What Can I Drink to Avoid Hyponatremia? The Guide to Safe Hydration

December 26, 2025 •

4 min read

Experts warn that drinking excessive plain water during intense activity can dangerously dilute sodium levels, a condition known as hyponatremia. Many people, especially athletes, often wonder what can I drink to avoid hyponatremia without sacrificing proper hydration. The answer lies in understanding the balance between water and electrolytes.

Quick Summary

This guide outlines the best beverages for preventing low blood sodium, including electrolyte-rich options and natural alternatives, and explains how to hydrate safely during exercise.

Key Points

Balance Water and Electrolytes: During intense exercise, replacing fluids with only plain water can dilute blood sodium, increasing hyponatremia risk. Use electrolyte drinks instead.
Drink to Thirst: For normal daily hydration and light exercise, use thirst as your guide. Avoid excessive or compulsive water intake.
Consider Electrolyte Drinks for Endurance: For activities over 1-2 hours or in high heat, switch from plain water to a sports drink, coconut water, or an oral rehydration solution to replace lost sodium.
Check Your Urine Color: Pale yellow urine indicates proper hydration, while consistently clear urine may suggest overhydration. Dark yellow suggests dehydration.
Be Mindful of Medications and Medical Conditions: Certain health issues (heart, kidney, liver disease) and medications can increase hyponatremia risk, requiring specialized hydration strategies and medical supervision.
Seek Medical Advice for Severe Symptoms: Confusion, seizures, or loss of consciousness are medical emergencies requiring immediate professional care.

Understanding Hyponatremia and Its Causes

Hyponatremia is a medical condition defined as a serum sodium concentration below 135 mEq/L. Sodium is a critical electrolyte that helps regulate the body's water balance, nerve impulses, and muscle function. When the sodium in your blood is diluted by too much water, water enters your cells, causing them to swell. This cellular swelling, especially in the brain, can lead to dangerous complications like seizures and coma.

Key Causes of Low Sodium Levels

While overconsumption of water is a major cause, particularly among endurance athletes, other factors can contribute significantly.

Excessive Sweating: During prolonged endurance activities like marathons, significant amounts of sodium are lost through sweat. Replacing lost fluid with only plain water dilutes the remaining sodium.
Underlying Health Conditions: Diseases affecting the heart (congestive heart failure), kidneys, or liver (cirrhosis) can cause the body to retain excess fluid, diluting sodium levels.
Certain Medications: Diuretics (water pills), some antidepressants, and pain medications can interfere with the body's sodium regulation.
Hormonal Imbalances: Conditions like Syndrome of Inappropriate Antidiuretic Hormone (SIADH) or Addison's disease can lead to water retention.

What to Drink for Safe Hydration

Instead of overdoing plain water, a balanced approach involves consuming fluids that help restore and maintain the body’s electrolyte equilibrium. This is especially important during and after prolonged, intense exercise or in hot weather.

Electrolyte-Rich Beverages

For strenuous activities, these drinks are designed to replenish fluids and lost electrolytes effectively.

Sports Drinks: Commercial sports drinks contain a balanced blend of water, carbohydrates, and electrolytes, particularly sodium and potassium. For many athletes, these are a convenient option. It is wise to opt for lower-sugar varieties to avoid excessive sugar intake.
Oral Rehydration Solutions (ORS): Often used for treating severe dehydration from illness, ORS products like Pedialyte are highly effective for replacing electrolytes. They contain a higher concentration of electrolytes than typical sports drinks and less sugar.
Electrolyte Tablets or Powders: Convenient and customizable, these can be added to water to create an electrolyte-balanced drink on the go. Many brands offer a range of sodium and other mineral concentrations.

Natural Electrolyte Options

For those who prefer natural ingredients, several drinks can help replenish lost minerals.

Coconut Water: A natural source of electrolytes, including a high amount of potassium. While it contains some sodium, it is typically not enough for intense, prolonged exercise unless supplemented.
Vegetable Juices: Certain vegetable juices, such as tomato juice, contain natural sodium and potassium. Reading the label is important, as packaged versions can be high in added salt.
Homemade Electrolyte Drinks: A simple DIY solution involves mixing water, a pinch of salt, a small amount of sugar or honey, and some fruit juice for flavor. This provides a customizable drink without unnecessary additives.

The Role of Plain Water

For normal, day-to-day hydration and light exercise, plain water is perfectly adequate. The key is to listen to your body's thirst signals and drink in moderation. The danger arises when over-consuming plain water, especially when significant sodium has been lost through sweat. Relying solely on water during endurance events can trigger hyponatremia due to a dilution effect.

Smart Hydration Strategies to Avoid Hyponatremia

Hydrate According to Thirst: Use thirst as your primary guide for how much to drink. This prevents both under- and over-hydration.
During Prolonged Exercise: For activities lasting over 1-2 hours, especially in hot conditions, switch to an electrolyte-containing fluid. Sip small amounts regularly rather than drinking large volumes at once.
Monitor Urine Color: Your urine should be a pale yellow color. Clear urine can indicate over-hydration, while dark yellow suggests dehydration.
Adjust for Conditions: Factors like high altitude, hot weather, and certain illnesses require increased fluid intake, but the sodium balance must still be considered.

Comparison of Hydration Drink Options


Drink Type	Key Electrolytes	Sodium Level	Sugar Content	Best For
Plain Water	None (unless bottled)	Very Low	None	Everyday hydration, light exercise
Sports Drink	Sodium, Potassium	Moderate	Variable (often high, low-sugar options available)	Strenuous exercise >1 hour
Coconut Water	High Potassium	Low	Natural Sugars	Everyday hydration, supplementing other sodium sources
Oral Rehydration Solution (ORS)	High Sodium, Potassium	High	Low	Illness (vomiting/diarrhea), intense activity if needed
Homemade Drink	Customizable	Customizable	Customizable	Custom needs, avoiding additives

Conclusion: Finding the Right Balance

Successfully avoiding hyponatremia boils down to one principle: maintaining a healthy balance of fluids and sodium. For most daily activities, drinking water when you are thirsty is sufficient. However, for endurance athletes, those working in hot climates, or people with specific medical conditions, a more deliberate strategy is necessary. Incorporating electrolyte-rich beverages like sports drinks, coconut water, or a homemade mixture can be crucial for replacing lost sodium and preventing dangerous dilution. Always listen to your body and, if you have underlying health concerns or experience severe symptoms like confusion or seizures, seek immediate medical attention from a healthcare professional.

Consult a Professional for Specific Advice

For individuals with chronic health conditions like heart or kidney disease, or for those taking diuretics or other medications, hydration needs are more complex. Consulting with a healthcare provider or a registered dietitian is essential for a personalized hydration plan. Never attempt to self-treat severe hyponatremia, as it can be a medical emergency requiring intravenous treatment. You can find more information on hyponatremia from authoritative sources like the Mayo Clinic to further your understanding.

Frequently Asked Questions

The primary cause during exercise is the over-consumption of plain water without adequate sodium replacement, which dilutes the sodium levels in the blood.

Yes, drinking excessive amounts of plain water, especially when losing sodium through sweat, can overwhelm your kidneys and dilute the sodium content of your blood, leading to hyponatremia.

No. While most sports drinks contain electrolytes, their sugar and electrolyte concentrations vary. Some may not provide enough sodium for very intense or long-duration activities, and many contain high sugar levels.

Coconut water is a natural source of potassium and other electrolytes. However, its sodium content is often too low to be the sole electrolyte replacement for preventing hyponatremia during prolonged, high-intensity exercise.

An oral rehydration solution (ORS) is typically used for rehydrating during illness (like severe vomiting or diarrhea) or for very intense activities where electrolyte loss is high, as it contains a higher concentration of sodium and less sugar than many sports drinks.

Severe symptoms include profound confusion, seizures, altered mental status, and loss of consciousness. These require immediate emergency medical care.

For light or moderate workouts lasting less than an hour, plain water is generally sufficient. The risk of hyponatremia is lower, and the body's sodium stores are typically not depleted enough to require replacement via a beverage.