Drinking problem...

eddiec said:

...of a sort...

Stumbled across this article on alt.mtb regarding drinking too much
water and a condition called hyponatremia which I'd never heard of...
I'm sure you fitness-freaks already know about it, but interesting
reading/food-for-thought nonetheless.

http://www.msnbc.msn.com/id/7491948/

Eddie(looking suspiciously at his camelback)c

--
eddiec

It's back of pack syndrome. People who don't exercise enough to need the
water and sports drink they're consuming.

Tam

I think hyponatremia literally translates to "not enough sodium". I don't
think table salt will help though (or taste very good).
--
Bean

Remove "yourfinger" before replying

"eddiec" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

..of a sort...

Stumbled across this article on alt.mtb regarding drinking too much
water and a condition called hyponatremia which I'd never heard of...
I'm sure you fitness-freaks already know about it, but interesting
reading/food-for-thought nonetheless.

http://www.msnbc.msn.com/id/7491948/

Eddie(looking suspiciously at his camelback)c

--
eddiec

Stick to the good stuff when you drop your disco biscuits kiddies

http://www.erowid.org/chemicals/mdma/mdma_health_water.shtml

http://www.abc.net.au/dimensions/dimensions_health/Transcripts/s871112.htm

(hmm.. not really cycling but anyway)

Tamyka Bell said:

It's back of pack syndrome. People who don't exercise enough to need the
water and sports drink they're consuming.

has me wondering about their choice of "sport drink". Admittedly I drink 1/2 strength gatorade, which is still as much sodium as powerade.

A very real and deadly problem but the reason most people havent heard of it is because its so rare.

A woman I worked with at Box Hill came down with hyponatremia while on a 7 day conducted walk in Kakadu. Air medevac, coma, 10 days intensive care and 2 months in hospital. She nearly died and 4-5 years later still has some problems.

I had a heap of links on this but cant find them.
My recollection is that the minerals in the body are in very small quantities and the "normal" levels are in a very narrow band and once outside the range problems start. Sodium is something like normal range of 110 - 130 mmol/L ( minute amount) and normally stays there without any probs.

US Army research (?) showed that continual snacking while doing heavy work in high temp and high water use prevented onset of the condition. This is something that Aust bushwalkers have done forever. Pockets full of "scrogin" ( nuts, dried fruits, Jatz type biscuits, chocolate etc and pocket fluff) and just keep nibbling and drinking.

One of the first signs of onset of hyponatremia is loss of interest in food. Then the big stuff starts, very subtle at first but progresses quickly. Argumentitive, irrational, paranoid, all of which can be overlooked but next will usually complain of heat, headache and start throwing clothes off and become totally unreasonable. Within a couple of minutes usually collapse and coma can occour within 30 minutes. Major organ failure follows.
Some will just save the arguments and collapse outright without any warning. Its really strange as it can look like a psycotic event or even mimic a "drug" induced collapse.

From what I have read and been told by patient its OK to keep drinking as long as the food is going in too. The desire for one will be balanced by the other.

The marathon people in the report must have been very inexperienced. Fancy weighing 4kg more at the end of a marathon due to water intake.

From memory there is a whole other syndrome attached to the upset of the calcium balance and it is part of what some snake venoms do. There is a potassium one too.

I used to moderate a First Aid group but it fizzled out when I moved up here and now I cant access it. Yahoo have killed it. Would like to have included links and refs as my memory may not be exact. Will look again.

My dehydration drink is a dash of "dietrite" "Lite Salt" (potassium chloride and sodium chloride) available from Supermarkets, corn syrup aka maltodextrin( from Home Brew shop) and Ginger Cordial to keep the stomach steady.

The good thing with cycling, and walking, is that food is well tolerated and part of the culture so the problem is rare.

Another good reason not to do that R.. thing

I prefer my water with hops in it.

Cheers
Hugh

HughMann <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

A very real and deadly problem but the reason most people havent heard
of it is because its so rare.

A woman I worked with at Box Hill came down with hyponatremia while on
a 7 day conducted walk in Kakadu. Air medevac, coma, 10 days intensive
care and 2 months in hospital. She nearly died and 4-5 years later
still has some problems.

I had a heap of links on this but cant find them.
My recollection is that the minerals in the body are in very small
quantities and the "normal" levels are in a very narrow band and once
outside the range problems start. Sodium is something like normal
range of 110 - 130 mmol/L ( minute amount) and normally stays there
without any probs.

<snip>

Try http://scholar.google.com/

Tam

Bean Long said:

I think hyponatremia literally translates to "not enough sodium". I don't
think table salt will help though (or taste very good).
--
Bean

Table salt _definately_ helps, being quite heavy in sodium. Depending on the individual, you lose about 3 grams/litre of sweat, which translates to somewhere around 6.5 grams of sodium chloride. Add a good teaspoon of salt to your litre of water and you're most of the way there. You can run low on potassium too, but your needs for sodium are more likely to go out of whack.

Remember that most western diets are already heavy in salt, so sodium supplementation is really only appropriate for endurance events/training (think of at least 2-3 hours as a minimum before really worrying too much about sodium)* Unless you happen to be in a very hot/humid environment etc etc... just think of this as a good rule of thumb and go from there.

Ritch

eddiec said:

...of a sort...

Stumbled across this article on alt.mtb regarding drinking too much
water and a condition called hyponatremia which I'd never heard of...
I'm sure you fitness-freaks already know about it, but interesting
reading/food-for-thought nonetheless.

http://www.msnbc.msn.com/id/7491948/

Eddie(looking suspiciously at his camelback)c

--
eddiec

I actually read a research paper about hyponatremia (low serum sodium)
on the weekend. I don't have the reference with me, it's at home, and I
can post it later if anyone cares. They studied people finishing the
Auckland Marathon, took blood etc., and not only people presenting to
the medical tent. They also did a review of other studies, focusing on
various other endurance events. Hyponatremia happened more significantly
in races in hotter climates where the race briefing promoted aggresive
hydration practices and had many water stations.

In one of the studies reviewed, the people presenting with symptomatic
hyponatremia had drunk up to 9L of water throughout the marathon. If you
were running a marathon as a back/midpacker, this would be about 2L of
water per hour. Very different to the 600 mL generally recommended for
strenuous exercise. If you were walking, the it'd still be over 1L per
hour, only the exercise wouldn't be strenuous. Imagine drinking that
much!

Mild hypernatremia (high sodium, associated with mild dehydration)
occurred in the faster runners and appeared to have no ill effects. The
race completion time varied approx inversely proportional to the serum
sodium levels.

The other part of the study was on use of NSAIDs in the 24 hours prior
to racing and the effect of this on the likelihood of renal problems.
Very interesting read. If you want a ref, email me and I'll send it.

On Mon, 18 Apr 2005 13:16:23 +1000, Tamyka Bell <[email hidden]>

Quoted message said:

I actually read a research paper about hyponatremia (low serum sodium)
on the weekend. I don't have the reference with me, it's at home, and I
can post it later if anyone cares. They studied people finishing the
Auckland Marathon, took blood etc., and not only people presenting to
the medical tent. They also did a review of other studies, focusing on
various other endurance events. Hyponatremia happened more significantly
in races in hotter climates where the race briefing promoted aggresive
hydration practices and had many water stations.

In one of the studies reviewed, the people presenting with symptomatic
hyponatremia had drunk up to 9L of water throughout the marathon. If you
were running a marathon as a back/midpacker, this would be about 2L of
water per hour. Very different to the 600 mL generally recommended for
strenuous exercise. If you were walking, the it'd still be over 1L per
hour, only the exercise wouldn't be strenuous. Imagine drinking that
much!

Mild hypernatremia (high sodium, associated with mild dehydration)
occurred in the faster runners and appeared to have no ill effects. The
race completion time varied approx inversely proportional to the serum
sodium levels.

This is consistant with the current theory that it's better to be
mildly dehydrated than overhydrated that's been floating(!)
around for a few months. There was some MU or RMIT paper
on it recently (last 3-6 months or so)

Quoted message said:

The other part of the study was on use of NSAIDs in the 24 hours prior
to racing and the effect of this on the likelihood of renal problems.
Very interesting read. If you want a ref, email me and I'll send it.

and your email address is? 🙂

Carl Brewer said:

On Mon, 18 Apr 2005 13:16:23 +1000, Tamyka Bell <[email hidden]>

Quoted message said:

I actually read a research paper about hyponatremia (low serum sodium)
on the weekend. I don't have the reference with me, it's at home, and I
can post it later if anyone cares. They studied people finishing the
Auckland Marathon, took blood etc., and not only people presenting to
the medical tent. They also did a review of other studies, focusing on
various other endurance events. Hyponatremia happened more significantly
in races in hotter climates where the race briefing promoted aggresive
hydration practices and had many water stations.

In one of the studies reviewed, the people presenting with symptomatic
hyponatremia had drunk up to 9L of water throughout the marathon. If you
were running a marathon as a back/midpacker, this would be about 2L of
water per hour. Very different to the 600 mL generally recommended for
strenuous exercise. If you were walking, the it'd still be over 1L per
hour, only the exercise wouldn't be strenuous. Imagine drinking that
much!

Mild hypernatremia (high sodium, associated with mild dehydration)
occurred in the faster runners and appeared to have no ill effects. The
race completion time varied approx inversely proportional to the serum
sodium levels.

This is consistant with the current theory that it's better to be
mildly dehydrated than overhydrated that's been floating(!)
around for a few months. There was some MU or RMIT paper
on it recently (last 3-6 months or so)

[censored], I better ditch one of my 18 bidon cages...

Quoted message said:

Quoted message said:

The other part of the study was on use of NSAIDs in the 24 hours prior
to racing and the effect of this on the likelihood of renal problems.
Very interesting read. If you want a ref, email me and I'll send it.

and your email address is? 🙂

In the "sender" or "from" field.

But even if it wasn't, there's bound to be someone you know that knows
my email address...

:P

Tam

"Carl Brewer" <[email hidden]> wrote

Quoted message said:

On Mon, 18 Apr 2005 13:16:23 +1000, Tamyka Bell <[email hidden]>

Quoted message said:

and your email address is? 🙂

You could try [email hidden]

Duh?

Theo

Theo Bekkers said:

"Carl Brewer" <[email hidden]> wrote

Quoted message said:

On Mon, 18 Apr 2005 13:16:23 +1000, Tamyka Bell <[email hidden]>

Quoted message said:

and your email address is? 🙂

You could try [email hidden]

Duh?

yeah yeah 🙂

There was a NZ review article published a few years back in Emergency Medicine Australasia on this. The abstract says:

"This paper reviews the extensive literature on hyponatremia, a common and potentially serious complication of ultra-distance exercise. Fluid overload is the likely aetiology. Fluid intakes are typically high in athletes who develop hyponatremia, although hyponatremia can occur with relatively modest fluid intakes. The development of fluid overload and hyponatremia in the presence of a modest fluid intake raises the possibility that athletes with this condition may have an impaired renal capacity to excrete a fluid load. The bulk of evidence favours fluid retention in the extracellular space (dilutional hyponatremia) rather than fluid remaining unabsorbed in the intestine. Female gender is an important risk factor for the development of hyponatremia. Management and prevention of exercise-associated hyponatremia are discussed. "

I have the whole article on PDF if anybody wants it...

cheers,
Ali

alison_b said:

There was a NZ review article published a few years back in
_Emergency_Medicine_Australasia_ on this. The abstract says:

"This paper reviews the extensive literature on hyponatremia, a common
and potentially serious complication of ultra-distance exercise. Fluid
overload is the likely aetiology. Fluid intakes are typically high in
athletes who develop hyponatremia, although hyponatremia can occur with
relatively modest fluid intakes. The development of fluid overload and
hyponatremia in the presence of a modest fluid intake raises the
possibility that athletes with this condition may have an impaired
renal capacity to excrete a fluid load. The bulk of evidence favours
fluid retention in the extracellular space (dilutional hyponatremia)
rather than fluid remaining unabsorbed in the intestine. Female gender
is an important risk factor for the development of hyponatremia.
Management and prevention of exercise-associated hyponatremia are
discussed. "

I have the whole article on PDF if anybody wants it...

cheers,
Ali

Did they conclude that sports drink is better than water? Every paper
I've read, they conclude that.

Tam

Carl Brewer said:

On Tue, 19 Apr 2005 12:13:08 +1000, Tamyka Bell <[email hidden]>

Quoted message said:

Did they conclude that sports drink is better than water? Every paper
I've read, they conclude that.

Or cordial and salt, at a pinch

Yum, ration pack cordial.

Carl Brewer said:

On Tue, 19 Apr 2005 12:41:46 +1000, Tamyka Bell <[email hidden]>

Quoted message said:

Carl Brewer said:

On Tue, 19 Apr 2005 12:13:08 +1000, Tamyka Bell <[email hidden]>
wrote:

>Did they conclude that sports drink is better than water? Every paper
>I've read, they conclude that.

Or cordial and salt, at a pinch

Yum, ration pack cordial.

meals rejected by ethiopians?

The meals, yeah, but the cordial is actually pretty good.

Tamyka Bell said:

Did they conclude that sports drink is better than water? Every paper
I've read, they conclude that.

Tam

Hi Tam,

They tend to roll all 'fluid' in together, but note a lab study that found a sports drink containing sodium may lessen the fall of plasma sodium concentrations (no real surprise there, i guess). The sodium deficiency might play a part in mild hyponatremia, apparently, so they suggest a sports drink containing sodium for ultra-distance events. But, they figure there's not enough research to really tell.

Ali

alison_b said:

Hi Tam,

They tend to roll all 'fluid' in together, but note a lab study that found a sports drink containing sodium may lessen the fall of plasma sodium concentrations (no real surprise there, i guess). The sodium deficiency might play a part in mild hyponatremia, apparently, so they suggest a sports drink containing sodium for ultra-distance events. But, they figure there's not enough research to really tell.

Ali

The problem with running based research into hyponatremia is that it omits the effect of food during the exercise. This omission makes the research fairly flawed when used as a basis for comparison to cycling ( not that anyone here has) where snacking is well tolerated and part of the culture .

This link is to a very technical medical article but there is plenty that is in plain language ( or use a medical dictionary)
In many disease states chronic (long continued) hyponatremia is present and generally not life threatening. Accute (brief and severe) hyponatremia is less comon and far more dangerous. There are numerous medical causes of hyponatremia with excessive intake of fluids being a minor one when compared to disease states. There is no reference to food in this article as it is mainly looking at pathology and treatment not especially non medical causes.

The MERCK Manual

Someone else mentioned NSAIDS and hyponatremia. Paracetamol will lower the onset threshold and amplify the symptoms of hypernatremia (dehydration) or hyponatremia Be careful when treating heat headache (no blows to head). Ask questions as to why have you got a headache, when did you last pee, what colour was it (yes if you are active you should look). Hydrate, ice pack on head and snack. Hold off NSAIDS until hydration stable (has a pee of reasonable volume and colour)

MRE yumm. Was a "guinea pig" on some of the components for the new rat packs. Barfff

The way minerals work in the body is so amazing.
Interesting subject.

Cheers
Hugh

HughMann said:

alison_b said:

Hi Tam,

They tend to roll all 'fluid' in together, but note a lab study that
found a sports drink containing sodium may lessen the fall of plasma
sodium concentrations (no real surprise there, i guess). The sodium
deficiency might play a part in mild hyponatremia, apparently, so they
suggest a sports drink containing sodium for ultra-distance events.
But, they figure there's not enough research to really tell.

Ali

The problem with running based research into hyponatremia is that it
omits the effect of food during the exercise. This omission makes the
research fairly flawed when used as a basis for comparison to cycling (
not that anyone here has) where snacking is well tolerated and part of
the culture .

The article I referred to (can send it) actually reviews several studies
done into triathlon esp ironman. In these studies, overall nutrition
was considered.

Mmmmm, bananas.

<snip>

Quoted message said:

Someone else mentioned NSAIDS and hyponatremia. Paracetamol will lower
the onset threshold and amplify the symptoms of hypernatremia
(dehydration) or hyponatremia Be careful when treating heat headache
(no blows to head). Ask questions as to why have you got a headache,
when did you last pee, what colour was it (yes if you are active you
should look). Hydrate, ice pack on head and snack. Hold off NSAIDS
until hydration stable (has a pee of reasonable volume and colour)

It was me. NSAIDS is a big worry in sport. But my doctors have always
told me not to take it before racing. Hey, does everyone know that most
doctor's databases have an option to list yourself as an elite athlete,
so that they will warn you about banned substances?

<snip>

Quoted message said:

MRE yumm. Was a "guinea pig" on some of the components for the new rat
packs. Barfff

<snip>

But no worse than the old ones, really...

Tam