The Gerson Institute of Ayurvedic Medicine

Scott Gerson, M.D., Ph.D. (Ayurveda) Medical Director, Jupiter Medical Center Dept. of Integrative Medicine Division of Education and Research

Jupiter Medical Center at The Calcagnini Center for Mindfulness
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The Importance Of Water In Human Health

Ayurvedic Viewpoint on Water

Jeevana is a synonym for water which means life-giving; life could not exist on this planet without water. In Ayurveda water is not only an essential nutrient but is one among the five fundamental proto-elements essential for the creation of this universe. It is known as jalamahabhuta. According to Charaka pure water has the qualities of liquid, unctuous, cold, soft, sticky and kashaya (astringent taste). The best water for drinking is slightly astringent, slightly sweet, thin, non slimy, light, smooth and does not block the srotas—channels—of the body Moistening, unctuous, binding, oozing, softening and exhilarating are the various effects of watery edible substances on the human body.

According to Ayurvedic teaching water is also the basis of rasa tanmatra, the sense of taste. Water is initially slightly astringent but otherwise tasteless. As it falls from through the sky, it acquires the properties of the remaining four elements, and eventually comes into contact with other substances (sunlight, sand, soil, minerals, etc.) and subtly different tastes are created in water.

Water and Soil

According to Charaka the pure rain water is sattvic in nature and possesses six qualities namely: cold, pure, wholesome, palatable, clean and light. But when water falls on earth its properties change according to the soil on which it has fallen. In white soil it becomes astringent, in yellow soil it becomes bitter, in brown soil-alkaline, in red soil-salty, in hilly areas-pungent, and in black soil it becomes sweet. The water from rain, sleet, hailstone and snow is tasteless.

Water and the Seasons

  • The water of spring season is astringent, sweet & rough.
  • In summer it is clarifying for the channels.
  • In autumn it is thin, light, and does not block the channels in the body.
  • In early winter water is unctuous, aphrodisiac, strength promoting & heavy.
  • In later winter it is light and alleviates Kapha & Vata.
  • In the rainy season water is heavy, sweet and causes blockage to the channels.

Modern Viewpoint on Water

Most people believe that we feel thirsty whenever our body needs more water. While this is true, recent research studies have indicated that there are several other indicators of inadequate water in some or all parts of the body. Ignoring these indicators can lead to several major diseases that medicines may cure but not treat. Almost everyone knows that drinking adequate water is good for health. But most people do not understand why this is so and what exactly happens when the body does not get adequate water. This issue focuses on the critical role of water in preventing several health problems, some of which can lead to major diseases. It also describes the various techniques of natural healing where water plays an important role.

Up to seventy percent of the total body weight is due to water. Although it is present in all parts of the body, it is more in organs such as lungs and brain and fluids such as blood, lymph, saliva and secretions by the organs of the digestive system. Water is available liberally in most places. There are two main sources of water - underground and surface water (rain-water). Normally, surface water is "soft' and underground water is 'hard". This means that the underground water has several minerals and/or compounds mixed in it. Soft water is more effective for therapeutic purposes as compared to hard water. It is however important to remember that impurities of soft water, if present, can adversely affect the health. Therefore, it is necessary to purify water to be used for drinking and for therapy.

Water has been an integral part of treatment of several diseases by the ancient Egyptians, Hebrews, Greeks, Persians and Hindus for several centuries. The Chinese used water as a remedy several centuries before Christ. Japanese used cold water for treatment of several diseases almost eight hundred years ago. Hippocrates, father of modern medicine, also used hot and cold water successfully for management of diseases such as fever, ulcers, bleeding in or outside the body, etc.

How is the body water regulated?

Whenever there is water shortage in your house, you would prioritize the use of water for essential purposes. For example, you would use the necessary water for drinking and cooking but reduce the amount of water used for bathing, washing, etc. Similarly, when the body receives insufficient water, histamine, a chemical compound present in many cells, initiates a system of water regulation. This physiological system prioritizes the distribution of water to more important organs of the body such as brain, heart, lungs, etc. Histamine directs and operates a system of chemicals called neurotransmitters. These chemicals either modify or transmit impulses in the nerves. Histamine directs some neurotransmitters to operate sub-systems to regulate water intake.

These sub-systems use chemical substances which include 'vasopressin' and 'renin-angiotensin’ to regulate water intake and distribution.

Vasopressin is a hormone that increases re-absorption of water by the kidneys and therefore decreases the production of urine. Renin is an enzyme produced and stored in kidneys. Whenever the volume of blood decreases, renin initiates a series of chemical reactions that produce a chemical compound, angiotensin. Angiotensin results in contraction of the blood vessels of the kidneys and therefore reduces the rate of filtration of blood by the kidneys. Reduced filtration helps the body to retain more water.

There are three stages of water regulation of body at different stages of life. These include (a) before birth, (b) between birth and adolescence and (c) in adulthood. Before birth, the unborn baby sends signals to the mother if more water is required for its growth and development. Thus, although the unborn baby sends the response, the mother experiences the effect. It is believed that morning sickness in a pregnant woman is the first indicator that the unborn baby needs more water. Water regulation efficiency of the body reaches the peak by the age of twenty years. Subsequently, it gradually declines through life. Thus, the thirst sensation gradually decreases as age advances. This is perhaps why chronic diseases such as arthritis, high blood pressure, etc. that are also associated with inadequate intake of water are more common in older age groups. The amount of tea, coffee,alcohol, carbonated drinks that you consume regularly may also adversely affect the water regulation in later life. The ratio of the water content in and outside the cells of the various organs is very important. As we get older, water content decreases. Since the water each cell plays a vital role in its normal function, inadequate water can lead to loss of some cellular functions. Loss of function, in turn, results in demonstrable signs and symptoms.

Why is water important for maintaining normal health?

As we have said, the water content in various parts of the body regulates their functions. It also helps regulate the functions of the solids such as minerals, vitaniins, etc. dissolved in the water. In other words, every function of the body is influenced by the flow of water in the various organs. Adequate distribution of water in all parts of the body ensures that water and the chemical substances that it transports (such as hormones, nutrients, etc.) first reach the more important organs such as the brain, heart, kidneys and lungs. Several organs secrete chemical substances that act on distant parts of the body. These chemicals regulate their own production and release into the "water" around them.

In addition, modern Ayurveda describes the following roles of water in our body.

1. Water helps maintain the moisture of the Uning of the internal organs ofthe body;

2. It maintains normal volume and consistency of fluids such as blood and lymph;

3. It regulates body temperature;

4. It removes "poisons" or "toxins" from the body through urine, sweat and breathing; and

5. Water is essential for regulating the normal structure and functions of the skin. The body loses about four liters of water every day. It is therefore necessary to replenish this volume by drinking at least the equivalent amount of water every day. Inadequate intake of water can lead to dehydration.

What is dehydration?

Dehydration is excessive loss of water from the body. It results in imbalance in sodium, potassium and chlorides levels. Normally, dehydration is the term used when there is inadequate water in all parts of the body. This is often the result of rapid loss of water due to conditions such as fever, diarrhea, vomiting, etc.

The common symptoms of dehydration of the entire body include increased thirst, loss of skin elasticity, dry skin, decreased urine production, and mental instability and confusion. This is the stage in which the body's natural compensatory mechanisms of water regulation are not able to meet the minimum requirement for the vital organs. As mentioned earlier, dehydration may be present in some specific cells or organs of the body without resulting in these acute symptoms.

What are the indications of dehydration?

Thirst is an early indicator of inadequate water in the entire body. However, there can be inadequate water supply to some parts of the body without resulting in thirst. Inadequate water in the body cells can adversely affect their functioning. Depending upon the organ affected by inadequate water supply, there are specific signs and symptoms. Chronic pains and allergies are the most common symptoms indicating abnormal function of an organ due to chronic dehydration.

What are the common health problems due to chronic dehydration?

Let’s briefly review some of the more common medical consequences of dehydration and you will understand why ayurveda places such strong emphasis on prevention of this condition.


Dyspepsia is the term used for a vague feeling of discomfort in the stomach region soon after eating food. This discomfort can be in the form of a feeling of fullness, heartburn, bloating and nausea. Dyspepsia is not a disease but a symptom indicating that there is an underlying disease such as ulcer in the stomach, diseases of the gall bladder or chronic appendicitis. Recently, the medical literature has confirmed the association of chronic dyspepsia with an increased incidence of esophageal cancer.

Why does inadequate water intake lead to dyspepsia?

There are two main reasons why inadequate water intake can lead to dyspepsia. These include:

  1. increased acid in the stomach and
  2. changes in the normal functions of the pancreas.

Increased acid in the stomach

The secretions that line the inner layer of the stomach consist of ninety eight percent water and two percent support like structure that "traps" water. This trapped water forms a protective layer on the inner lining of he stomach. The cells below this protective layer secrete a chemical compound, sodium bicarbonate, which in turn is trapped by the inner water layer. Acid is secreted in the stomach for breakdown of complex food particles. When this acid, which contains chloride, tries to enter the protective layer of water in the stomach, the sodium bicarbonate neutralizes it. As a result, sodium from the bicarbonate and chlorine from the acid combine form salt. Excess salt reduces the amount of water trapped on the inner layer of the stomach. When the water content in the protective layer decreases, the acid comes in contact with the inner layer of the stomach and causes pain.

Changes in the functions of the pancreas

Pancreas is an organ of the digestive system that is situated behind the stomach. Although its main function is to secrete insulin for regulation of blood sugar, it also secretes some important digestive enzymes into the intestine. In addition, it secretes a watery bicarbonate solution that makes the intestines alkaline. Thus, when the acid from the stomach reaches the intestines, the bicarbonate solution neutralizes it.

As solid foods are digested by the acids in the stomach, the food becomes liquefied. This liquefied but slightly acidic food enters the first part of the small intestine (duodenum) through a valve called the pyloric valve.. This valve normally does not allow the contents of the intestines to enter back into the stomach. It is regulated by messages from both the sides. This means that the valve can function effectively when it receives a message that the stomach is ready to send food to the intestine and the intestine is ready to receive it. The intestine sends the message to the pyloric valve to open when there is adequate watery bicarbonate. When the pancreas does not get adequate water from the blood circulation, there is inadequate secretion of watery bicarbonate solution. As a result, the intestine is not able to send effective manages to the pyloric valve to allow food to enter.

How does drinking more water prevent dyspepsia?

When you drink a glass of water, especially on empty stomach, it passes into the intestines immediately and is absorbed into the body. After about one to one-and half- hours, the absorbed water is secreted into the stomach through its inner layer and as a result removes the excess salt deposits on it. Thus, the protective layer of water remains intact. The acids therefore cannot penetrate the layer and cause dyspepsia. This is why Ayurveda recommends drinking water at least an hour priot to before meals. You can cure many cases of gastritis and heartburn just by increasing the intake of water to about two and a half liters of water per day. Normally, the discomfort and pain subside within a few days. However, if the symptoms have been present for a long time, the symptoms may not subside for a few weeks.

What is the role of medicines in dyspepsia?

Medicines such as Ranitidine or Cimetidine that are extensively prescribed for control of dyspepsia are sometimes very effective for short-term therapy. However, it is likely that prolonged use of these medicines may actually be harmful. This is because they block the action of histamine on specific receptors in the body. Some cells in the stomach that produce acid are sensitive to the blocking action on histamine and therefore secrete less acid. However, many cells in other parts of the body that do not produce acid are also sensitive to the blocking action on histamine. As mentioned earlier, one of the important functions of histamine is to control water regulation in different cells of the body. If its action is blocked in some cells, it can cause chronic dehydration in these cells.


Some medical practitioners feel that pain in the joints is one of the early indicators of water deficiency in the affected joints. The terminal parts of all our bones which form joints have a protective structure called cartilage. Cartilage has more water content as compared to bone, which is harder. The water in the cartilage helps provide lubrication and therefore enables the two ends of the bone to glide one over another with a minimum of friction. During this gliding motion, some cells die and are broken down. These dead cells are replaced by new cells. When there is less water content in the cartilage, there is less lubrication. Thus, the number of dead cells increases. Joint pains result when the number of dead cells is more than the number of new cells being produced.


Stress is the term used for any emotional, physical, social or other factors that requires a response or change. Dehydration is also a type of stress and therefore this stress mobilizes body reserves to deal with the stress. As a result, some of the body reserves of water are also used up. Thus, dehydration causes stress and stress can cause further dehydration.

Depression is the term used to describe an abnormal emotional state that results in exaggerated feelings of sadness, dejection, worthlessness, emptiness and hopelessness. These feelings are not inappropriate and represent a distortion of reality. Inadequate water in the brain can precipitate depression. The brain generates electrical energy from the water present in it. Decreased water in the brain leads to inadequate production of this electrical energy. Thus, the functions of the brain that depend on this type energy become inefficient. When the normal fimctions of the brain are affected, depression can occur.

What are the effects of stress an water regulation?

Any type of stress results in secretion of several hormones. These hormones continue to be in higher than normal concentration until the stress is relieved. Since the body is not able to distinguish between different types of stress, dehydration also results in secretion of higher amount of these hormones. Detailed below are some of the hormones secreted in large amounts during any type of stress.

Endorphins.. These hormones are secreted by a small gland in the brain called the pituitarygland. They act on the nervous system to reduce pain. Excessive secretion of endorphins may affect the normal pain reaction in the body.

Cortisone. This is a chemical compound produced by adrenal glands. During emergencies, cortisone stimulates the process of breakdown of fats and proteins for releasing energy and formation of new proteins and chemical substances for use by the muscles. Thus, cortisone promotes utilization of some of the body reserves. Prolonged action of cortisone may therefore reduce specific body reserves.

Prolactin. Prolactin is a hormone secreted by the anterior pituitary gland. It ensures that a woman continues to produce milk after child-birth even when there is dehydration or stress that can cause dehydration. Thus prolactin secretion increases during stress or dehydration in order to maintain the normal water content of the breast milk. Research studies have indicated that long- term increased prolactin secretion can lead to breast tumours in mice. Some medical practitioners therefore believe that the risk of breast tumour may be higher in women who have increased prolactin secretion due to chronic dehydration.

Vasopressin: Vasopressin, a hormone secreted by the pituitary gland, is one of the hormones that is involved in the rationing and distribution of water as per the priority of the vital organs. In case of dehydration, the nerve cells produce more vasopressin as compared to other cells of the body.

What is the effect of alcohol on water regulation?

Alcohol adversely affects water regulation because of two main reasons:

  1. it suppresses the secretion of vasoprmin and
  2. it leads to chronic dehydration in some parts of the body.

Alcohol suppresses the secretion of vasopressin from the pituitary gland. Decreased vasopressin can adversely affect the body's natural compensatory mechanisms of water regulation. This adds to the stress and results in excessive secretion of other hormones such as endorphins, which are naturally addictive.

Regular intake of alcohol and caffeine (in coffee, tea, soft drinks, etc.) can lead to chronic dehydration in some organs ofthe body. In such situations, whenever the nerve tissues require more water, the blood circulation along the nerves increases. Increased blood circulation results in increased release of histamine from the cells supplying the nerves. Persistently high histamine can cause inflammation-like reactions that may damage the nerves over a period of time. When the rate of damage exceeds the rate of repair, nerve disorders can occur.


Whenever there is water shortage in some parts of the body, the compensatory mechanism takes sixty-six percent of the additional requirement from the water normally present in the cells, twenty-six percent from the water outside the ceus and eight percent from the blood volume. In order to maintain the normal blood volume, some capillaries close down and pour their water content in the blood. Thus, the extent of activity in the capillaries in different parts of the body ultimately determines the volume of the circulating blood. Closed capillaries increase the resistance to blood flow around them. Increased resistance to blood flow leads to high blood pressure. It is important to remember that drinking more water alone cannot prevent or control high blood pressure. This is because there are several other important factors that usually contribute to this condition. Adequate water intake can however delay the onset of high blood pressure or reduce its severity.


The brain is very sensitive to low energy levels available for its functions. Low energy levels cause thirst and hunger sensations. Normally, hormones are necessary to mobilize energy from the stored fat. Since this process takes some time and the brain requires energy urgently, it depends on the blood sugar for the energy. It also uses water to produce electricity and transport its messages to various parts of the body. Thus, the sensation of thirst and hunger are felt together to indicate the brain's needs for more instant energy. Drinking adequate water before the meal will reduce the intensity of the thirst and therefore help prevent overeating. When water intake is inadequate, you are likely to feel more "hungry" and eat larger portions of food at more frequent intervals in order to supply necessary sugar to the brain. It is important to note that only twenty percent of the energy from the food reaches the brain. The energy from food that is not used by any other part of the body is storedas glycogen and fat. On the other hand, if the brain derives more energy from water, the unused water is excreted as urine. Thus, the risk of weight gain is greatly reduced.


High blood cholesterol often indicates that the arterial linings of our circulatory vessels are coated with this fatty substance. This causes a loss of the ability of adequate water to escape from the arterial cells, through the arterial cell walls, and into the bloodstream. This is because cholesterol is like natural cement that fills the gaps of the cell walls and prevents water from passing through it. Some medical practitioners feel that excessive deposition of cholesterol in the cell walls is a natural protective mechanism against dehydration of these arterial cells. This is because during dehydration, the normal quality of water to form an adhesive lining to bind the cell walls together is lost. Several weeks after increasing the daily water intake, the water content in the cells will become normal. Thus the flow of water through the cell walls will also become normal. As a result, the need for our cholesterol defense mechanism against passage of water across the cell walls will gradually decrease. Hence, the body will produce less cholesterol.


Asthma is a disease of the respiratory system that causes repeated attacks of difficulty in breathing, wheezing due to constriction of the air passages, coughing, and thick secretions of the air passages. It is often interlinked with allergies of different types. People with asthma have increased histamine in the lung, which results in contraction of the air passages. Since the lungs are major sites of water excretion, contraction of the air passages will lead to decreased loss of water. This is also one of the body’s defense mechanisms which preserves water in scenarios of dehydration.

Histamine also plays an important role in the body's natural defense mechanism against disease causing agents. When the histamine level increases, the defense mechanism becomes exaggerated. Some studies on animals have indicated that increased water intake reduces histamine production after one to four weeks of appropriate water regulation. They therefore are less prone for allergic reactions. This is why some medical practitioners opine that drinking adequate water may help control asthma. It is important to remember that drinking excess water will not control asthma immediately. Drinking about eight to ten glasses of water per day for a few weeks can lead to adequate water in all cells of tbe body. It is generally after several weeks of consistent water intake in these quantities that the beneficial effects of water in asthma and allergic conditions can be experienced.

What is the normal daily requirement of water?

It is very difficult to quantify the exact amount of water each person requires to maintain normal functioning of all the organs of the body. This is because the quantity of water required for the body functions depends on several factors such as age, climate, season, physical activity, type of food consumed, amount of condiments and spices used for cooking, the water content in the food, salt intake etc.

Normally, our daily diet provides about two-third of the body's requirement of water. Some health practitioners suggest that you drink about eight to ten glasses of water everyday to meet the remaining one-third of the body's requirement. You also need to drink a lot of water when you are tired and/or are sweating profusely.

It is also important to learn when not to drink water. It is desirable that you avoid drinking large quantities of water while eating food, as it will adversely affect proper churning of the food and the secretion of the saliva. Small amounts of liquids consumed during the meal is perfectly fine however. The water leaves the stomach within five to ten minutes of drinking it, and therefore if large quanties of water are consumed, the food is also likely to leave the stomach along with the water. Thus, digestion of the food is likely to be adversely affected. Excessive water also dilutes the digestive juices in the stomach to some degree, thus possibly creating incomplete digestion. It is most desirable that you drink water on empty stomach or three hours after food or one to one and a half hours before food.

One of the ways to ensure tbat you are drinking adequate water is to observe the colour of your urine. If it is almost white, it means that all parts of your body are well- hydrated.A yellowish tint to the urine indicates that the kidneys have to work harder to remove the waste products because of inadequate water in the blood.

How should you drink water?

Most people tend to drink water in large gulps. Ayurveda recommends that you need to "eat liquids and drink solids". This means that you need to take water sip by sip, and "chew" it in the mouth in order to mix it with the saliva. Avoid regular use of straws for drinking water and/ or fluids.

Other general benefits of water are as follows:

1. Regulates body temperature

2. Dilutes the blood to an optimum specific gravity and reduces its viscosity to prevent abnormal clotting

3. Promotes excretion of toxins via the skin in the form of perspiration

4. Stimulates the normal functions of the kidneys and therefore increases the rate of removal of toxins from the body through the urine;

5. Increases movements of the intestines, thus facilitating formation and passing of soft stools.

One of the first behavioral modifications that a patient will learn about upon visiting an ayurvedic physician will be to optimize all the features of water consumption. It is not an exaggeration to say this is one of the most important things we can do for ourselves to promote a healthy, vigorous body and mind.