Received a Message From Dr. Kenji Sato! – Water Restriction on NMT (For Adults)


I’m honored to be able to provide a great message from Dr. Kenji Sato at Hannan Chuo Hospital in Osaka, Japan to the readers of this blog all over the world!  To read his message below, you’ll realize that you are super lucky to be this blog’s reader!

As most of the readers know, Dr. Sato is the advocate of NMT (No Moisturizing Treatment) that draws attention to TSW (Topical Steroid Withdrawal) sufferers worldwide having remarkable results for more than 3 decades in Japan and then all over the world.

Today’s topic is regarding Water Restriction and it will be VERY helpful for all TSW sufferers.



Anyone with experience of limiting water is convinced that it has a great effect on healing.  However, once you start to try it, you’ll realize that the protocol is not only tough but also notice there are some parts that you have to judge by yourself.  So you are required accurate knowledge about it learning it seriously to achieve it.


Below is the explanation that is provided for readers of this blog by Dr. Kenji Sato and translated by me.




About Water Restriction on NMT (For Adults)◆

                                                                                         -Written by Dr. Kenji Sato


How Much Water Do Human Bodies Need?】


An average Japanese weighs about 60 kg.  If such an average person fasts for any reason in the hospital, he/she has to be infused 2000-2500 ml fluid daily, meaning, if you don’t eat and drink anything, you need this amount of water.  If your weight is higher, your water intake must increase accordingly.



The Amount of Water Contained Inpatients’ Meals


The total amount of water (ml) contained in inpatients’ meals that is served three times a day at Hannan Chuo Hospital (including milk in the morning and soup for lunch and dinner) is estimated at 70-80% of kilocalories in food.  For example, a 2000 kcal meal would have 1400 – 1600 ml water in it.  Therefore, the amount of water in food does not reach the required amount (2000 – 2500 ml).  If you consume 1500 ml of water contained in your meal, you need to take 500-1000 ml more fluid except your meal.

If you disregard the water contained in the meal, your water intake could be much more than planned, so if you had a meal that contains a lot of water such as soup, your water intake may be too high even if you strictly monitor and limit your fluid intake.  Consequently, we must consider water in meals.

Overhydration at home tends to occur often in this way.



Water Loss Due to Sweating 


You get sweaty when you exercise.  In my experience, exercising for about an hour in the hot season, I lose about 1 kg usually, meaning, I lose approximately 1000 ml water from my body due to expiration (=exhalation) from the lung and sweating.  This reduced amount of water must be replenished.  If water is not replenished, you will be dehydrated and it is very dangerous.  In dehydration, the density of salt in the blood becomes abnormally high, so you may get neurological symptoms such as strong thirst, headache and lightheadedness, etc…



Check the Color of Urine and Degree of Thirst to See If Water Restriction Goes Well   

If your water intake is too high and unmonitored, the color of your urine will be clear.  And conversely, if you do the water restriction too much, it will be reddish-yellow.  To keep normal yellow urine, don’t drink fluid in a gulp but sip little by little in small portions.

When it is difficult to calculate the water intake, you can judge it with the degree of your dry mouth. You should always feel a little thirsty.



Other Notes】  


1.The reason for practicing water restriction for TSW is to prevent followings:

A large amount of water intake causes an increase in the amount of exudate (ooze).

Your skin is easily damaged with too much water intake.


2.You should avoid drinking fluid at night as much as possible.  Do not intake fluid after dinner to the next morning.


3.If the erythema occupies a large area of your body, as it evaporates more water from the surface of the skin than having it on a smaller area, you need to take a little more fluid intake.


4.If you have an infectious disease such as a cold and have a fever over 38 ° C, you should temporarily refrain from the water restriction and take as much fluid as you like.  Once the fever subsides, you will need to start it again.


5.It is safer not to limit water for children under 6 at home.


6.The water content of many fresh fruits is around 85% of the edible weight (net weight).  In other words, it is about 85 ml for 100 g of peeled oranges.



Written by Dr. Kenji Sato

Translated by Tokuko 






Well, I hope your questions about water restriction cleared up with this information above.

For inpatients, Dr. Sato gives appropriate direction (amount of intaking water) to see each one’s symptoms considering other multiple factors like patient’s information, circumstances, etc…at the same time, however, if you do it at home, try to find a trustful doctor as much as possible.  I believe this requires medical supervision because there are sicknesses that only medical professions can diagnose.  I fully know that it is very difficult to find non-steroidal dermatologists, so until you find one, please learn NMT seriously from the below source as long as you do NMT.


😊Tokuko’s Room To Feel Uplifted (This blog) 

😊Tokuko’s 365 Days of Pep Talk for NMT

😊NMT Education Group (Facebook)

😊The NMT Healed Club (Facebook)


There are many other blogs, good reports and the information in SNS explaining NMT nowadays and it is really wonderful that this great method is known by many sufferers/caregivers who are struggling against TSW symptoms.  I know all of the information providers are sharing NMT to pay it forward with a deep love for others, however, if you initiate NMT, please try to learn it from the source above first because I receive tons of questions from ‘all over the world’ regarding things that I have never said…😅  Most of them are misunderstanding shared personal experiences with NMT as a part of NMT protocol


People who share NMT are trying to help you including personal experiences too with deep love and I love such actions very much.  However, when you learn the protocol, since the medical information should be correct/accurate, you need to tell what part is NMT and what part is a personal experience.  As for the information in the source, Dr. Sato squeezes in his precious time to review as much as possible to help the sufferers in the world so as long as you start to learn NMT, again, please get the information from the source above.  Don’t take a shortcut for your healing.



In other articles, I have explained water restriction here and there so please check it out utilizing the search bar.  Below also is the translated Dr. Sato’s explanation in the old article.  Please try to figure out the amount of water intake by yourself with all of the provided information so reading and learning NMT very hard is essential.




Dr. Sato wrote the explanation to my blog this time too for those of you who he has never met because he fully knows how tough TSW symptoms are.  For translating medical information, he helped me a lot thinking about sufferers who are in agony in the world.  Have you met such a doctor ever?  Witnessing a real doctor‘s noble action, I am moved to the point of tears and believe that you also realize his deep love for even those who are not his patients.


You may be spending days that you are likely to collapse in anxiety, frustration, and pain, however, please remind this.

There may be someone who is thinking about you though he/she is invisible from you being far away from you.  You may have a big supporter of your healing.  By knowing that you are supported by such deep love at least this time, you will be able to redirect your mind upwards, won’t you?



Producing a warm reaction by yourself with gratitude, try to overcome this experience brightly until the day comes.  You are not alone.  Keep on smiling!

Hang in there, friends.  Healing happens to you too.


Have a GREAT day!



Copyright © 2020 Tokuko Abfab All Rights Reserved.


Below is the advice that I posted in the NMT Education Group on Facebook. 

Hope this also encourages you.


NMT Education Group 

(***You will be required to answer 3 questions to join this group.)




Japanese Version

   👇 CLICK HERE! 👇

佐藤健二先生よりメッセージが届きました! - 脱ステ・脱保湿中の水分制限について



Received a Message From Dr. Kenji Sato! – Water Restriction on NMT (For Adults)」への5件のフィードバック

  1. ToTokuko san:
    Thank you very much for translating my message about water restriction on NMT and posting it quickly. You also give many important notes concerning water restriction.

    To TSW sufferers:
    Please read my message and Tokuko’s notes carefully.

    • Dr. Sato,

      This clarification helps a lot of sufferers ALL OVER THE WORLD. It is amazing! Without having your assistance, so many sufferers needed to spend a long time with horrible symptoms. Your exploit is unbelievably wonderful! Thank you SO much!

  2. Dear Dr. Sato and Tokuko,

    Thank you so much for taking the time to share this knowledge to all of us going through TSW all around the world. I have been trying to find some contact information in regards how to book an appointment (preferably online) to Dr. Sato but I have not find any information regarding whom I should contact. Would you be kind to inform me where I should turn to book an appointment?

    Thank you in advance,

    • Hello Sir/Ma’am,
      Thank you very much for your kind comment.

      Well, I recorded lots of notes from Dr Sato when I was admitted to the hospital for my horrible TSW symptoms. I then created this Blog page to help people and caregivers who could not attend the hospital in Japan and are mostly at home. I know it is a great treatment but NMT is practiced only in Japan since NMT doctors’ outstanding studies are not accepted by the doctors’ association usually, I mean, most of them are steroidal doctors and the situation is the same with your country. That is why I thought that patients needed to disseminate this great method for the world sufferers/caregivers.

      Please understand that my role is to spread the word but not advertize the hospital. While I was in the hospital, I saw Dr. Sato was seeing outpatients until 8:00 or 9:00 pm often though they start at 9 a.m. and close the day’s appointment at 11:30 am, meaning a lot of patients are coming to be seen by him from all over Japan. So if I shared the hospital’s information in my blog, the hospital will receive inquiries from all over the world because my blog readers are in over 150 countries in the world and most Japanese don’t speak foreign languages very well.

      If you can get a trustful doctor’s support often, of course I know it is very difficult in any country, NMT is possible to accomplish at home. Still, since there are no NMT doctors except in Japan, you need to learn it very seriously to master it. So successfully healed people and I keep saying, ‘Read, read and read!” over and over. Reading the protocol just once or twice is not enough because this ultimately leads to asking lots of questions when most of the answers are already in the Blog pages. Keep reading until no more questions arise and you are able to make decisions on your own.

      I created the ‘NMT Education Group’ and ‘The NMT Healed Club’ on Facebook so that members can read and learn the NMT protocol by themselves. Think of the groups as ‘online textbooks.’ There is also an archive of members’ posts and questions organized in the Topics section. Lastly, You can search for topics and questions by utilizing the group search bar. This is what I can do for sufferers/caregivers in the world.

      Sorry, I can’t provide your expected answer but there are tons of sufferers who are healed/improved with my blogs (Tokuko’s 365 Days of Pep Talk for NMT & this blog) and the groups all over the world.

      Coming to Japan and waiting for your turn in the hospital is very hard but you also can make it there.
      Wishing your healing happens to you soon!

  3. Dear Mr. or Ms. A:

    Thank you very much for your comment.
    I am very sorry that I do not perform online examination. If you want to have dermatological examination by me, I would like you to visit Japan. However, because of Corona-virus problems, you cannot visit Japan at the moment. Please read NMT-related protocol and other comments. See below.

    NMT Education-

    NMT Support-

    NMT Healed Club-


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