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Intro

Information about hydration testing with all information provided on this page.

Hydration testing is often proposed as a way to monitor athletes’ weight loss and protect their health. But if the tests don’t reflect  real fluid loss, or give different results each time, they become  misleading and unusable.

Why do accuracy and reliability matter in hydration testing?

Accuracy means: Does the test reflect the true amount of fluid or weight lost?

Reliability means: Will the result be the same each time we test?

If hydration tests are inaccurate or inconsistent, they cannot be used to monitor, assess, or regulate  rapid weight loss practices.

Accuracy

How well do hydration markers reflect actual weight loss?

  • 2% urine specific gravity
  • 11% serum osmolality
  • 22% fingerprick blood
  • 8% tear osmolarity.

✅ Fingerprick blood was the best, but still only explained 22% of the weight lost.

❌ Other markers like urine and tear fluid explained even less.

👉 Conclusion: Biomarkers do not accurately reflect rapid weight loss.

 

Reliability

Can hydration markers give the same result across trials?

  • 46% urine specific gravity
  • 35% serum osmolality
  • 61% fingerprick blood
  • 6% tear osmolarity.

✅ Fingerprick blood was again the best, but agreement was 61% across two identical trials.

❌ Other methods were even less consistent.

👉 Conclusion: Biomarkers are not reliable enough to track weight loss over time.

Conclusion

⚠️ Hydration testing should not be used to assess or manage rapid weight loss before competition.

👉Even though it can appear objective, hydration testing is not accurate or reliable enough to be useful in this context.

Doherty CS, Fortington LV, Barley OR. Blood, Sweat, and Tears: Implications for Hydration Testing in Combat Sports-Investigating Body Mass Loss and Biomarker Changes. Scand J Med Sci Sports. 2024, 34(8):e14701. doi: 10.1111/sms.14701.

 

 

Page reviewed 01 July 2025