Heart Failure: Simple Ways to Manage Fluid Buildup

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Getting a diagnosis of heart failure can be daunting, in part because of all the adjustments you must make to keep yourself as healthy as possible. And some of the most important changes have to do with managing your fluid levels. That's because swelling can be a sign that your heart failure is getting worse.

So how do you know if you’re retaining water—and, even better, how can you prevent it from happening in the first place? Here’s what you need to know.


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Why Fluid Buildup Is Dangerous

When the heart struggles to pump blood throughout the body, your kidneys go on high alert: In order to increase your blood volume, they activate hormones that tell your body to hang onto whatever water it has. If too much fluid accumulates, it’s not only a sign that heart failure is progressing, but you could also need emergency care, according to Harvard Health. Excessive fluid levels can be life-threatening because it can put too much pressure on key organs, like your lungs or liver.


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Know the Signs

A number of things can signal excess water retention, according to Harvard Health:

  • Weight changes (one of the earliest signs)
  • Bloating in the belly and feeling full despite not eating much
  • Swollen legs, ankles, or feet
  • Nausea
  • Persistent coughing and shortness of breath
  • Fatigue
  • Loose stools

Call your doctor if you notice any of these signs—especially weight gain.


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Weigh In Every Day

Stepping on the scale every morning is one of the best way to monitor your fluid level, says Gurusher S. Panjrath, M.D., associate professor of medicine at George Washington University and chair of the American College of Cardiology Heart Failure and Transplantation Council. If you notice a gain of more than 2 to 3 pounds in a day or 5 pounds in a week, that’s a potential sign of water retention—so you should call your doctor right away.

Weigh yourself first thing in the morning, before eating and after using the bathroom, and write down the amount.


Limit How Much You Drink

The most important thing in preventing fluid retention, according to the NIH, is to simply watch your fluid intake. How much you need to cut back depends on your specific situation, however, says Dr. Panjrath. “The amount may vary based on individual, location, and weather.”

For example, if your heart failure is not very severe, you might not have to limit fluids much at all. But if it gets worse, you may need to stick to 6 to 9 cups (1.5 to 2 liters) per day, according to the NIH. Your doctor can help you come up with guidelines that make sense for you. It can be helpful to keep a log of your fluid intake in a small notebook or the notes app on your smart phone.

When you’re at home, use the same size glass at all your meals. All you really need is 1 cup (8 oz. or 240 mL) of liquid, according to the NIH. At restaurants, keep rogue refills in check by placing an extra napkin on top of your glass in between sips, then turnover your empty glass when you’re done.


Watch the Water That You Eat Too

It sounds pretty straightforward—just don’t have too many drinks in a day, right? Well, it’s trickier than it seems because it’s not just beverages you need to worry about. You eat a lot of water too, especially in foods like:

  • Soup
  • Ice cream
  • Popsicles
  • Puddings
  • Gelatin

So when you’re watching your fluid intake, you’ve got to factor these foods in. While you may want to skip these types of treats, you don’t necessarily have to give up chunky soups and stews. Try eating them with a fork and leaving most of the broth behind.


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Avoid Salty Foods

There’s a reason why you want a glass of water with those salty potato chips—eating too much salt may make us thirsty and bloated, according to the NIH. And that’s bad for heart failure patients in two ways: One, because it makes you want to drink more water, and two, because high levels of sodium cause our bodies to retain fluid anyway.

“It is important to restrict sodium, which is prevalent in lot of common foods especially processed meats, breads, and soups among others,” says Dr. Panjrath.

So for those who are trying to limit fluid buildup with heart failure, salty snacks may be a no-go. And remember to check nutrition labels regularly, especially on canned and frozen foods, which can contain high levels of sodium, says the National Institutes of Health (NIH). Check with your doc to see if there’s a specific amount of sodium you should limit yourself to per day.


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Stock Up on Gum

When you’re trying to limit your fluid intake, your thirst can get the better of you. Instead of gulping down a glass of water, go for a stick of gum, or try rinsing your mouth with cold water and spitting it out, suggest experts at the NIH. You can also try sucking on hard candies, lemon slices, or small chunks of ice.


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Try Diuretics

Beyond limiting your fluid intake, you can also help your body eliminate excess fluid by taking what’s called a diuretic, says Dr. Panjrath. These are often referred to as water pills, and some types can be purchased over the counter. Taking them makes you urinate more often, ridding your body of extra liquid and helping to prevent fluid buildup. Ask your doctor if one is right for you.

There are also natural diuretic herbs and supplements you can try, too. Some studies find that parsley, ginger, and dandelion extract may help, according to the Mayo Clinic. Still, more research is needed, so talk to your M.D. before relying too heavily on these.


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Recruit Help

It can be hard to keep tabs on your fluid intake on top of everything else that comes with managing heart failure. One way to help prevent fluid retention is to involve your loved ones: Ask your partner or other family members to help you monitor what you're eating and drinking, and to help you remember to take your meds, suggests the NIH. It's also smart to teach them about the symptoms of fluid build up so that they can keep an eye on you too.


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The Bottom Line

Taking medications regularly as prescribed, including drugs to help you manage your blood pressure (because excess sodium can up BP, too) will also help keep fluid buildup in check, says Dr. Panjrath. Tracking your symptoms, medications, and doctor’s appointments can be a lot at first, but as you make changes little by little, you'll soon have a new routine you can stick with.