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CHECK OUT THIS TOPIC HERE...I DIDNT REALLY KNOW ABOUT THIS, AND NOW I AM PRETTY SURE I HAVE IT...


Exercise-Associated Hyponatremia: Who’s at Risk?
Medical Author: Melissa Stoppler, M.D.
Medical Editor: William C. Shiel, Jr, MD, FACP, FACR

We’ve all learned that fluid replacement is critical to replace fluids lost when exercising, but drinking pure water exclusively isn’t the safest choice for those who participate in very strenuous or long-duration exercise.

When significant amounts of fluid are lost through high-intensity exercise, replacement with water alone can lead to a chemical imbalance in the body and deficiencies in electrolytes, which are nutrients critical for organ functioning. The electrolytes in our body include sodium, potassium, chloride, calcium and phosphate, but sodium is the substance of most concern when replacing fluids lost through exercising.

Hyponatremia is a condition in which the body’s stores of sodium are too low, and this condition can result from drinking extreme amounts of water. Hyponatremia can lead to confusion, lethargy, agitation, seizures, and in extreme cases, even death. Early symptoms are nonspecific and subtle and may include disorientation, nausea, or muscle cramps. The symptoms of hyponatremia may also mimic those of dehydration, so athletes experiencing these symptoms may be given more water to drink, further worsening the condition.

It’s important to note that drinking water is a healthy habit, and our bodies absolutely require water to function. Drinking the recommended eight glasses of water per day will not lead to electrolyte imbalances or hyponatremia. Hyponatremia is only a danger when extremely high volumes of fluid are lost and replaced with water – for example, when athletes engage in vigorous activity for a protracted time (such as in marathons or triathlons), or when any strenuous physical activity is carried out in very hot temperatures.

In one study, 62 out of 488 runners in the Boston marathon who gave blood samples at the finish line had abnormally low blood sodium levels. Hyponatremia was more common in the thinnest runners – those with a body mass index (BMI) of about 20 – than in runners of normal weight. Hyponatremia tended not to affect the fastest runners (those who finished the marathon in about two hours) and was more common in those who took four hours or more to finish the race.

Hyponatremia is a medical emergency, and persons with suspected exercise-associated hyponatremia should receive immediate emergency care.

To prevent hyponatremia and electrolyte imbalances, athletes should replace lost body fluid with drinks that contain electrolytes, such as sports drinks.

Reference: Almond CS, Shin AY, Fortescue EB, Mannix RC, Wypij D, Binstadt BA, Duncan CN, Olson DP, Salerno AE, Newburger JW, Greenes DS. Hyponatremia among runners in the Boston Marathon. N Engl J Med. 2005 Apr 14;352(15):1550-6


A COUPLE OF WEEKS AGO HIKING TO SUPERSTITION PEAK ON A PRETTY HOT DAY, THOUGH IT DIDNT FEEL LIKE IT TO ME AT FIRST, I ONLY HAD BROUGHT 2.5 LITRES OF WATER WITH ME, AND I DIDNT REALLY REALIZE IT BUT I WAS SEVERALY DEHYDRATED. I LOOK BACK ON IT NOW, AND FEEL THAT WAS MORE SEVERE THAN THAT, I WAS ON THE BRINK OF A HEAT STROKE. I WAS PROFOUNDLY DISORIENTED, BLURRED VISION, DRY MOUTH, CONSCIOUSNESS WAS VERY DULL. I CAN HARDLY EVEN REMEMBER SOMETHINGS ON THE RETURN TRIP. I COULDNT REALLY TALK STRAIGHT. NOW WHEN I GOT BACK TO MY CAR I WENT TO WALGREENS AND GOT A GATORADE AND A WATER. WHICH HELPED, BUT TO GET TO THE POINT WHICH MEETS WITH THIS TOPIC, SINCE THEN I HAVE HAD WHAT FEELS LIKE A LOWER BACKPAIN, AND IS REALLY UNCOMFORTABLE, I CANNOT SLEEP VERY WELL AT NIGHT DUE TO THE DISCOMFORT. NOW IT DOESNT FEEL LIKE THE MUSCLES IT FEELS INTERNAL, LIKE THE ORGANS ARE IN PAIN, IM THINKING ITS THE KIDNEYS AS ITS ON BOTH SIDES OF THE LOWER BACK AREA..??... NOW BEFORE I READ THIS ALL OF MY HIKING HAS BEEN PURE WATER, BUT I HAVE NEVER HAD A PROBLEM WITH IT BEFORE NOW. BUT THEN AGAIN I NEVER REALLY HIKED BIG DISTANCES IN SUCH HOT WEATHER AS IT NEVER REACHED ABOVE 100 DEGREES WHERE I WAS HIKING IN CALI.

I DONT KNOW FOR SURE, BUT FEELING LIKE CRAP (MOSTLY AT NIGHT) FOR ALMOST 2 WEEKS SINCE THAT HIKE DOESNT SEEM NORMAL.. I THINK I GONNA HAVE THIS CHECKED OUT...

ANYBODY EVER GET THIS???

Sounds like you were on the edge of heat stroke there. I doubt it was Hyponatremia if you only drank 2.5 liters of water. You were just flat out dehydrated. Now if you drank 2 gallons of water with no electrolytes/salts then you would be more at risk for Hyponatremia.

Also it's not something you get for two weeks, so I'm sure thats something totally different.

Do you need to type in all CAPS?

In response to davis2001r6's reply:
I agree with Tim. Your issue sounds more like a dehydration issue. Definitely see a Doctor. Dehydration can impact the kidneys. A friend actually developed very painful kidney stones after being severely dehydrated.

Have you read Fritzski's article on Hydration in the HAZ Articles section? Right click next to the MAIN drop-down menu and go to Articles. He shares some great wisdom.

In response to IRIE_LION's reply:

I agree completely with davis2001r6. Probably not enough fluid for hyponatremia, and it is not a condition that can persist very long unless you continue to overhydrate, which (if you did) would present different symptoms than your back problem.

al1inaz wrote: ... A friend actually developed very painful kidney stones after being severely dehydrated.

Kidney stones were one of the first things that popped in my head. I'm skeptical of their relationship to dehydration, but they can cause the pain described.

I had not thought of Kidney Stones but I have heard of that as well. I had a friend do the Superstition Ridgeline as an out and back, so 22 miles not 11. Ended up spending the nights in the hospital with Kidney Stones.

Both hyponatremia, caused by too much water and not enough salts, food or electrolytes, and heat stroke can be very quickly fatal--you would not have been able to hike out and would have needed to be rescued. You likely were dehydrated, as the others said. How are you feeling now?

When it's extremely hot and you are exercising it can quickly become impossible for you to hydrate enough to replace what you're losing. You should use ERG or gatorade or other electrolyte replacement in addition to drinking lots of water. I used to carry a gallon of fluid--about 4 liters--or 128 ounces--with me on a summer dayhike in the desert, before I quit hiking in summer in the desert!

Due to conditions in the desert in Iraq, all Marines in my son's unit are being taught to set IVs--in some conditions an IV will quickly make a person feel a lot better! Not to say we should start taking lactated ringers on our hikes, but just to illustrate that sometimes you just can't drink enough fluids. At that time your body is telling you to sit in the shade and wait until dark before continuing on!

Some people can hike in the desert better than others. Some people's bodies cannot adjust very well, even if they work up to it, others can. We are not all made exactly the same. A person needs to learn this from experience, lots of experience. You can learn all sorts of tricks to help deal with the heat, but your own personal physiology also is a factor. Many people do not understand their own limitations--this comes with experience. It is ok to have limitations, ok to understand where they are and whether they can be stretched a bit or not. But when it comes to heat stroke and hyponatremia, we are talking about conditions that are potentially very quickly fatal. It would be good to read up on these conditions, their causes and treatments. You may be in a position to help another person sometime, or yourself.

That's why I bring plenty of bacon with me at all times. Replace that sodium!

Thanks for all info...Since i posted this i read something about how hyponetremia effects some function in the kidneys so i just increased my sodium intake in my liveit and since then i have felt better. The kidney pains arent there as much, or maybe i just got used to it...but anyway it doesnt bother so i guess its fine now. I'll be fine, just gotta make sure im bringing enough out there when im hiking in rough places..

I always bring way too much water on a hike, but if you don't mind carrying the weight, its nice. Plus keeping extra water in the car at the trailhead I've found to be a great idea as well, especially if the nearest whatever you're craving is a couple hours away.