Staying Hydrated When You Have Sickle Cell Disease

When you live with sickle cell disease (SCD), it is important to drink plenty of water and other fluids. This helps you to stay hydrated. If you become dehydrated, your sickle cell symptoms may become worse.¹

People with sickle cell disease have a problem with their red blood cells. Their red blood cells contain an abnormal type of hemoglobin. Hemoglobin is the substance in the blood that carries oxygen from the lungs to other areas of the body. Instead of being round like normal red blood cells, their red blood cells look like a C-shaped farm tool called a “sickle.” These abnormal cells can have trouble getting through small blood vessels. They can get hard and sticky. Also, there is a constant shortage of red blood cells in someone with sickle cell disease.^2,3

When the abnormal blood cells block small blood vessels in the body, less blood reaches that part of the body. Eventually, these parts of the body can become damaged.²

What happens when you become dehydrated?

When you use or lose more fluids than you take in, you become dehydrated. This means your body does not have enough water and other fluids to carry out normal functions. Just because you are not thirsty does not mean you are drinking enough water. Many people, especially older adults, do not feel thirsty until they are already dehydrated.⁴

Signs of dehydration often differ by age. In children, symptoms of dehydration may include dry mouth and tongue, no tears when crying, and no wet diapers for 3 hours. In adults, signs may include extreme thirst, dark-colored urine, fatigue, and dizziness.⁴

Dehydration is especially worrisome in people with SCD. When you have SCD and you are not well hydrated, your red blood cells can clump together. This can cause a condition called sickle cell crisis. During a sickle cell crisis, you can experience pain. The pain is mostly in the bones of the spine, arms, and legs.^5,6

Sickle cell crises can last from hours to days. You need medical treatment when you are having a sickle cell crisis. Staying hydrated can help prevent a sickle cell crisis.^5,6

What causes dehydration?

There are a number of reasons why you can become dehydrated. In some cases, dehydration occurs simply because you do not drink enough water because you are sick or busy. Lack of access to safe drinking water can also lead to dehydration.^1,4,5

Other causes of dehydration include:^1,4,5

• Consuming alcohol. Alcohol causes your body to remove fluids at a much quicker rate than other liquids.
• Excessive sweating. Your body loses water when you sweat. This may happen during vigorous exercise or activities. Hot, humid weather can also increase the amount you sweat.
• Diarrhea and vomiting. Diarrhea that comes on quickly and violently can cause you to lose a great deal of water and minerals in a short amount of time. Vomiting along with diarrhea increases the amount of water and minerals that are lost.
• Fever. When you have a fever, you often sweat more. This can cause you to lose fluids and minerals. You may also drink less fluid when you are feeling sick. Fevers along with diarrhea and vomiting can make dehydration even worse.
  Increased urination. Certain medicines, like diuretics and some blood pressure drugs, can cause you to urinate more and lead to dehydration. Increased urination can also be a sign of undiagnosed or uncontrolled diabetes.

Tips for staying hydrated

When you have sickle cell disease, it is very important to stay hydrated. Keep bottle or cup of water near and drink from it throughout the day. Aim for 8 to 10 8-ounce glasses of water each day. Eating foods that are high in water, such as fruits and vegetables, can also help you get enough fluids.^1,4

Other tips for staying hydrated include:^1,4

• Drink enough water and other fluids so your urine is light yellow or clear
• If you are sick, be sure to drink extra fluids
• Drink plenty of fluids before, during, and after you exercise or when it is hot out
• Kids with SCD should have a water bottle with them during school or when they are on a playdate or other outing
• Limit alcohol and foods that are high in salt

Both kids and adults should also limit sugary drinks like soda, juice, sports drinks, and flavored milks. Drinks with lots of sugar can reduce the amount of fluid your body retains. These drinks also discourage the habit of drinking plain water and add empty calories to your diet.^1,4,7

There are many ways to encourage everyone in your family to drink plenty of water and stay hydrated. Try these tips to make staying hydrated more fun:⁷

• Infuse water with lemons, berries, fresh mint, or sliced cucumber
• Enjoy fruits and vegetables that are high in water content. Cucumbers, iceberg lettuce, zucchini, watermelon, cantaloupe, and strawberries are high in water content
• Freeze fruit inside of ice cubes
• Serve water in a special bottle or cup, or try adding an umbrella or swirly straw
• Make popsicles using pureed fruit