The six signs you're not drinking enough water

When did you last have a decent drink of water? We all know we should down more H₂O, yet the average Briton sips less than half the recommended six to eight glasses a day, shows recent research by PureGym. This doesn't just leave us feeling parched, it can put us at risk of dehydration and long-term health issues.
' Water is essential for life and plays a vital role in nearly every body process,' says Stavros A. Kavouras, a professor of nutrition and director of the Hydration Science Lab at Arizona State University. 'It helps regulate your temperature, transport nutrients, remove waste and lubricate your joints. Proper hydration aids digestion, supports kidney and heart health, and enhances physical performance.'
The human body is around 60 per cent water, but we constantly lose fluid – about 2 to 2.5 litres a day – through our sweat, urine, stools and breath. Replacing that fluid regularly is crucial.
'Many of us are mildly dehydrated or 'under-hydrated' without realising it,' says Prof Kavouras. 'This can subtly, yet significantly, impact how we feel and function. More importantly, it's linked to chronic health conditions such as hypertension, diabetes and dementia, which in turn means a reduced life expectancy.'
In hot weather, dehydration can escalate quickly, potentially leading to collapse or even death. The risk rises if you're older, taking multiple medications or have sickness and diarrhoea. Dehydration is one of the most common reasons for A&E admissions in the elderly.
Here are the telltale symptoms to watch out for:
1. You're thirsty
Feeling parched? You're already mildly dehydrated. ' Thirst is the first stage of dehydration,' says Dileep Lobo, a professor of gastrointestinal surgery at University of Nottingham, who researches fluid and electrolyte balance.
'Once you've lost two per cent of your body weight in fluid (1.4 litres for a 70kg person), it triggers receptors in the brain which make you feel thirsty. Mild dehydration can happen easily if you're out in the sun or working in a warm office and not drinking much. You lose quite a lot of water through your sweat, especially if you're not acclimatised.' At this point, dehydration is easily reversed by drinking fluids.
'If you replace the water you've lost, you'll feel better immediately,' says Prof Lobo. 'The fluid enters your bloodstream and corrects the imbalance.' Our sense of thirst declines with age, so sip water throughout the day.
2.Your urine is darker
Check the colour of your urine. If it's honey coloured, you need to drink more. If it's darker brown, you may be seriously dehydrated. 'Once thirst occurs, your body starts holding on to water,' explains Prof Lobo. 'Your kidneys send less water to the bladder, making your urine more concentrated.' This is a major risk factor for kidney stones.
'If you don't drink enough, your kidneys have to work really hard and this raises your risk of certain diseases, including urinary tract infections, especially if you're a woman,' adds Dr Lewis James, a reader in human nutrition at Loughborough University. Kidney function declines with age, making dehydration more likely, so keep an eye on your urine output. Ideally, you'll be passing urine about seven times a day, and it should be transparent yellow.
3. You've got brain fog
The brain is 73 per cent water so your brain cells can struggle to function once you're dehydrated. 'Even a low level of dehydration can reduce cognitive skills such as memory, attention and motor coordination,' says Dr James. 'This may affect your performance whether you're working in an office, driving your car or deciding if it's safe to cross the road.'
A study in the Journal of Clinical Nutrition found 45 per cent of doctors and nurses were dehydrated by the end of their shifts, and their short-term memory was impaired. Just drinking a 300ml glass of water has been shown to improve memory recall. As dehydration progresses, you can become confused and disorientated.
4. Headaches
Dehydration is a common trigger for headaches. As fluid leaves your brain, it can put pressure on the pain receptors and nerves in the brain's lining. The pain can worsen when you bend and turn your head or move around. Most dehydration headaches improve within an hour or two, once you've rehydrated and rested. Stay out of the sun and try putting a cool compress on your forehead.
A dehydration headache can turn into migraine, so try to drink fluids even if you feel nauseous – small sips are best. 'Drinking enough water can help reduce risk of a migraine attack through dehydration,' says Pippa Coulter, health information manager for The Migraine Trust. A study in the Journal of Clinical Neuroscience found migraine pain, duration and frequency was significantly lower in patients who drank more water.
5. You're tired and listless
Dehydration is behind one in ten GP consultations for fatigue, according to a study of 300 GPs by the Natural Source Water Association. Regularly sipping water keeps your body and brain energised, especially if you're active. During hot weather, you can lose 1.5 to 2 litres of water an hour through sweat whether you're hiking or playing a round of golf. 'If you don't replace these fluids, your blood thickens, and your heart has to work harder to maintain your blood pressure and oxygen levels,' warns Prof Lobo.
As we age, dehydration can make daily life exhausting. 'An 80-year-old who weighs 40kg (88 lb) and loses bodyweight through fluids is more likely to feel the effects,' says Prof Lobo. ' Our research shows that older adults, admitted to hospital with dehydration, stay in for longer and have a 6 per cent higher mortality rate.'
6. You feel dizzy and faint
'Once you've lost four per cent of your bodyweight in fluid, sweating becomes difficult and your temperature rises, putting you at risk of overheating,' says Prof Lobo. 'Blood pressure drops, and you can become dizzy or faint.' This is 'moderate dehydration' and you should seek medical advice. Oral electrolyte solutions can help but sometimes an IV drip is needed. Without treatment, dehydration can progress to 'severe' (a 7 per cent loss of bodyweight) within 24 hours. It's now a medical emergency. 'The body reduces blood flow to non-vital organs, like your kidneys,' says Prof Lobo. 'Cellular waste builds up, organ damage can occur and, without intervention, you may eventually suffer seizures or collapse.' Multi-organ failure, coma and even death can follow. Hot weather can accelerate the process, so always carry water and seek shade if you feel tired or light-headed.
FAQs
How much water should I drink a day?
'Your body needs around two litres of fluid a day,' says Johanna Hignett, consultant nutritionist. 'Some of that comes from food, such as fruit and vegetables, so aim to drink 1.5 to 2 litres of water (about six to eight 250 ml glasses). If you're very active or it's hot, your fluid needs rise.'
Tea and coffee do count. 'The diuretic effect of the caffeine is offset by the fluid content – research shows up to four cups of coffee (400mg caffeine) a day is ok,' says Hignett. 'Milk counts too – it's over 80 per cent water – as does fruit juice, but plain water is best because it's absorbed directly and contains no calories or sugar.'
Is it better to drink cold or room temperature water?
'It doesn't matter what temperature your drinking water is,' says Hignett. 'It warms up in your stomach to body temperature.' Drinking warm or hot water is said to aid digestion and circulation. Chilled water feels refreshing so may quench your thirst and cool you more in summer.
Is tap water safe to drink?
UK tap water is some of the safest in the world. It must meet standards set by the Drinking Water Inspectorate, and the latest report (2023) shows a quality rating of 99.97 per cent. 'The taste of tap water depends on where you live,' says Hignett. 'If you're not keen on it, try flavouring it with fresh herbs or fruit slices, or try natural source waters, like mineral or spring water.'
Should I drink water before, after or during exercise?
'If you're exercising for up to an hour, you can be guided by thirst,' says Dr James. 'Ensure you're hydrated before you start, then a drink afterwards may be sufficient.' For longer sessions, you may need to top up with water or a sports drink while you exercise. 'You can calculate your fluid losses by weighing yourself before and after your session,' says Dr James. 'If you've lost half a kilo and drunk half a litre during your workout, you've lost about a litre of sweat, so aim to replace that fluid over the day, on top of what you'd normally drink.'
Is it possible to drink too much water?
'It's rare, but it can happen,' says Hignett. 'If you drink large amounts in a short time, your cells become too dilute (hyponatremia) meaning essential minerals, such as sodium and potassium, can't perform their functions. Your kidneys struggle, your cells swell and you can get confusion, cramps, vomiting, seizures and, in extreme cases, coma or death. This is why it's important to drink little and often.' Our kidneys can process about a litre of water an hour, so avoid exceeding that.
When's the best time to drink water?
'Drinking little and often keeps your fluid levels steady, rather than the balance going one way, then the other,' says Hignett. 'Waiting until you're thirsty, then drinking lots of water, makes your body think it's well hydrated, so it excretes more. This happens when you have a cup of tea before bed, then wake up in the night needing the bathroom.' Don't avoid drinking for fear of needing the loo – concentrated urine aggravates the bladder, exacerbating the problem. 'Just drink regularly so your body gets used to it,' says Hignett. Research shows that drinking 500ml water before a meal can aid weight loss by preventing overeating. It's also thought to help digestion.
Can food count towards your fluid intake?
'Up to a third of the water we consume comes from food,' says Prof Lobo. Fruit and vegetables are good sources of water, as are soups, stews and porridge cooked with milk or water. Cucumbers, tomatoes and broccoli are over 90% water. 'Look for squishy fruits, such as melon and strawberries,' says Hignett. 'Anything that doesn't freeze well will have a high-water content.'
Does alcohol cause dehydration?
Although alcohol contains water, it's a diuretic, making you need the loo more and so you'll lose extra fluid. 'If you want an alcoholic drink, a spritz is a sensible choice,' says Hignett. 'Adding sparkling water can help hydrate you, and it means you'll drink a bit less alcohol, fewer calories and less sugar. Beer with less than four per cent alcohol can hydrate you, but I don't recommend it! Try to alternate each alcoholic drink with water.'
Can medication cause dehydration?
'Some antidepressants (selective serotonin reuptake inhibitors, like Prozac) and weight-loss drugs (GLP-1 receptor agonists, like Ozempic) can suppress thirst, potentially increasing risk of dehydration,' says Professor Kavouras.

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She'd been using sunbeds for three years. 'I was really young and loved having a tan without the faff of getting all messy using fake tan,' recalls Georgia, now 27, from Horley, Surrey. 'My friends and I would go together for 10 minutes and you'd feel like you'd gone to Spain and back. It became addictive.' Even though she was at school when she started, like Taylor, she says she was never asked for ID. I was called back in and there was a consultant and a Macmillan nurse – I knew it wasn't good news and broke down. Georgia Edwards 'I just put my card into the machine and selected how many minutes I wanted. "I was going three or four times a week, but I could have gone twice a day if I'd wanted. No one stopped me.' Georgia showed her GP the affected mole in March 2017, after going to the doctor for a chest infection, and was immediately referred. After a biopsy, she was diagnosed with stage two melanoma that May. 'I was called back in and there was a consultant and a Macmillan nurse – I knew it wasn't good news and broke down.' Georgia, who works in a rehabilitation centre for children with brain injuries, was referred to London's Royal Marsden Hospital for treatment. 6 6 She had two surgeries to remove the cancer. Fortunately, it hadn't spread. 'I had a wide, local incision to cut out the mole and surrounding area as it was quite deep in my skin and close to the lymph nodes,' she says. 'I have a 12cm scar on my leg and, eight years later, I'm still regularly checked as there's a high risk of it returning. 'I was young and naive. I thought it wouldn't happen to me. That was my mindset. Young people simply aren't aware of the dangers, and in years to come there's going to be a mass of people getting diagnosed. "Influencers promoting sunbeds have no idea of the dangers, they don't realise it could cost someone their life.' 'I lost my sister and best friend to sunbed use' Jessica Crowe knows only too well the the pain sunbeds can bring. Her sister Tazmyn spoke to Fabulous in 2021 after being diagnosed with skin cancer in 2014. The mum of three died in March 2023, aged just 31, having used sunbeds up to twice a day when she was younger. 'When we were teenagers, Tazmyn would use them all the time,' recalls Jessica, 31, a healthcare assistant and mum to Poppi, 14, and Memphis-Cub, two. 'I went with her a couple of times, but I'd just burn, so I stopped going. She was the tanned one and she loved it. "But after her diagnosis, she'd often say: 'Why did I do it?' She immediately stopped using them and regretted ever having gone on one.' Five years after her diagnosis, the cancer returned to her lymph nodes – reaching stage three. "Pregnant with her third child at the time, Tazmyn delivered her son 10 weeks prematurely in order to have further cancer treatment, almost losing him to a pulmonary haemorrhage. Tragically, despite further surgery and medication, Tazmyn's cancer spread, progressing to stage four, and in March 2023 she passed away, leaving her children Dillyn-Angel, 14, Saylor-Doll, 11, and Boss, five, to grow up without their mother. Still grieving, Jessica, from Northern Ireland, says she finds social media posts advocating sunbed use and tan-boosting products distressing. 'It makes me so sad and angry. They make it sound like having a sunbed is harmless, when it's not. "As a family, we learned that the hardest way. Everything that Tazmyn went through began with sunbed use. "I was devastated when we lost her. I still am. She wasn't just my sister, but my best friend. 'My daughter would never use a sunbed, as she knows what happened to her aunt, but her friends do – some are only 13. "They are easily influenced by TikTok and Instagram.' This high-intensity UVA radiation can lead to genetic changes and mutations over time, which can build up and increase the risk of skin cancer. Susanna Daniels, CEO of Melanoma Focus The charity Melanoma Focus recently revealed that almost a third of people aged 16 and over in the UK use sunbeds, and that figure rises to 52% among 18-21 year olds. "More worryingly, only 47% of that age group understood that sunbeds increase their risk of skin cancer – and 20% even believed it could decrease the risk. 'These figures are really concerning,' says Susanna Daniels, CEO of Melanoma Focus. 'There is a swathe of misinformation on social media. Rather than being good for your health and increasing levels of vitamin D, as some influencers claim, most sunbeds mainly emit UVA radiation – which damages the DNA in skin cells – rather than UVB, which is required for vitamin D production. 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'If young people aren't making the right choices, we need to help them' Meanwhile, Jessica has a very different message. 'I'd like to see sunbeds banned like they are in other countries such as Australia, or at least some restrictions so they are not promoted online,' she says. 'When you're young, you don't think about the risks, but if young people aren't making the right choices, we need to help them.' 'Skin cancer took my sister from me and robbed her children of their mother. "My message to young women is: please stop using sunbeds, and ignore these influencers promoting them. Your life is worth more than a tan.' Call the Melanoma helpline on 0808 801 0777, 1-2pm and 7-9pm Monday-Friday, 7-9pm on Sundays ( 6 6

Daily Mail​

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• Daily Mail​

The Stitch-Up by Emma Szewczak with Dr Andrzej Harris: Help! My vagina has fallen out

The Stitch-Up by Emma Szewczak with Dr Andrzej Harris (Chatto & Windus £22, 288pp) In 2019, Emma Szewczak was being sewn up following the birth of her second child when the midwife paused and said: 'Your vagina's fallen out.' Those words, the author says, were the worst thing anyone had ever said to her. Not even a problematic first experience of childbirth could have prepared her for this. Eventually informed she was suffering a prolapse, she spent three years seeing specialist after specialist, moving from the NHS to private care to the so-called 'wellness' sector, with no one able to offer a solution. Along the course of that journey Szewczak and her husband Dr Andrzej Harris (Associate Professor of Pharmacology at Cambridge) became angrily aware of how many aspects of medicine let women down. Angry and frustrated, they wanted to find out why there's a complete lack of treatment options for conditions (from endometriosis to menopause and everything in between) affecting vast numbers of women across the world. The couple set out to examine 'how medical misogyny harms us all'. The shocking healthcare failures, in medical care and research, may or may not always be the result of institutional 'misogyny' – although most feminists (as I count myself) would level that charge. The problems are acute. In recent years there have been many books on this subject, from Elinor Cleghorn's Unwell Women to Breaking The Taboo by Theo Clarke. The personal stories are bleak, the cold carelessness in female as well as male medical staff often appalling – as Szewczak and Harris make clear. The case for the prosecution mounts: the outrage of vaginal mesh implants, the lack of awareness of potential birth trauma and perinatal psychosis, unnecessary breast surgeries as well as vaginal nips and tucks post-birth, inappropriate intimate examinations, and (of course) the series of maternity hospital scandals, including Shrewsbury and Telford. Endometriosis makes thousands of women suffer but doctors often fail to consider the condition when women seek help for their specific range of symptoms. Why? Underpinning this densely researched book is a simmering rage that women are so often addressed with patronage or indifference. In case you thought the process of birth a doddle, Szewczak provides a frightening litany of possible complications: 'Perinatal tearing… injuries to the pelvic floor… lacerations… episiotomies can become complicated with infection, pain and excessive bleeding… the bladder and urethra can be injured… severe bleeding and shock… damage to the symphysis pubis… postpartum haemorrhage…'. And much more. Who'd be a woman? Which is my problem with the book. For none of the above horrors will be suffered by biological males calling themselves female – or 'trans women', as they would have themselves identified. Yet routinely Szewczak uses the terms 'cis woman' or 'cisgender' for those of us born with the apparatus likely to cause us trouble throughout life, from the first period to the menopause and beyond. How can a book that claims to attack the neglect of women's health dare to belittle the experience of real women by calling it 'cisnormative'? And, astonishingly, just after the dire 'obs-and-gynae' catalogue above, Szewczak, with a degree in gender studies, attacks 'misgendering' (meaning consciously or accidentally calling someone the wrong gender) and 'obscene waiting times for gender-affirming care' for trans people. Is 'misgendering' really as bad as a prolapse or stillbirth? For Szewczak, the answer seems to be yes.