A 35-year-old Indiana mother died of water toxicity after drinking too much water during a recent vacation, her family said.
The family is now looking to raise awareness and prevent what happened to Ashley Summers from happening to others.
It all happened over the Fourth of July holiday weekend.
"She went boating all weekend and got severely dehydrated," her brother, Devon Miller, posted on Facebook on July 7. "On Tuesday she drank alot of water (at one point 4 bottles in less than 30 minutes). All this caused her brain tissue to start swelling. By Tuesday evening she was unconscious in the hospital and never woke up again."
(What is water toxicity and how much water is too much? More details below)
Get Tri-state area news delivered to your inbox. Sign up for NBC New York's News Headlines newsletter.
Later in July, Miller issued a warning to others.
"With the extreme heat this week, please monitor the amount of water you drink," he said. "And if you feel like you can't get enough, try to have a Gatorade or other drink that replenishes your electrolytes."
Summer left behind two daughters, both under the age of 10, and a husband, her brother wrote.
"If she would have drank Gatorade, or took in the water more slowly, she would be alive. To all my friends, do a little research on water toxicity. It may save someone's life," Miller said.
While such cases may be rare, they aren't unheard of.
In 2005, a California fraternity's hazing led to water intoxication of a young pledge, who later died after being forced to drink from a five-gallon jug repeatedly, NPR reports.
More recently, a woman doing the so-called "75 Hard" challenge revealed in a viral TikTok that she was diagnosed and hospitalized with "severe sodium deficiency" due to her water consumption.
"If you're ever thinking about doing a challenge that requires a crap ton of water remember this video," she said.
What is water toxicity?
Water toxicity, according to the Mayo Clinic, can happen when you drink too much water and "your kidneys can't rid of the excess water."
"The sodium content of your blood becomes diluted," the hospital group notes. "This is called hyponatremia and it can be life-threatening."
Hyponatremia can cause your body's water levels to rise and "your cells begin to swell."
The Cleveland Clinic notes that certain medical conditions, drinking too much alcohol and certain medications or other drugs can lead to an increased risk for hyponatremia.
"The severity of the symptoms depends on how low the sodium levels are in the bloodstream and how quickly they fall," the clinic reported. "In many cases, blood sodium levels fall gradually, producing only mild symptoms as the body has time to make adjustments. Symptoms are more serious when blood sodium levels fall quickly."
Harvard's school of public health adds that "women and children are also more susceptible to hyponatremia because of their smaller body size."
How much water is too much?
The U.S. National Academies of Sciences, Engineering, and Medicine found an adequate daily fluid intake for an average, healthy adult living in a temperate climate:
- About 15.5 cups (3.7 liters) of fluids a day for men
- About 11.5 cups (2.7 liters) of fluids a day for women
But the Mayo Clinic notes that such recommendations "cover fluids from water, other beverages and food," adding that roughly 20% of daily fluid intake typically comes from food.
Still, some adjustments may need to be made.
According to Mayo Clinic, total fluid intake could need to be modified based on several factors, such as the following:
- Exercise. If you do any activity that makes you sweat, you need to drink extra water to cover the fluid loss. It's important to drink water before, during and after a workout.
- Environment. Hot or humid weather can make you sweat and requires additional fluid. Dehydration also can occur at high altitudes.
- Overall health. Your body loses fluids when you have a fever, vomiting or diarrhea. Drink more water or follow a doctor's recommendation to drink oral rehydration solutions. Other conditions that might require increased fluid intake include bladder infections and urinary tract stones.
- Pregnancy and breastfeeding. If you are pregnant or breastfeeding, you may need additional fluids to stay hydrated.
Harvard's school of public health adds that "higher amounts may be needed for those who are physically active or exposed to very warm climates" and "lower amounts may be needed for those with smaller body sizes."
"It’s important to note that this amount is not a daily target, but a general guide," the school's website reads.
How do you know if you're properly hydrated?
According to the Mayo Clinic, signs of adequate hydration include rarely feeling thirst and urine that is colorless or a light yellow.
What are symptoms of water toxicity?
The Cleveland Clinic notes that "hyponatremia causes neurologic symptoms ranging from confusion to seizures to coma." But there are other signs and symptoms to also watch for. Those include:
- Muscle cramps or weakness.
- Nausea and vomiting.
- Lethargy, or low energy.
- Headache.
- Mental status changes.
How can you prevent water toxicity?
Experts say there are other ways of staying hydrated that may not always include drinking water.
Food such as watermelon or spinach and a number of other fruits and vegetables are another source of water. Other beverages like milk, juice and herbal teas are also made up largely of water.
"Even caffeinated drinks — such as coffee and soda — can contribute to your daily water intake," the Mayo Clinic reports. "But go easy on sugar-sweetened drinks. Regular soda, energy or sports drinks, and other sweet drinks usually contain a lot of added sugar, which may provide more calories than needed."
