Question

What are the causes of swelling in my body during the night? The lower half of my body is swollen - there's no itching, but some breathlessness (maybe due to excitement). No blood clots found in my legs by ultrasound. I'm now taking furosemide 40mg and potassium supplements. I'm 49, weigh 195lbs, height 5'6". I smoke one pack a day, drinking no less than 6 glasses of water a day.

Answer

The retention of fluids in the body is a regular part of everyday living. It is mostly water and contains a mixture of waste products, minerals, and a wide variety of chemicals that the body needs to operate its daily metabolism. It is not exaggeration that the living body is made up mostly of water. After all is said and done, after life is over and all the water leaves us, there is only a handful of dust left.

Water gets into the system with the foods we eat and the liquids we drink. Many people don't drink water itself, so most of their body fluids come from the foods we eat.

Water leaves the system through the kidneys, bowel, lungs, and skin. Keep in mind that quite a bit of water leaves the body through noticeable sweating and breathing. Unnoticeable sweating, called insensible sweat, also accounts for a fair amount.

It is not at all unusual for body weight to vary as much as three to five pounds a day, all depending on your fluid balance and fluid retention.

You can get a pretty good idea about how your own weight variations due to fluctuation in fluid retention by checking your weight first thing in the morning and at bedtime. Do this every day for two weeks and consider taking the written record to your doctor for advice.

Remember that the picture can vary with your diet. Vegetables, fruits, and carbohydrates have quite a bit more water in them than fats and proteins. How much salt you use will make a difference since it causes your body to retain water. Your physical activity will make a difference also. The more active you are, the more water you get rid of.

Remember too, that gravity has an effect on the amount of fluids you will notice in yourself. After you have been in bed all night, you will see and feel more swelling in your face and hands. By bedtime, this fluid will gravitate to your feet and legs, so you will see and feel it there. This is especially noticeable if you sleep on only one side during the night. When it is very prominent, you can press your thumb firmly against the side of the shin bone, hold for a half minute and note that a thumb-sized dimple will be left behind.

The amount of fluids retained can vary with disease conditions that affect the circulation. Some common ones include hypothyroidism (low thyroid activity), high and low blood pressure, heart and kidney disorders, and diseases of the arteries and veins. Excess retention is much more common in women than men because of the effect of female hormones on the body's metabolism and circulation.

I just don't have enough facts to be more specific for your edema problem. If your morning swelling doesn't resolve in the first hour or so after awakening make sure that your physician is aware of the situation so that proper tests can rule out the above problems.