Perhaps some of you are tired of being asked whether you drink enough water.
In this issue, I will discuss the problem of drinking too much water and the reasons why drinking LESS water may solve many chronic health problems, including headaches, migraines, dizziness, fatigue, indigestion, bloating, diarrhea, nausea, insomnia, urinary problems, and joint pain.
When I began studying acupuncture and Oriental medicine in Japan more than 25 years ago, teachers and practitioners more often than not emphasized the importance of limiting fluid consumption. This teaching is primarily based on Kampo (Japanese traditional medicine, evolved from classical Chinese medicine), according to which retained excess water in the body is called suitai (stagnation of body fluids or dampness in Traditional Chinese Medicine). Suitai is one of the most commonly seen Kampo (Traditional Japanese Medicine) disease patterns in modern society.
In North America, however, health professionals overwhelmingly recommend that their patients drink more water. It is hard to find a health magazine that does not mention, in almost every issue, the importance of drinking water. As a result, many people make a conscious effort to drink larger quantities of water and drink it more frequently, even when they are not thirsty.
The so-called “waterholism” trend is now spreading to the East. In recent years, a growing number of Japanese people have started to carry colorful water bottles everywhere they go. This phenomenon has caused serious concern for some Japanese doctors such as Yumi Ishihara, M.D., Ph.D., an internal medicine specialist in hematology. In his recent book, The Danger of Excessive Intake of Fluids: Stop Forcing Yourself to Drink Water (title translated from the Japanese, Kousaido, 2008), he warns about the potential negative impact of excessive water intake on a wide range of illnesses, including cardiovascular, immunological, reproductive, and psychological conditions.
Absorption of new fluid begins with the elimination of fluid
Many water advocates suggest that water has detoxifying effect in other words, that water washes toxins from the body and purifies the blood. This idea sounds nice and clean, but unfortunately, it is simplistic and, in part, misleading.
I will explain my reasoning with a simple analogy. If you drink a generous amount of water, the urine will eventually become almost colorless. This phenomenon may make you feel “clean,” but it does not necessarily mean you have eliminated all the toxins from your body. The body works like a sponge. If a sponge is soaked with dirty liquid, don’t you squeeze out the old water first before soaking it in clean water? How about gardening? Water is most effectively absorbed by trees and plants when the soil has almost dried out from a previous watering or rainfall. Overly frequent watering can rot the root system and end up killing a plant (a phenomenon known as wet feet). Likewise, in order to absorb new fluid into our cells, the excess water must be expelled first.
Oxygen (O2) is another example. Just as with water, we cannot live without oxygen. However, rigorous repetitive inhalation can cause a condition called hyperventilation. The best way to maximize respiratory efficiency is actually not to pay any attention to inhaling oxygen. Instead, the focus should be placed on exhalation-breathing air (CO2) out completely to empty the lungs. Fresh oxygen then fills the lungs naturally.
In the same way, it is important to eliminate excess fluid from the body first in order to allow it efficiently to absorb new fluid into the cells. Excessive water consumption can cause electrolyte imbalance and may have serious consequences. A widely known example is the 2007 death of a 28-year-old California woman due to water intoxication shortly after she participated in a “Hold Your Wee for a Wii” contest, which involved drinking large quantities of water without urinating.
How to find out if you are retaining excess water
Common signs and symptoms of retained fluid include swollen eyelids, migraines, fatigue, watery stools, nausea, edema in extremities, and worsening of pain or other symptoms on rainy days. When observing your tongue, it may appear swollen and teeth marks may appear on the sides of the tongue. It is also useful to pay attention to the color of your urine. If it is clear or a very faint yellow, it is unlikely that you are dehydrated. And remember: symptoms such as nausea, vomiting, headaches, and muscle cramping commonly occur in both dehydration and water intoxication.
At The Pacific Wellness Institute, we utilize the research-quality Bio-Impedance Analyzer. Our system not only provides an estimate of the body’s fat and muscle content, but it also provides an estimate of intracellular and extra-cellular fluid volume. Patients who are prone to retaining unneeded fluid in their bodies almost always have a higher percentage of extra-cellular fluid. In addition, some patients are asked to fill out the “Kampo Constitutional Evaluation Questionnaire” (Tanaka, T. H www.kampo.ca/online-forms), which contains a series of questions about the characteristics of an individual’s thirst, urine, and sweat to help determine each patient’s unique constitutional patterns.
How many glasses a day should I drink?
Dogs and cats show zero interest in the water dish when they do not feel thirsty. Humans are a unique species in that we drink water even when not thirsty. You may have heard the claim made that “by the time you feel thirsty you are already dehydrated.” In my opinion, this is true only in special circumstances, such as being in direct sun or undergoing rigorous physical activity for an extended period of time.* Otherwise, I suggest that most people trust their senses and drink water only according to their desire.** If the desire to drink is low, it could actually be a sign of fluid retention in the body, according to the Kampo understanding of water metabolism, suitai.
Keep in mind that most of us have fewer occasions for exertion-induced sweat than in previous eras. Meanwhile, bottles of freshwater and other beverages are conveniently available, thanks to modern sanitation infrastructure developments and household comforts such as air conditioning and refrigerators. As a result, fluid retention is extremely common in civilized urban society. An appropriate treatment approach focuses on the elimination of retained fluid in the body by using Kampo medicine modalities such as acupuncture, herbs, and food therapy.
Water is essential to our health. We cannot live more than a few days without water. Inadequate fluid intake and dehydration can indeed cause or aggravate many health conditions. At the same time, I see a growing number of cases of health conditions that appear to be caused or aggravated by excessive water intake. The oft-repeated guideline “eight glasses of water a day” should not be applied uniformly. It is important to remember that some people have decreased fluid processing abilities due to constitutional weakness, causing them to produce inadequate amounts of urine. Thus, water intake requirements vary from individual to individual, depending not only on an individual’s activity level, body size, environment, diet, and other beverage intake, but also on his or her constitutional ability to process and eliminate water as urine and sweat.
* However, a common circumstance that can lead to acute water intoxication is simply the excessive intake of plain water during physical activity in hot weather.** People with a history of blood clotting, kidney disease, and certain other health conditions require a particular water intake level as recommended by their doctor.
Celiac disease (CD), also known as celiac sprue, non-tropical sprue, and gluten-sensitive enteropathy, is an inherited autoimmune condition that affects almost one percent of the North American population. Though this disease can develop at any point in an individual’s life, from early infancy to late adulthood, those with a family history have the greatest risk for developing this disease due to its significant genetic component. It is also more prevalent in those of European descent, Caucasians and women.
CD is a disorder of gluten intolerance, in which the digestion of gluten, the protein component of grains such as wheat, barley, and rye, is impeded. In order for efficient absorption of food to occur, small fingerlike projections (called villi) that protrude from the small intestine are required for food to be absorbed through the walls of the intestine and into the bloodstream. When individuals with CD ingest gluten, their immune system produces a response by damaging or destroying the villi necessary for nutrient absorption. As a result, the symptoms of CD discussed below can manifest.
Diagnosing CD can be difficult, as the symptoms are not always pronounced. The degree of manifestation of symptoms depends largely on the amount of intestinal damage that has occurred. In cases where there are clear symptoms of abdominal pain, bloating, diarrhea, weight loss and foul-smelling, fatty stools, suspicion for a diagnosis of CD appears clearer. However, not all cases produce this “classic presentation,” resulting in a delayed diagnosis. Adults are less likely to present with the textbook digestive symptoms and can instead manifest a more vague variety of complaints consisting of unexplained iron deficiency anemia, fatigue, anxiety and depression, joint pain and issues surrounding fertility. Often, an itchy rash consisting of small clusters of red bumps may be the only clue that CD is underlying in an otherwise healthy adult.
YOU’VE GOT TO BE “GLUTEN” FREE!
Seeing as “gluten” clearly plays the role of the antagonist in CD, a brief discussion on what gluten is and where it can be found, or hidden, seems warranted. As stated early, gluten is a protein most commonly found in grains such as wheat, barley, and rye. It is a baker’s best friend as it helps to make the dough more pliable. Although there is no “cure” for CD, it can be effectively controlled by living gluten-free! There is a wide variety of grains available that are gluten-free and include: corn, rice, potato, amaranth, teff, quinoa, millet, buckwheat, arrowroot, and carob. Additionally, numerous food companies and restaurants are jumping on the G – FREE bandwagon, making living gluten-free an attainable goal.
Reading labels to identify the big three (wheat, barley, and rye) is the easy part of carrying out a G-FREE lifestyle. However, gluten does have a sneaky way of getting past the naked eye. Hidden sources of gluten to consider are lipsticks and balms, certain candies, soy sauce, grain alcohol (such as beer), vegetable protein sources (such as veggie burgers and hot dogs), imitation meats, malt (vinegar, extract or syrup) and even certain medications or supplements. If you know you have CD or are suspicious of gluten sensitivity, befriend your pharmacist or naturopathic doctor and make certain that what you are ingesting is indeed gluten-free.
AND THE MILLION DOLLAR QUESTION IS…
Could you possibly be ailing from CD? If either you or your healthcare provider, are suspicious of an underlying cause of CD, certain blood tests will aid in confirming a diagnosis. Individuals with CD will present with higher than normal levels of particular autoantibodies, namely: anti-tissue transglutaminase antibodies (tTGA), anti-endomysial antibodies and anti-gliadin antibodies (AGA). These can be ordered by your primary care practitioner, but require a blood draw and do not provide instantaneous results.
Here, at The Pacific Wellness Institute, we are now proud to offer a reliable, quick and virtually painless test for CD, which requires only a small blood sample from an individual’s finger. The test, performed in-house, measures the levels of transglutaminase autoantibodies, which are highly predictive markers of active CD, and provides results within minutes of obtaining the sample.
If you think that CD might be the underlying cause of your symptom picture, it is well worth investigating with the use of this simple test. However, if you have been on a G-FREE diet, for 30 days or more, the validity of your results will begin to decrease. This test will provide a clearer picture in terms of the activity of the disease, however, it is important to note that the gold standard to confirm the diagnosis of CD is, and always has been, intestinal biopsy.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), back pain affects approximately 8 in 10 people. Lack of regular exercise and the presence of other diseases (e.g. arthritis, osteoporosis, disc disease) may contribute to back pain. However, one of the most common factors is often related to poor posture, occupations that require heavy lifting or simply sitting through most of the day at a desk or in a car. Sitting for long periods of time shortens and tightens a muscle called iliopsoas (il-e-o-SO-us).
What is the iliopsoas?
It is composed of three muscles: psoas major, psoas minor, and iliac. Psoas major and psoas minor lie in the back wall of the abdomen; whereas, the iliacus attaches to the inside of the hip bone. These muscles join together to insert in the leg bone called the femur. We rely on this particular muscle for standing, walking, and running. It is a very strong muscle that brings your knee up toward your chest, similar to a sitting position. It also bends the trunk forward and it can raise the trunk like when you are doing a sit-up. Moreover, iliopsoas helps stabilize posture while standing.
How does the iliopsoas lead to back pain?
Iliopsoas has often been clinically implicated in low back pain. As mentioned above, prolonged sitting and heavy lifting overwork the muscle. As a result, it shortens the length of the muscle which may rotate the pelvis forward and downward. This increases the curve in the lower back which bears more weight and stress onto the spine, also known as lumbar lordosis. The shortened muscle may limit hip extension and develop trigger points that may mimic deep and achy pain to the hip, leg and low back. Furthermore, there is a lot of discomforts when you go from sitting to standing position.
Massage therapy is effective in addressing low back stiffness. On the other hand, if you feel that the relief is short-lived or that there are no improvements with further treatments, then perhaps a massage for the back alone is not enough. Ask your RMT to include the iliopsoas in the treatment. Since it is located deep in the abdomen, it involves putting firm pressure on the muscle which may feel very tender. However, with slow deep breathing, the muscle will loosen up fairly quickly and the end result is usually positive. Regular treatments to this area will remove trigger points and prevent them from returning, which will ultimately minimize pain referring to the lower back. Although massage therapy is beneficial, it is also important to be active in maintaining your own wellbeing. Here are some of the following things you can do to help reduce the stiffness in the low back.
1) Sleeping posture Avoid sleeping on your side in a tight fetal position because it shortens the iliopsoas to the point of pain. Instead, https://www.pacificwellness.ca/chiropractic-care-for-sciatica.htmsleep on your back with a pillow under your knees to lessen the tension in the muscle.
2) Heat therapy A heating pack, hot bath, or sauna are a few examples of heat applications that you can use to alleviate pain, decrease muscle tension, and increase blood flow which promotes soft tissue healing. Plus, it is easy, relaxing, and inexpensive to do.
3) Stretching Stretching is essential to minimizing low back stiffness. It helps increase flexibility and range of motion; as well, it allows the body to move more efficiently. As a reminder, stretches should be pain-free and held for about 30 seconds. Never hold your breath; instead, breathe slowly and regularly. An Iliopsoas stretch may be useful.*
4) Strengthening exercises In order to provide a strong core to help stabilize the spine, it is important to strengthen the abdominals and lower back. The plank exercise increases the strength of the abdominals and the lower back simultaneously.*
Low back stiffness is a common condition that results in persistent pain that can be disabling. Many of us assume the location of the pain is often the source of the pain and as a result, we tend to overlook the iliopsoas. Next time when you come in for a massage session and fit the description of symptoms mentioned above, be sure to ask our RMTs at the Pacific Wellness Institute to include the iliopsoas in the treatment.
* If you have any history of chronic back pain, it is recommended that you perform this exercise under the supervision of a professional. Please ask your registered massage therapist for detailed instructions.
Monica Yeoh holds a bachelor’s degree in kinesiology from York University and completed the Registered Massage Therapy program at Sutherland Chan massage therapy school. To arrange a therapeutic massage session and iliopsoas exercise demonstration with Monica, call The Pacific Wellness Institute at 416-929-6958.