A doctor explains how to deal with common causes of water retention, and when to see your GP.
Medically reviewed by Dr Roger Henderson and words by Emma Pritchard
The body is made up of up to 60 per cent water, but in some instances – hormonal changes or long haul flights, for instance – your body may retain some of that water. This is called water retention, and it may cause bloating, swelling and puffiness.
Water retention can occur for a number of reasons. Some of these are nothing to worry about; others are more serious and require medical attention.
We talk to Dr Riccardo Di Cuffa, Director and GP at Your Doctor, about the possible causes of water retention, how to deal with them, and when to see a doctor:
What is water retention?
Water retention is a common health issue. It occurs when your body holds onto excess water, and can occur for a number of possible reasons, from hormonal changes to long-haul flights through to poor diet choices.
Water retention symptoms
Symptoms of water retention may include:
- bloating, particularly around the abdominal region
- swelling, particularly in the legs, feet and ankles
- stiff joints
- weight fluctuation.
Water retention causes
- Poor diet
‘Convenience foods are a godsend,’ says registered nutritional therapist Kym Lang. ‘But the salt they contain can make your body hang onto water to maintain a balance in your cells: hence that bloated face in the mirror. And you all know that white refined carbs make your blood sugar levels spike, which causes a speedy release of insulin. But too much insulin can also trigger your kidneys to re-absorb salt, causing your body to hold onto even more fluid.’
A high-salt diet can increase your chances of high blood pressure and chronic water retention, which, over time could lead to kidney and heart disease. Lang suggests swapping in complex carbs and eating small meals across the day to keep blood sugar levels stable. And going easy on the salt. ‘Boost flavour with herbs, spices and citrus,’ she says.
- Menstrual changes
‘Many women will notice water retention in the two weeks leading up to their period,’ says Lang. You’ve got those pesky hormones oestrogen and progesterone to thank for that. ‘Their changing levels, around the time of ovulation, control how much water your body retains,’ Lang says. You don’t need an expert to tell you that everyone’s hormone levels are different and this is why some of you puff out each month, like clockwork, whereas others might experience a little bit of mild bloating, now and then.
Period-related fluid retention will gradually disperse once your hormone levels change again and you start your period. Lang suggests reducing your salt intake and supping your magnesium in the run-up to your period to alleviate symptoms, and, when your period starts, drinking plenty of water to support your kidneys and encourage them to flush out more liquid. You could also try these other tips for preventing period weight gain.
- Hormonal contraception
It may help keep you regular but chances are that pill you’re on is also responsible for your monthly bloat. According to Dr Di Cuffa, many contraceptives offer water retention as a side effect, and it all comes back down to hormones. ‘Oestrogens and progesterone affect your body’s ability to excrete water meaning you temporarily gain what is essentially a water weight,’ says Dr Di Cuffa. ‘That should normalise when your period starts.’
It’s just a bit of a nuisance and not something to consider coming off the pill for. Fill up on foods containing vitamin B6, which are thought to help reduce water retention – a bowl of porridge topped with a banana should get you off to a flying start, says Lang. Then when your period strikes, switch to a low-bloat bowl of Bircher muesli, instead.
- You’re pregnant
Who hasn’t heard a pregnant friend complain about swelling in their legs and ankles during pregnancy? It’s part of the course, right? ‘Water retention during pregnancy is perfectly normal, says Lang. ‘It helps your body to soften and expand as your baby grows.’ It’s also the result of the baby itself.
According to Dr Di Cuffa, the unborn child places additional pressure on the abdominal area, obstructing the blood flow around the body and leading to pooling in the ankles and legs.
Take it as a warning sign to elevate those legs when you’re sitting down or sleeping, or to go for a gentle swim. ‘Muscle contractions stimulate your blood and lymph vessel walls to contract rhythmically, boosting lymph flow and the return of blood to the heart,’ says Georgios Tzenichristos, nutritionist and director of the LipoTherapeia clinic.
‘Hormone levels fluctuate dramatically around the time of the peri-menopause, making fluid retention more likely and more frequent,’ says Lang. ‘You’re even more susceptible if you experienced water retention or other PMS symptoms when you were younger.’
If you’re showing other menopause symptoms, then it’s worth getting yourself checked out as there are treatments available. If it turns out you’re experiencing monster PMS symptoms, this might help.
- Long-haul flights
It’s partly the result of all that sitting down – exercise is essential for lymph function – but it could also be that a change in your routine and diet means your bowels aren’t moving quite as they should. ‘Constipation obstructs blood and lymph flow in the abdominal area leading to swollen ankles and legs,’ Tzenichristos says.
It shouldn’t be but it’s why it’s always best to bag an aisle seat. Ankle rolls, flexing your feet, pointing your toes and regularly walking around the plane will all help to increase circulation and reduce swelling. And if you can, swerve that glass of Sauvignon Blanc for an orange juice – vitamin C supports your blood vessels and improves their contractions says Tzenichristos.
- Kidney problems
Kidneys are like little recycling plants. While you’re busy enjoying Happy Hour, they’re filtering your blood, sorting out the bits (think fluids and minerals) in it that can be reused by the body, from those that need to be excreted as waste. So, if they stop functioning properly, the waste – which will also include water – will build up, leading to water retention.
According to Dr Di Cuffa, this could be a warning sign of kidney failure, which is often symptomless until the advanced stages. Watch out for other giveaways such as anaemia, an increased need to pee, difficulty sleeping, muscle cramps, headaches and unexplained weight loss.
- Thyroid problems
Your thyroid plays a key role in keeping your energy levels up. So, if it goes a little haywire – something which is typically caused by your immune system accidentally attacking it – you’re going to start feeling tired, headachey and continuously cold. You also may experience heavy periods and, you guessed it, fluid retention.
Best get checked. Left untreated, an underactive thyroid could lead to heart disease, pregnancy problems and, if the gland swells, difficulty breathing.
- Change in temperature
It’s not your imagination that the body swells during hot weather – it does. And normally on the day when you’re about to strip off and already feeling a tad anxious.
The solution – drink more and cool down. ‘If you’re dehydrated, your tissues hold on to water due to the water scarcity,’ Tzenichristos says. It also happens if you have too many iced lattes. ‘Excessive caffeine leads to poor fluid drainage and water retention,’ says Tzenichristos. ‘Switch to a diuretic herbal tea, such as dandelion leaf tea, or simply water. Alternating hot and cold temperatures in the shower will also help to boost circulation.’
When to see a doctor
If your water retention hasn’t settled down within two weeks, continues beyond 3-5 weeks, or is accompanied by other symptoms such as pain and redness of the skin, you should see your doctor.