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Hyponatremia: How To Recognize, Treat And Prevent It

Summer is here
and it

Summary
The key is prevention. Determine your fluid
and sodium requirements and follow them. Remember

  • A bloated athlete is overhydrated, the exact
    opposite of dehydrated.
  • Bloating is a red flag for hyponatremia.
  • Mental changes plus bloating in an athlete
    indicate hyponatremia with brain swelling, and represent a dire medical
    emergency.
  • Don’t be fooled by a bloated athlete who is not
    urinating: he/she is overhydrated and on the way to hyponatremia if not
    already there.
  • Don’t be fooled into thinking that an athlete
    who is throwing up is becoming dehydrated. Vomiting is frequently a symptom of
    hyponatremia.
  • Do not give a bloated athlete any fluid (except
    as a vehicle for salt).
  • Give a bloated athlete salt.
  • When it is hot and an athlete is distressed, do
    not automatically conclude that the cause is dehydration and the remedy is
    fluid ingestion.
  • Sweat typically has 1000 mg sodium/quart; a
    typical sports drink has 440 mg sodium/quart. If during a sufficiently long
    ride, you ingest nothing but sports drinks, you will become hyponatremic at
    some point.

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One Reply to “Hyponatremia: How To Recognize, Treat And Prevent It”

  1. This advise comes off the Bike Washington DC list:

    I’ve been biking throughout the heat. However, I do take some
    precautions:

    1. I make sure to allow plenty of time for my rides, since trying
    to rush in the heat is the fastest way to end up dehydrated.

    2. I carry a CamelBak, and also stow various bottles of water in
    my paniers.

    3. I carry envelopes filled with a rehydration mixture consisting
    of 3 tablespoons of sugar and a teaspoon of salt, and a bottle of 595
    mg. potassium tablets. If I start to feel dizzy, I mix an envelope of
    the rehydration mixture into a liter of water, and drink it down with
    3 of the potassium tablets. A doctor friend tells me that Gatorade
    alone can be bad, because people’s sweat changes salt content as they
    acclimate to the heat, and they may end up taking in too much salt if
    they drink nothing but Gatorade when their sweat has developed a lower
    salt content. My method allows me to drink plain water most of the
    time, but switch to a Gatorade equivalent when I start to feel dizzy,
    without having to carry separate heavy bottles of water and Gatorade.

    4. When I see a water source, I stop and refill my CamelBak and
    bottles. Often, I’ll also put my whole head under the tap, which
    helps cool down quickly.

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