Abstract

Water is the most crucial nutrient that constitutes roughly 20% of the cortical bone by volume, yet most ignored in health and nutrition areas. Hydration significantly influences the mechanical properties and tissue quality of bone, whereas bone dehydration causes an increase in its elastic modulus. Moreover, the low water content in the trabecular skeleton changes its construction (shrinkage) and leads to a significant alteration in mechanical properties. Numerous internal (a lack of thirst sensation) or external (polypharmacy or chronic consumption of certain drugs) factors cause hypohydration. Unfortunately, frail elderly individuals are more vulnerable to developing dehydration particularly, due to a decrease in the fat-free mass, which contains 73% of total body water. Today, technical advancements have led to an emerging understanding of how bone water changes in various conditions including aging, diabetes, osteoporosis, and osteogenesis imperfecta. Drugs may also change the impression of hypohydration through the increase of water elimination causing diarrhoea, diuresis, or sweat; a decrease in thirst sensation or appetite; or affecting the central thermoregulation mechanism. However, research on the interaction between bone hydration status and drugs/excipients has been insufficient. In the present review, we evaluate studies that focus on the significance of bone hydration and the effects of drugs/excipients on hydration status.