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October 2023 Newsletter


Hello, this is Dr. Ellen. In this month’s ‘Real Common Sense’ newsletter, I want to address the subject of dehydration. Acute episodes of dehydration are an important area of concern for those who participate in prolonged exercise and endurance events. For others, dehydration can be brought on by excessive exposure to high temperature conditions, especially with high humidity.

However, a large number of patients have come to me with a number of different health complaints that have persisted without an obvious reason. Through discussion and energetic testing, some are found to have mild, chronic dehydration. By correcting this through modification of fluid intake and diet, as well as Ellen Cutler Method (ECM) desensitization, there is often improvement and even resolution of their presenting problem. I’ll touch on both acute and chronic dehydration in this newsletter.

By the way, if you haven’t had a chance to see my previous newsletters, you can find them on my website, www.drellencutler.com under ‘Media’. 

What is Dehydration?

Dehydration occurs when you lose more fluid than you take in, impairing the normal functions of your body. You can become dehydrated if fluids are not sufficiently replaced either to compensate for a sudden short-term loss or if there is inadequate replacement over time. Dehydration is especially problematic for young children and older adults. The most common cause in children is severe diarrhea and vomiting.(1)

As we age, there is usually a decreasing total amount of water in our bodies. This is caused by several factors, including a decreased thirst responses to dehydration, decreased ability to concentrate urine (thus losing more water volume), and an increasing fat mass that tends to replace a decreasing muscle mass (important because muscle cells contain much more water than do fat cells). Older adults may also take medications (e.g., diuretics) or they may have conditions that increase their risk of dehydration. For example, even relatively minor illnesses, such as seemingly mild infections affecting the lungs or bladder, can result in dehydration in older adults.(1,2)  

At any age, with prolonged moderate to maximal exertion, especially in hot, humid conditions, the stage is set to become acutely dehydrated. The primary way water is lost is through perspiration, which is derived from plasma, the non-cellular fluid of the blood (plasma makes up less than one tenth of the total body fluid). Because the total amount of plasma goes down, the blood pressure decreases, and the pulse typically increases to try to compensate. With continued loss, there can be increased body temperature, decreased perceived exertion and power output, dizziness, fatigue, and confusion.(2,3) Always remember that dehydration can become a medical emergency if allowed to persist or, worse, to progress. This can lead to heat injury, significant kidney problems, low blood volume shock, and seizures.(1)

On the other hand, mild, chronic dehydration is a more insidious problem. There can be a long term, ongoing loss of water volume due to an undetected urinary or hormonal imbalance. In my practice I have more often discovered there to be inadequate water/fluid consumption. There are a number of health concerns associated with chronic dehydration. Studies have shown associations between low habitual fluid intake and some chronic diseases, including kidney stones, constipation, asthma, cardiovascular disease, diabetic hyperglycemia, and even some cancers.(4)

How to maintain/replenish better hydration status

If you are going to engage in strenuous physical activity, are anticipating having a prolonged exposure to hot and/or humid conditions, or especially if both will be occurring at the same time, your best course of action is preventing yourself from becoming dehydrated. If mildly exerting yourself and the weather is not particularly hot or humid, drinking water is often sufficient. Drink water before the strenuous activity or exposure to hot, humid conditions, and make sure your intake is adequate by drinking water whenever thirsty. If you are an older adult, you may need to drink a little beyond quenching your thirst. The exact amounts vary between individuals and in different circumstances for each individual.

With moderate, prolonged exertion or greater, with or without prolonged heat and/or humidity exposure, water containing electrolytes may be better than plain water. Generally speaking, the ions (aka, electrolytes) in the plasma and other fluids outside of the cells help maintain the water balance with the fluids within the cells. In the plasma, by far the most important electrolyte is sodium (Na+).Sweat has a lower but nonetheless significant percentage of Na+ in it compared to the plasma. Water containing a concentration of electrolytes similar to sweat allows replacement of electrolytes lost through sweating. If your exertion is  prolonged for, say, more than an hour and a half or two, water with electrolytes can also contain some glucose, which is being used up by the continuous muscle activity.(3)

Whatever the case may be for you, check with your health care practitioner to review your replacement needs, especially if you have underlying health concerns or are on medications.

There are some general guidelines for daily water consumption requirements to maintain health and reduce chronic disease risk. However, there remains some controversy regarding this. It is commonly stated that one should drink at least 8 glasses of water a day. The National Academies of Medicine has recommended a little more than 11 cups (2.7 liters) of fluids per day for the average woman and almost 16 cups (3.7 liters) for men as a baseline, needing more for increased output of water, such as increased levels of exertion or hot, humid weather. However, this refers to total water intake: about 80% comes from drinking water and beverages, which can include caffeinated beverages; the rest comes from the moisture in foods.(5)

Intake of caffeine of more than 400 mg per day (about 3-4 cups of brewed coffee or 8 cups of black tea) generally produces a mild dehydrating effect, though there is individual variation. Those drinking caffeinated beverages on a regular basis tend to be more resistant to the possible diuretic effect.(6) Alcohol is also a known diuretic and can cause dehydration, especially when drunk in excess. This is especially true when drinking alcohol on an empty stomach, not drinking sufficient water as the alcohol is consumed, and when drinking a large quantity over a short period of time, thus not allowing your body to sufficient time to break down the alcohol.(7)

The Ellen Cutler Method

Over my years of practice, many of my patients have come in with various complaints that remained unexplained and/or inadequately addressed. By using ECM energetic testing, I have been able to identify those in whom mild, chronic dehydration played a role. Once identified, I have then been able to determine the best means of addressing their problems. Most important among them are energetically clearing relevant sensitivities and identifying optimal lifestyle choices for each patient, including patterns of fluid intake. I have found this approach to be the most efficient and successful way of achieving optimal improvements in wellness and the decrease or resolution of the patient’s complaints in those with problems related to dehydration.

So, be well, be healthy, and remember…

“If you neglect to recharge a battery, it dies. And if you run full speed ahead without stopping for water, you lose momentum to finish the race.”
Oprah Winfrey

Dr. Ellen


  1. “Dehydration” at https://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/syc-20354086
  2. “How does aging increase risk of dehydration?” at https://peterattiamd.com/hydration-in-the-elderly/
  3. “#200 – AMA #33: Hydration—electrolytes, supplements, sports drinks, performance effects, and more” by Peter Attia
  4. “Hydration, morbidity, and mortality in vulnerable populations” at https://academic.oup.com/nutritionreviews/article/70/suppl_2/S152/1811927
  5. “Report Sets Dietary Intake Levels for Water, Salt, and Potassium To Maintain Health and Reduce Chronic Disease Risk” at https://www.nationalacademies.org/news/2004/02/report-sets-dietary-intake-levels-for-water-salt-and-potassium-to-maintain-health-and-reduce-chronic-disease-risk
  6. “Coffee and Tea Can Hydrate, Too” at https://foodinsight.org/coffee-and-tea-can-hydrate-too/#:~:text=Coffee%20and%20tea%20often%20get,stay%20hydrated%20throughout%20the%20day.  
  7. “Does Alcohol Dehydrate You?” at https://www.healthline.com/health/does-alcohol-dehydrate-you

* These statements have not been evaluated by the Food and Drug Administration. The products are not intended to diagnose, treat, cure, mitigate, or prevent any disease.

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