Help! Doctor said to drink 100oz a day! There’s no way!?

This week, Jill answers a frequently asked question about the difficulties of drinking 100oz of water in a day.

Jeff Sarris
Welcome back to the Kidney Stone Diet Podcast, the show about reducing your kidney stone risk and living your best life. I’m your host and fellow student, Jeff Sarris.

Jill Harris
I am Jill Harris, your kidney stone prevention nurse.

Jeff Sarris
Today, we’re going to go with an FAQ instead of a listener question. If you do have a question, though, the number again is 773-789-8763. Or if you’re outside the US, you can always send a voice memo to podcast [at] kidneystonediet.com. And that’s another way to get your voice on the show.

What are we talking about today, Jill?

Jill Harris
This is something that’s very, very common, and specifically the amount.

“Help Jill, my doctor told me to drink 100 ounces of water a day, there’s no way there’s no way I can do that!”

This is a very generic order from doctors, it is a daily thing I hear. It’s extremely common. Now, let’s just give an example. And this is why we as healthcare professionals really need to be careful about giving generic advice.

So 100 ounces of water is a hell of a lot of water if you haven’t had a glass of water since 1922. All the patient hears is I gotta wake up tomorrow and drink 100 ounces, there’s no way I can do that. What happens is, they won’t even start because they feel hopeless. Immediately.

This is the scenario I hear every day, “my doctor told me to drink 100 ounces of water a day.” I’m looking at their urine collection, and they peed out maybe a liter. So they’re probably not even drinking three cups of water a day. Then they say, “what am I going to do? I don’t know how to do this. There’s no way I can do that.”

What I tell them is this, I’ll ask how much are you drinking a day, maybe 3 glasses. So this week, continue on three glasses per day. Next week, I want you to add one glass of water for a total of four glasses of water a day. The next week, five, and so on up until you get to the point where you’re peeing out at least 80 ounces.

How do I know if I’m peeing out 80 ounces? Well, you can save your hat or your jug from your urine collection if you’ve done it. And a lot of my patients do this, don’t think I’m drunk. People do this. They save their collection materials so they can use them once in a while to say, “hey, I think I fallen off track” and see where they’re at.

Another good way to know if you’re hydrated, is turn around or if you’re a man just look down on the toilet bowl and see. Does your urine look like water coming out of you? If there’s some kind of tint drink a little bit more.

This doesn’t mean you have to drink, drink, drink. I don’t want people going crazy. I want you to slowly increase your fluids. Your bladder is a muscle, when you slowly increase your fluids it will adapt. Now, even when it adapts you’re definitely going to be peeing more than you did when you didn’t drink any water. That’s just the name of the game.

We want to be peeing more because we don’t want these crystals to be sitting in our urine. We want to flush them out. The kidneys are filtering your blood and all the waste and sending it out in the urine. The body doesn’t want waste, it’s not going to be utilized.

So you want these things to come out of you. You want to slowly increase your fluids. That’s very important. Now, I’m 5’2″ and 117 pounds. I walk in the office and the doctor says 100 ounces. He doesn’t ask me if I’m eating a lot of vegetables. If I’m a vegan, vegetarian, he doesn’t ask me any of that.

He doesn’t ask if I have CKD (chronic kidney disease), he may know if he’s dealing with my kidney stone, he may know that. But there’s other things that could be going on with me why I’m not urinating. Maybe I’m drinking tons, but I’m eating way too much salt and sugar.

When we eat too much salt and sugar, we will pee less. Some people say I drink all this, but nothing’s coming out. It’s because you’re eating too much sugar and salt. Or maybe you have prostate problems, and you just pee a little bit, little bit a little bit.

That’s another medical reason why we want to slowly bring an increase of fluids to people. We need to tell patients when they’re trying to make lifestyle changes.

1. Change is hard. So manage your expectations.
2. You practice change. Nobody’s doing this stuff overnight. If you haven’t done what you’re being asked to do in decades, how in God’s name are you supposed to do it tonight, it’s not going to happen. So you must manage your expectations.

Now, maybe Jeff and I drink the same amount of water. I may pee more than Jeff simply because I eat a super low salt and sugar diet. I know Jeff does too, pretty much. But I’m just saying my diet will dictate how much fluid comes out.

I’m 5’2″, 118 pounds. I eat a lot of vegetables, I may not need on 100 ounces of fluid because I’m getting a lot of fluids in my diet. Maybe I only need to drink 75 ounces, and I’ll get to where I need to be.

The output should be 2.5 to three liters of urine a day. A lot of 24 hour urine reference ranges will say you only need to pee out two liters. We want it to be 2.5 and above.

Honestly, the more you pee, the better off you are.

We have to be careful giving generic advice about fluids. and it’s not easy to increase your fluids. I just want to put that out there so you slow your roll when you’re doing it.

Also, there may be days where you know you’re may not drink what you normally drink for whatever reason. That’s okay. Just get right back on track when you can. Not a problem, but don’t drown yourself in fluids when you get back home. Just get back to your normal lifestyle. Don’t worry about it.

You can’t make up for that time because you were already dehydrated for those six hours. I’ve had people say I drank so much when I got home because I didn’t drink all day that I threw up. Or they’re not eating because they’re so filled with water. Don’t do that.

Water takes time to increase. Fruits and vegetables will also increase your urine because they’re mostly water. All fluids count. Water is best. “So Jill said I could drink soda all day for my water.” Jill did not say that, folks.

All fluids count water is best. You know I have coffee every day, but I’m not drinking it all day long. Have all those other things in moderation. All fluids will count, but pay attention to those fluids that have excess sugar and salt.

You want to also eat your water, fruits and vegetables your best friend and you can have all of them on a low oxalate diet. Just watch the portion of the really high ones. Spinach I take away because it’s almost 700 milligrams of oxalate in a cup.

So, you may not need 100 ounces of water to get where you need to go. So just know that. That’s very, very important. A 6’2″ man and a 5’2″ woman are getting the same generic advice from a doctor. It doesn’t make sense to me. But, you know, they’re busy. They don’t have time to hold your hand and wipe your brow and talk about all this with you. So that’s why we do these free videos so you could get a little bit more extra love and support and and handholding. That’s why Jeff and I do what we’re doing here. So that sums it up.

For the water, do your best.

Jeff Sarris
Yeah, that is a big hurdle. I could see how it could scare people off. Because immediately you’re like, oh, this that number alone just sounds huge. So I think that’s great advice.

If you’re out there and you have a question, the number again is 773-789-8763. Or you can send a voice memo. Record it on your phone, and email that to podcast [at] kidneystonediet.com.

And at kidneystonediet.com, you’ll find all the free resources, the weekly email newsletter Jill sends to keep you on track and keep you going throughout the week. You can find the Kidney Stone Prevention group on Facebook, there are Kidney Stone Diet Meal Plans, the Kidney Stone Prevention Course and the Group Coaching Calls where you can work with Jill in a group setting, which is a very helpful space to be in. Whether you’re looking to focus on the Kidney Stone Diet, or if even for losing weight. You can find all of that and more kidneystonediet.com.

And again, we appreciate each and every one of you for tuning in for liking, subscribing, for sharing these episodes with a friend who needs help. We’re simply trying to reach as many people as possible. So it really means a lot to both of us. And we appreciate each and every one of you.

With that, I think we’ll wrap. See you next week.

Jill Harris
Bye everybody.