By Team Ayurved Sutra
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Overhydration Cases Rise in Summers as Doctors Warn of Hyponatremia Risk
India’s annual advice to “drink more water” during summer is drawing renewed scrutiny as doctors warn about a rise in overhydration-related complications. Hospitals across the country are treating patients with Hyponatremia, a condition caused by dangerously low sodium levels in the blood after excessive water intake dilutes the body’s electrolytes.
Hyponatremia is defined as a serum sodium concentration below 135 mEq/L. According to the Mayo Clinic, the condition develops when the kidneys cannot remove excess water fast enough, causing sodium levels to fall and cells to swell. In severe cases, it can lead to seizures, coma, and death.
Athletes and elderly patients among the highest-risk groups
Medical experts say the risk increases during long periods of exercise combined with heavy consumption of hypotonic fluids such as water or sports drinks. Athletes, especially young women participating in endurance activities lasting more than three to four hours at lower intensity, are considered particularly vulnerable.
Doctors warn that symptoms such as headache, nausea, confusion, and disorientation are often mistaken for dehydration. Continued fluid intake under those conditions can worsen the sodium imbalance and trigger acute brain swelling.
A study published in the Journal of Clinical Medicine on November 4, 2025, reviewed 337 patients hospitalised with moderate to severe Hyponatremia between January 2018 and October 2025. Researchers reported a mortality rate of 40.7 per cent. Severe Hyponatremia accounted for 71.8 per cent of the cases, with July identified as the most common month of presentation.
The study found drug-induced Hyponatremia to be the leading cause, while decompensated heart failure emerged as the most common cause of death among affected patients.
Nearly 30 per cent prevalence in Mumbai hospital study
Another prospective observational study conducted at a tertiary care centre in Mumbai reported a Hyponatremia prevalence rate of 29.36 per cent among 355 hospitalised patients studied over six months.
The study, published through PubMed in 2025, found that most patients were above 60 years of age. Researchers linked the condition to multiple overlapping factors including comorbid illnesses and medications such as diuretics. Liver disease, endocrine disorders, and syndrome of inappropriate antidiuretic hormone secretion were also commonly associated with the condition.
Researchers noted that the severity of Hyponatremia closely correlates with mortality risk, underscoring the importance of early diagnosis and timely treatment.
Post-surgery and cancer patients face higher complications
Studies cited by HCPLive showed that Hyponatremia is also associated with poorer outcomes after cardiac surgery. Researchers found that 59 per cent of patients developed postoperative Hyponatremia, with higher mortality rates and longer hospital stays compared to patients without the condition.
Patients with Hyponatremia stayed in hospital for an average of 11 days, compared to seven days for non-hyponatremic patients.
Cancer patients with severe Hyponatremia were also found to face significantly higher mortality risks. HCPLive reported hazard ratios of 3.46 among severely affected patients. In liver disease cases, hypervolemic Hyponatremia was linked to hepatic encephalopathy, hepatorenal syndrome, longer hospital stays, and increased mortality both before and after liver transplantation.
Doctors advise drinking to thirst, not by schedule
Medical guidance is shifting away from rigid hydration schedules toward a more balanced approach. Findings published in the *Clinical Journal of Sport Medicine* showed that a “drink to thirst” strategy prevented Hyponatremia in 95 per cent of athletes, compared to those following “drink ahead of thirst” routines.
The Indian Council of Medical Research-National Institute of Nutrition (ICMR-NIN) also recommends replenishing salt lost through sweat during extreme heat and prolonged physical activity.
Health experts continue to stress that hydration remains essential during Indian summers, but caution that excessive water intake without adequate electrolyte balance can become dangerous.
