From: gkr	Date: April 17th, 2008 01:33 am (UTC)		(Link)

Juice this morning, one latte, 3 cups of coffee, glass of water, can of coke, two more glasses of juice. Not to mention my dinner was noodles, which is mostly water. I think I've had plenty of fluids today.

From: gargoylettelc	Date: April 17th, 2008 04:35 am (UTC)		(Link)

Caffeinated drinks don't count, as they dehydrate you. Also, depending what your noodle dish was, especially if Asian, could add to the problems. Juice and water, and move slowing when going sit to stand, don't move until your head clears.

	From: gkr	Date: April 17th, 2008 04:43 am (UTC)		(Link)

There is no scientific evidence that caffeinated drinks don't count toward required amounts of fluid intake. In fact, there's no scientific evidence that anyone has ever figured out what the minimum amount of fluid intake is.

At least not at the time this peer-reviewed paper appeared in the Journal of Physiology: http://ajpregu.physiology.org/cgi/reprint/00365.2002v1.pdf

From: gargoylettelc	Date: April 17th, 2008 06:48 am (UTC)		(Link)

Read JAMA as there is evidence, and working with RN's who work with people more medically fragile than you is probably generally good advice. Caffeienated drinks don't count for fluid intake, is simple physiology, period, as caffiene will diuerese your volume. That is a fact. General fluid intake can be based on weight, ie if you weigh 120, you should drink 60oz, or your urine should be a color lighter than apple juice by noon. Medical diagnoses, and comorbidities, exercise intensity, can influence what you drink. You are probably a healthy adult, and what you described above, I suspect doesn't meet the minimum requirement.

	From: gkr	Date: April 17th, 2008 07:32 am (UTC)		(Link)

The article notes that what it refers to is people who fit my description. The review of studies done by Valtin discredits not only the eight glasses of water a day advice, but also the if you are thirsty it's too late and the dark urine means you are dehydrated and the caffeinated beverages don't count advice.

If there is a study or article in the J.A.M.A. that corrects this article, please point me to it. I searched for "minimum water" and "minimum fluid intake" between January 2002 and now at the J.A.M.A. site and came up with nothing relevant.

I also went back to the original journal (which I got wrong, it's not the American Journal of Physiology, it's American Journal of Physiology - Regulatory, Integrative and Comparative Physiology) to see if they have any more recent articles covering the subject. They don't.

I also when to Valtin's home page at Dartmouth to see if he has further research or reviews on the subject. However, it appears he is a professor emeritus and no longer conducting research there.

	From: gkr	Date: April 17th, 2008 07:46 am (UTC)		(Link)

And here's a study done to test specifically whether caffeinated beverages have a diuretic effect, compared to water.

Unfortunately, only the abstract is available without paying:

http://www.humankinetics.com/IJSNEM/viewarticle.cfm?aid=845

Recreational enthusiasts and athletes often are advised to abstain from consuming caffeinated beverages (CB). The dual purposes of this review are to (a) critique controlled investigations regarding the effects of caffeine on dehydration and exercise performance, and (b) ascertain whether abstaining from CB is scientifically and physiologically justifiable. The literature indicates that caffeine consumption stimulates a mild diuresis similar to water, but there is no evidence of a fluid-electrolyte imbalance that is detrimental to exercise performance or health. Investigations comparing caffeine (100Ð680 mg) to water or placebo seldom found a statistical difference in urine volume. In the 10 studies reviewed, consumption of a CB resulted in 0Ð84% retention of the initial volume ingested, whereas consumption of water resulted in 0Ð81% retention. Further, tolerance to caffeine reduces the likelihood that a detrimental fluid-electrolyte imbalance will occur. The scientific literature suggests that athletes and recreational enthusiasts will not incur detrimental fluid-electrolyte imbalances if they consume CB in moderation and eat a typical U.S. diet. Sedentary members of the general public should be at less risk than athletes because their fluid losses via sweating are smaller.

From: gargoylettelc	Date: April 17th, 2008 04:13 pm (UTC)		(Link)

You will not find any difinitive answer as to X is the amount everybody should drink, because it varies with size, activity, etc, and frankly different experts vary with their opinions, as in any field. You can find any 1 research article to support any one side. It would take much longer than the time you spent to fully research that answer. Since I do not sit in front of a computer all day, I cannot direct you to a specific article, but I have read them and it is common medical practice. Also, the fact you are dizzy every time you stand up-*IS* an indication you may have volume depletion, and could be verified by taking postural vitals. Stress doesn't help, but honestly, if you are having that kind of symptom, it might be a hint you are not getting enough water, no matter what is recommended.

	From: gkr	Date: April 17th, 2008 05:35 am (UTC)		(Link)
	Re: how's your blood pressure?

I don't know at the moment, but it's usually be on the high side when I've been tested. Not very high, but on the higher end of normal. Of course, B.P. can vary quite a bit so it could be that.

Basically, I figure I'll be fine after a night of sleep. I almost never really worry until something affects me for 3 days straight. That's my cut off for going to the doctor. Though I will go earlier in some cases (like when my knee popped a few years ago).

	From: laurelfan	Date: April 17th, 2008 05:43 am (UTC)		(Link)
	Re: how's your blood pressure?

who needs a doctor? You have the wisdom of the lj-commenting crowds :)

	From: gkr	Date: April 17th, 2008 06:09 pm (UTC)		(Link)

It's probably that I'm Oscar the Grouch.