What You Should Know About Fluid Overload HYPERVOLEMIA

Hypervolemia is usually a sign of trouble and it means there is too much fluid (water) in the blood; also known as fluid overload. While the body is mostly composed of water, too much of anything, - even water – can unbalance the body. The biggest cause for most hypervolemia is too much salt in the diet causing fluid retention in an attempt to balance. It can also be from a hormone imbalance. Much of the time it is self-resolving, or easily treated if discovered early enough. Some medications cause hypervolemia as a side-effect.

Congestive heart failure is another common cause of chronic heart failure and results from the heart’s inability to pump enough blood to the rest of the body. This condition decreases kidney output and causes an excess buildup of fluid in the body. Heart failure or end-stage kidney disease causing hypervolemia may lead to sleep apnea.

Kidney failure … The kidneys regulate the delicate balance of sodium and water in the body, so kidney problems often result in hypervolemia. This is another cause of the heart conditions above.

Cirrhosis of the liver is a condition when the liver fails to properly process food and filter out toxins and can cause hypervolemia, particularly present in the extremities and abdomen known as abdominal ascites.

IV fluids which are frequently administered in the hospital when one is dehydrated or can’t consume enough fluid (after surgery). These fluids contain salt/sodium designed to help with fluid retention. However sometimes too much is administered and hypervolemia results, particularly when other conditions are present. In extreme cases, this can increase the risk of death.

Hormones … Pregnancy and pre-menstrual syndrome may cause bloating and swelling due to water retention. High blood pressure may result and cause problems with baby and mother alike.

Medications … That cause hormone changes such as hormone replacement therapy or birth control pills can result salt retention and hypervolemia. Other meds with similar side-effects are:

• NSAIDS – non-steroidal anti-inflammatory drugs
• Blood pressure meds
• Anti-depressants

Eating too much salt … according to the American Heart Association, Americans eat too much salt. The recommended limit is 2,300 mg, while we consume 3,400mg, which causes fluid retention bloat and hypervolemia, in many people. In most cases one would have to eat that much and more over long periods of time to create health problems in the heart or kidneys. A low salt diet is always best for long-term health.

Symptoms … Rapid unexplained weight gain can be an early symptom of hypervolemia, others are:

• abdominal swelling, which is common with liver problems
• swelling in the arms and legs
• shortness of breath caused by fluid in the lungs

Diagnosis … In addition to a complete physical exam and blood work (checking for excess sodium) doctors will listen for excess fluid in the lungs, which may indicate CHF (congestive heart disease, heart failure, kidney problems or liver disease.

Treatment … The first line of defense is prescription of diuretic medication to lower the fluid volume. Absolute reduction of salt intake by itself may fix the problem providing no damage has been done to other organs. However, in the case of severe kidney damage diuretics may not go far enough. Additional kidney medication and treatment may be necessary. Patients with CHF or other heart conditions may have to limit their fluid intake as well.

When to see a doctor … Some water retention and bloating is fairly normal during the pre-menstrual phase of a woman’s period. Prolonged periods of standing, walking or air flights may likewise cause swelling in the legs and ankles. However, if it doesn’t resolve within a few hours of landing it should be discussed with your doctor.

Anytime one experiences frequent or chronic swelling in the legs, ankles or feet should see a doctor and get examined, particularly if there is any family history of liver, heart or kidney disease.

Legs and feet may also experience minor swelling after a long day of standing or walking and on long flights. This is not usually a problem for people in good health and resolves within a few hours.

Anyone experiencing excessive swelling, weight gain, or water retention without an apparent cause should see a healthcare professional, especially if the person has a family history of heart, kidney, or liver problems.