“Life is difficult. … Once we truly see this truth, we transcend it. Once we truly … understand and accept it-then life is no longer difficult. Because once it is accepted, the fact that life is difficult no longer matters.”
― M. Scott Peck, The Road Less Traveled: A New Psychology of Love, Traditional Values and Spiritual Growth
Focusing on Fluid
Our bodies naturally contain around 60% water. However, the percentage can vary from roughly 45–75%. However, some serious medical conditions are linked to fluid retention. These commonly involve hormone fluctuations or vital organs such as the kidneys, liver or heart leading to water retention.
While researching this post I came to realise I could write a text book solely on fluid retention. Instead I have focused on three themes. Firstly, fluid retention in general. Secondly fluid retention and hormones. Lastly, fluid retention and heart health. I include lived experiences and tips and tricks offered from our transplant community.
Fluid Retention – Oedema Overview
Fluid retention, or oedema, is a common issue marked by swelling in various parts of the body. This can often be in the abdomen, legs, ankles, and feet. It occurs when excess fluid accumulates in the body’s tissues. This can signal underlying health issues, such as heart, liver, or kidney conditions. While mild fluid retention may be harmless, managing it effectively is crucial for those with chronic health concerns.
Common Causes of Fluid Retention
Fluid retention can stem from numerous factors, including:
Heart Failure
Reduced heart function can cause blood to back up, leading to fluid accumulation, particularly in the lungs and legs.
Kidney Disease
Compromised kidney function can prevent efficient fluid and sodium balance, often resulting in general swelling.
Medications
Certain medications, like corticosteroids and some blood pressure drugs, can trigger fluid retention as a side effect.
Lifestyle and Dietary Factors
High salt intake, long periods of sitting or standing, and inadequate exercise can contribute to fluid buildup.
Pregnancy
Increased blood volume during pregnancy commonly leads to oedema, particularly in the legs.
Hormonal Shifts
Hormone fluctuations related to the menstrual cycle commonly occur during perimenopause, menopause, and certain hormonal medications. Hormones play significant roles in regulating water and salt balance in the body.
Symptoms of Fluid Retention
Oedema symptoms vary depending on the cause and severity. Common signs include:
Swelling in the limbs and extremities
Often observed in the legs, feet, and ankles, where gravity causes fluid to pool.
Weight Gain
A sudden increase in weight may be due to retained water.
Skin that Pits with Pressure
Pressing on the swollen area may create a temporary indentation.
Shortness of Breath
Especially in cases where fluid accumulates in the lungs, causing breathing difficulties. If you are having difficulty breathing, particularly when lying down you need to seek immediate medical attention. Pulmonary oedema is fluid on or around the lungs and is to be investigated asap.
Managing Fluid Retention
Managing fluid retention effectively involves addressing the root causes and making lifestyle adjustments. Consider the following:
Dietary Modifications
Reducing salt intake helps decrease water retention. Fresh, whole foods and low-sodium options can support fluid balance.
Exercise and Movement
Regular physical activity can improve circulation, reduce swelling, and prevent blood pooling. Particularly the legs, ankles and feet.
Elevation
Elevating swollen limbs above heart level promotes fluid drainage.
Compression Garments
Compression stockings or sleeves apply gentle pressure, supporting the return of fluid to the bloodstream.
Consult Healthcare Providers
Persistent or worsening oedema requires medical assessment to identify underlying health issues and tailor treatments effectively.
Hormones and Fluid Retention
Fluid retention, or oedema, is a common concern among people experiencing hormonal shifts. This can include those related to the menstrual cycle, perimenopause, menopause, and certain hormonal medications. Hormones like oestrogen, progesterone, and cortisol (stress hormone) play significant roles in regulating water and salt balance in the body. Understanding these hormonal effects and incorporating lifestyle adjustments can help alleviate fluid retention and its discomfort.
Causes of Fluid Retention Due to Hormonal Changes
Menstrual Cycle
Many women experience fluid retention in the days leading up to menstruation. This can be due to higher oestrogen levels and decreased progesterone, leading to increased sodium and water retention.
Perimenopause and Menopause
Hormonal fluctuations during perimenopause and menopause can contribute to water retention. Decreases in progesterone and changes in oestrogen levels can also lead to bloating.
Hormonal Contraceptives
Contraceptives containing oestrogen can increase fluid retention as a side effect, leading to swelling, especially in the extremities.
Stress and Cortisol
Chronic stress raises cortisol levels, which can affect electrolyte balance, leading to fluid retention.
Fluid Retention Symptoms
Fluid retention can present as bloating. It may also cause swelling, especially in the legs, ankles, and hands. Weight fluctuation and a feeling of heaviness are other possible symptoms. For some, this can also lead to joint stiffness or discomfort.
Remedies to Reduce Hormone-Related Fluid Retention
Diet Adjustments
Reducing salt intake helps prevent the body from retaining excess sodium and water. Foods rich in potassium, such as bananas, avocados, and spinach, can also balance fluid levels.
Stay Hydrated
While it may seem counterintuitive, drinking water regularly actually helps the body flush out excess sodium and reduces water retention.
Regular Exercise
Physical activity encourages circulation and prevents fluid from pooling in lower extremities, reducing swelling.
Magnesium and Vitamin B6
Magnesium aids in balancing fluid and electrolyte levels, while Vitamin B6 has shown benefits in alleviating premenstrual symptoms, including bloating.
Herbal Teas
Teas such as dandelion and parsley act as natural diuretics, helping the body release excess water.
Hormone Balance
In some cases, you may need hormonal supplements. You might also need adjustments to existing hormone therapy. Consult a healthcare provider for personalised advice.
When to See a Doctor
If fluid retention persists or is accompanied by other concerning symptoms, it is advisable to consult a healthcare provider. Prolonged oedema may indicate other health conditions such as kidney or heart issues, which require medical intervention.
Heart Health and Oedema
How Serious Is Excess Fluid on the Heart
Fluid retention, or oedema, is a common symptom in people with heart conditions. It often signals underlying issues like heart failure or high blood pressure. As the heart’s efficiency in pumping blood decreases, fluid builds up in tissues. This fluid accumulation happens especially in the legs, ankles, and abdomen.
This condition can lead to weight gain, swelling, and breathing difficulties. These are especially pronounced during physical activities or when lying down. Effective management of fluid retention is essential for maintaining heart health and quality of life.
Causes of Fluid Retention in Heart Health
Fluid retention arises due to poor circulation and the heart’s reduced ability to pump blood efficiently. This is a condition often seen in heart failure. The kidneys may start to retain salt and water to compensate for the heart. Often this leads to further fluid buildup in the body’s extremities, lungs, and abdomen. This can worsen with other health factors, including high salt intake, lack of physical activity, and medications that retain fluid.
Recognising Symptoms of Fluid Retention
Key signs of fluid retention due to heart issues include:
- Swelling in the legs, ankles, and feet
- Sudden weight gain (2 kg or more in a short period)
- Shortness of breath, especially when lying down
- Fatigue and reduced physical stamina
- Bloating and a sensation of fullness in the abdomen
Tracking these symptoms through regular weight monitoring is crucial for early detection. Sudden weight changes may indicate fluid buildup, prompting adjustments in treatment, such as diuretic medications or fluid intake restrictions.
Effective Management Strategies
Currently I am battling Constrictive Pericarditis of my recently transplanted heart. This condition causes common symptoms experienced by Heart Failure patients. One of these symptoms being fluid retention. I asked our transplant community for tips and tricks they suggest to deal with fluid retention. My next post will focus on coping with fluid restrictions and hacks to make this difficult process easier.
Medication
Diuretics are commonly prescribed to help the body remove excess fluid through urine. Common diuretics used for heart patients include Furosemide, Spironolactone and even Jardiance. Jardiance was originally created to control sugar levels in diabetics.
Other heart medications, such as ACE inhibitors, ARBs, and beta-blockers, also aid heart function by improving blood circulation. Thus, reducing strain on the heart, and preventing further fluid buildup.
More information about Spironolactone can be found here. Visit Non Anti Rejection Medications After Transplant. Also, see Battling Hair Loss After Heart Transplant.
Dietary Adjustments
Salt
Limiting salt intake helps reduce water retention, as sodium causes the body to hold onto fluid. The Heart Foundation recommends aiming for less than 1,500 mg of sodium per day, focusing on fresh, unprocessed foods. Lowering sodium intake has shown to ease symptoms of heart failure and reduce the risk of complications.
Simple Sugars
Reducing white carbohydrates like sugar, flour, rice, pasta, and bread will also reduce water weight. This is because carbohydrates are stored as glycogen. For each molecule of glycogen we retain 3 molecules of water.
That equates to 3 grams of retained water for each gram of carbohydrate you consume. That is why I reduce simple low nutrient dense carbohydrates to help me keep fluid retention to a minimum.
Lifestyle Modifications
Moving Your body
Daily low-impact exercises like walking and strength-building activities can help maintain circulation and reduce swelling. Cardiac rehabilitation is a significant feature of post transplant recovery. No matter how bad I feel, I walk each day. If I really feel terrible I will just walk for 5 minutes. After that 5 minutes I will either stop or I will do another 5 minutes. I walk in increments of 5 successful minutes of moving. After the walk I add in full body stretches to maintain the range of movement.
Monitor Fluid Intake
In addition to monitoring fluid intake you need to gauge urine output. Fluid restrictions are difficult to cope with and torturous to live with. Managing a strict fluid restriction is tricky. This is because many foods we eat contain lots of water. These foods need to added into our total daily water restriction.
Some transplant patients I have met have to endure fluid restrictions of less than 800 ml each day. That is not a lot! Before my transplant I was on fluid restrictions for 18 months. I was allowed 1. 2 Litres a day. That may seem like a lot but it is not. I go into more depth about Fluid Restrictions in my next post. The post includes tips and tricks offered by our transplant community.
Regular Checkups
Maintaining regular appointments with healthcare providers is vital. These include your family doctor, heart failure management programs and cardiac rehabilitation. Dealing with unexplained fluid retention can improve health outcomes through early diagnosis of underlying medical conditions. Improved quality of life and longevity rely on fluid and dietary management, physical activity, surgical interventions and medication adherence. Take early and decisive action and have agency over your health. Life is difficult enough.
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Related Posts include: Heart Failure. Hair Loss occurs after a heart transplant. Another post is about what you need to know about hospital meals and food choices. Lastly, learn about cardiac rehabilitation.
Love and light
X
Wednesday
References
Australia, H. (2024, November 1). Fluid retention. Healthdirect Australia. https://www.healthdirect.gov.au/fluid-retention
Better Health Channel. (2023). Heart failure. Retrieved from https://www.betterhealth.vic.gov.au
British Heart Foundation. (2023). Managing heart failure and fluid retention. Retrieved from https://www.bhf.org.uk
Fluid retention (oedema). (n.d.). Better Health Channel. Retrieved November 1, 2024, from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Fluid-retention-oedema
Harvey, G. (2019). Water retention: Causes, symptoms, and treatments. Patient. Retrieved from https://www.patient.info
Health Navigator NZ. (2023). Fluid retention due to heart failure. Retrieved from https://www.healthnavigator.org.nz
Queensland Health. (2023). Heart failure management guide. Retrieved from https://www.health.qld.gov.au
Verywell Health. (2023). Water retention: Symptoms, causes, and remedies. Retrieved from https://www.verywellhealth.com
Water retention causes, symptoms, and treatments. (n.d.). Retrieved November 1, 2024, from https://patient.info/news-and-features/what-causes-water-retention
