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Severe hydration is a medical emergency. It’s important to know how to recognize this advanced state of dehydration and know what to do.

You may need intravenous fluids in an emergency room and other treatments to avoid organ damage and other health complications if you experience severe dehydration.

Children, older adults, and those who are pregnant are especially susceptible to serious health problems related to severe dehydration. Let’s take a look.

Dehydration defined

The body is in a state of dehydration when fluid levels drop to a point at which organs and bodily functions, such as circulation and respiration, can’t function normally. It occurs when the body loses more fluids than it takes in.

You can usually remedy mild dehydration by drinking water or drinks packed with electrolytes.

  • Heat. Excessive sweating due to extreme temperature exposure, such as being active in hot weather or spending too much time in a sauna, may cause dehydration.
  • Illness. An illness that triggers bouts of diarrhea or vomiting can also rob the body of fluids in a short amount of time. If you’re vomiting or have diarrhea and you can’t keep down replenishing fluids, mild dehydration can progress into severe dehydration.
  • Not drinking enough or often enough. You can also become dehydrated by not drinking enough to keep up with typical fluid loss.
  • Medications. If you take certain medications, such as diuretics for high blood pressure, fluid loss may be quicker.

If you don’t notice the early signs of dehydration or you don’t rehydrate soon enough, you can move from being mildly to severely dehydrated.

Symptoms of severe dehydration include:

  • Thirst. You may think that feeling thirsty is the first indication that you may become dehydrated. The reverse is usually true: Your body starts to feel thirsty after dehydration has already started.
  • Peeing less. In addition to feeling thirstier than usual, the signs of dehydration include less-frequent urination and darker colored urine.
  • Not peeing. If you’re not urinating at all, it’s likely you’re severely dehydrated and should get immediate medical attention.
  • Not sweating. Without enough fluids to function normally, your body can start to overheat, which can quickly lead to heat-related illnesses, such as heat stroke and heat exhaustion.
  • Headache and dizziness. Dizziness and lightheadedness are signs of mild or moderate dehydration. If those symptoms worsen and you have trouble concentrating and communicating, seek medical attention.
  • Poor skin turgor. Poor turgor is when your skin takes longer to return to its original appearance after lightly pinching an area.

Severe dehydration can lead to brain damage and even death in some cases.

Older adults need to be especially mindful of staying hydrated as they may be less aware of when they’re thirsty and becoming dehydrated.

Skin fold and dehydration

You can get a sense of how dehydrated you are by pinching or folding your skin between the pads of two fingers. If you pinch the skin on your arm, for example, it should quickly return to its normal appearance once you let go. The term for this kind of skin elasticity is turgor.

If the skin appears to “tent” or sticks together under the surface, it’s usually a sign that you’re severely dehydrated.

In very young children, severe dehydration may be the case when they have:

  • no tears accompany crying
  • signs of lethargy
  • dry diapers for longer than usual
  • cold, clammy limbs

Serious health consequences can happen fast in children if severe dehydration isn’t treated quickly.

Symptoms of severe dehydration during pregnancy include:

  • extreme thirst
  • sunken eyes
  • rapid heart rate
  • drop in blood pressure
  • dry mouth
  • dry skin, as well as poor turgor
  • early labor

Dehydration can also trigger Braxton-Hicks contractions, which feel like real contractions, but are considered to be signs of false labor.

Rehydrating through severe dehydration usually requires more than providing water or other beverages.

Treatment with intravenous fluids should begin as soon as you can get medical care.

IV fluids are usually a saline solution, made of water, sodium, and other electrolytes. By getting fluids through an IV rather than by drinking them, your body can absorb them more quickly and recover faster.

While in the hospital, your blood pressure and heart rate will probably be monitored to make sure they return to normal as your body recovers.

You’ll also be encouraged to drink water or other hydrating beverages, too.

For children

While sport drinks do contain a lot of added sugar, they also contain water and important electrolytes, such as sodium and potassium.

  • A diluted sports drink — 1 part sports drink to 1 part water — may be helpful for children.
  • Try giving very young children diluted sports drinks or water a teaspoon at a time. If swallowing is difficult, try using a syringe.

This can help keep fluid levels in a healthy range after mild dehydration or IV rehydration treatment.

When you’re pregnant

You can also rehydrate with water or sports drinks. If you feel nauseated in the morning or any time of day, try to find a time when you’re feeling better to get your fluids down.

Good drinks for rehydrating

Along with water and certain electrolyte sports drinks, soup, milk, and natural fruit juices all count as rehydrating beverages.

Drinks to avoid

Keep in mind that not all beverages help with rehydration.

  • Colas and sodas. Sugar-sweetened soft drinks can actually make your dehydration worse and lead to further kidney-related dehydration problems.
  • Alcohol, including beer. As refreshing as a cold beer might sound when you’re exceptionally thirsty, you should avoid alcohol if you’re trying to rehydrate.
  • Caffeinated drinks. Caffeinated and alcoholic beverages act as diuretics, causing you to urinate more than usual and increasing your fluid loss compared to your fluid intake. This includes coffee, black tea, green tea, and energy drinks.

Severe dehydration is a potentially life-threatening medical emergency. It can cause serious damage to your kidneys, heart, and brain. To avoid severe hydration, respond to signs of dehydration by drinking fluids that rehydrate you.

You can also avoid even the hint of dehydration if you consume fluids throughout the day. How much you should drink depends on several factors, including your age, weight, and overall health.

People with kidney disease, for example, need to drink less than other individuals. People who are physically active need to drink more than others.

If you’re not sure, talk to your doctor. You can also do a quick check by looking at the color of your urine. If you’re peeing regularly each day and the color is almost transparent, you’re probably well hydrated.