Did excess water intake kill Bruce Lee?

Bruce Lee, the martial arts legend and iconic figure in the history of cinema, died on July 20, 1973, at the young age of 32. The official cause of death at the time was reported as a probable drug reaction and classified as "death by misadventure." Hours before his death, Lee complained of a headache while visiting a fellow actress Betty Ting Pei at her apartment. She gave him one of her own prescription painkillers (one that contained aspirin and meprobamate), and he laid down to take a nap. He never woke up and was unable to be resuscitated even after being transferred to a Hong Kong hospital.  

In the years since Lee's death, many theories have been put forward as to the true cause of his passing. These theories include murder by gangsters or a jilted lover, a family curse, epilepsy, heatstroke, and possibly even illicit drugs (cocaine and/or marijuana). Bruce Lee's widow (Linda Lee Cadwell) and his daughter (Shannon Emery Lee Keasler) have publicly decried the many nefarious speculations and have staunchly defended his memory and legacy. In a 1998 letter to the editor of the LA Times, Cadwell wrote, “Without going into every detail, let me rebut for those who wish to know the truth: Bruce died from cerebral edema caused by hypersensitivity to an ingredient in a prescription medication called Equagesic. This determination was made after an exhaustive, nine-day coroner’s inquest during which the testimony of forensic pathologists from all over the world, who had studied every tissue in Bruce’s body, was heard.” 

It turns out that Lee's death may NOT have been caused by an allergic reaction or hypersensitivity to a medication. It may have been due to drinking too much water.

Spanish nephrologists (kidney experts) proposed in a recent journal article that  "water intoxication" caused hyponatremia which ultimately culminated in causing brain swelling (cerebral edema) that was found on autopsy.   "Who Killed Bruce Lee? The Hyponaetremia Hypothesis," published in March of 2022, revisits the possible pathophysiology that may have culminated in the iconic martial artist's death. 

The authors of the article published in the Clinical Kidney Journal analyzed what was known about Bruce Lee and concluded that he had many risk factors that make water intoxication the most likely etiology for his death. Lee had been suffering from constant headaches, and two months prior to his death, he had even been admitted to the hospital with hyponatremia and signs of cerebral edema, where he was administered mannitol. At the time of his death, Lee's brain was found to weigh 13% more than it should have.

The theory suggests that Lee had been consuming large amounts of water during training sessions, which could have led to water intoxication and ultimately caused his death. Lee was known to use "juice cleanses," which contained large amounts of water as part of his fitness/weight loss regimen when he was intensively training, and he also reportedly sometimes drank alcohol to excess.

The researchers concluded that Bruce Lee "died from a specific form of kidney dysfunction: the inability to excrete enough water to maintain water homeostasis, which is mainly a tubular function. This may lead to hyponatremia, cerebral edema, and death within hours if excess water intake is not matched by water excretion in urine, which is in line with the timeline of Lee’s demise.”

There have been no public comments or rebuttals to the Spanish researchers' water intoxication theory from Lee's widow or daughter.  Shannon Lee staunchly defended her father's legacy in a July 2021 article where she blasted Quentin Tarantino's depiction of Bruce Lee in his film Once Upon a Time in Hollywood and comments he made on Joe Rogan's podcast.  

According to the Mayo Clinic, the ideal consumption of water per day is approximately 15.5 cups (3.7 liters) for men and 11.5 cups (2.7 liters) for women. When a person drinks an excess of water, the kidneys are unable to expel or excrete that excess water, causing a life-threatening sodium imbalance called hyponatremia.  Low sodium levels in the blood can be fatal. Sodium is an electrolyte that helps to regulate the amount of water in and around the cells, tissues, and organs of our body. When there are low levels of sodium in the blood, the body decompensates, leading to kidney failure, multisystem failure, including brain swelling, and when not properly recognized and treated, death.

Lee helped to popularize the quote, "Be water, my friend." Post-humously, his legacy should include a recommendation to "Drink water, my friend...just not too much."