9 ms·

Water drinking acutely improves orthostatic tolerance in healthy subjects (2002)

121 points by pizza 5y ago

yalogin 5y ago
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?
- crawfordcomeaux 5y ago
  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 5y ago
    Maybe one of them had a Mom: https://news.ycombinator.com/reply?id=29660885&goto=item%3Fid%3D29660497%2329660885 https://news.ycombinator.com/reply?id=29660885&goto=item%3Fi...
    - crawfordcomeaux 5y ago
      Mine always said it was the hamstring if it was a physical issue, otherwise thyroid.
- xpe 5y ago
  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.
fredley 5y ago
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 https://en.wikipedia.org/wiki/Orthostatic_intolerance
- davelacy 5y ago
  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 5y ago
    > 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 5y ago
      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.
srean 5y ago
@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 5y ago
  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 5y ago
  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 5y ago
dehyrdation is the root of all bodily problems - Mum was always right ;)
- joejohns 5y ago
  I agree, thus the reason to drink water all day.
- bitwize 5y ago
  I thought it was inflammation? Or gut bacteria?
  - colordrops 5y ago
    Wouldn't be surprised if those two are exacerbated by dehydration.
bobthechef 5y ago
"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.
- cloudcalvin 5y ago
  Use Sodium Bicarbonate or Potassium Bicarbonate instead, it helps as antiacid as well
- spuz 5y ago
  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 5y ago
    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_ 5y ago
    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.
cblconfederate 5y ago
interestingly when people faint they are usually given water
01100011 5y ago
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.
vstm 5y ago
It's the study that laid the groundwork for /r/hydrohomies
amelius 5y ago
Can this help jet fighter pilots and F1 drivers?
refurb 5y ago
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 5y ago
  next time add in a 15-minute hot tub stay -- - - it's an orthostatic decathlon!
ta988 5y ago
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)
inamberclad 5y ago
Wouldn't being dehydrated reduce your blood pressure -> being properly hydrated restores blood pressure.
- hashmymustache 5y ago
  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.
mensetmanusman 5y ago
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 5y ago
  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).
  - ford_o 5y ago
    I have never heard of dry fasting. It sounds pretty dangerous.
  - mensetmanusman 5y ago
    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 5y ago
    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 5y ago
    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.
GoodOldNe 5y ago
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.
jmnicolas 5y ago
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 5y ago
  Most of the time it's from locking your knees, which reduces circulation a surprising amount.

121 points by pizza 5y ago

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?

crawfordcomeaux 5y ago
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 5y ago
  Maybe one of them had a Mom: https://news.ycombinator.com/reply?id=29660885&goto=item%3Fid%3D29660497%2329660885 https://news.ycombinator.com/reply?id=29660885&goto=item%3Fi...
  - crawfordcomeaux 5y ago
    Mine always said it was the hamstring if it was a physical issue, otherwise thyroid.
xpe 5y ago
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.

fredley 5y ago

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 https://en.wikipedia.org/wiki/Orthostatic_intolerance

davelacy 5y ago
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 5y ago
  > 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 5y ago
    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.

srean 5y ago

@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 5y ago
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 5y ago
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 5y ago

dehyrdation is the root of all bodily problems - Mum was always right ;)

joejohns 5y ago
I agree, thus the reason to drink water all day.
bitwize 5y ago
I thought it was inflammation? Or gut bacteria?
- colordrops 5y ago
  Wouldn't be surprised if those two are exacerbated by dehydration.

bobthechef 5y ago

"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.

cloudcalvin 5y ago
Use Sodium Bicarbonate or Potassium Bicarbonate instead, it helps as antiacid as well
spuz 5y ago
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 5y ago
  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_ 5y ago
  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.

cblconfederate 5y ago

interestingly when people faint they are usually given water

01100011 5y ago

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.

vstm 5y ago

It's the study that laid the groundwork for /r/hydrohomies

amelius 5y ago

Can this help jet fighter pilots and F1 drivers?

refurb 5y ago

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 5y ago
next time add in a 15-minute hot tub stay -- - - it's an orthostatic decathlon!

ta988 5y ago

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)

inamberclad 5y ago

Wouldn't being dehydrated reduce your blood pressure -> being properly hydrated restores blood pressure.

hashmymustache 5y ago
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.

mensetmanusman 5y ago

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 5y ago
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).
- ford_o 5y ago
  I have never heard of dry fasting. It sounds pretty dangerous.
- mensetmanusman 5y ago
  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 5y ago
  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 5y ago
  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.

GoodOldNe 5y ago

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.

jmnicolas 5y ago

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 5y ago
Most of the time it's from locking your knees, which reduces circulation a surprising amount.