How Endurance Athletes Can Avoid Hyponatremia
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Hyponatremia is a condition that usually and frequently affects athletes. The main issue is that, on many occasions, it’s complicated to make a diagnosis and name all the annoying symptoms that athletes suffer from. That’s why it’s essential to learn about this health issue.
The early signs of hyponatremia are very subtle and may look similar to dehydration and can cause confusion, Slurred speech, and disorientation. Many athletes start drinking more water at this point because they have mistaken it for dehydration. Water creates further more problems in the body. In extreme cases, the athlete can also die.Unfortunately, water alone will increase the problem of hyponatremia.
At the most extreme, an athlete may experience seizures, coma, or death. Treatment. At the first sign of symptoms, an athlete should drink a sodium containing sports drink such as Extreme Hydration Formula and avoid those with too much sugar and fillers. Ideally, an athlete should plan ahead and estimate his or her fluid loss and need for sodium replacement.
In more serious cases, excess fluid is pushed out of the blood vessels and into the cells, causing puffy fingers and ankles—picture the edema experienced by many athletes at the end of an endurance event. Extreme hyponatremia can begin to affect the brain, resulting in seizures, coma, or even death.What You Need to Know About Hyponatremia www.runnerclick.com There was a time when dehydration was thought to be one of the biggest risks of long distance running. As a result, runners were encouraged to drink specified amounts of fluid per unit of time, regardless of whether they felt thirsty. Which, in hindsight, had disastrous consequences.
adaptations are the reports of dilutional hyponatremia. The endurance. athlete requires approximately 10-14 days training in exposure to similar. heat and humidity as imposed during an event that lasts 3-6 hours in. length at an exercise pace of 75-85% VO2 Maximum Heart Rate. If 10-14 days.
What causes hyponatremia? Hyponatremia happens when too much sodium leaves your body, or when more water than sodium stays in your blood. Any of the following conditions can lead to hyponatremia: A diet that is low in sodium; Drinking too much water or receiving too much fluid through an IV; Intense and prolonged exercise that causes excessive sweating.Endurance athletes are at particular risk of hypernatremia and hyponatremia. Athletes lose electrolytes through sweat but maintaining sodium balance is clearly key to optimal physical performance.
For particularly hot sessions – either indoors on the turbo or.Hyponatremia is a dangerous condition of low blood sodium concentration that can occur during exercise. Most cases of hyponatremia are due to over-consuming water and sports drinks during exercise, and are more common in athletes taking more time to complete endurance events.Above all, the history of hyponatremia and the patient’s most recent previous serum sodium level are essential to know.” Acute hyponatremia—defined as having started within 48 hours—merits rapid correction with hypertonic saline to prevent brain herniation, according to a joint guideline issued by European societies in 2014.
Determining sweat rate and sweat sodium content is a good first place to start. If these are high and salty, then the athlete can be predisposed to hyponatremia during long exercise session.Hyponatremia again hit the headlines fairly recently with the publication of data 1 on the prevalence of the condition in IRONMAN finishers in Europe. Worryingly, over 10 percent of athletes tested in a study conducted over the last eight or so years had hyponatremia at.
The primary cause of hyponatremia in athletes is drinking too much water. The incidence of hyponatremia appears to be between 13% and 15% among endurance athletes. Sodium supplementation has no effect on the occurrence of hyponatremia. There seems to not be a single case of death resulting from sports-related dehydration in the medical literature.
There are a few different causes of the condition, but the one of interest to athletes is when dilution of sodium levels in the blood is driven by excessive drinking. This can be exacerbated by the loss of sodium in sweat during prolonged exercise. This variant of the condition is known as ‘Exercise Associated Hyponatremia’, or EAH.
Incidence. Until recently, the incidence of hyponatremia during endurance exercise was unknown and thought to be relatively uncommon. However, recent studies have shown that endurance athletes not uncommonly develop hyponatremia at the end of the race, usually in the absence of clear central nervous system symptoms (9,10,12,15–25).For example, in the 2002 Boston Marathon, Almond et al.
List of related literature:
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| from Williams’ Essentials of Nutrition and Diet Therapy E-Book |
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| from Wilderness Medicine E-Book: Expert Consult Premium Edition Enhanced Online Features |
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| from Advanced Sports Nutrition |
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| from Practical Applications In Sports Nutrition BOOK ALONE |
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| from Visualizing Nutrition: Everyday Choices |
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| from Practical Applications in Sports Nutrition |
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| from Sports Nutrition for Health Professionals |
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| from Nutrition: Science and Applications |
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| from Sports Science Handbook: A-H |
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| from Discovering Nutrition |
39 comments
And I will carry your legacy as the last. my toast is on you good friend, see you soon.
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would you say y axis is na concentration instead of na? so the area is (na/h20)xh20 which make more sense? good video btw, thnk u!
5:12 I’m experiencing but I wanna wait a day before going in to the doctor’s my pee has been clear for 6 months some times in the morning in comes out yellow but later on in the day it will return clear and when I drink water I’m still dehydrated
Could low sodium cause extreme ticks of seizures like, you could be sitting perfectly fine but then out of the blue have a extreme jerk attack and nearly fall out of your chair and it repeats every 5 minutes or less.
thanks doctor for your nice lectures which i watch every other time to refresh my knowledge. i would like to ask you 3 questions if your time allow:
1. if pt present with severe symptoms despite being hyperovlemic (pulmonary edema, ascites or renal failure for example), in this case shall i treat the cause specifically (diuretics or dialysis) without initiating the hypertonic saline?
2. when initially correcting the severe symptoms (seizure for example) and raise sodium say by 3 when symptoms resolve; shall i subtract this value so that the allowed amount for me now to raise over 24 hrs id 3?
3. if pt with cirrhotic ascites come with hyponatremia and hypovolemic, in such case, shall i resuscitate with NS plus managing the ascites with diuretics or total paracentesis?
Hello I signed up for free trial for this site and i cannot view vids for fluids and Electrolytes that says private on youtube. Instead all I am getting is a 10 sec video with a giant lock. Free trial so I know what I am getting into but if I cannot even view the videos that is private on youtube, and get more videos on youtube why should I pay to join this site??????????????
This was definitely a life saver! Currently prepping for the fluids and electrolytes section of my exam����⚕️������
they are asking if the patients eyes are wet or dry?ha ha. teachers are sick. now plz you tell me.how the patients eyes wet or dry?
Hi Mark, I took a laxative called sodium picosulfate and since then I am experiencing lots of water retention, cramps, muscle pain and weakness, insomnia.
My guess is hyponatremia and hypokalemia.
I went to doctors here in Mexico but they are not familiarized, what can I do? Ingest more salt?
Please help
at 2:44 units of osmolality is mosm/kg and not what is stated!
Taking magnesium when your adrenals are struggling can also cause sodium to plummet.
Hey i have a question… I thought that the thiazide diuretics were potassium sparing and loop were postassium wasting?
Thanks for ur response, plz continue to upload other general topics which will benefit both internists and surgeons, appreciate all your hard work. Looking forward to endless hours of such informative lectures.
Sutirtha
India
i just wanted to clarify that hyperglycaemia does not cause pseudonatremia, it causes a hypertonic hypernatremia
sir, please make a video on the topic of hypo & hyperkalemia
I knew I was gonna get it when I click on this. Brilliant teacher ��. You can break things down so well.
I have a patient’s question. I walka lot both in my avocation and backpacking, walking locally instead of transport.I log @ 50 miles a week @ 66 years. I am well aware of hyponatremia. I am facing boutique ‘smart water’ expensive electrolyte powders and capsules and home made brews with lemon juice, ‘Himalayan pink salt’a rip off, apple cider vinegar.
Is there a worthwhile product or formulation? Can I support my needs with diet? I’ve noticed dates, a traditional desert food staple has as much calcium and potassium as the above powders. I pack them with filtered water and salted nuts.
What if both Potassium and sodium are low with Potassium being critically low?
Thanks for the feedback. I know many of my viewers are non-native English speakers. I try to balance between speaking slower so people can understand, without speaking too slowly and making an already long video even longer. I’ve tried to improve the audio quality over the last 2 years, predominantly to help the non-native English speakers, and I include more text on each slide than I do when teaching in person in the US. It’s not perfect for everyone, but it’s the best balance I can do.
I thought kidneys have Na+/HCO3 cotransporter, so both Na+ and HCO3are reabsorbed into bloodstream from tubules. This would help the low Na+ situation, right? The only reason for hyponatremia from vomiting is from the initial loss of electrolytes (including Na+) in the vomit, right…?:/
I have Hypervolemic Hyponetremia as my body wastes sodium seemingly to childhood nutrient deficiency and I drink so much water. I’ve even became vegan eating so much nutrients is there anyway this condition can be reversed naturally?
Hello!!! There is only one thing I finf difficult understanding. Congestive HF, Liver Cirrhosis cause Hypotension and as such the first mechanism to be activated to increase blood volume shouldn’t it be the RAAS?
I wanted to clarify. Hyponaturaemia is incorrect spelling. I apologise. It should be “Hyponatraemia” or “Hyponatremia”.
Aside from the spelling the physiology does not change
HI DR Eric BRILLIANT AND COMPREHENSIVE EXPOSITION AND ILLUSTRATION OF SODIUM POTASSIUM AND WATER HOMOEOSTASIS.what about the distal delivery of sodium in this scenario and implications
Thanks for the video, excellent work as always. One note though: pseudohyponatremia due to hyperlipemia only happens when measuring Na in serum indirectly. Direct ISE (ion selective electrode) methods are not impacted by this.
Great work on a favourite topic of mine! A couple of interesting additions if you don’t mind:
the rate of serum sodium correction is largely determined by free water loss from the kidneys (mediated by ADH). Unfortunately this is very difficult to predict in the symptomatic patient and will almost always lead to an over correction of sodium levels. The ‘desmopressin clamp’ technique prevents free water loss from the kidneys, allowing for accurate correction over time. In many centres this is the standard of care in management of hypernatraemia. It can also be used to reverse and even re-lower sodium in the case of the rapidly over corrected patient. For more information on that, see here: https://emcrit.org/pulmcrit/taking-control-of-severe-hyponatremia-with-ddavp/
Central Pontine Myelinolitis has now had its terminology changed to Osmotic Demyelination Syndrome, which more accurately describes the nature of the condition which is not always limited to the pontine region. Note that this is an exceptionally exceptionally rare condition and usually occurs in those with poor premorbid function with serum sodiums less than 115. Most interestingly, symptoms don’t present for up to 7 days following rapid correction of sodium. I.e. even if you are the doctor that causes it in the ED, you are unlikely to see the outcome due to the patient being admitted elsewhere.
For more information check out EmCrit’s excellent podcast on this topic https://podcasts.apple.com/au/podcast/emcrit-podcast-critical-care-and-resuscitation/id314020330?i=1000431448268
Thanks again for this excellent video!
Tanks for this video..pls keep making contents like this…it helps me a lot..
learnwiko also have stuffs like these… pls check and like back
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Thanks for the suggestion! I’ve looked at a couple of platforms for delivering content on-line in a more robust fashion than YouTube, but despite their huge support and publicity, I haven’t felt completely convinced of their effectiveness yet. Plus, most invite their course creators (not the other way around), and the type and purpose of content I try to deliver works best if it’s on-demand. Not to say I wouldn’t be interested if Coursera gave me a call…
I have BP 149/98, and sodium 134, I feel very sleepy, it is very hard to drive 2,3 miles.? If I take salt, that may increase BP high. What should I do? Suggest me pls
8:45 Could you explain how in theory fluid deprivation would correct a reset osmostat hyponatremia? Wouldn’t that cause more ADH release via hypotension and thus make hyponatremia more severe?
Great lecture! 7:33 the table mentions cyclosporine, but you say cyclophosphamide; it’s actually cyclophosphamide right?
Isnt corrected sodium equation in dka has 1.6 as multiplication factor @ Strong medicine
Thanks once again for this great content!
I have a question though regarding Step 3 in the Diagnosis Process. How can I reliably determine a patient’s volume status? Hypervolemic might be easy due to odema, but what about differentiating between hypoend euvolemic?
Thank you
Bloody hell this IMO is one of the most complicated topics in Medicine… Thank you! I’m taking some time to proccess all that information
Does this has a part two? Is there is a video on management?
Very complete and helpful!!!!!! Thank you so much. Greetings from Argentina
I remember having heard a lecture by Conrad Fischer where he put a lot of stress on the fact that THE CONCENTRATION OF SODIUM IN URINE and Sweat CANNOT BE MORE THAN THE CONCENTRATION OF SODIUM IN BLOOD The hyponatremia is actually caused due to drinking water.
This made sense as far as sweating and Urine is considered
BUT DOES THE PERSON ALSO FEEL THIRSTY IN CIRRHOSIS AND CONGESTIVE HEART FAILURE.
Have endocrine and urogenital exams next week and didn’t understand the aquaporins and natremia and the T3 T4 effect on heart in Physiology til I watched this video now I know all the Physiology
Thanx alot god bless u ������