In March I attended a very informative seminar presented by Dr. Marty Hoffman M.D. of UC Davis and Nick Nudell of Ultra Medical Team near San Diego. They covered the many ways athletes are presented to emergency medical services, medical professionals and medical race volunteers. I will narrow this down to one of the most common, and potentially dangerous conditions that exist in long-distance endurance events – over hydration.
In the many events you have entered over the years, how many water bottles do you have in your cupboard? How many times do you refill that water bottle during the race? How many liters of Gatorade and Propel, and the like, do you chug down during an event? If you’re reading this you were lucky enough not to over hydrated yourself into a condition known as hyponatremia. Hyponatremia occurs not only from from taking into little electrolytes, but from drinking too much water or sports drinks, too often.
Exercise associated hyponatremic encephalopathy is dangerous condition by which the athlete dilutes the body’s electrolyte balance with too much fluid. In many well-known endurance races, I’m sure you are aware that runners are weighed at each aid station. This accomplishes two goals-making sure that the runner has hydrated enough, and checking to see if the runner is on the path to overhydration. Fluctuations greater than 3 to 4% in either direction may flag the medical team to keep an eye out for this runner, as they may experience potential problems further along in the race. A sign displayed at mile 55 in the Western States 100 showed pictures of beer, ranging from Bud Light to Guinness.
The sign read ” What Color is your Pee?” Bud Light equals good, pale ale= hydrate, IPA=Hydrate more, and if it looks like Guinness, see Medical ASAP!
How do we over hydrate ourselves?
Our bodies have this wonderful built-in the system that tells us how much we should be drinking… it’s called thirst. When we don’t listen to our bodies but listen to Camelback, Gatorade, Propel, S!Caps, etc. we may follow the path to overhydration. You may ask why I included S!Caps with the electrolyte drinks… How can electrolytes and electrolyte charged drinks cause me to be over hydrated? Simple… Salt drives thirst – your body is trying to normalize the concentration of electrolytes and fluids in your body.
In 2015, a paper published by the international Exercise Associated Hyponatremia consensus group stated “… The evidence is firm that every single death from EAH is avoidable if athletes adhere to rational hydration strategies and avoid excessive and unneeded fluid intake.”
In short, listen to your body, not elaborate marketing schemes. Use your body’s thirst mechanism to tell you when and how much to drink. As for salt, A little is good, a lot is not better… There is plenty of sodium in all of the food and snacks you may eat at aid stations along the way – additional intake of electrolyte tablets may just drive your thirst to drink more water than your body needs.
Let the season begin next weekend at The Canyons Run…see you there in Foresthill on the Medical Team!