Doctor warns about overhydration, says ‘clear pee’ should not be the goal

I love how in the midst of the Stanley Quencher Cup mania we’re hearing more and more doctors pipe up with warnings about overhydration. It tickles my little impish heart. I get that our understanding of science is always evolving and improving, and that’s a good thing! But yeah the timing cracks me up. Back in January we covered signs of overhydration, and I was thrilled to learn that I have a new scapegoat to blame my irritability on. That update also noted that your first wee of the day should be on the lighter lemonade-colored side. Now UK-based NHS Dr. Sermed Mezher is adding that “clear pee” should not be the goal, at any time of the day:

One of the most popular health trends over the last few years has been staying as hydrated as possible, evidenced by the massive popularity of 40-oz Stanley Quencher cups. The theory among those who obsess over hydration is that, when you pee clear, you’ve removed all the waste in your body and are enjoying the incredible benefits of being 100% hydrated. Congratulations.

However, according to Dr. Sermed Mezher, an NHS doctor in the UK, peeing clear isn’t always a sign of being healthy.

“If you’re peeing clear, that means you’re having more than 2.5 liters (85 ounces) of fluid per day, which means your kidneys are working overdrive to keep that water off your brain,” Dr. Mezher said. He goes on to add that when kidneys can’t keep up with their water intake, it can cause water intoxication, which can lead to dangerous, even lethal, brain swelling.

According to Dr. Mezher, it’s all about finding balance when it comes to hydration and the goal shouldn’t be to pee clear all the time. “Of course, like most things in life, too much is not great, and too little isn’t either,” he continued. Two liters (68 ounces) [of water] is good for a healthy adult, and babies under six months shouldn’t be given any water at all.”

The news came as a bit of a shock to some folks in the comments. “One minute it’s not enough water, the next it’s too much… I’m tired,” Tiyana wrote. “I always thought the goal was clear,” Mountain Witch added.

[From Upworthy]

So the countdown is on for when Goop declares that clear pee is the only way it should be, no? I’ll say this, I did not have “we’ll be routinely discussing ideal pee color” on my bingo card for 2024. Now I’m disappointed that Pantone didn’t make their Color of the Year something on the wee spectrum! (And before you say, “Ew, Kismet!” May I remind you of the sad-sack, raw chicken breast-reminiscent color they gave us this year: Peach Fuzz.) As much fun as regularly keeping tabs on the tint of my pee sounds, for now I’m just going to focus on the suggestion of 68 ounces of water a day. That’s doable. I have two non-Stanley cups (why go Stanley when you can go Bubba!) that are 24 and 32 ounces respectively, so I could easily gauge my intake… If I made the effort to track. Which I’m totally motivated to do! After all, I still have that lofty goal of trying to drink enough water to balance out my potato chip intake. You gotta have a dream.

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50 Responses to “Doctor warns about overhydration, says ‘clear pee’ should not be the goal”

  1. Cheshire Sass says:

    Being the youngest in the generation of “we drank from the hose outside” I am more than a little concerned about how people pay more attention to tik Tok influencers than actual trained doctors. Water intoxication was never an issue heard until recently . Optimal health we were always told is all things in moderation.

    • Concern Fae says:

      Nope. People have been dying ever since they started all the hydration stations at road races. When they never had deaths from dehydration.

      The wellness industry is dangerously cultish, pushing standards for what “counts” as hydration higher, even while the hazards become more obvious.

      • Mia says:

        Deaths from dehydration and hyponatremia are both rare in endurance sports. Generally hydration stations in marathons are stocking electrolyte drinks like Gatorade which contain sodium, so most runners can safely take cups as needed. Not saying overhydration doesn’t happen- but the hypervolemia generally resolves on its own over the course of a day or two unless the water loading continues

    • Pinkosaurus says:

      I remember Oprah decades ago was lecturing that you should be drinking at least 8 oz an hour, and should need to pee every hour to be properly hydrated. That was in the bad old days when women were told that if you feel hungry, you’re probably just thirsty so go drink water 🙄

      This may be espoused by Tiktokers but has been toxic diet culture forever.

      • JP says:

        Absolutely. I very clearly remember one of my college professors telling his class that if your urine had any color, you either had consumed too much salt or not drank enough water. This was around 2005.

      • Colleen says:

        Oh my gosh, that was always my mom’s answer — you aren’t hungry, you are probably just thirsty.

        Nope, I’m 13 and just had cheer practice – I’m HUNGRY. 🙁 I will not do the same to my kids.

    • SarahLee says:

      I’m with you Cheshire. Drinking water really wasn’t a thing for most of my life (I’m 62). When I was thirsty as a kid, I drank from the water hose. As an adult, I grabbed a drink from the water fountain. Never did I carry around a large water bottle all day. Now, I have a 32oz bottle on my desk and I try to drink 2 of them per day but usually don’t get that much. What ever happened to just listening to our bodies and drinking when we were thirsty?

      • AMB says:

        OK, @SarahLee, I’m 61. How on earth do you drink all that water every day and not have to pee like every 28 minutes? 😉

      • SarahLee says:

        @AMB I do have to pee a lot! I say I ‘try’ to drink 2. I usually only drink 1 and maybe part of the 2nd one. All this water stuff has made me laugh for years now. People our age NEVER drank water! The one thing I notice when I do drink at least 32 oz a day is that my skin looks better (and I have to pee).

    • BeanieBean says:

      Still remember the metallic taste from the hose…. Which is why I dislike water from most water bottles, the metallic ones. Bleh.

  2. Izzy says:

    I’d always heard that 64 oz was the goal and that hasn’t changed over the years, the only exception is when you are sweating a lot and need to replenish more fluids, but even then, you still need to be careful about over-hydration.

  3. Concern Fae says:

    Team You Are Drinking Too Damn Much Water Here.

    The other issue is that 64oz includes all the water that is in your food and other beverages. So your coffee counts towards your water, your smoothie counts towards your water, your soup, your fruit – all of it. Your body pulls the water out of everything you eat and drink.

    It’s diet culture. If something’s sold as making you healthy, AKA thin, Americans can’t help but overdo it to the point where it actually endangers their health. And then complain about getting mixed messages.

    • Mcmmom says:

      Except I don’t think that’s the guidance – yes, your body pulls water from everything you consume, but I believe you are supposed to drink 64 ounces of WATER per day. Coffee does not count towards that amount.

      Though I will caveat that by saying I am not a doctor, not a nutritionist, and not even a Tik Tocker – but that reflects what I have heard from legit doctors over many decades.

      • Sudie says:

        The Nephrologist that I see for kidney issues says the 64 oz per day includes all beverages (excluding alcoholic drinks) you drink not just water. Therefore, 64 oz of liquids per day excluding alcoholic beverages.

      • Colleen says:

        My doctor said it includes everything….coffee, soda. I’ll listen to her.

    • Rainbow Kitty says:

      When I looked up how much water I should be drinking for my height/weight it says close to 90oz a day. Which is nearly impossible. So fill my 40 oz water bottle twice, plus another glass or so. I’d never leave the bathroom.

    • Snarky says:

      It’s true–the 64 oz includes all the water in your food and drinks, and 64 oz is not necessary for everyone! I never drink 64 oz of just water, I’m not often thirsty, and my labs are always fine. I don’t sweat very much and I’m only 5’3″, so it’s not surprising that I don’t need as much water as other people. Like all things, everyone is different! This article from WaPo explains it too:

  4. BeyondTheFringe says:

    Only caveat I would add here is my own doctor said it does depend on your weight. The more you weigh, the more you tolerate/need. I weight more so I can stand a bit more than 64 oz but not like 2 gallons worth or anything crazy.

    • Allyn says:

      What I have been told is to take your body weight in pounds, divide by two, and that’s about what you want to consume of water in ounces. And that’s about right for me; anything less and my arthritis lets me know. 😟

  5. Harla A Brazen Hussy says:

    I’ve noticed that when I drink more than 40+ ounces of water a day, I get foot cramps really bad which leads me to think that my electrolytes are off. I have a 40oz tumbler (just like Meghan’s) and I aim to make that last me the day.

  6. StillDouchesOfCambridge says:

    Young Gen X here: I drink water exclusively when I feel thirsty, is there anything wrong with that? Same with eating. Old fashion?

    • Vera says:

      yes – same here.

    • Chantal1 says:

      Also Gen-X. Same here as well.

    • LadyMTL says:

      Old milennial here and it’s the same for me too – other than occasionally with a meal I pretty much drink water when I’m thirsty.

    • North of Boston says:

      Agree – drink when you’re thirsty, eat when you’re hungry.

      I’m reminded of those studies done with young children old enough to feed themselves if a range, variety of nutritious foods were accessible to them. Basically over the course of several days, allowed to eat what they wanted, they ate a balanced diet in pretty much the correct proportions. Even if for one meal they ate only strawberries and at another they ate only cheese. It balanced out.

      Of course that simple guidance only applies if nothing is going on that causes us to miss or misread our bodies’ cues, or have glitches in our metabolism, endocrine systems that trigger/shut down hunger and thirst signals, disconnecting them from actual healthy needs. (And there is SO much our society – in media, influencers and individuals in our lives – do that can lead to dysfunction there, and it starts SO young). Or people who have particular nutritional needs because of health conditions.
      So it doesn’t work for everyone.

      And also requires us to override sophisticated advertising designed to trigger cravings.

  7. Vera says:

    no one needs a cup that size as it the photo. It is madness to carry that with you, you can refill a much smaller one. It must weigh a tonne. My water bottles are 200ml max.
    I probably drink way less than 2 litres a day and I am still alive. I drink when I am thirsty. We all also get liquid from soup and fruit etc so it’s not just about drinking water. in the summer I eat lots of watermelon
    I always struggled to drink more than a small glass in one go, I actually feel pain in my stomach if I have to chug water down. I have to drink plenty of water before my blood tests and it takes me at least 20-30 minutes to drink it.
    So I am glad this drink constantly craze is being called out!

    • SarahCS says:

      You mean pay attention to your body and trust what it’s saying? Then how will people sell you things you don’t need!?

      • Vera says:

        I’m sure they get me in other ways somehow, otherwise my house wouldn’t be full of junk in it that I never use, lol

  8. SarahCS says:

    I’m 45 and growing up it just wasn’t a thing to be carrying a drink with you at all times. Shops didn’t allow you in with drinks! I find this obsession so weird and strongly agree with the comments about how it all comes back to people getting us worried about things we (most of us) don’t need to worry about to then sell us things we don’t need.

    And yes, trust doctors and professionals in their field, not random people who have made themselves popular online.

    My b/f is at his folks this week for work and the other night he sent me a link to a new water jug they just bought that has a replaceable bag of stuff you put in the bottom (so not a water filter, I guess it has to ‘steep’) that promised BETTER HYDRATION amongst other things. It’s water FFS. The ‘expert’ they had promoting it was a dermatologist (I know there’s a link between hydration and skin health but if I have an issue with my kidneys a dermatologist would not be my first port of call). Sigh.

  9. Bren says:

    I bought a Bubba 24oz over the weekend at Walmart for $10 and it’s wonderful. It keeps my nightstand water cool overnight. I highly recommend it.

  10. Michelle says:

    Sad raw chicken breast And potato chip intake both made me laugh out loud!

  11. Shawna says:

    I kind of like Peach Fuzz! I know it’s close to millennial pink, but it’s cheerful.

  12. Melissa says:

    Truthfully, I like drinking my large amount of water. I find working from home and being on Teams all day draining, and I get so tired around 2 – 3 pm. But if I keep drinking water (even if it’s mostly eventually just going into the toilet), it seems to help feel less sleepy in the afternoon. So, even if it’s a placebo or just coincidence, the routine seems to help. But I just use the water bottle I got from work 🙂

    • BeanieBean says:

      It’s habit. I also work from home & get up every couple of hours & go outside for a 15min walk. That keeps me awake & makes my heart happy.

    • SenseOfTheAbsurd says:

      Me too. I’m just generally a really thirsty person and absolutely love icewater. Or anything very cold, really.

  13. Marion says:

    I drink one liter in the morning and one liter in the afternoon plus during meals. Have been doing so for over 25 years I think.
    Just have regular sips and you won’t rush to the toilet evry minute and lose the electrolytes that are necessary for your body to function.
    Overhydration is no joke.

  14. mia says:

    Family doctor here and I would never say you need to carry around 40z water bottles everywhere you go and making sure your pee is clear all the time but this NHS doctor’s advice for all adults to drink 64oz is ludicrous. If you’re an athlete who sweats a lot, or on certain medications, it could be inadequate. If you have certain heart or kidney conditions it could be too much. If you’re a heavier person, it could be inadequate. Everyone is different, every day is different. Also water intoxication is very serious and not at all common. Typically acute water intoxication comes from some kind physiological or psychological condition which causes water consumption beyond what the kidneys can handle, Drinking 2-3 40oz bottles over the course of the day while also having coffee, smoothies, and hydrated foods would not cause water intoxication in the vast majority of adults with healthy kidneys.

    You don’t have to be over-hydrated to the point of running to the bathroom every half hour, but let’s not scare people into thinking they’re going to face water intoxication because they like to say well hydrated and carry around a water bottle. Everyone is different and if you have concerns about your water consumption or the color of your pee- please discuss it with your own doctor.

    • Emily says:

      Thank you for this! Your advice sounds sensible.

    • Moneypenny424 says:

      Thank you! Glad to have your input here. I’m pretty active, so on a non-exercise day (or phase like I’m in right now because we moved), I drink 64oz for sure. When I’m in my normal state and exercising, I drink about 95oz because I’m sweating a lot.

  15. Becks1 says:

    I drink when I’m thirsty but that usually puts me closer to 100 oz a day – I work out regularly though and I feel like I eat a lot of salty foods, so maybe that’s why I always feel thirsty? My pee is never clear though so I guess I’m okay, lol.

    I have the Brumate tumbler that actually locks so it doesn’t leak in your bag and its amazing. I recommend that over a Stanley.

    I feel like drinking more water than i did 20 years ago isn’t a bad thing, and then I read articles like this and I freak out about my kidneys, but……pee still has some color to it, LOL.

    • Mia says:

      That level of hydration for you sounds fine but check with your doctor if you have concerns. Healthy kidneys and even mildly diseased kidneys benefit from hydration. For those with mild kidney disease, usually(and everyone is different and should never diagnose themselves if they have concerns) more hydration is recommended. It is well known that mild dehydration is very common- many people don’t drink enough. No need to scare anyone into carrying around barrels of water but let’s not scare anyone into thinking they’re going to get water intoxication because they drank a large soda at the theater

  16. Lizzie Bathory says:

    “Geriatric millennial” (lol) here. I just keep a good old fashioned glass of water next to me & I have no idea how many ounces I consume in a day. Very off-trend, I guess!

  17. MsIam says:

    Yet another thing to obsess and judge people about. Is the amount of water you drink going to be this years “How often do you bathe?” discussion. All I know is that years ago, I read the “8 glasses of water a day” thing wasn’t based on any scientific research but that it came from some magazine for personal trainers. I just drink when I’m thirsty and eat when I’m hungry. I also cut out drinking soda for the most part a few years ago.

    • SenseOfTheAbsurd says:

      I’m completely fascinated with the almost entirely British phenomenon of getting irrationally angry at people who carry a water bottle, especially heaven forfend one with a nozzle, and making strange accusations about breastfeeding which came entirely from their own minds. Any UK newspaper article about drinking water and they’re there.

  18. Vizia says:

    Water intoxication, or over-hydration, has been common in both alcohol and eating disorder treatment centers for many years. Dangerous over-hydration makes you feel drunk at a certain point, for the alcoholics, and over-hydration before a weigh-in gives the appearance of having put on a couple lbs in eating disorder centers. Staff in those places are well aware, and watch for this behavior.

    Burning Man has had “Piss Clear” as a mantra since they first moved out to the Black Rock desert in the early ’90s. But that’s a very extreme and harsh physical environment, and they also recommend that you have salty snacks of some kind on your person at all times in case you start to feel over-hydration symptoms. I don’t know how many people these days actually pay attention to that, but that was the original intention, and the first place I heard “Piss Clear”.

  19. Shayna D says:

    I drink a gallon of water and then some/day. Ive been doing this for at least a year and I’m perfectly fine. I think the issue is drinking too much too fast. I start in the morning and drink till 10pm

  20. BeanieBean says:

    Currently in this pickle & having a heckuva time righting it. For the past two years, my blood sodium & chloride levels have been below the norm. I’ve spent so much time in my life as a long-distance runner & then as a field-going archaeologist that staying hydrated has always been a must & ensuring I had water on hand is second-nature. I am now no-longer running & am office bound for work, but I think I may still be drinking the amounts of liquids I used to. Not sure. Still puzzling this out with my doc. Doesn’t help living in tropical climates with no air-con.
    As for pee color, we had a helpful poster on the wall at work–all about staying hydrated & what color your pee should be. Gah!! I’m so confused!!

  21. Chaine says:

    I have a 27 oz bottle and I always wake up incredibly thirsty and I drink the whole thing right away in the morning. I probably drink 2-3 more during the course of the day depending on whether I go to the gym.

  22. Susie Q says:

    I actually did know of someone who got sick from drinking water. Since it’s dec ages ago now (she was ahead of her time!) I think it had to do with diluting the electrolytes/salt in her system. But I don’t think the average person has much to worry about, it’s really hard to drink gallons of water a day.

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