Summer is finally here! Sunshine, fresh air, and outdoor therapy are back, but not without risk. With rising temperatures comes an increase in heat-related illnesses, which can be particularly dangerous for people with pre-existing medical conditions.
With mounting global temperatures, emergency departments are experiencing an increase in heat-related visits compared to previous years. Older adults are at the highest risk of fatalities, with over 80% of heat-related deaths occurring in people over 60. This is partially due to the fact that increased body temperature can trigger cardiovascular complications in people with underlying heart disease.
Anyone with a chronic medical condition, like diabetes, hypertension, respiratory issues, and obesity, should take extra care stepping outside when temperatures exceed 80 degrees. Chronic conditions can make it more difficult for our bodies to regulate temperature, something that can be exacerbated by medications.
You should try to stay hydrated at all times if you can, here’s how you can tell if you’re well hydrated:
Your urine should be pale yellow, dark urine indicates dehydration or other underlying conditions, and clear urine indicates ion washout (we’ll explain that later).
You should urinate every 3-4 hours.
Your energy and mood should be stable.
Your lips and skin should be moist. Dry or sticky skin and cracked lips are both indicators of dehydration.
#1 - Know the Signs of Dehydration
Mild dehydration can sneak up on you, especially in hot weather. Knowing how to recognize the early signs of dehydration is critical to prevent it from escalating to heat exhaustion or heat stroke.
Phase 1: Mild Dehydration
When you’re mildly dehydrated, you may have a dry mouth, sticky saliva, headache, light-headedness, darker urine, fatigue, weakness, or light muscle cramping.
What to do: Stop physical activity, rest, and drink some water until you feel back to normal.
Phase 2: Heat Exhaustion
Heat exhaustion is a sign that you are severely dehydrated, and it serves as a warning for impending heat stroke if you don’t act quickly. Heat exhaustion typically begins with heavy sweating, cold, pale, or clammy skin, a fast but weak pulse, nausea or vomiting, dizziness, and severe muscle cramps.
What to do: Stop activity and move to a cooler area, slowly sip some water or a light electrolyte solution, elevate your legs, and apply a cool compress. If your symptoms persist beyond an hour or two or worsen, seek medical advice.
Phase 3: Heat Stroke
A heat stroke is a medical emergency, you should call 911 if you notice that someone has gone from profuse sweating to not sweating at all, since that means your body is no longer actively cooling you down.
This is accompanied by an elevated body temperature, rapid, bounding pulse, and mental symptoms like confusion, slurred speech, or in extreme cases, unconsciousness or seizures.
What to do: This is a medical emergency, you should call 911 immediately. While you wait for help to arrive, move to a cooler location and try to begin reducing their body temperature by placing a cold compress or ice on the body’s axial points: the armpits, groin, and neck. If they are conscious and able to swallow, offer them small sips of cool water.
#2 - Drink Water Before You Feel Thirsty
Hydration is your body’s first defense against overheating, but surveys indicate that almost 50% of Americans are not drinking enough water. And by the time you’re thirsty, you’re already mildly dehydrated.
So, how much water is enough? General guidelines indicate women should drink about 9 cups of water per day, and men should drink 13 cups. These figures are just an average, since body size, where you live, activity levels, and medical conditions can affect your hydration status.
If you’re reading this and realizing that you’re not drinking enough water, don’t rush to your fridge to down a few glasses. Your body constantly regulates your hydration levels, so sipping water throughout the day is a more effective way to gradually absorb water over time. This will also help you avoid feeling bloated.
If you know you’ll be spending time outside or getting your sweat on at the gym, try to drink 16-20 oz of water 2 hours beforehand. Not only will this prevent dehydration in many cases, but your muscles also perform better when hydrated.
While spending time outside or working out, we recommend topping up with 5-10 oz of water every 20 minutes if you are actively sweating
#3 - Don’t Forget Your Ions!
Replacing lost water from sweating is only half of the battle, because you’re losing ions (otherwise known as electrolytes) too. These charged particles are sodium, potassium, calcium, chloride, and magnesium. They are essential for the function of your muscles, nerves, vascular system, and more.
Losing too many electrolytes and not replacing them, a condition known as ion washout, can disrupt your body’s ability to function properly. Older adults are at a higher risk of washout because they often have lower electrolyte reserves, impaired organ function, or are taking medications that accelerate ion loss.
If you’re sweating for an extended period of time, try to replace your electrolytes with a low-sugar electrolyte replacement drink. You can also keep your electrolytes up with foods that are naturally high in ions, like citrus fruit, bananas, leafy greens, dairy, nuts, seeds, and soups.
If you have high blood pressure, make sure you talk to your physician before increasing your electrolyte intake since high-sodium foods can exacerbate hypertension.
#4 - Eat Your Water with Hydrating Foods
If you don’t love plain water or your medical team has you on a fluid restriction protocol, you can also hydrate yourself with water-rich foods. Most fruits and vegetables are high in water content and contain essential electrolytes. You can hydrate with:
Cucumbers
Lettuce
Squash
Celery
Melon
Berries
Even a bowl of fruit or a side salad can contribute to your daily fluid intake. Plus, fruits and vegetables add nutritional value to your diet, supporting health from the inside out.
#5 - Know How Your Medications and Medical Conditions Affect Hydration
Some common medications can impair your ability to stay hydrated or respond to heat, including:
Diuretics like Lasix (furosemide), Microzide (hydrochlorothiazide), and Aldactone (spironolactone) increase urine output and can quickly lead to fluid and electrolyte loss.
Beta-blockers and ACE-inhibitors like Lopressor (metoprolol), Tenormin (atenolol), and Norvasac (amlodipine) can interfere with your body’s response to heat and blood pressure regulation, making heat exhaustion more common.
Laxatives like Ducolax (bisacodyl) and MiraLAX (PEG 3350) can lead to dehydration from fluid loss.
Allergy medications like Benadryl (diphenhydramine), Zyrtec (cetirizine), and Claritin (loratadine) can cause dry mouth and reduce sweat production, making it harder for your body to cool itself.
Antidepressants like Prozac (fluoxetine), Zoloft (sertraline), and Seroquel (quetiapine) can trigger excessive sweating, making you more susceptible to dehydration.
Some conditions increase the risk of dehydration:
Heart failure often requires fluid restriction, making it more difficult to stay hydrated.
Kidney disease affects electrolyte and fluid regulation, so you should stay more vigilant for signs of ion washout or dehydration, even if you think you’re drinking enough water.
Diabetes causes frequent urination, making dehydration more common.
Cognitive decline or dementia can impair thirst recognition, so make sure to pay extra attention to physical signs of dehydration.
Before making any changes to your fluid or electrolyte intake, talk to your care team to make sure it’s safe for you.
#6 - Protect Your Skin from the Sun
Sunburn and hydration seem unrelated, but sunburns can affect your whole body. Sunburns are an inflammatory reaction that pull fluid to the surface of your skin to cool it off, leaving you more vulnerable to dehydration, electrolyte imbalance, and fatigue. In patients with existing health conditions or healing wounds, it can even slow recovery or trigger a flare-up.
Severe sunburns can trigger swelling and fever, making it harder for your body to regulate its temperature. For people with diabetes, vascular disease, or fragile skin, even minor burns can take longer to heal or become infected.
If you do end up getting a sunburn, be sure to drink water and hydrate your skin with an aloe-based cream or gel.
#7 - Make it a Habit to Stay Cool and Hydrated
When it comes to heat safety, building habits into your daily routine is the best way to stay safe. Whether you’re heading to an appointment, spending time outdoors, or relaxing in a sunroom, proactive cooling strategies can help prevent dehydration, especially if you’re taking medications or managing chronic conditions.
Here’s what we recommend:
Seek shade whenever you can, or avoid going out during the hottest time of the day: 12 PM to 4 PM.
Wear sunscreen with an SPF of at least 30, and reapply every 90 minutes to 2 hours.
Keep a water bottle with your keys or purse, and take it with you everywhere you go.
Add a pinch of salt or a squirt of lemon to your water to support your electrolyte balance.
Wear loose, light-colored clothing made from breathable fabrics like cotton or linen.
Wear a hat to keep the sun off of the top of your head.
Bring a handheld fan or a spray bottle if you plan to be outdoors in the sun for an extended period.
If you tend to forget about drinking water, use a water tracking app or set alarms on your phone throughout the day to remind you to drink water.
Keep extra water, electrolytes, and towels you can soak in water in your car.
Stay Safe this Summer!
As long as you are proactive about your hydration during the summer months, it’s easy to avoid dehydration. For people who have recently undergone medical treatment, older adults, and those managing chronic conditions, hot weather poses an extra risk.
But with the right habits, such as staying hydrated, maintaining your electrolyte balance, dressing appropriately, and monitoring signs of dehydration and heat exhaustion, you can stay cool and safe.
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