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[pct-l] Hyponatremia
I suppose there's some danger of running this topic into the ground, but I
thought I'd make a couple of points and then shut up.
1. Chicken soup is good, but sodium is not the only electrolyte to worry
about. You need to replenish calcim, magnesium and potassium and maybe a
few other sweat components.
2. The key is to avoid hyponatremia rather than treat it. That means
taking smaller hits of electorlytes before your tank is empty. The e-caps
I've used contain 100 mg. of Sodium Chloride, 50 mg. Calcium, 25 mg.
Magnesim & Potassium and some other stuff. Dosage is highly variable
depending on the intensity of excercise, heat, elevation etc. They
recommend 1-3 caps 30-60 min. before excercise, 1-6 caps per hour during and
1-3 caps after. For a ten hour day of hiking that is a range of 12-66 caps
and would invovle 1200 to 6600 mg. of sodium chorlide. You could probably
get enough sodium (ignoring the other stuff) from soup/broth on the lower
end of this spectrum, but 6600 mg sodium is a lot of soup. I can't imagine
taking 66 caps a day. That would be expensive and probably extreme for
hiking. I think six caps an hour would make more sense for, say, an intense
three hour event in searing heat. Anything longer and you'll be eating and
drinking other stuff as well.
3. All of this highly specific to each individual and each different
physical challenge. Runners figure out what they need by training under
conditions that replicate the event. The point of training is both to get
your body accustomed to processing lots of fluid and electolytes and to
figure out what works for you under "event conditions." I don't think you
can easily train specifically for a thru-hike except by thru-hiking. It is
just too variable. The main message here is to pay attention to electrolyte
replacement in your nutrional plan from the time you wake up until you climb
into the sack and factor in the possiblity of hyponatremia when something
goes wrong. Sometimes hyponatremia is mistaken for dehydration and water
alone is taken. Just makes things worse.
[OK, he's shutting up now.]
Wayne Kraft
----- Original Message -----
From: "Judson" <judson@jeffnet.org>
To: "'dude'" <dude@fastmail.ca>; <waynekraft@verizon.net>
Cc: <pct-l@mailman.backcountry.net>
Sent: Sunday, April 24, 2005 7:41 AM
Subject: RE: [pct-l] Hyponatremia
> Dude, I must disagree. I have a friend who just ran a 50K. She collapsed
> at the finish line and went into convulsions. She almost died and spent
> a week in the hospital. According to the doctors, she was suffering from
> hyponatremia. As a trail runner, I and several people I know have
> suffered from this at even shorter distances. You can get hyponatremic
> even after 10 mi. if it's a hot day and you haven't prepared well.
>
> Judson
> Southern Oregon Trail Runners
> Ashland
>
> -----Original Message-----
> From: pct-l-bounces@mailman.backcountry.net
> [mailto:pct-l-bounces@mailman.backcountry.net] On Behalf Of dude
> Sent: Sunday, April 24, 2005 12:12 AM
> To: waynekraft@verizon.net
> Cc: pct-l@mailman.backcountry.net
> Subject: Re: [pct-l] Hyponatremia
>
> Wayne - For the type of events that you talk about (marathons, half-
> marathons, 50k's, 20 milers), hyponatremia is not a concern, and your
> statement here would be accurate: "In my experience hypnatremia occurs
> when someone engages in a serious endurance activity and rehydrates
> only with water, avoiding sports drinks and food."
>
> The reason for this is the duration of the event. The longets of these
> events is the trail 50k, which most people can finish in a maximum of 6
> hours or so. When you start exercising strenuously for longer than
> that, hyponatremia is ***MUCH*** more likely. Until my first 50 miler,
> I had run several marathons and 50k's, as well as hiked many 25+ mile
> days on the PCT, without ever having any problems with dehydration or
> electrolytes (hyponatremia). When I ran my first 50 miler, I
> contracted a touch of hyponatremia at about mile 35. I had to stop and
> take electrolyte supplements and rest for about 30 minutes before I
> could continue.
>
> I wanted to make sure to respond to the comment noted above about
> sprots drinks because SPORTS DRINKS ALONE WILL NOT PREVENT
> HYPONATREMIA. Virtually all sports drinks contain only a TINY fraction
> of the amount of soduim required to replace that which is lost due to
> exercise. Intraveinous Saline is 0.9% salt by weight, and is 154
> meq/liter of sodium. Normal Blood PLASMA is between 135 and 145 meq
> sodium/liter. Gatorade is 20 meq sodium/liter. Hence Gatorade won't
> really do jack squat for anyone who is hyponatremic.
>
> The only thing to give to someone who is bloated and hyponatremic is
> something with sodium concentration GREATER than 154 meq/liter. The
> only thing that I know of that you can eat or drink (as opposed to
> intraveinous injection) that has enough salt to reverse hyponatremia is
> Campbells Chicken Broth, which has about 260 meq/liter of sodium.
>
> Another thing to consider when trying to determine how much sodium
> replacement you need is the temperature. When its hot and you are
> sweating alot, you'll need alot more electrolytes. I've hiked so many
> 20+ mile days in the Sierras that I couldn't count them all and I've
> never had an issue with electrolytes, but I know several people who got
> a touch of hyponutremia at the 2002 Houston Marathon when it was 80
> degrees out. The same was true at the 2004 Boston Marathon, as the NYT
> article mentions. I've never hiked the desert sections of the PCT, but
> my guess is that this is the only section that dehydration of
> hyponuatremia would really be a threat. IMO (and I am no expert), as
> long as you are in normal health, these issues shouldn't really effect
> a thru-hike.
>
> peace,
> dude
>
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