It’s that time of year when the common cold and cough are frequently encountered symptom by all. On average, adults suffer from 4 to 6 colds per year. Cold and cough can be allergic in nature or associated with bacteria and/or viruses infections which is commonly referred to as upper respiratory tract infections (URTIs).

According to India’s national health portal, more than 4 million cases of respiratory tract infections were reported in 2019. In addition to coughing, the patient may have complaints such as sore throat, fever, muscle pain, runny nose, nasal congestion and may show fatigue, but what tends to be missed or overlooked in these conditions are the signs of dehydration.

What is dehydration?

In an interview with HT Lifestyle, Dr. Abdul Majid Khan, consultant physician and diabetologist at Olive Hospital in Hyderabad, said, “Dehydration is depletion of body fluids due to excessive losses or reduced intake or both. All types of fluid lost contain electrolytes in varying amounts, so fluid loss is always accompanied by some degree of electrolyte loss. This is called silent dehydration because one can miss it due to lack of awareness. Silent dehydration is a widespread concern that is also seen in the common cold and cough associated with upper respiratory tract infections. Electrolytes such as sodium and chloride help maintain the balance of body fluids, while potassium, calcium and magnesium are involved in the proper functioning of nerves and muscles.”

He explained: “In upper respiratory tract infections, the fever itself leads to dehydration (deficiency of fluid and electrolytes) due to excessive sweating and increased breathing. In addition, as the body uses energy to fight infection, increased energy demands can lead to energy deficits. A sore throat, which is a common initial symptom, can affect fluid intake, further adding to dehydration. The deficit is further amplified by inadequate food and fluid intake leading to fluid electrolyte energy deficits.”

Impact of fluid, electrolyte and energy losses in URTI

According to Dr. Abdul Majid Khan, fluid, electrolyte, and energy deficiency in viral infections and URTIs can lead to muscle pain, muscle cramps, and muscle weakness. He explained: “Additionally, dehydration can lead to thickened secretions that become difficult to remove from the lungs. Dehydration can also have a negative impact on respiratory symptoms such as coughing, impair immunity, delay recovery and increase the chances of recurrent infections. In a Knowledge Attitude and Practices study conducted with Indian physicians, it was found that these deficits in upper respiratory tract infections have a large impact on recovery. The patient may continue to experience fatigue and muscle soreness that will hinder recovery.”

How can oral electrolyte drinks combat dehydration during colds and coughs?

In the same study, it was found that 87% of doctors agreed that fluids, electrolytes and energy supplements given to patients with upper respiratory tract infections as adjuvants can help improve the speed of patients’ recovery. Dr Abdul Majid Khan pointed out:

• An international association called the American Society of Parenteral and Enteral Nutrition (APSEN) recommends drinking 60-120 ml of clear liquids containing electrolytes and calories every 15 minutes to thin respiratory secretions during such illnesses. This indicates the importance of focusing on fluid, electrolyte, and energy restoration in upper respiratory tract infections.
• Susceptibility to muscle cramps only increases with water consumption. Therefore, drinking electrolytes along with water can help relieve muscle aches and cramps. During infections, carbohydrate intake must be maintained to protect against the breakdown of muscle protein for energy.
• While fluids and electrolytes can be supplemented through the WHO standard ORS (World Health Organization Oral Rehydration Solutions), they are best suited primarily for diarrheal conditions.
• In conditions such as fever and other non-diarrheal illnesses, electrolyte energy drinks can play an important role in recovery. This is corroborated by an Indian expert panel whose recommendation suggests that the use of WHO ORS may fall short of energy targets in non-diarrheal conditions due to its low sugar content. In addition, the strong salty taste of WHO ORS makes it unpalatable, which may affect adherence.
• The addition of energy (glucose) to fluid and electrolyte drinks helps meet energy needs as well as satisfying taste requirements. Certain ready-to-serve electrolyte drinks may also contain additional electrolytes or ingredients such as magnesium that can support muscle function, as well as micronutrients such as zinc, selenium to further support immune function.
• While there are readily available and affordable homemade coconut water options to address fluid electrolyte and energy deficits in upper respiratory tract infections, ready-to-serve electrolyte drinks can also be considered. Such formats contain a known concentration of fluids, electrolytes, and energy with acceptably good taste and hygienic packaging that help replenish fluids, electrolytes, and energy and can aid the patient in the recovery process.

Dr. Abdul Majid Khan concluded: “Patients with the common cold and cough associated with upper respiratory tract infections develop silent dehydration and energy deficits due to fever, sore throat and the infection itself. This can lead to muscle pain and cramps that can hinder recovery. It is necessary to restore these fluid electrolyte and energy deficits in an appropriate format so that the patient can recover faster. It would be advised to consult your doctor if you have a high fever, cough, persistent muscle pain or symptoms of dehydration such as dry tongue, dark urine, etc.”

Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always ask your doctor for advice with any questions about a medical condition.