Heart failure means that a person’s heart is unable to pump blood around their body properly. Heart failure can reduce liver and kidney function and cause fluid to build up in the organs. As a result, a person with heart failure may need to limit their fluid intake to reduce strain on the heart and other organs.

About 6.2 million adults in the United States have heart failure, otherwise known as congestive heart failure.

The National Heart, Lung, and Blood Institute notes that the condition can lead to serious complications, including pulmonary hypertension and other heart conditions.

The reduced blood flow that occurs can also prevent the kidneys from working properly. The kidneys help remove excess fluid from the body. When the kidneys cannot function correctly, fluid retention can get worse.

This article outlines the reasons for restricting fluid intake and gives practical tips to make this easier. It also explores the link between fluid and sodium restriction and explains when to contact a doctor.

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Fluid restriction can benefit some people with heart failure. However, not all of these individuals should restrict their fluid intake.

Research from 2016 found that temporary fluid restriction was beneficial for people who had decompensated heart failure. Decompensated heart failure is the term for when heart failure symptoms become severe, and the person requires urgent medical attention.

The study also showed that people who had heart failure alongside hyponatremia benefited from restricted fluid intake. Hyponatremia is the medical term for abnormally low blood sodium levels.

A review from 2015 also reported “significant heterogeneity” across studies in the outcomes of people with chronic heart failure who either did or did not restrict their fluid intake. Although they found no overall difference in readmission rate, mortality rate, and other measures, the researchers noted that the study sizes were small and that further research was required.

A person should talk with a doctor before restricting fluids.

The National Academies of Sciences, Engineering, and Medicine recommend that females consume close to 2.7 liters (l), or 91 ounces (oz), of fluid per day. Males should consume about 3.7 l, or 125 oz.

For people restricting fluid, the standard recommended intake is 1.5 to 2 l per day. The exact amount will depend on how much a person weighs, their basal metabolic rate, and the severity of their heart failure.

One 2016 review concluded that restricting fluid intake to 30 milliliters per kilogram of body weight per day was reasonable. The researchers noted that this amount of fluid intake also had the most minor effect on a person’s thirst level.

A doctor can advise a person regarding how much fluid they should aim to consume per day.

A person with heart failure should reduce their fluid intake if a doctor recommends doing so. Not restricting fluid intake may result in a person:

The person may also develop serious complications, such as:

  • kidney or liver damage due to fluid buildup and reduced blood flow
  • fluid buildup in or around the lungs
  • malnutrition, as swelling in the abdomen can make it uncomfortable to eat

Restricting fluids can be challenging. Knowing what counts as fluid intake can be helpful.

The following foods and drinks contribute to a person’s fluid intake:

  • water, milk, or juice
  • tea and coffee
  • soup and broth
  • puddings
  • yogurts
  • gelatin-based desserts, such as Jell-O
  • ice cubes
  • frozen desserts, such as ice cream, sorbet, and popsicles

Some tips for how to restrict fluid intake include:

  • using small glasses, such as juice glasses
  • limiting salt intake
  • sucking on hard candy, frozen fruit, or ice cubes
  • chewing gum
  • sipping, rather than gulping, liquid
  • spacing out fluid intake
  • controlling sugar intake
  • measuring out daily fluid intake in a large bottle
  • making a note of fluid intake through the day
  • using a refreshing mouthwash when the mouth feels dry

According to a 2021 article, fluid restriction can lead to an imbalance in a person’s internal water and sodium levels. If a person does not take in enough fluid, the sodium level in the body can become more concentrated. This can lead to increased feelings of thirst and fluid retention.

If a person has too much sodium in their blood, their body will try to dilute it by increasing a person’s thirst. The body will also try to hold on to water already inside it, leading to fluid retention.

Evidence for sodium restriction

According to a 2020 review in the International Journal of Molecular Sciences, evidence to support the benefits of sodium restriction for heart failure is unclear.

The current scientific evidence suggests that people who are at risk of heart failure or have asymptomatic heart failure might benefit from restricting sodium. However, a 2016 study suggests that sodium restriction may adversely affect people currently experiencing heart failure symptoms.

Learn more about a low sodium diet.

If a person finds it difficult to stick to a restricted fluid intake, they should ask a doctor for advice.

A person should also speak with a doctor if they develop any of the following symptoms:

If a person with heart failure experiences the following symptoms, they should receive immediate medical care:

Heart failure can cause a person to retain excess fluid and reduce how the kidneys and liver function. Fluid retention can add strain to the heart.

Temporary fluid restriction can be helpful for certain people with heart failure. A healthcare professional may also prescribe diuretics and sodium restrictions to treat heart failure. If a person does not restrict fluid intake when a doctor advises it, they could develop serious complications.

Knowing what foods and drinks count as fluid can help a person restrict their fluid intake. A person may also wish to portion out their daily fluid intake so they do not exceed their daily allowance.

If a person experiences any serious symptoms of heart failure, they should seek immediate medical attention.