The Importance of Hydration for Managing Lymphedema

Lymphedema is a chronic illness that affects about one-third of women who undergo armpit lymph node removal due to treatment for breast cancer. The condition can strike soon after radiation, chemo, or surgical interventions. Or it can manifest years after these treatments have concluded.

Damage to the lymphatic vessels and/or nodes causes patients to experience a loss in the lymphatic system’s ability to properly drain extracellular fluid from affected tissues. As a result, fluid builds up in the affected limbs (usually the arms or legs), causing swelling and tenderness. Breast cancer survivors are not the only individuals susceptible to lymphedema. It can affect anyone who has experienced trauma to local lymphatic vessels and structures.  

Therapies, such as manual drainage (a type of lymph-draining massage), and wearing appropriate compression garments, are among the only effective treatments at present. There is no known cure for lymphedema. 

The Relationship Between Liquids and Lymphedema

It seems intuitive that if you have lymphedema, limiting your intake of water and other liquids might help reduce the accumulation of fluids in affected areas. But this is not the case. On the contrary, staying properly hydrated is actually beneficial — for one’s overall health and for promoting the filtration and elimination functions performed by the kidneys. In fact, staying well hydrated is one way you can cleanse your lymphatic system naturally. 

Lymphatic congestion, or the buildup of extracellular fluid known as lymph, is the underlying problem that causes tenderness, swelling and skin tissue changes among lymphedema patients. While it’s probably true that you should limit your intake of alcohol or caffeine if you have lymphedema, drinking water is another story. Staying hydrated with water is advantageous.  

Tips for Staying Hydrated

Lymphedema and drinking water go together like lymphedema and compression garments. Drinking plenty of water — and wearing your compression garments regularly — are two important actions you can take to help control the symptoms and progression of your disease. Good old plain, water is your best source for healthful hydration. Drinking sweetened beverages, or even drinks with artificial sweeteners, is counter-productive. These beverages can contribute to weight gain, and should be avoided. 

The jury is still out on coffee and caffeine, but it’s a certainty that drinking alcoholic beverages is not recommended. Green tea is almost certainly healthful and hydrating. The relative amounts of caffeine in green tea are slight, and the beneficial antioxidant compounds in green tea may actually be helpful at reducing inflammation.

Dehydration, which can result from not drinking enough each day, can lead to other health problems in addition to impaired lymph drainage. A recent study conducted in Europe noted that dehydration is linked to undesirable effects, such as worsened mood, fatigue, headaches, loss of concentration and reduced alertness. Feelings of thirst and dry mouth were, of course, also common among dehydrated subjects.

Water, Water Everywhere…   

So how much should you drink each day to maintain proper hydration? The old adage about eight 8-ounce glasses of water per day is widely repeated, but this recommendation is somewhat misleading, as it does not account for water from other daily sources. Most people maintain appropriate hydration by simply obeying their thirst. Other factors, such as local temperature, humidity, and activity level will also affect your need for water.

Keep in mind that water from every source, including one’s food, counts towards rehydration. So, too, do liquids such as milk. According to a study published recently in Nutrients, “…the European Food Safety Authority (EFSA) recommends a daily total water intake (water from food and beverages) of 2.5 L for men and 2.0 L for women.” 

One liter (L) is roughly equivalent to one quart (1L = 1.06 Quarts); therefore women should aspire to ingest about two quarts of liquid per day. But, again, this does not mean you must guzzle two quarts of water. The total includes water from all dietary sources, including foods. Some whole foods, such as fruits and vegetables, may contain more water than you might think.  Watermelon, for instance, is comprised of approximately 92% water. Eating just one 1-cup serving, then, should supply you with nearly 1 cup of water towards your daily goal of 8-10 cups per day.  

References

Braun H, Andrian-Werburg J v, at al. Differing Water Intake and Hydration Status in Three European Countries—A Day-to-Day Analysis. Nutrients 2019, 11(4), 773; https://doi.org/10.3390/nu11040773 Accessed Apr. 10, 2019 at: https://www.mdpi.com/2072-6643/11/4/773/htm

Lemanne D, Maizes V. Advising Women Undergoing Treatment for Breast Cancer: A Narrative Review. J Altern Complement Med. 2018 Sep/Oct;24(9-10):902-909. doi: 10.1089/acm.2018.0150.  

Stookey JD. Analysis of 2009⁻2012 Nutrition Health and Examination Survey (NHANES) Data to Estimate the Median Water Intake Associated with Meeting Hydration Criteria for Individuals Aged 12⁻80 in the US Population. Nutrients. 2019 Mar 18;11(3). pii: E657. doi: 10.3390/nu11030657. Accessed Apr. 10, 2019 at: https://www.mdpi.com/2072-6643/11/3/657

Xing L, Zhang H, Qi R, Tsao R, Mine Y. Recent Advances in the Understanding of the Health Benefits and Molecular Mechanisms Associated with Green Tea Polyphenols. J Agric Food Chem. 2019 Jan 30;67(4):1029-1043. doi: 10.1021/acs.jafc.8b06146. Epub 2019 Jan 17.