article on hyponatremia

Ignoramus20182 said:

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Because of the law of conservation of mass, the only cause of their
weight gain was drinking (and eating, if there was any). Weight
could not come from thin air.

True, but I'm talking about drinking water and not being able to
eliminate it in a timely manner due to improper sodium concentration.

Well, someone who gains 11 lbs from drinking during a run, drinks no
less than 11 lbs. That's too much, regardless of how much is
eliminated...

Yes, 11 pounds is a bit much. That's about 1.4 gallons!

--
Phil M.

Donovan Rebbechi wrote in message ...

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Dot dot.h@#duh?att.net said:

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If they're drinking that much they can't be running very fast. Sounds

like

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the 5 hour + person who stops at every aid station and drinks 3 cups.

They

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never get going fast enough to sweat it out...

For those of us who do sweat profusely during summer exercise and are

still

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losing weight during our runs, the ultra solution of salt tabs really

does

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seem to work to aid absorption.

-Tony

To add to your comments, people should read this 1st person account:

http://www.restonrunners.org/special/hyponatremia/michele_burr_hyponatremia.
php

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I couldn't find the 2002 VT100 results (blank page), but my recollection
was that she was one of the lead women, but I could be wrong - certainly
not a back of packer (or I might have stories twisted). (Doug may
remember) Granted, "fast" in a hot 100 is relative.

That's an *ultra*. She was certainly out there for more than 5 hours, much
like a slow marathoner ! It's also possible that she actually stopped at
water stations -- wouldn't be unheard of even for a competitive ultra

runner

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(again, like a slow marathoner). But even if she didn't stop, cumulative
errors over 18hrs or more could put you in the danger zone. I know a
competitive marathoner who gained 1.5lb in a race without stopping to walk,
fairly moderate intake. Of course she was fine, but repeat that error 6

times

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over and you could have some trouble.

Cheers,
--
Donovan Rebbechi
http://pegasus.rutgers.edu/~elflord/

Very informative, thanks Dot and Donovan. That's the best article I've read
about it, and I didn't think it was possible during a 100. (Biography is the
best form of writing IMO). Scary stuff. Makes me think I had that during my
50 miler. I wasn't dehydrated, but I was very disoriented at the end and had
to lie down for over an hour. I doubt I actually gained weight, but I'm
certain looking back I lacked salts, which I didn't know as much about at
the time.

-Tony

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

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I thought so too, and asked an exercise physiologist friend. He said
that
overdrinking is the problem,

Agree.

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and that he'd never take salt in a marathon.

maybe for 32 hour marathoner is cool weather. Turn up the temp and add
those that run for 4 or more hours and you physiologist friend needs to
take a refresher course in hyponatremia

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He also said that plasma sodium levels *increase* during exercise.

I'd like to know how this happens and even more about his credentials.
Does this imply the body creates salt?

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You don't
"balance" overdrinking with salt capsules, you just don't overdrink in
the
first place.

This is a slippery slope and easier said than done. Understand Donovan
that if you drink too much water or gatorbarf you did NOT get enough
salt especially for those in the 4+ hour bracket. if you do over drink
either and you are bloated some additional salt will cause your stomach
to one again empty. the EMT/MD"s at the finish lines are now very
cognizant when people enter the medical tent to ascertain if the runner
is dehydrated and put them on an IV or some degree of hyponatremia and
gibe them a heavy dose of salt. Putting an IV into hyponatremia runner
can send them into a coma.

Quoted message said:

One thing you notice reading that article carefully is that the people
in the
article *gained* weight -- and in some cases, gained 10 pounds or
more. They
were simply drinking way too much.

True but if they had sensed this feeling and taken some salt they may
have [censored] their brains out on the course but have been healthier felt
more comfortable and maybe run a better time.

My point especially for your physiologist - yes you can drink too much
and when the salt content of the fluid is too week you need more salt.
Anything less is inviting a dangerous situation. And to say don't
overdrink is like saying only invest in stocks that will go up.

For you and your physio guy take a look at the anecdotal
http://www.geocities.com/madeads/hyponatremia.html and the reference web
pages it points to.

-DougF

"Dot" <dot.h@#duh?att.net> wrote in message
news:[email hidden]...

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Dot said:

I couldn't find the 2002 VT100 results (blank page), but my
recollection was that she was one of the lead women, but I could be
wrong - certainly not a back of packer (or I might have stories
twisted). (Doug may remember) Granted, "fast" in a hot 100 is
relative.

I finished an hour and some change after her, in time watch them take
her off in an ambulance. We were both vertical on a cot with a blanket
but I was awake talking, er, babbling (big surprise). Michele was an
experienced ultra runner that thought she was getting enough salt but
ignored the weight gain and fell into the trap. In a way her case helped
all of us on the circuit to understand hyponatremia. In fact there has
been a fantastic dialog going on the ultra forum as we speak.

By the way, she is still running and doing well. We both did the HAT(3rd
F) and Bull Run(4th F) this year but she was still standing at the
finish of both.

-DougF

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

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It's also possible that she actually stopped at
water stations -- wouldn't be unheard of even for a competitive ultra
runner
(again, like a slow marathoner).

Donovan just a nit but let me help you with your myopic mind set. All
runners in trail ultras stop at aid stations, not just the slow and
infirm as you seem to think, to replenish their bottles and grab some
food. If you have a crew and/or are experienced you know what you want
and minimize the amount of time you stop but stop, they do!

-DF

On Sun, 17 Apr 2005 11:55:19 GMT, "Doug Freese" <[email hidden]>
wrote:
....

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One thing you notice reading that article carefully is that the people
in the
article *gained* weight -- and in some cases, gained 10 pounds or
more. They were simply drinking way too much.

True but if they had sensed this feeling and taken some salt they may
have [censored] their brains out on the course but have been healthier felt
more comfortable and maybe run a better time.

all this banter back and forth doesn't seem to add anything
that I can use to determine how much salt/electrolytes
to take.

i'm slow. 5 hour marathoner (well, maybe 4.5 if my knees don't hurt).
and i don't have much experience. this year i'll be doing one
long race in july and one in october (it'll be cool). i don't
feel mentally prepared for the july one. probably will be hot.
probably i'll drink 1 litre of water per hour. since it's
a loop i will be able to add some gatorade which seems to agree
quite nicely with me. i may cut back on the water if that
works out.

but, how much salt to take? somebody suggested sucking
on s!caps and when they begin to taste blah, spit them out.
sort of a self-regulating feed. i like that but i don't know
if it's a valid way of maintaining electrolyte levels.
i may even have it backwards. i'll have to find that
suggestion and read it again.

thanks for any more ideas...thehick

frank-in-toronto said:

i'm slow. 5 hour marathoner (well, maybe 4.5 if my knees don't hurt).
and i don't have much experience. this year i'll be doing one
long race in july and one in october (it'll be cool). i don't
feel mentally prepared for the july one. probably will be hot.
probably i'll drink 1 litre of water per hour. since it's

One advantage you have over faster marathons is that you will probably
be performing fairly long training runs at your marathon race pace. So
you can take some weight measurements to get a better idea as to how much
you should drink. Hyponatremia occurs because water accumulates in the
digestive system. You won't get it if you don't overdrink. I'm afraid I
don't know if salt caps will do you much good (I suspect there isn't
universal agreement on this either)

Cheers,
--
Donovan Rebbechi
http://pegasus.rutgers.edu/~elflord/

Doug Freese said:

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

Quoted message said:

It's also possible that she actually stopped at
water stations -- wouldn't be unheard of even for a competitive ultra
runner
(again, like a slow marathoner).

Donovan just a nit but let me help you with your myopic mind set. All
runners in trail ultras stop at aid stations, not just the slow and
infirm as you seem to think, to replenish their bottles and grab some
food.

Yeah, I know. But the point I'm making here is that stopping or walking gives
them an opportunity to overdrink, because one thing that stops a fast
marathoner overdrinking is that you just can't drink very much when you're
running fast.

Cheers,
--
Donovan Rebbechi
http://pegasus.rutgers.edu/~elflord/

"frank-in-toronto" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

all this banter back and forth doesn't seem to add anything
that I can use to determine how much salt/electrolytes
to take.

i'm slow. 5 hour marathoner (well, maybe 4.5 if my knees don't hurt).
and i don't have much experience. this year i'll be doing one
long race in july and one in october (it'll be cool). i don't
feel mentally prepared for the july one. probably will be hot.
probably i'll drink 1 litre of water per hour. since it's
a loop i will be able to add some gatorade which seems to agree
quite nicely with me. i may cut back on the water if that
works out.

but, how much salt to take?

A really good question and short of race day trial and error, I would
suggest you use body weight before and after your long runs especially
the hot days. In addition if you find your stomach bloating, i.e. you
are not emptyting you are likely low on salt. This assumes you are not
popping too many salt caps know as hypernatrenia. To suggest how much
to take is impossible, you must see how your body behaves. For me in
heat , I would take about one s!cap an hour with a sport drink. If the
sport drink was Gatorade, which I can't drink, I would take a bit more.

Anecdotal but some years back I did the Vermont City Marathon and the
temps were in the 90's. I was also doing ultra races so I understood
fluids and salt. It was the only road marathon that I ran with a bottle
and salt caps and boy did they save my ass. The medical tent was wall to
wall people and I was walking around with Heineken in my hand. I had to
stop a few times to take a leak but well worth the lost time. You gotta
know when to hold'em........

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somebody suggested sucking
on s!caps and when they begin to taste blah, spit them out.

They have no taste, it's a cap and down they go with fluid. I never
tried to chew or suck on them. 😉

-Doug

Doug Freese said:

maybe for 32 hour marathoner is cool weather. Turn up the temp and add
those that run for 4 or more hours and you physiologist friend needs to
take a refresher course in hyponatremia

I don't know if he was talking about >4hr marathoners -- since he was talking
about what he'd do, and what he'd recommend for me.

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He also said that plasma sodium levels *increase* during exercise.

I'd like to know how this happens and even more about his credentials.

His credentials ? Better than yours, Doug. I'm not going to post his CV, but
he has the degree and the publications. You don't. He could reasonably claim
to be an expert on this stuff. You can't.

Quoted message said:

Does this imply the body creates salt?

No.

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This is a slippery slope and easier said than done. Understand Donovan

The people who had problems in that article were up 10lb or so. When you've
only 20 water stops or so, it takes some work to do this. In particular, you
will not even come close to this drinking on the run.

Cheers,
--
Donovan Rebbechi
http://pegasus.rutgers.edu/~elflord/

Doug Freese said:

wall people and I was walking around with Heineken in my hand. I had to
stop a few times to take a leak but

Which means you were overdrinking.

Cheers,
--
Donovan Rebbechi
http://pegasus.rutgers.edu/~elflord/

or under-salted, as the kidneys when faced with hyponatermia will
attempt to flush water from the system to regain balance.

Donovan Rebbechi said:

Doug Freese said:

wall people and I was walking around with Heineken in my hand. I had to
stop a few times to take a leak but

Which means you were overdrinking.

Cheers,

Hyponatremia doesn't occur because of a buildup of fluid in the gut,
that is a response to the body discovering that it is in a hyponatremic
state and shutting down the passage of water into circulatory system
which would just make matter worse. The condition may have been the
result of not enough sodium in the system to begin with, loss of sodium
via sweating, ingestion of sodium-less or low sodium drinks which were
accepted into the system before it realized something was awry or a
combination of all three. The addition of salt into the fluid in the gut
will usually result in the fluid being absorbed.

From an experiment of one I can attest to the success of Succeed! caps
for a 5+ hour marathoner. After a medical condition left me in the 6
hour range marathon for two years, my "duh!" moment was reading Doug and
Dot (and probably some others who I can't remember at the moment) write
about Succeed! caps and equating it with my craving for salt around the
20 mile point, in spite of drinking only, but lots of, PowerAde. I was
literally licking the salt off of pretzels.

I tested Succeed! caps in a couple of 24 and 28 mile training runs with
good results. So for this year's Disney I took one the night before, one
before the race and two during. I finished stronger, faster (40 minutes
better than last year) and didn't crave salt toward the end and it was
82 degrees at the end. Enough to convince me.

What we know and learn about the human body is likened to a boat load
of tourists, someone spots something of interest on the port side and
everybody rushes over to get a look until they almost sink the boat,
blessedly someone will usually yell to move enough back to the starboard
side until a balance is reached. Unfortunately sometimes a tourist will
have to fall overboard before anyone realizes there is a problem.

Ciao

Donovan Rebbechi said:

Hyponatremia occurs because water accumulates in the
digestive system. You won't get it if you don't overdrink. I'm afraid I
don't know if salt caps will do you much good (I suspect there isn't
universal agreement on this either)

Cheers,

Donovan Rebbechi said:

One advantage you have over faster marathons is that you will probably
be performing fairly long training runs at your marathon race pace.

This does not compute. Why is it that a "slow" marathoner should be able to
hold a higher percent of target pace (you are suggesting 100%) than a
"faster" marathoner?

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

Quoted message said:

Doug Freese said:

wall people and I was walking around with Heineken in my hand. I had
to
stop a few times to take a leak but

Which means you were overdrinking.

Utter [censored] in the heat. When you factor lost time in a hot matathon
to take a [censored], is to place speed above health. I don't know how else to
state this but IGNORANT. Sometimes your dedication to redlining borders
on insanity.

-DF

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

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I'd like to know how this happens and even more about his
credentials.

His credentials ? Better than yours, Doug. I'm not going to post his
CV, but
he has the degree and the publications. You don't. He could reasonably
claim
to be an expert on this stuff. You can't.

Poor Donovan, gets back into a corner and takes the proverbial cheap and
childish shot. It's not my credentials at stake but the credentials of
people that are actively involved in hypernatremia studies, publishing
papers, running ultras and have credentials that would make you
physiologist look like a GED grad. Now that's a equally cheap shot
because one may have a degree in buffalo [censored] and still spend an
enormous amount of time to understand a topic. In the running that I do,
proper hydration is measured buy the frequency you [censored] and not the
time on the clock and this includes elites. You can bet your sweet ass
we understand this topic.

Quoted message said:

The people who had problems in that article were up 10lb or so. When
you've
only 20 water stops or so, it takes some work to do this. In
particular, you
will not even come close to this drinking on the run.

You are now showing how wrong and silly you can get.

-DF

Donovan Rebbechi wrote in message ...

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snip<
The people who had problems in that article were up 10lb or so. When you've
only 20 water stops or so, it takes some work to do this. In particular,

you

Quoted message said:

will not even come close to this drinking on the run.

Up 10 pounds is insane. Those people must have been paranoid about losing
too much through sweat. That it also happened to that high-placed woman in
an ultra is illustrative - it appears that in long efforts of varying heat
conditions, getting it just right in terms of water and sodium intake is far
from a no-brainer. In an ultra one could also be paranoid of not getting
enough liquid, and with the pain one endures in an ultra, normal bodily
awareness isn't what it normally is.

-Tony

steve common said:

Donovan Rebbechi said:

One advantage you have over faster marathons is that you will probably
be performing fairly long training runs at your marathon race pace.

This does not compute. Why is it that a "slow" marathoner should be able to
hold a higher percent of target pace (you are suggesting 100%) than a
"faster" marathoner?

Not just a "slow" marathoner -- we're talking about a relatively slow,
undertrained first time marathoner. So -- correct me if I'm wrong, Frank --
he is probably focused on finishing and not too hung up on a particular time
goal. He will also be running in fairly tough conditions. Therefore, a
reasonable pacing strategy would be to try to hold approximately training pace
for 26.2 miles.

Cheers,
--
Donovan Rebbechi
http://pegasus.rutgers.edu/~elflord/

Doug Freese said:

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

Quoted message said:

Quoted message said:

I'd like to know how this happens and even more about his
credentials.

His credentials ? Better than yours, Doug. I'm not going to post his
CV, but
he has the degree and the publications. You don't. He could reasonably
claim
to be an expert on this stuff. You can't.

Poor Donovan, gets back into a corner and takes the proverbial cheap and
childish shot. It's not my credentials at stake but the credentials of
people

No ... not unless they are actually reading and posting here. Otherwise, we're
stuck with your own very limited comprehension of these guys. You may indeed
know some experts, but unless they have authorised you to speak for them, or
unless you quote them verbatim, your comments are not backed by the weight of
their authority -- and thankfully, no-one will question their credentials on
account of your own senile ramblings.

Quoted message said:

that are actively involved in hypernatremia studies, publishing
papers, running ultras and have credentials that would make you
physiologist look like a GED grad. Now that's a equally cheap shot

And also an extraordinarily stupid thing to say, since you know nothing about
the person you're criticising, and you're not qualified to evaluate him
anyway.

But it's not unprecedented for you to be a DF, after all it's your name.

Cheers,
--
Donovan Rebbechi
http://pegasus.rutgers.edu/~elflord/

Donovan Rebbechi said:

steve common said:

Donovan Rebbechi said:

One advantage you have over faster marathons is that you will probably
be performing fairly long training runs at your marathon race pace.

This does not compute. Why is it that a "slow" marathoner should be able to
hold a higher percent of target pace (you are suggesting 100%) than a
"faster" marathoner?

Not just a "slow" marathoner -- we're talking about a relatively slow,
undertrained first time marathoner. So -- correct me if I'm wrong, Frank --
he is probably focused on finishing and not too hung up on a particular time
goal. He will also be running in fairly tough conditions. Therefore, a
reasonable pacing strategy would be to try to hold approximately training pace
for 26.2 miles.

i'd guess this is probably normal for us slow guys. we train
at the pace we run. and at this stage, yes, my focus is
finishing. there's still some doubt about that. especially
as i'm more interested in trails and gonna do a short
ultra for the first time. perhaps i'm pushing it a bit
quicker than those that want a good time. i want
the experience.
....thehick