Alcohol and Dehydration

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Photo Credit: Amit Lahav @amit_lahav

Hello Sobertown,

When you were drinking did you ever wonder how it could be possible that you can urinate so much? Did you ever think about the rough volume you would send to the toilet or urinal or tree and think it had to significantly exceed the actual volume of alcohol you were putting into your body? If you did, you would be correct.

First lets do a crash course on the kidneys because this information is vital to explain how alcohol so dramatically increases the amount we urinate. Our kidneys are essentially filters. In a nut shell the blood flows to the kidneys, the kidneys filter the blood removing waste and extra fluid from it as well as removing acids produced by our cells and reabsorbing or removing various salts and minerals from the blood to allow us to maintain a crucial balance of these salts and minerals as well as water in the blood. These guys maintain our blood, they filter it allowing us to rid the body of that which we do not need or have too much of and reabsorb and keep what we do need. The kidneys do a great job of this filtration process no doubt about it however there are many things we can do which make it difficult for the kidneys to perform their role and keep our blood at optimal levels.

Alcohol as with most systems in our body does have a significant effect on the function of the kidneys. One such effect involves a hormone. We have a hormone named “anti-diuretic hormone” also knows as Vasopressin, the name sums it up “anti-diuretic”. A diuretic is something which will rid your body of salts and water so as the name suggests anti-diuretic hormone acts to stop the salts and water loss from your body by acting on the kidney and how it functions. Anti-diuretic hormone is made as a prohormone in the neurons of the brain region called the hypothalamus which then travels down the nerve fiber into the pituary gland which will release the hormone into the bloodstream depending on the pressure gradient of the fluid outside of our cells which tells it when it is required to act. The hormone travels through the blood to the kidneys where it acts on the kidneys to increase the amount of water they reabsorb back into the bloodstream rather than allow it to filter into the bladder and to the outside world. Essentially the hormone signals to the kidneys, it is a vital messenger to tell our kidneys how much to keep and how much to let go. Our body under normal circumstances maintains this equilibrium and releases the correct amount of anti-diuretic hormone to tell the kidney how much fluid to reabsorb and keep vs. how much to allow out to the ureters and to the bladder to excrete.

Alcohol has the effect on our body of BLOCKING the release of anti-diuretic hormone, this is kind of like a double negative, the hormone blocks the diuretic effect and alcohol blocks the hormone that blocks the diuretic effect, Alcohol does this by suppressing the hormone release at a neurological level in a somewhat complicated manner and it has been shown that those who abuse alcohol show more severe reductions in anti-diuretic hormone levels while drinking (2). When we block the hormone whose job it is to tell the kidneys to hold onto much needed water and salts guess what happens, the kidneys do what they think is correct and they dump that fluid and salt into the bladder and out it goes down the toilet leaving you dehydrated and in a poor state of balance in salts, water and minerals which logically can be one of the reasons you feel so average after drinking too much. When I say the kidneys dump excess fluid into the bladder I am not just referring to the fluid you are currently consuming with the alcohol, I am referring to all the fluid in your body which is circulating in the blood and in various other locations, the effect in non discriminate, it simply takes your body fluids and sends them out to the bladder.

Do you recall drinking a few alcoholic beverages and as you continue to become intoxicated the amount of urine you produce just seems to be unreasonable and perhaps even unnaturally large in total volume? This is why. You drink alcohol, alcohol blocks anti-diuretic hormone, kidneys get confused as they don’t have the hormone to tell them to keep the fluids and do not dump them, kidneys continue to send your much needed fluid and salts to the bladder and there you go, just another way alcohol causes our systems to function poorly.

Keep drinking, keep dehydrating, keep feeling average. Get sober and the process starts to balance things out, anti-diuretic hormone is finally allowed to release properly, the kidneys then have to act to rebalance fluids and you thirstily consume water and salts as you gobble up salty and terrible food and drink fizzy versions of sugary water, minerals and salts. Gradually we return to healthier levels of hydration, albeit unhealthily, we might start to feel better. Drink again, block the hormone, dehydrate, strain the renal system, recover, go again and so on. This causes strain and load on just one aspect of one system due to alcohol consumption but to be very clear this is a very important system. When we pee out the water we need to be keeping in our body we do not function well, our balance of salts and minerals vital for neurological function are incorrect, our vital signs are out and our systems are all taxed until our hydration levels return to a functional level. Drinking regularly means inevitably we live in a chronic state of dehydration which aside from being a very unhealthy state to be in will also lead to generally feeling unwell, having dry and unattractive skin, bad breath, abnormal vitals and poorer athletic performance. Living in this dehydrated state is not sustainable nor is there a way around it, there is no “hack” to overcome this effect the relationship is simple and as follows, overconsumption of alcohol equals blocking of antidiuretic hormone equals dehydration equals feel crap, look crap, perform crap. Simply drinking more water while consuming alcohol may help by adding greater net intake volume of fluid to be drawn from to retain but it does not alter the fact that alcohol simply blocks the hormone responsible for telling your kidneys not to dump the fluid you need which means no matter how much fluid you consume that more than should be will simply be sent to the bladder and back out to the toilet.

When they say, don’t break the seal in reference to the imaginary seal of the bladder and the first pass of urine, I say just don’t break the seal of that alcoholic beverage to begin with. Put it down, grab a soda water, feel better, be better, live longer, save money, live sober, live better. Save your kidneys the trouble and stay hydrated.

REFERENCE

(1) Wang X et al. 2014. Ethanol reduces vasopressin release by inhibiting calcium currents in nerve terminals. Brain Res. 1991 Jun 14;551(1-2):338- 41.

(2) Harper KM et al. 2018. Vasopressin and alcohol: A multifaceted relationship. Psychopharmacology (Berl). 2018 Dec; 235(12): 3363–3379.

Published online 2018 Nov 3. doi: 10.1007/s00213-018-5099-x