I am 23 years old, work out regularly, eat a well-balanced diet, and take vitamin supplements. I recently have had problems with water retention. How can I deal with this problem?
Water retention generally means a swelling of the lower legs, and occasionally elsewhere, which can be indented by pressing on the skin with a fingertip. The medical term for this is edema, and it can be a sign of many different diseases. In someone who is young and otherwise healthy, like yourself, it is most likely to be idiopathic, meaning that the cause is not known. It is most common in women, so I am assuming that you are a woman.
Water inhabits three different spaces in our bodies; the forces that keep the amount of water balanced between these spaces are complicated and modified by a variety of factors. The three spaces are the intravascular, the water that forms the liquid portion of blood; the intracellular, the water held within cells; and the interstitial, the water that is neither in our circulatory system nor in our cells. This last type is found in the spaces between the cells in our tissues. An increase in this interstitial water — or a shift from the circulating water to the interstitial water — creates edema.
The blood in our circulatory system is responsible for moving water around: from the intestine where it is absorbed, to the lungs, kidneys, and skin where it is lost, to the tissues, where it may contribute to interstitial fluid and cause edema.
Water can move freely out of the circulatory system into the interstitial space; the real question here is why it all doesn’t move out all the time. The answer lies in the opposing forces that tend to push water out and those that force it back into the circulatory system. Without going into too much detail, hydrostatic pressure — fueled by blood pressure and gravity — tends to pull the push water out of the blood. Oncotic pressure — produced by salts and proteins in the blood — tends to pull water back into the blood. Tissue pressure — produced by the skin and tissues which can hold only so much volume — also tends to force water into the blood.
Water in the body is always accompanied by salt, so by controlling the total amount of salt in the body, we can control the amount of water. We must balance the salt we eat with secretion from the kidneys and the loss of salt in our sweat. If we eat too much salt, we can overwhelm even healthy kidneys, and the total amount of salt in the body increases, along with the water. The water has to go somewhere, and the amount that can be held in the cells and the circulatory system is strictly limited; so the excess then goes into the interstitial fluid, and the result is edema.
Four kinds of conditions can lead to edema: those that cause the kidneys to retain salt, including kidney failure, heart failure, and liver disease; those that reduce the amount of protein in the blood, including some kidney diseases, liver failure, and protein starvation; those that increase the hydrostatic pressure in the legs, such as standing immobile and sitting for prolonged periods (long airplane trips are a particular problem); and those that reduce tissue pressure, such as varicose veins and lack of muscular contractions (exercise) in the legs.
There are a number of easy, natural things that you can do to reduce your water retention. First and most effective is to reduce salt intake, especially in hot weather. Keep exercising. If you have a sedentary job, keep your legs moving: walk around regularly or do some deep knee bends at work. Keep your feet elevated above hip level as much as possible, especially after work, when watching TV, etc. You might wear elastic hose to work; it increases the tissue pressure. Avoid constricting garters, underwear, and clothing, which tend to increase hydrostatic pressure in the legs, particularly in people who are obese or have heavy thighs.
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