Water Retention: Symptoms, 11 Causes & What to Do

Updated in December 2023

Water retention is the abnormal accumulation of fluid within body tissue that can occur due to hormonal changes, excess salt intake, prolonged positioning, or lack of regular exercise. It can cause symptoms like swelling in the legs, arms or abdomen. 

Generally, water retention can be relieved with simple methods like elevating the legs, raising your arms or opening and closing your hands. However, it may be a symptom of another condition like diabetes, high blood pressure, liver disease or kidney disease, all which require follow-up with your doctor. 

In addition, you should monitor for other symptoms that can occur with water retention, like sudden leg, arm or hand swelling, redness in the swollen areas, shortness of breath or chest pain. You should seek immediate medical attention if any of these occur so that assessment and appropriate treatment can be initiated. 

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Water retention is noted on the right hand

Main symptoms

The main symptoms of fluid retention are

  • Swelling in the face, belly, legs, ankles, feet, arms, hands or back
  • Tight, shiny skin in the affected area
  • Pain or increased sensitivity in the area
  • Stiffness in the affected joint
  • Increase in body weight
  • Decrease in the amount of urine produced and eliminated per day

One way to tell if it's fluid retention is to press on the swollen area for about 30 seconds. If the area is marked, this indicates that there is an accumulation of fluids there. 

Although swelling is more common in one or more parts of the body, generalized swelling can also occur, i.e. throughout the body, and this condition is known as anasarca. Understand what anasarca is and how to identify the symptoms.

Possible causes

The most common causes of water retention are: 

1. A diet that is high in salt 

High salt intake can cause fluid retention becomes salt contains lots of sodium. High amounts of sodium in the body can lead to fluid accumulation. 

What to do: Use salt with low sodium content or reduce your salt intake by opting for more spices or herbs in your food.

2. Pregnancy

Water retention is pregnancy is a normal symptom. Increased production of the relaxin hormone causes increased dilation of blood vessels, leading to swelling in the legs and ankles.  

Swelling occurs because when blood reaches the lower extremities, it is harder for it to return to the blood. This results in the accumulation of liquid between the cells and causes swelling.

What to do: Drink at least 8 cups of water during the day and keep your legs elevated whenever possible. To improve your blood circulation and to stimulate liquid elimination, decrease your salt intake and ensure you are keeping physically active with light exercise, like walking or water aerobics..

3. Not drinking water during the day

Keeping the body hydrated is fundamental for normal cellular and kidney function. It helps to eliminate excess sodium in the body.

Dehydration can also stimulate the body to keep its water to compensate for the lack of intake, which can lead to retention and swelling. 

What to do: Drink at least 2.5 to 3L (10 to 12 cups) of water per day in its natural form, or with gas or flavours (preferable with no added sugar). 

4. Lack of physical activity 

A lack of physical activity can influence blood circulation and make it slower, leading to increase water retention, especially in the lower extremities. 

What to do: Engage in regular physical activity to prevent and improve water retention. Exercises forces blood to circulate more efficiently in the body, therefore you should exercise at least 3 times per week for 30 minutes. Some activities can include a light walk or water aerobics. 

5. Staying too long in the same position 

Long periods of sitting or standing, like at work or during long plane rides, can lead to water retention. It makes blood return more difficult in the arms or legs, causing swelling in the extremities. 

What to do: If you know you will be sitting for a long time, you should aim to move your feet up and down every hour, or walk every 5 minutes. You should also open and close your hands to stimulate circulation. If you stand for long periods at a time, you should flex your legs and ankles and make circular movement with your feet. Lift your arms up and open and close your hands to prevent fluid accumulation. You can also massage the areas and perform lymphatic drainage to stimulate circulation. 

6. Using medication

The use of  some medications can cause water retention and swelling in the hands and feet, as seen with steroids, minoxidil and high blood pressure medication like captopril, enalapril, lisinopril, amlodipine and nimodipine.

What to do: The prescribing doctor should monitor you to ensure the dosing is correct and treatment is effective. However, you can try elevating your legs, lifting your arms or massaging affected areas. You can also take a light walk to improve circulation and relieve fluid retention.

7. Hormone changes with a period

Water retention is very common in women due to hormonal changes in the menstrual cycle, especially during PMS. Swelling is most noticed in the abdomen and breast.

Menopause can also cause fluid retention.

What to do: In severe cases of swelling, gynecologist should be consulted to assess female hormones such as estrogen and progesterone. If abnormal, the doctor can start the most appropriate treatment, which can be done with the use of contraceptives or hormone replacement therapy, for example, indicated by the doctor.

8. Thyroid diseases

Some hormonal diseases can also cause water retention, such as hypothyroidism, due to variations in the amount of T3 and T4 hormones. These are important for maintaining fluid levels in the body and can cause abdominal swelling, in the legs, arms or face, for example.

What to do: An endocrinologist should be consulted to assess thyroid hormone levels so that the most appropriate treatment for hypothyroidism can be indicated, which is usually levothyroxine. Learn about the hypothyroidism diet your doctor may recommend to help manage symptoms like water retention.

9. Cardiovascular problems 

Water retention can occur due to cardiac problems like high blood pressure, cardiac insufficiency or venous insufficiency. It occurs when the heart has trouble pumping blood to the body, or because the valves inside the veins are not functioning properly. Both of these situations make blood return to the heart more difficult, and can cause fluid to accumulate in the legs, feet, hands, arms or abdomen. 

What to do: Consult a cardiologist to assess your heart status and the water retention. Appropriate treatment usually involves the use of anti-hypertensives (for hypertension) or diuretics (for cardiac insufficiency). In the case of venous insufficiency, the doctor may recommend compression socks or even surgery.  You should also engage in light physical activity as indicated by your doctor, like walking, and move your legs and arms throughout the day. When lying, elevate your legs higher than heart level for 20 minutes before sleeping. 

10. Renal insufficiency

Renal insufficiency is a condition in which the kidneys do not function properly and are unable to eliminate fluid in the body through the urine. This results in accumulation of fluid and swelling in the feet, hands and face. 

What to do: Renal insufficiency should be monitored by your doctor so that treatment can be adjusted as necessary. In more advanced stages of renal failure, dialysis may be necessary. 

11. Liver failure

Liver failure is characterized by decreased liver function and can also lead to fluid retention, especially in the hands, feet and abdomen. This is due to the decreased levels of albumin in the blood, which is a protein that helps to maintain blood within the blood vessels. 

This illness can be caused by alcohol abuse, hepatitis or the misuse of medication like acetaminophen. 

What to do: Liver failure should be treated by your doctor. Treatment involves the removal of alcohol, salt and protein from the diet to prevent swelling in the hand, abdomen and feet. 

When to see the doctor

Some symptoms that can occur with water retention and require medical assessment include:

  • Shortness of breath
  • Cough or phlegm
  • Chest pain 
  • Headache
  • Pain below the ribs
  • Leg pain or swelling
  • Sudden swelling
  • Stretched or shiny skin
  • Swelling in just one hand or foot
  • Redness in the swollen areas
  • Fever
  • Tingling in the arms, legs, feet or hands

If any of these symptoms occur, you should seek medical attention immediately or proceed to an emergency room. Swelling that occurs after a long plane ride can present like a thrombosis, and should also be assessed.