Exercise-Associated Hyponatremia

Rosner, Mitchell H.

doi:10.1007/978-1-4614-6645-1_10

Cited by 12 publications

(9 citation statements)

References 97 publications

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“…Therefore, sodium use during exercise should be with regard for some potential risks. In fact, avoiding excessive sodium supplementation has been recommended as an appropriate approach to maintaining hydration during endurance exercise (5,30).…”

Section: Introductionmentioning

confidence: 99%

Is Sodium Supplementation Necessary to Avoid Dehydration During Prolonged Exercise in the Heat?

Hoffman

Stuempfle

2016

Journal of Strength and Conditioning Research

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The primary purpose of this work was to gain further insight into the need for sodium supplementation for maintenance of appropriate hydration during prolonged exercise under hot conditions. Participants of a 161-km ultramarathon (ambient temperature reaching 39° C) underwent body weight measurements immediately before, during, and after the race, and completed a postrace questionnaire about supplemental sodium intake and drinking strategies during 4 race segments. The postrace questionnaire was completed by 233 (78.7%) race finishers. Significant direct relationships were found for percentage weight change during the race with intake rate (r = 0.18, p = 0.0058) and total amount (r = 0.24, p = 0.0002) of sodium in supplements. Comparing those using no sodium supplements throughout the race (n = 15) with those using sodium supplements each race segment (n = 138), body weight change across the course showed significant group (p = 0.022), course location (p < 0.0001), and interaction (p = 0.0098) effects. Posttests revealed greater weight loss at 90 km (p = 0.016, -3.2 ± 1.6% vs. -2.2 ± 1.5%, mean ± SD) and the finish (p = 0.014, -3.2 ± 1.5% vs. -1.9 ± 1.9%) for those using no sodium supplements compared with those using sodium supplements each segment. Six runners who used no sodium supplements, drank to thirst, and only drank water or a mixture of mostly water with some electrolyte-containing drink finished with mean weight change of -3.4%. Although the use of supplemental sodium enhanced body weight maintenance, those not using sodium supplements maintained a more appropriate weight than those consistently using sodium supplements. Therefore, we conclude that the supplemental sodium is unnecessary to maintain appropriate hydration during prolonged exercise in the heat.

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Section: Introductionmentioning

confidence: 99%

Is Sodium Supplementation Necessary to Avoid Dehydration During Prolonged Exercise in the Heat?

Hoffman

Stuempfle

2016

Journal of Strength and Conditioning Research

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“…A myriad of previous investigations have been geared toward determining the biological mechanism (s) associated with the development of hyponatremia in endurance disciplines (Armstrong, 2000;Montain et al, 2001;Noakes, 2002;Murray & Eichner, 2004;Noakes et al, 2005;Montain et al, 2006;Chorley et al, 2007;Anastasiou et al, 2009;Rosner & Kirven, 2007;Speedy et al, 2001a). Initially, it was Table 3.…”

Section: Discussionmentioning

confidence: 99%

Sweat sodium loss influences serum sodium concentration in a marathon

Lara

Salinero

Areces

et al. 2015

Scandinavian Med Sci Sports

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The aim of this investigation was to determine the influence of sweat electrolyte concentration on body water and electrolyte homeostasis during a marathon. Fifty-one runners completed a marathon race in a warm and dry environment (24.4 ± 3.6 °C). Runners were classified as low-salt sweaters (n = 21; <30 mmol/L of sweat Na concentration), typical sweaters (n = 20; ≥30 and <60 mmol/L of sweat Na concentration), and salty sweaters (n = 10; ≥60 mmol/L of sweat Na concentration). Before and after the race, body mass and a sample of venous blood were obtained. During the race, sweat samples were collected by using sweat patches, and fluid and electrolyte intake were recorded by using self-reported questionnaires. Low-salt, typical and salty sweaters presented similar sweat rates (0.93 ± 0.2, 0.92 ± 0.29, 0.99 ± 0.21 L/h, respectively), body mass changes (-3.0 ± 1.0, -3.3 ± 1.0, -3.2 ± 0.8%), total Na intake (12.7 ± 8.1, 11.5 ± 9.7, 14.5 ± 16.6 mmol), and fluid intake (1.3 ± 0.8, 1.2 ± 0.8, 1.2 ± 0.6 L) during the race. However, salty sweaters presented lower post-race serum Na concentration (140.8 ± 1.3 vs 142.5 ± 1.1, 142.4 ± 1.4 mmol/L; P < 0.01) and serum osmolality (297 ± 6 vs 299 ± 5, 301 ± 6 mOsm/kg; P < 0.05) than low-salt and typical sweaters. Sweat electrolyte concentration could influence post-race serum electrolyte concentration in the marathon. However, even the saltiest sweaters did not develop exercise-associated hyponatremia or associated symptoms.

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“…4 The standard treatment for symptomatic EAH is a 100 mL bolus of intravenous hypertonic saline (3% NaCl). 4 Given the risks associated with intravenous lines (such as infection and damage to surrounding structures) and intravenous hypertonic saline (pontine demyelination, a concern but one which is much more likely in chronic hyponatraemia), 5 it would be preferable to use oral therapies if similar results can be achieved.…”

Section: Clinical Scenariomentioning

confidence: 99%

Oral versus intravenous hypertonic saline for exercise‐associated hyponatraemia

Berger

2017

J Paediatrics Child Health

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Exercise-associated hyponatraemia is a potentially serious acute condition that may present early as asymptomatic or mildly symptomatic. Standard treatment is intravenous hypertonic saline, which can be challenging and carries some risk. An alternative may be oral therapy. We undertook a review of existing literature to assess whether paediatric populations should receive oral or intravenous hypertonic saline solutions. One study addressed our question but was aimed at a presumably adult population of runners. That study found that intravenous and oral solutions provide similar effects on biochemistry, but intravenous hypertonic saline provides superior effects on subjective relief and plasma volume.

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Exercise-Associated Hyponatremia

Cited by 12 publications

References 97 publications

Is Sodium Supplementation Necessary to Avoid Dehydration During Prolonged Exercise in the Heat?

Is Sodium Supplementation Necessary to Avoid Dehydration During Prolonged Exercise in the Heat?

Sweat sodium loss influences serum sodium concentration in a marathon

Oral versus intravenous hypertonic saline for exercise‐associated hyponatraemia

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