Fluid retention: how to identify and when to seek medical help

Swollen legs at the end of the day, with marks from socks or shoes on the skin. It is not uncommon for people to experience this characteristic symptom of fluid retention. However, what many people don’t know is what the causes are, nor that retention can be associated with more serious health problems, such as hypothyroidism, heart failure, renal influence and circulatory problems.

Find out below what exactly fluid retention is, in which situations it can appear, what are its signs and when it is necessary to seek medical help.

What is fluid retention?

Larissa Garcia Gomes, director of the Brazilian Society of Endocrinology and Regional Metabology São Paulo (SBEM-SP), CRM SP-102980, explains that fluid retention is an increase in the reabsorption of water and salt by the kidneys, leading to an increase in blood volume circulating fluid, which can leak into the body’s tissues causing swelling. There are several causes: from inadequate nutrition to heart failure or circulatory problems.

Fluid retention in pregnancy is also a common complaint. “Estradiol, a hormone that increases significantly during pregnancy, leads to adaptive hormonal changes that culminate in increased salt and water retention. From a physiological point of view, this increase in circulating blood volume is important to nourish the placenta and the fetus, however, it can cause symptoms of swelling”, explains Larissa.

There may also be fluid retention in the postpartum period. “During pregnancy, a woman increases her circulating blood volume and this volume can be gradually and variably lost in the postpartum period. Postpartum fluid retention is more common in patients undergoing cesarean delivery, in which saline solution is administered. This is because the serum has a concentration of sodium that can promote fluid retention, however, this retention is temporary”, explains the endocrinologist.

Liquid retention with oral contraceptives (OAC), highlights Larissa, was more common in old formulations that had high doses of ethinyl-estradiol, a synthetic estrogen present in most preparations. “Current low doses of ethinyl estradiol or estradiol, and the use of progesterone with fluid retention prevention characteristics, have considerably diminished this finding in clinical practice,” she explains.

Fluid retention with medication can also occur and depends a lot on the medication you are using. But in general, the final mechanism is increased fluid retention by the kidneys. The main drugs associated with retention are antihypertensives (amlodipine), glucocorticoids (cortisol derivatives), estrogens.

How to identify fluid retention?

Some signs are very characteristic of fluid retention in the body:

• Presence of edema or swelling of the tissues under the skin, especially in the arms and legs;
• Sock and/or shoe marks on the skin, especially at the end of the day;
• When squeezing the region of suspected edema, a depression is formed;
• Thin, shiny skin in the swollen/swollen region;
• When squeezing the lower ankle region continuously, a “sinking” is observed that takes time to return to normal (edema);
• Swollen eyelids and/or face;
• Weight gain unrelated to increased caloric intake and/or reduced physical activity.

In some cases, swelling may also be accompanied by a feeling of shortness of breath or fatigue.

How to eliminate swelling from fluid retention?

Larissa highlights that it is essential to identify the cause of the swelling to properly treat each case. But some general tips are:

1. Elevate the lower limbs

Larissa advises elevating the lower limbs during the day to improve blood return. This will help prevent fluid retention in your legs. Do this on short breaks at work, if possible, or at the end of the day when you get home.

2. Avoid processed foods

The endocrinologist highlights that, if the retention is abusive, it is important to reduce foods rich in sodium. And this implies reducing mainly the consumption of industrialized foods, such as cookies and soft drinks, canned goods in general, sausages, soy sauce, ready-made sauces, among others.

3. Reduce salt

Decreasing the salt used in food preparation can also help prevent fluid retention in the body. Good tips for this are: using more natural seasonings, always having a specific measure of salt in food preparation to avoid the famous “salt by eye” and not adding salt to dishes that already contain cheese, olives (ingredients that are normally already salted). ).

4. Bet on lymphatic drainage

Larissa highlights that performing lymphatic drainage helps to reduce limb edema. It works specific and smooth movements that stimulate the lymphatic system to work faster, thus moving fluids through the body more effectively.

5. Consume water

Always give preference to water to hydrate. If you don’t usually drink it throughout the day, make it a habit to have a bottle by your side. This goes for the desk at work, for moments when you are at home and even in the car.

6. Practice physical activity

Avoid sedentary lifestyle by practicing physical activity regularly. Choose a physical activity that gives you pleasure, as this is the secret to staying motivated with the practice. It can be walking, running, dancing, weight training… The important thing is to see the activity as something pleasurable, which provides you with more health and well-being.

7. Have a healthy diet

In addition to avoiding processed foods and sausages, it is important to regularly consume whole grain cereals (which are sources of fiber), fruits (especially watermelon and pineapple), vegetables (arugula, cucumber, lettuce, zucchini, chayote).

8. Bet on teas

Although water should not be replaced, teas can also be allies when it comes to avoiding fluid retention, as most of them have a diuretic effect. Good suggestions are hibiscus, horsetail and green tea. But it is worth remembering that teas should be consumed without sweetening. Otherwise, they can lead to weight gain and even increase retention.

These measures are simple and important, however, they should not inhibit the search for a doctor when the signs of fluid retention are persistent.

When to see a doctor to treat fluid retention?

According to the specialist, fluid retention can be a clinical sign of some underlying disease, such as heart failure, kidney disease, liver cirrhosis, venous insufficiency or protein malnutrition. This reinforces the importance of being attentive and not hesitating to seek medical help when you notice one or more of these signs:

• New-onset edema: You have never had the problem before, but now swelling/edema has become frequent.
• Persistent swelling: When the swelling recurs, your feet are swelling a lot or daily, to the point where your shoes and socks are tight at the end of the day.
• Severe edema: when it is possible to notice swelling of important extremities, to the point of other people talking to you, for example.
• Swollen face: if you notice that you have been waking up with your eyelids or your whole face swollen.
• Specific body part swollen: when only one of your legs or only one of your arms, for example, is swollen.
• Unexplained weight gain: if you’ve noticed that you’ve gained weight on the scale without making any major changes in your diet and/or physical activity.
• Tiredness: when, in addition to swelling, you feel great tiredness, shortness of breath, among other discomforts.

In many cases, fluid retention is avoided with simple measures, such as reducing processed foods. In others, however, it deserves a more careful investigation.

In any case, as fluid retention can be associated with a more serious health problem, when you notice signs of swelling associated or not with other symptoms, do not hesitate to look for your trusted doctor.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.