The hyponatremia of exercise may exist in symptomatic and asymptomatic forms. Symptomatic hyponatremia is usually characterized by severe alterations in cerebral function including coma and grand ma1 seizures; it develops especially in less competitive athletes who have maintained high rates of fluid intake during endurance events lasting at least 5 hours. The hyponatremia becomes symptomatic when the volume of excess fluid retained exceeds 2 to 3 liters. The etiology of the condition is unknown. Possibly as many as three or more pathologies (abnormal fluid retention possibly due to inappropriate ADH secretion, abnormal regulation of the extracellular fluid volume, translocation of sodium into a "third space") must be present for symptomatic hyponatremia to develop. The avoidance of overhydration would appear to be the only certain way that susceptible individuals can prevent symptomatic hyponatremia. Sodium chloride containing solutions ingested in physiologically significant concentrations would likely prevent a possible "third space" effect.A belief widely propagated in the scientific literature is that fluid losses during prolonged exercise are large and that progressive dehydration is an inevitable consequence (2,3,5,(34)(35)(36)(38)(39)(40)48,54,78,79,87,95,101,102). Indeed some authors have estimated that fluid losses can be as much as 4 1 per hour during exercise in the heat (5,43,79). Since maximum sustainable rates of fluid delivery to the intestine even during exercise of short duration are of the order of only 1 to 2 1 per hour (60), it follows that even if maximum rates of intestinal water absorption can match such high rates of fluid ingestion, progressive dehydration would be an inevitable consequence of prolonged exercise were such high sweat rates maintained.Progressive dehydration is believed to cause hyperthermia in proportion to the fluid deficit (39,43,101,102) and, when extreme, is considered to be the principal cause of the exercise-associated collapse that has become a common feature especially of ultradistance running and triathlon events (2, 36, 39,43,48, 66-68, 70, 78, 83, 85, 87, 91, 95). Therefore persons participating i n prolonged exercise have been encouraged to drink as much as possible to avoid these potentially serious complications, particularly heatstroke and other forms of heat Timothy D. Noakes is with the