Drinking too much water can be harmful in rare cases. These cases typically involve heavy physical activity, substance use, or other contributing factors.

It’s common knowledge that water is essential for good health. But too much of it can lead to water intoxication.

Other terms for this include:

  • hyperhydration
  • water toxemia
  • water poisoning

There aren’t any firm guidelines about how much water can kill you, but drinking more than a liter (L) or so per hour for several hours isn’t something doctors recommend.

Read on to learn more about water intoxication, including its symptoms and when it can be life-threatening.

Symptoms of water intoxication tend to start appearing after you consume more than 3 to 4 L of water in a few hours.

Potential symptoms include:

  • head pain
  • cramping, spasms, or weakness in your muscles
  • nausea or vomiting
  • drowsiness and fatigue

In more severe cases, water intoxication can also cause seizures or loss of consciousness. If a person doesn’t receive treatment, water intoxication can be fatal.

If you or someone else is showing any signs or symptoms of water intoxication, especially seizures or drowsiness, it’s best to seek immediate medical attention.

As fluid builds up in the body, all of its cells, including brain cells, begin to swell. Swelling in the brain can eventually lead to coma, seizures, and death if a doctor doesn’t treat it quickly.

Eating a salty snack may provide some short-term relief while waiting for help to arrive.

Make sure it’s not dehydration

Water intoxication symptoms can seem very similar to those of dehydration. If you aren’t sure which one you’re experiencing, get immediate help. Avoid drinking or withholding water until you confirm the underlying cause of your symptoms.

There isn’t a set amount of water that always causes life-threatening water poisoning. Instead, it’s best to think in terms of the amount of water that someone drinks per hour. Someone’s age, gender, and overall health can also play a role.

The kidneys of a healthy adult can flush out 20 to 28 L of water each day, but they can only get rid of about 1 L each hour. This makes it hard for your kidneys to keep up when you drink more than 1 L per hour.

The kidneys of older adults and children tend to be less efficient, so the amount of water that they can safely drink per hour might be a bit lower.

Water intoxication can happen more quickly in children or older adults.

When you drink too much water, it can cause hyponatremia, which happens when your blood sodium concentration becomes very low. If you drink more water than your kidneys can flush out, it’ll dilute the sodium in your bloodstream, causing cells to swell.

Most of the reported cases of life-threatening water intoxication have involved intense physical activity, such as military training or running a marathon. Others have resulted from excessive water consumption due to an underlying mental health condition or forced consumption as a form of abuse.

Water intoxication has also been linked to using the drug MDMA, especially at music festivals. That’s because people in these settings are often dancing for long periods of time in hot environments. This, combined with MDMA’s tendency to raise your body temperature, can make you drink a lot of water.

While this is good for avoiding dehydration, it can quickly become too much because MDMA also causes urine retention. This means that you aren’t urinating frequently, allowing all that extra fluid to build up in your body.

If you regularly find yourself drinking a lot of water over a short period of time, there are a few general rules that can help you avoid water intoxication.

Generally, it’s best to stick with drinking water at the first feeling of thirst. Once you feel quenched, hold off until you start to feel thirsty again.

Your urine color can also be a helpful indicator. Clear urine may be a sign that you’re at risk of overdoing it. On its own, clear urine isn’t necessarily bad, but it’s a good indicator that you don’t need to drink any water for a while.

If you’re about to do an intense workout, consider hydrating with an electrolyte drink that contains sodium, such as a sports drink.

While it’s possible to die from drinking too much water, it’s rare. You’d have to drink a lot of water in a short period of time, which most people will have a hard time doing accidentally.

But if you’re an endurance athlete or do a lot of strenuous physical activity, you could have a higher risk. In these cases, you can usually look to your urine color and thirst level to tell you whether you really need to be drinking extra water.

If you’re concerned about your water intake, talk to your healthcare provider. They can give you more specific recommendations based on your overall health, size, and other factors.