Monday, April 16, 2012

Hyponatremia

I never thought I will tell someone "Yea, I didn't manage the race correctly. I got hyponatremia".

For those who don't know what hyponatremia is, here is a definition
Hyponatremia is a condition that occurs when the level of sodium in your blood is abnormally low.

It is funny, because hyponatremia has incorrectly been dubbed as a "slower runner's" issue. It got this label as a result of a few isolated incodents in big city marathons. In the severe cases, it happened to runners finishing or tracking in the 5+ hour time.

Problem is, it has less to do with speed and everything to do with water intake and how much one sweats.

Up until yesterday, I would have added to the precious sentence "and how much electrolytes you are taking". Well...... there is a catch to that last sentence. And I can't believe I have missed it in my now 2+ years of struggling with this.

Here is the bombshell quote from Karl King, founder of Succeed! spots nutrition.
The sodium concentration in extra-cellular fluid is the ratio of weight of sodium ions to weight of water. So, if I have too much water, I can just add more sodium, right? Well, it depends on where you are with respect to normal sodium content in the body. If you have too little sodium, then adding more will help you return to normal. An example many runners have experienced would be low sodium with adequate water, leading to puffiness in the hands and wrists. Taking in more sodium will correct the situation and the puffiness will go down.

But if you have the right amount of sodium, adding a lot more is not good. Excess sodium can increase thirst and prompt more drinking, which is bad if you already have too much water on board ( excess weight ).

Thus, the safest course is to drink to maintain body weight ( or be a little down ), and take sodium supplementation conservatively. A deficiency of water or sodium can be corrected within minutes, but correcting excesses of either one can take hours.

The thing that really hit me is figure out hydration FIRST, then electrolytes.

Take a look at the table on here. It is Karl's table of electrolytes. I went through an asked myself "did I experience this based on these symptoms?"

I tried to relive the last few.... okay, many DNF's, and they all told a somewhat different story. But what they all had in common was overhydration. Superior last year was the best example of moderating it, though. I clearly remember my fingers getting puffy, then going away. It happened many times. This is..... A GOOD SIGN! meaning I (we.... Bill P the crew) were keeping the conditions at bay, and adjusting.

I also look at the "low hydration" column and realize I have not felt these symptoms in a while. I have felt all of them, but not in any recent races. And notice the fix for that column, very simple. The fix for overhydration seems simple as well, but as Karl said

A deficiency of water or sodium can be corrected within minutes, but correcting excesses of either one can take hours.

So what do I do? Over the next 2 weeks I am going to do my best to test this again. I will
> Weigh myself as much as I can before and after runs, and see what my %dehydration is
> Run a 50k loop at afton consuming half the water I am used to, and see what happens.

Guess I have my work cut out for me in the next 2 weeks. I have to redeem myself at Ice Age. If I can't work this out/figure this out, then I am throwing in the racing towel and switching to crew/volunteering. It aint' worth it.

I came home on Saturday in an unhealthy state. It wasn't good for the family balance.

3 comments:

Scott said...

The puffy hands throws me off because its a sign of high hydration but either high or low electrolytes. But reading through that table, I'm pretty sure I have been low on electrolytes in my last few races. Glad you posted this, I think to think on that. (I accidentally left this on your race report post too.)

Running with MTP said...

Nice post - Interesting and helpful string of thoughts. I tend to over-hydrate and over S-cap in races. In 24 hour racing I might have to pee 18 times.

I fear being underhydrated and under-salted.

I never have percived it as a limiting factor in my racing - But that is just my perception.

Keep sharing your journey

Michael Henze

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