Why dehydration sneaks up after 60
Most women picture dehydration as something that happens on a hot day or after a long walk, with a dry mouth to announce it. That is not the version Dr. Martin worries about. The one he worries about is quiet.
It is widely recognised that the sense of thirst tends to get duller as we age, so the cue that used to send you to the tap at 40 may barely register at 70. Dr. Martin puts the same problem more simply.
Dr. Martin, The Doctor Is In, Episode 1003People walk around because they don't have a little light bulb on their head that tells them they're dehydrated.
So the body will not always warn you. That is the whole reason he does not want anyone waiting to feel thirsty before they drink. He wants the water going in on a schedule, whether you feel like it or not.
He opened this episode with a long running study on water, following thousands of people for 25 years, with a headline he was glad to read out: dehydration is linked to early aging and chronic disease. His reaction was that research after research is confirming what he has been saying for a long time.
The medication factor
This is the part that lands hardest on women over 60. He used to measure the thickness of patients' blood in his office, and one pattern came up again and again.
Dr. Martin, The Doctor Is In, Episode 1003the vast majority of people, if you are on any medication, any medication, you're gonna be dehydrated even more than normal.
Then he did the arithmetic out loud. Once you get to 65 and up, he puts the share of people on some kind of medication at around 90 percent, and he lists blood thinners and statins among the common ones. Put those two facts together and you have a population that is drier than normal, with a thirst signal that is quieter than it used to be. That is the woman he is talking to on this episode.
He is not telling anyone to stop a prescription. If you take one, the case for drinking water on purpose is stronger.
How much water he wants a day
He does not hedge on the number. After almost 50 years in practice, he says, he gets to tell you what he thinks, and this is it.
Dr. Martin, The Doctor Is In, Episode 1003You need 64 ounces or two liters of water a day. Okay? How much water? Two liters, 64 ounces for my American friends, okay? That's how much water you need on average. Not less. Not less. Maybe more.
That is roughly eight standard glasses spread across the day. If you have never measured it, he suggests you do, at least at the start, because most people who think they drink plenty find they are well short. He says he saw tens of thousands of dehydrated patients get what he calls immediate results once they started, and that they could not get over how much better they felt.
Asked on the episode what kind of water, he said spring water is his first pick, because it is mineralized. The bigger point is the volume.
"Only water is water."
Dr. Martin, The Doctor Is In, Episode 1003Why only water counts
The most common pushback he hears is that there is water in everything else you drink. Coffee is mostly water. Fruit is full of it. He does not argue with the chemistry. He argues with the result.
Dr. Martin, The Doctor Is In, Episode 1003And only water is water. You cannot substitute.
His explanation is about the route it takes. Coffee, juice and food have to be processed before your body gets the fluid out of them. Plain water does not.
Dr. Martin, The Doctor Is In, Episode 1003When you drink water on its own, it takes a direct route to your bloodstream.
He still likes coffee, and he says so on this episode. It just does not go toward the two liters. Neither does watermelon, and neither does juice.
What it does to your heart and blood
He calls your blood vessels the river of life, over 60,000 miles of them, and a river has to flow. When you do not drink enough water, he says, your blood thickens and your heart, which is a pump, has to work harder to move it.
Dr. Martin, The Doctor Is In, Episode 1003There's nothing better for your circulation, for your heart, for your brain blood supply.
He also thinks of the heart as an electrical grid, and he links dehydration to atrial fibrillation, the irregular rhythm that is so common after 60. On this episode he gives two reasons he believes AFib is so widespread: dehydration, and a lack of strength in the mitochondria of the heart muscle, which run on CoQ10. He adds that dehydration will push blood pressure up, and that statins, the drug class so many women over 60 are on, lower CoQ10. More on the circulation side is in how to improve circulation after 60, and on pressure in blood pressure in women over 60.
Signs he saw in the office
Because thirst is unreliable, it helps to know what dehydration looked like in the patients he saw. The one he was most consistent about was headaches. He was clear there are other causes, hormones among them, but this is the pattern he kept seeing.
Dr. Martin, The Doctor Is In, Episode 1003people who suffer with headaches are dehydrated. They're dehydrated.
He says it may not be everything, but it is a big factor.
None of these signs proves you are dehydrated. They are reasons not to assume you are not.
Building the habit
He admits plenty of people do not like the taste of water. His reply to them was always the same: you do not have to like it, it is a vitamin, you need it.
What he promises is that it gets easier, and he puts a time on it.
Dr. Martin, The Doctor Is In, Episode 1003Don't wait for your thirst mechanism, but you will create like almost like a light bulb that will go off if you start drinking water by the time you get to the third week.
That is the light bulb you were missing at the start. You build it yourself. A glass when you wake, one with each meal, and the rest spread across the afternoon is an easy way to get to two liters without thinking about it. Three weeks in, by his count, you will realise how thirsty you had been all along.
Common questions
Why are women over 60 more likely to be dehydrated?
The thirst signal tends to get quieter with age, and Dr. Martin points out that most people over 65 take at least one medication, and any medication dehydrates you more than normal. Together that means many women are low and do not feel it.
How much water should a woman over 60 drink?
His number is 64 ounces, or two liters, of plain water a day. He says not less, and maybe more.
Does coffee or tea count toward my water?
Not in his view. He likes coffee, but he says only water is water, because plain water goes straight to your bloodstream without having to be processed.
Should I wait until I am thirsty to drink?
No. He says not to wait for your thirst mechanism. Drink on a routine, and by about the third week the habit starts to feel natural.
Water first, then the heart muscle
Dr. Martin gives two reasons for the heart rhythm trouble he sees so often: dehydration, and heart muscle mitochondria short on CoQ10. Water covers the first. Martin Clinic's Ubiquinol is a CoQ10 for the second.
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