How Much Water Do We Need to Drink a Day, Eight (8) Glasses?                     James Chin-Ti Lin, MD,

    In 45 years of practicing urology, too many patients complained to me of going to bathroom often, which has inconvenienced and
    disturbed their life, and asked me to help rid their bothersome frequenting bathroom.

    Surprisingly, my asking them why they drink so much water has always incited an instant righteous response by saying:  They love
    and need to drink a lot of water so to flush body-system and they have been taught to drink at least eight (8) glasses of water a day
    since childhood.

    Coincidentally, such notion on water drinking was exactly the same like what I was taught some 60 years ago in schools over
    other continent - Asia. Does this ubiquitous daily 8-glass water drinking imply the existence of another universal code of daily
    living?

    But, now, they want me to help them. And what and how I can help them as well as what and how they can help themselves has
    constantly nagged my mind to ponder over what and how I can do to help solve their quest to stop frequenting bathroom. Huey.
    This is quite a pressing demand for help, but against the tide of global pounding with drinking 8 glasses a day.

    To overcome such dilemma, my exhausting search for solution from literature and common sense has eventually brought us the
    following:

    “How much water do I need to drink a day?"  has been a common question everywhere among daily conversations.  As well, “to
    drink a lot or at least 8 glasses a day in order to flush the system” has been a common and compassionate “wise-person’s”
    personal and professional advice from friends, relatives, medical professionals and offices, magazines, newspapers, TV or radio
    talk shows, and even the Internet.

    How much truth is it in this notion? And is it medically or personally or just socially correct? And “should I drink a lot of water even
    though I have to urinate very often, even too often?” To iron out potential confusion in this pressuring issue, I churned up the
    following two questions to ask and share.

    First, are there any mammals on our planet like human beings being taught to drink a lot of water? As I know of or as you probably
    would agree to, there has been none but human beings - us.

    Second, where did we originally learn and discover how we regulate water and electrolytes? Was it directly from human bodies or
    somewhere else? The truth is from animal laboratory where we used dogs, pigs or monkeys to search and identify the location
    and function of pressure and chemical sensors for regulating water and electrolytes. Then we extrapolated what were discovered
    and record them in the textbook of physiology for us to study and learn.

    So, we know these well-known sensors are inside our hormonal, circulatory and neurological systems; they provide a delicate
    “automation for internal regulation. Thereby, we have a sense of thirst as mammals do and all mammals rely on this natural
    sense of thirst to decide when and how much they would need to drink for survival and growth. And they do, they do well. Are we
    human beings really any different from other mammals in this aspect of life?

    Based on such truth and basic understanding, I personally do not advise my patients to drink a lot. Instead, I encourage them to
    respect and closely listen to their bodies telling them what to do; in other words, they should drink whenever they feel thirsty.
    However, I do recommend them to drink more if they have the following conditions:

    1.        Recurrent urinary stone disease,
    2.        High-output kidney failure,
    3.        No or low anti-diuretic hormone (ADH) due to damage to pituitary gland at the middle low spot of
              the brain,
    4.        Poorly controlled diabetes mellitus (high blood sugar),
    5.        Indwelling catheter from the outside to the urinary bladder or the kidney(s),
    6.        Gross hematuria (visibly gross bloody urine) from any causes,
    7.        On special medications with a need to minimize stone formation and kidney/bladder damage, and
    8.        Excessive sweating under unduly high-temperature environment, hot weather and / or strenuous,  
              vigorous physical activities.

    By now, you should have a reasonably clear idea as to how much water you really need to drink a day.

    In general, just drink water timely whenever you feel thirsty. If the amount of water you drink is more than what your body needs,
    you would have no choice to make more urine so you would have to urinate more often.

    However, if you insist on following the common “wise-person’s” advice to drink a lot of water, you would have to graciously endure
    the inconvenience of frequenting bathroom.

    As long as you are able to void with steady continual urine flow to empty bladder under a satisfactory control and urine
    examination (urinalysis) is normal, your bladder should be just fine in its deserved healthy state.

    I hope the above discussion can bring you a realistic perspective and insight to answer your concern onhow much water do I
    need to drink a day?

    I wish you well. And have a wonderful healthy life and a happy bladder.

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    An Update on Water Drinking
       In 1990s, I gave a talk on the subject of  "how much water do we need to drink a day?" to a group of physicians at DO annual
    national convention. The contents of presentation then generated a significant amount of interest from and entertainment to an
    audience of physicians.

          Recently, a doubt about the truth and wisdom of drinking eight glasses a day begins to come out here and there among  
    various media and even directly coming out from some medical professionals. Such a change is encouraging to revive and bring
    about an attention to the respect of nature and commonsense of life. The promulgation of long-term traditional advice to drink 8
    glasses of water a day largely resulted from the power of commercialism to push more sale of water as well as the reluctance
    and shyness of medical professionals to face the pressure of political correctness.

          At this moment, I am pleased to see more people have a courage to raise the question on how true it is the necessity to drink
    eight glasses of water a day. Based on the above discussion, we should let common sense and intuition prevail and guide us to
    conduct daily living. Hopefully, more people will be mentally set free to trust intuition; the existence and strength of intuition have
    played an important role in achieving the harmony and happiness of life.

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