxins build up plus your body starts to break down what it can to get sugar.
anyone you know who is diabetic, nah scratch that, proper hydration is key. Take it from the Dune, water is life.
On the first day after I had my tonsils removed, I thought that maybe using oral rehydration solution at lukewarm temperatures would be less painful than water.
It worked so well that I barely needed any painkillerss during my recovery after that. Quite surprised my doctor didn't suggest it to me though.
The sugar was the big news to me, as well. I usually use an electrolyte mix if I've been drinking, and it usually works - but there's been some times when it hasn't. I just looked at the formula, and zero sugar.
I'll be adding some sugar to it to see if it improves things.
So that time back in my Army days when I collapsed from dehydration, I'm guessing the solution that was forced on me -- sit on this rock and chug two full canteens of plain water (no salt/sugar/electrolytes) -- was probably not the best idea?
Possibly, you're not dead so it worked. The better solution would have been ORS, and water. In the military and other physically demanding activities with a culture of water drinking, a concern can be hyponatremia.
Ah, I'm told I spent a good portion of the remainder of that day in a state of incoherence and delirium. I also slept for 12 hours... I'm able to code nowadays, so apparently I didn't fry my brain too much :)
I recall being taught (public school system) roughly 20 years ago that "we used to think salt was good for countering dehydration if you were stranded in the desert, but now we know that plain water is better." This isn't necessarily false (water is likely better than pure salt), but I wonder if we threw the baby out with the bathwater at the time as far as salt was concerned.
EMT here. Venous access is mandatory protocol in many emergent cases, such as trauma and cardiac. If they already have hypovolemia, eg bleeding, it's not going to get better by itself. Reduced BP, impaired perfusion, or anemia will all end up shorting the brain and heart muscle eventually, so they want to stay ahead of that. Also, if a surgery is expected later, they want an empty stomach because vomiting is not good when inhaled. Another reason is for drug delivery, even if it's just an "saline lock" (no bag, just a port for later) to insert meds. I think oral fluids are great, but only when indicated.
Aye, but then, you're potentially in the shit right? emergency medicine is basically assuming the worst.... an unknown patient, suffering potentially large injuries, its best to get that cannula in right now, before its much, much harder. Its totally prudent to get a line in.
What I was talking about was walking in to A&E with a slight cold and a headache, you might get a drip if your totally drunk, but you're going to get a grey needle (the largest one you can get.) and its not going to be comfortable.
I was sent to the ER a while ago. I spent several hours there, mostly waiting in between test results. After a while I got really thirsty. But they wouldn't let me drink until a doctor cleared me for drinking. This went on for several more hours, at which point I ended up dehydrated. They gave me an IV bag to rehydrate. The cynic in me suspects they routinely tell people they can't drink water simply so they can charge for IV bags.
In this case, if you needed a surgical intervention (or anything requiring sedation), its safer to be hydrated via IV fluids. Unfortunately ER's (and Hospital's in general) can move incredibly slow (often for no reason) and outside of emergencies are rarely good at any kind of prioritization. Add it all up and you get situations like yours :(
Actually there is a reason the ER moves slow for what looks like no reason: they need to always have free beds and time just in case a more serious emergency comes up. If you can wait it is better to not see you even though they could to ensure that if somebody comes in with a seconds count emergency they are able to take care of it in seconds.
This is fascinating for me to read as a person who is rather convinced that trendiness tends to overwhelm reason in much of wellness practices.
But I happened to try an elective iv clinic on Sunday — after a hard workout and long night the previous day — https://www.onusiv.com. I’ve never had an iv before — but the experience was genuinely awesome — muscle pain decreased, I felt lighter and energized, and my mood improved dramatically.
It’s funny to read about how iv’s aren’t useful so quickly after having used one for the first time and been genuinely persuaded that it was effective ...
The article isn't about IV being ineffective, rehydration IV are absolutely effective.
The article is about them being unnecessary unless absolutely humongous amounts of rehydration are necessary (emergency rehydration), "modern" oral rehydration is amply sufficient, cheaper, simpler, and less risky (ORS requires clean water but IV requires aseptic fluid and procedure and even then there's a risk of infection).
One of the most amazing disease-related things I've ever read was something about cholera (of course I will never remember the original source), and the fact that it doesn't have to be fatal at all, so long as you rehydrate properly. Apparently in the vast majority of cases the body will fight off cholera just fine, so long as it doesn't run out of fluids in the meantime. If only people had known that they couldn't just drink plain water...
The (possibly apocryphal) article also went into modern educational efforts in rural India, where people were being taught the proper handfuls of sugar and salt to add to water, to combat cholera there.
Thank you for this. The use of 'unnecessary' is super interesting to me and makes me empathize with the spectrum of problem's Dr.'s must have in deciding treatment plans ... I feel that arguing convincingly about the lack of necessity of a given effective technique would make for an incredibly hard communication/decision-making problem ...
Also interesting, the presence or absence of necessity was not at all a factor in my usage. I elected to pay a bunch of money for what was certainly an 'unnecessary' use of an I.V. with a goal of enhancing well-being/accelerating recovery time.
In the context of opt-in usage: not in a hospital full of sick people and disease, where provider can simply refuse to offer any service to patients if risk factors are present, with ability to pay premium market-based prices for supplies/storage since its an upscale opt-in product ... I would imagine the actual complication rate from such opt-in usages are likely to be lower than would result from unnecessary uses in a hospital environment... (Or perhaps this line of reasoning is simply me trying to rationalize this unnecessary behavior to myself -- regardless of the lack of necessity in a hospital setting, I still think I might opt-in to this treatment again from time to time ...)
> Also interesting, the presence or absence of necessity was not at all a factor in my usage. I elected to pay a bunch of money for what was certainly an 'unnecessary' use of an I.V. with a goal of enhancing well-being/accelerating recovery time.
When I commented about unnecessary, I wasn't commenting about the goal but the means. You get the same benefits from ORT as you get from IV rehydration[0], at lower risk, and lower cost.
> In the context of opt-in usage: not in a hospital full of sick people and disease, where provider can simply refuse to offer any service to patients if risk factors are present, with ability to pay premium market-based prices for supplies/storage since its an upscale opt-in product …
Also not in a hospital full of professionals used to aseptic procedures and products.
> I would imagine the actual complication rate from such opt-in usages are likely to be lower than would result from unnecessary uses in a hospital environment…
I would imagine the opposite.
> I still think I might opt-in to this treatment again from time to time …
Or you could use regular ORT and get the same benefits. But it's your health and money so you do you.
[0] again unless it's a case of emergency rehydration, or the patient is unable to drink, obviously
I changed the subject from use of IV for hospital rehydration treatment to possible performance enhancing uses in my original post and thank you for calling me out at incorrectly interpreting the original article.
Now, however, I think you might be guilty of extending the argument beyond its original domain in pursuit of snarkiness. Is it
your claim that an IV is useful for no purposes beyond rehydration? It’s certainly possible to include other substances in the iv which are rapidly absorbed into the bloodstream.
It seems to me like studies showing suitability of ORT to rehydration wouldn’t necessarily offer insight into these other uses ...?
Also regarding complication likelihood — I think your argument glosses over the fact that the sheer complexity of the hospital environment introduces all sorts of incidental complexity not present in a simpler context. A “factory” that does one thing is much easier to optimize (including to optimize for safety) than a place like a hospital which has to house the entire complexity of the full medical process.
In Taiwan, it used to be a thing to get vitamin B shots all the time for no good reason. The placebo affect was probably involved. It turns out that the vitamins were almost certainly useless, but some 90% of the population got Hepatitis B. Guess who didn't sterilize everything properly?
I would stay the fuck away from quacks who want to inject magic solutions. At least the detox crowd just drinks that stuff.
Also, jeez, for the cost of one of those infusions, you can drink a lot of delicious, potassium-loaded fresh coconut water, even at restaurant prices.
A specific medical claim will trigger FDA requirements to prove efficacy in the US. Thats why you see lots of products not making claims, for instance — “High in antioxidants!”, some people will interpret that to mean improved health outcomes, but the manufacturer is not claiming it.
Part of me wants to try to market some strong reducing agents as "high in antioxidants". Like carbon monoxide air fresheners, cyanide candy, hydrazine sport drinks, etc.
Coconut water is marketed for hydration because it does have a relatively high electrolyte content, but it's mostly potassium with minimal sodium, so not as effective as an oral rehydration powder which has those specific ratios of electrolytes / sugar that maximize the speed of uptake/hydration.
I second this. Because it keeps forever and is relatively small, I keep it around in the medicine cabinet. If you've ever had a guest lose a fight with a Norovirus, you appreciate having some of it right at hand.
By the way, the Amazon product searches for this return a cesspool of magic woo. I recommend going to your local drug store, looking for the powdered Pedialyte, then looking in the meter-or-so surrounding that area for the cheaper store-brand version.
> I second this. Because it keeps forever and is relatively small, I keep it around in the medicine cabinet. If you've ever had a guest lose a fight with a Norovirus, you appreciate having some of it right at hand.
Then again sugar and salt also keep forever. I guess the sealed unidoses help though.
A neighbor of mine became dehydrated because of an infection (I think it was a kidney infection, but I'm not sure). She went to the emergency room and they pushed IV fluids, and I mean pushed. They hung a total of three bags, and at one point they were squeezing the bags to increase the flow of fluids. They over-hydrated her, and then they had to give her something to deal with the over-hydration. The over-hydration, or the medicine they gave her for that, affected her heart. She went into the hospital with a simple infection, and left needing expensive heart medication.
This sounds more like the patient had previously-undiagnosed heart failure, didn’t respond well to rehydration (since it’s easier to become volume-overloaded with heart failure), and required further work-up.
To the best of my knowledge, she was in good health before she developed the infection. Her body mass index was in the normal range, and she did the recommended amount of aerobic exercise (150 minutes, moderate intensity / week).
It sounds to me like an intern over-reacted to her dehydration, and over did it with the IV fluids.
Hospitals also insanely overcharge for IVs. A few years ago I was in the hospital, and I knew I could keep down oral re-hydration solution. The hospital put me on a saline IV anyway. When I got the bill, the IV line item was $2000! Insurance discounts brought that down to $200. I paid all that for a couple dollars of salt water I didn't need.
Well, that's the amount you paid. Some fraction of the insurance premiums which you and your employer paid also went to the hospital for that IV.
I wonder how much. Obviously not $2000, that's absurd. But maybe $200. Or $2. Or maybe the insurance company gets paid $20 by the hospital so they get to make $180 off of you for the IV.
I'm on an HSA. The hospital would have gotten nothing from the insurer, and I would have had to pay the whole bill, if I hadn't hit my deductible. If I'd just been to the ER and not been admitted, I would have probably had to pay for it all.
I have it on good authority that saline IV bags are dirt cheap. The hospital used a machine to control the delivery rate, but that cost should have been amortized over hundreds or thousands of patients. The nursing labor involved was negligible, not more than a half-hour for the whole stay.
Grainger sells 1L bottles of saline for $12.15. Bags are about the same price elsewhere on the internet. One thing I'm wondering is if the $200 (or $2000) also includes the labor to set it up and the consumables that go along with the IV.
I think the best place that this is illustrated is in the UFC. When they banned rehydrating through IV's (I read they test for it by checking for by products of rubber in the blood, which presumably would have come from running liquid through rubber tubes into the arm) we expected to see the entirety of the sport move up in weight classes. It was not a big secret that everyone was cutting large amounts of weight to gain an advantage on naturally smaller opponents. There wasn't a large scale shift in the fighter's weight classes though. They just swapped to oral rehydration.
One of the big concerns from this change though is that some doctors are claiming you don't rehydrate fully in a short period of time this way. Fighters weigh in the day before a fight, so they're peak dehydrated roughly 24 hours before they fight. There are claims that it takes the brain many days to fully rehydrate after a weight cut if you're not using IV's, so people paying attention in the sport are really worried that brain injuries are going to start going up.
What would be a plausible mechanism for a faster brain rehydration using an IV? To me it seems that once the fluid is in the blood stream, it doesn't matter anymore which way it entered. It certainly doesn't take days for ingested fluids to reach the blood.
It seems that the ban would be more effective if, rather than banning a specific rehydration method, they banned the process of cutting weight through dehydration. A cheap urine refractometer costs $25 - you can grab one yourself on Amazon if you like - and would tell you whether the athlete at the scales was dehydrated (and also give you a urine sample to check for other banned substances).
Sure, then athletes might show up to the scales hungry, but that's more healthy than sweating.
And by 'they', sure, the UFC could make a big change...but where this really needs to start is the high-school wrestling mat, where you have kids establishing a culture of 'grit' as defined by running in hoodies. I haven't been a wrestler myself - I was a track kid in high school - but I can vividly remember swiftly passing our varsity wrestling team during winter training on the indoor track in our gym. They shuffled along in their uniform, heavy sweats, fists bunched up to their chests (from too much bench pressing and curling and not enough triceps/lats work) while I wore nothing but some short shorts and was dripping with sweat anyways.
UFC fighters are appropriately compensated and informed of their risks. High school kids are not.
State wrestling finals for my state are in two days. It's 11:45 here, so right this minute, a lot of kids are just wrapping up their lunch and some of the best wrestlers across the state are going back to class hungry and dangerously thirsty - on purpose - so they can make weight this weekend.
I remember the wrestlers in my high school carrying water bottles in classes before competitions that they would spit in throughout the day for that little bit extra weight drop.
"One of the big concerns from this change though is that some doctors are claiming you don't rehydrate fully in a short period of time this way. Fighters weigh in the day before a fight, so they're peak dehydrated roughly 24 hours before they fight. There are claims that it takes the brain many days to fully rehydrate after a weight cut if you're not using IV's, so people paying attention in the sport are really worried that brain injuries are going to start going up."
I have always been skeptical of this notion that rehydration takes hours or days or whatever.
First of all, practical experience shows that mucus, urine, sweating[1], etc. very quickly revert to full hydration. You can go from dark yellow urine to clear urine in less than two hours.
Second, what mechanism could there possibly be to restrict water absorption in your body while dehydrated ?[2] I don't think you could slow down rehydration if you tried to[3]. Your body doesn't have to digest it and it can transport nearly immediately outward to every tissue (as evidenced by nasal mucus production which reverts as quickly as your urine color does).
I think it's just bro-science and it's surprising that it is so persistent (I have heard it in the gym, at basic training, in the fire service, etc.) because immediate, practical evidence contradicts it.
[1] I am not talking about heatstroke, etc., which are separate issues.
[2] The only thing I can possibly think of is stuffing yourself with very absorptive food prior to rehydrating ... which would be odd.
[3] Assuming normal water with normal mineral content. Obviously, distilled water will cause problems.
>But as my colleagues and I have manifestly demonstrated in our lackluster response to these efforts over the past several years, spending more money on something is kind of the American way, because spending more feels like doing more, measurable upside be damned.
The higher the cost, the higher value of the percentage skimmed off the top from insurance.. there is no cost incentive here from the POV of the charging institution.. this has nothing to do with 'measurable upside'
The title sounds misleading. It has to be judged on case to case basis. I do not understand why this well known thing is posted here. ORS is commonly used and prescribed.
The article is wrong; although the practical recommendations it makes are mostly correct, it is promoting a potentially dangerous medical theory unsupported by any evidence.
The glucose is important because it enables the _enteric_ sodium-glucose cotransport mechanism to work, allowing the sodium to get out of your gut and _into your blood_ many times faster.
Neither glucose nor sodium directly help with rehydration; on the contrary, glucose and sodium in your gut decrease osmotic pressure and reduce rehydration. However, kidneys tightly regulate the osmotic pressure, and in particular the sodium content, of your blood. If you take in water without taking in sodium, your kidneys will work to excrete the water without the sodium, producing hypotonic urine. If you overwhelm this mechanism with too much water, or if your kidneys are damaged, you can go into hyponatremia, which can kill you.
So, even though sodium interferes with rehydration in the sense of "absorbing water", it is necessary for rehydration in the sense of retaining water.
This is where the glucose comes in. In addition to simple diffusion of sodium out of your intestines, it was discovered in 1968 that the small intestine has a much faster active sodium-glucose cotransport mechanism, which allows you to absorb sodium about ten times as fast. It transports a single ion of sodium together with a single molecule of glucose across your intestinal wall. Until this discovery, as explained in the UNICEF page linked from the article, diarrhea was the leading cause of death among children. Oral rehydration solution diminished that problem enormously, as the article points out, and now respiratory infections are the leading cause of death among children.
(In a stunning example of the failure of diffusion of knowledge, it turns out that enteric sodium-glucose cotransport had been discovered by Crane in 1960, but the discovery wasn't applied to save lives on a large scale for some 11 years. You can read more about the mechanism at https://en.wikipedia.org/wiki/Sodium-glucose_transport_prote... or PubMed.)
The article claims that this cotransport mechanism is important in absorption of sodium from the blood by all the cells in the human body, not just in kidneys and intestines. As far as I know, this is a novel medical claim, and should be treated as alternative medicine. I am not aware of any evidence that adding glucose to an IV drip speeds recovery from dehydration.
However, the article's recommendation that dehydration should be treated with oral rehydration solution when possible, rather than intravenous fluids, is sound, already an official recommendation of the WHO, and should be more widely practiced.
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[ 2.7 ms ] story [ 204 ms ] thread32 ounces ≈ 0.95 litre
As someone who only uses traditional units, I wish that more articles would use them. Perhaps a good compromise between us would be for articles to use both!
There was a program that taught women in developing countries to make oral rehydration solution for their children - the result was decreasing deaths due to cholera by an order of magnitude. Many of these women didn't have tools for measuring the ingredients, and the program didn't distribute them - requiring such tools would restrict the spread of the program.
The heuristic is a liter of water, a handful of sugar and a generous pinch of salt. The result may not be exactly the optimal concentration, but it's essentially always close enough to have the desired effect. This heuristic has saved millions (probably tens of millions) of lives.
I did this several years ago, after dehydrating myself while working outside on a hot day. Water didn't touch my thirst, then I realized I needed electrolytes. I used lemon juice, sugar, and a good amount of salt. It was delicious.
“take around 4700 mg of potassium per day max 2000 up to 3000 mg of sodium per day max” into a liter of water for a full day’s worth
Edit: Nevermind, I should have read the entire thread first...
You're being down-voted, but I know a number of military medics and hospital employees who do this after heavy drinking. Seems to work like a charm.
Even if the person has nausea, they can drink a bit at a time
> Second, she says, is to resist the temptation to drink at a normal rate—let alone chugging the stuff. An ounce at a time every few minutes decreases the odds that the liquid will, um, return from whence it came.
Not necessarily. Sometimes the nausea is so severe that even a teaspoon of water gets sent back the way it came in… a most unpleasant feeling when the body refuses to take anything and ends up vomiting fluids beyond the stomach—e.g. bile.
Having a needle in your arm for hours is not pleasant. My dad doesn't heal so quickly these days, so he's going to have bruising and tenderness for a week where they put the needle in. Watching my dad go through this, and my girlfriend's brother who has mental disabilities a couple of years ago, and now realizing it would have been a lot more comfortable for them if they'd just let them sip on some Gatorade seriously pisses me off.
> resist the temptation to drink at a normal rate... An ounce at a time every few minutes
This should be something everyone learns. Many common headaches are just dehydration. When you've got a cold or flu, dehydration is common and makes you feel even more miserable. Got a hangover? This will make things better for you.
The only part of this I've never realized was how much sugar is needed to optimize it. Good to know for next time.
edit: it's in the article:
> for rehydration, glucose is basically as important as sodium. The two compounds work together to pull water into shriveled cells that have been deprived of ample water.
And the sodium also (and originally) serves to combat hyponatremia, as lost fluid generally brings sodium along for the ride if you rehydrate with non-electrolytic water you find yourself with mild to severe low sodium levels.
There's many a time, I believe, I've mistaken a loss of appetite control for some "emotional event" when it's been mere dehydration.
I recently traveled for several days without drinking much and sugar binged when getting home. I assumed the travel had stressed me, rather, I was just severely dehydrated.
Thanks for the link.
A big part of the hangover is waiting for your body to get rid of acetaldehyde. Drinking more reduces your awareness of the effects of acetaldehyde, but increases the total amount of it in your body, prolonging the hangover.
Whether you get hangovers or not largely depends on the relative efficiency of your ADH versus your ALDH enzymes. If you clear aldehyde faster than you can metabolize the alcohol, you never get hangovers unless you have some odd sulfur-based chemistry happening in your body. If you clear aldehyde slower than you metabolize alcohol, you get hangover effects. If you have an ALDH defect, or are taking a drug that antagonizes it, you might experience "Asian blush", with immediate unpleasant reactions to drinking alcohol.
Dehydration has its own unpleasant symptoms, and since alcohol is a diuretic, it can dehydrate you. Drinking water or electrolyte rehydration solutions will help with that. You can be fully hydrated and still have a hangover, but at least you won't have a hangover and be dehydrated too.
I have never had a hangover, but the chemistry suggests that if you get them routinely, supplementing your diet with NAC might help. Eating tofu and shiitake (high in tryptophan/niacin) with MSG as you drink or after you drink might also help. It's mostly your genetics, though. If you get bad hangovers, there's no easy cure for it other than to drink less alcohol.
Simply drinking a large glass of water before going out, and having a glass of water after each alcoholic drink, is a pretty good way to avoid a hangover.
(also the water will help you pee out a lot of toxic crud that your kidneys have kindly removed from your bloodstream for you).
At the start of my bachelor party (and possibly later on that night? It gets blurry) we brought workout hydration powder, the kind you use during and after a gym session. Drank a lot of it ideally to prevent or reduce hangovers.
I have no idea how much it helped, because I was still hungover the next day.
Adding - 1/2 tsp of salt is 2.5 grams of which it is 1 gram of sodium. G2 - 435mg sodium, 120mg potassium; normal - 400mg, 100mg.
Note that the label says it contains 21g sugar, 150mg sodium, 35 mg potassium - per 12 fluid ounces. Multiply by 2.66 if you drink the whole bottle.
In table format:
(per 32 Oz)It's striking how similar the regular Gatorade and Powerade are. Also, the powerade.com nutritional info site is "down for maintenance", had to search elsewhere: http://archive.is/2018.02.22-160258/https://www.powerade.com.... They have the Coca-Cola logo.gif on the site, but unfortunately no animated orange construction barrels.
Edit: Added Pedialyte
Gatorade has glucose (aka dextrose, the same sugar as an IV bag) while Powerade has high fructose corn syrup.
Glucose can be used directly by your cells while fructose is metabolized in the liver first. So for quick relief from dehydration I choose Gatorade.
* Glucose = 100% dextrose
* table sugar / sucrose = 50% dextrose
* high fructose corn syrup = ~40% dextrose
I have seen in stores sodium-free salt, and reduced-sodium salt, which both substitute potassium for the "missing" sodium, which can be a source of potassium if the added benefit is worthwhile.
So for 32oz, that 986mg sodium, and 24g sugar, which seems spot on to the articles recommended ratios.
https://pedialyte.com/products/classic/mixed-fruit
Hydration is no joke.
Simply because they are probably more likely to drink and eat that :)
example, while sick and headed to hospital her blood sugar being pass two hundred. This is having only eaten once in three days. Two hours later it hit seven hundred plus in emergency. They got her out of it but the simple reason is, you dehydrate and toxins build up plus your body starts to break down what it can to get sugar.
anyone you know who is diabetic, nah scratch that, proper hydration is key. Take it from the Dune, water is life.
It worked so well that I barely needed any painkillerss during my recovery after that. Quite surprised my doctor didn't suggest it to me though.
I'll be adding some sugar to it to see if it improves things.
Indeed, it wasn't a solution!
As a physician we do occasionally see folks die from hyponatremia (low salt) from overly correcting dehydration with water. It’s a terrible tragedy.
Plain water still works fine. It's just slower.
In the UK its pretty rare to get an IV bag, unless you are a celebrity.
What I was talking about was walking in to A&E with a slight cold and a headache, you might get a drip if your totally drunk, but you're going to get a grey needle (the largest one you can get.) and its not going to be comfortable.
But I happened to try an elective iv clinic on Sunday — after a hard workout and long night the previous day — https://www.onusiv.com. I’ve never had an iv before — but the experience was genuinely awesome — muscle pain decreased, I felt lighter and energized, and my mood improved dramatically.
It’s funny to read about how iv’s aren’t useful so quickly after having used one for the first time and been genuinely persuaded that it was effective ...
The article is about them being unnecessary unless absolutely humongous amounts of rehydration are necessary (emergency rehydration), "modern" oral rehydration is amply sufficient, cheaper, simpler, and less risky (ORS requires clean water but IV requires aseptic fluid and procedure and even then there's a risk of infection).
The (possibly apocryphal) article also went into modern educational efforts in rural India, where people were being taught the proper handfuls of sugar and salt to add to water, to combat cholera there.
Also interesting, the presence or absence of necessity was not at all a factor in my usage. I elected to pay a bunch of money for what was certainly an 'unnecessary' use of an I.V. with a goal of enhancing well-being/accelerating recovery time.
In the context of opt-in usage: not in a hospital full of sick people and disease, where provider can simply refuse to offer any service to patients if risk factors are present, with ability to pay premium market-based prices for supplies/storage since its an upscale opt-in product ... I would imagine the actual complication rate from such opt-in usages are likely to be lower than would result from unnecessary uses in a hospital environment... (Or perhaps this line of reasoning is simply me trying to rationalize this unnecessary behavior to myself -- regardless of the lack of necessity in a hospital setting, I still think I might opt-in to this treatment again from time to time ...)
When I commented about unnecessary, I wasn't commenting about the goal but the means. You get the same benefits from ORT as you get from IV rehydration[0], at lower risk, and lower cost.
> In the context of opt-in usage: not in a hospital full of sick people and disease, where provider can simply refuse to offer any service to patients if risk factors are present, with ability to pay premium market-based prices for supplies/storage since its an upscale opt-in product …
Also not in a hospital full of professionals used to aseptic procedures and products.
> I would imagine the actual complication rate from such opt-in usages are likely to be lower than would result from unnecessary uses in a hospital environment…
I would imagine the opposite.
> I still think I might opt-in to this treatment again from time to time …
Or you could use regular ORT and get the same benefits. But it's your health and money so you do you.
[0] again unless it's a case of emergency rehydration, or the patient is unable to drink, obviously
Now, however, I think you might be guilty of extending the argument beyond its original domain in pursuit of snarkiness. Is it your claim that an IV is useful for no purposes beyond rehydration? It’s certainly possible to include other substances in the iv which are rapidly absorbed into the bloodstream.
It seems to me like studies showing suitability of ORT to rehydration wouldn’t necessarily offer insight into these other uses ...?
Also regarding complication likelihood — I think your argument glosses over the fact that the sheer complexity of the hospital environment introduces all sorts of incidental complexity not present in a simpler context. A “factory” that does one thing is much easier to optimize (including to optimize for safety) than a place like a hospital which has to house the entire complexity of the full medical process.
In Taiwan, it used to be a thing to get vitamin B shots all the time for no good reason. The placebo affect was probably involved. It turns out that the vitamins were almost certainly useless, but some 90% of the population got Hepatitis B. Guess who didn't sterilize everything properly?
I would stay the fuck away from quacks who want to inject magic solutions. At least the detox crowd just drinks that stuff.
Also, jeez, for the cost of one of those infusions, you can drink a lot of delicious, potassium-loaded fresh coconut water, even at restaurant prices.
Unless you are vomiting, unconscious or potentially going into surgery, using an IV to administer the fluid is unnecessary.
Also, I've heard, but have not verified, that coconut water is a decent approximation. I'm not sure if this is true, but it's certainly delicious.
By the way, the Amazon product searches for this return a cesspool of magic woo. I recommend going to your local drug store, looking for the powdered Pedialyte, then looking in the meter-or-so surrounding that area for the cheaper store-brand version.
Then again sugar and salt also keep forever. I guess the sealed unidoses help though.
It sounds to me like an intern over-reacted to her dehydration, and over did it with the IV fluids.
I wonder how much. Obviously not $2000, that's absurd. But maybe $200. Or $2. Or maybe the insurance company gets paid $20 by the hospital so they get to make $180 off of you for the IV.
I have it on good authority that saline IV bags are dirt cheap. The hospital used a machine to control the delivery rate, but that cost should have been amortized over hundreds or thousands of patients. The nursing labor involved was negligible, not more than a half-hour for the whole stay.
One of the big concerns from this change though is that some doctors are claiming you don't rehydrate fully in a short period of time this way. Fighters weigh in the day before a fight, so they're peak dehydrated roughly 24 hours before they fight. There are claims that it takes the brain many days to fully rehydrate after a weight cut if you're not using IV's, so people paying attention in the sport are really worried that brain injuries are going to start going up.
Sure, then athletes might show up to the scales hungry, but that's more healthy than sweating.
And by 'they', sure, the UFC could make a big change...but where this really needs to start is the high-school wrestling mat, where you have kids establishing a culture of 'grit' as defined by running in hoodies. I haven't been a wrestler myself - I was a track kid in high school - but I can vividly remember swiftly passing our varsity wrestling team during winter training on the indoor track in our gym. They shuffled along in their uniform, heavy sweats, fists bunched up to their chests (from too much bench pressing and curling and not enough triceps/lats work) while I wore nothing but some short shorts and was dripping with sweat anyways.
UFC fighters are appropriately compensated and informed of their risks. High school kids are not.
State wrestling finals for my state are in two days. It's 11:45 here, so right this minute, a lot of kids are just wrapping up their lunch and some of the best wrestlers across the state are going back to class hungry and dangerously thirsty - on purpose - so they can make weight this weekend.
http://bleacherreport.com/articles/2555772-weight-cutting-so...
I have always been skeptical of this notion that rehydration takes hours or days or whatever.
First of all, practical experience shows that mucus, urine, sweating[1], etc. very quickly revert to full hydration. You can go from dark yellow urine to clear urine in less than two hours.
Second, what mechanism could there possibly be to restrict water absorption in your body while dehydrated ?[2] I don't think you could slow down rehydration if you tried to[3]. Your body doesn't have to digest it and it can transport nearly immediately outward to every tissue (as evidenced by nasal mucus production which reverts as quickly as your urine color does).
I think it's just bro-science and it's surprising that it is so persistent (I have heard it in the gym, at basic training, in the fire service, etc.) because immediate, practical evidence contradicts it.
[1] I am not talking about heatstroke, etc., which are separate issues.
[2] The only thing I can possibly think of is stuffing yourself with very absorptive food prior to rehydrating ... which would be odd.
[3] Assuming normal water with normal mineral content. Obviously, distilled water will cause problems.
The higher the cost, the higher value of the percentage skimmed off the top from insurance.. there is no cost incentive here from the POV of the charging institution.. this has nothing to do with 'measurable upside'
The glucose is important because it enables the _enteric_ sodium-glucose cotransport mechanism to work, allowing the sodium to get out of your gut and _into your blood_ many times faster.
Neither glucose nor sodium directly help with rehydration; on the contrary, glucose and sodium in your gut decrease osmotic pressure and reduce rehydration. However, kidneys tightly regulate the osmotic pressure, and in particular the sodium content, of your blood. If you take in water without taking in sodium, your kidneys will work to excrete the water without the sodium, producing hypotonic urine. If you overwhelm this mechanism with too much water, or if your kidneys are damaged, you can go into hyponatremia, which can kill you.
So, even though sodium interferes with rehydration in the sense of "absorbing water", it is necessary for rehydration in the sense of retaining water.
This is where the glucose comes in. In addition to simple diffusion of sodium out of your intestines, it was discovered in 1968 that the small intestine has a much faster active sodium-glucose cotransport mechanism, which allows you to absorb sodium about ten times as fast. It transports a single ion of sodium together with a single molecule of glucose across your intestinal wall. Until this discovery, as explained in the UNICEF page linked from the article, diarrhea was the leading cause of death among children. Oral rehydration solution diminished that problem enormously, as the article points out, and now respiratory infections are the leading cause of death among children.
(In a stunning example of the failure of diffusion of knowledge, it turns out that enteric sodium-glucose cotransport had been discovered by Crane in 1960, but the discovery wasn't applied to save lives on a large scale for some 11 years. You can read more about the mechanism at https://en.wikipedia.org/wiki/Sodium-glucose_transport_prote... or PubMed.)
The article claims that this cotransport mechanism is important in absorption of sodium from the blood by all the cells in the human body, not just in kidneys and intestines. As far as I know, this is a novel medical claim, and should be treated as alternative medicine. I am not aware of any evidence that adding glucose to an IV drip speeds recovery from dehydration.
However, the article's recommendation that dehydration should be treated with oral rehydration solution when possible, rather than intravenous fluids, is sound, already an official recommendation of the WHO, and should be more widely practiced.
(Originally posted at https://news.ycombinator.com/item?id=16440265)