From the October 2012 issue of Runner’s World

4 ways to avoid hyponatremia

Marathon day was warm. White tends to overheat, so 57-year-old Jeff White drank a cup of performance drink and a cup of water at each water station. He finished strong, just 33 seconds off his 18-year-old PB of 3:17:12. Public transport was backed up, so it took two hours for his wife to reach their meeting point. “During that time, I was feeling dehydrated,” he says. “I probably drank three litres of water and a litre of Cytomax [performance drink].” At the hotel, he downed a litre of Gatorade. Soon he was nauseous and vomited repeatedly. They rushed him to the hospital. “The doctor said my blood sodium was 122 [normal is 135 to 145], dangerously below normal,” says White. “I had hyponatremia and had to stay overnight.”

WHAT WENT WRONG
AND HOW TO PREVENT IT:

Hydrate safely with simple strategies
While rare, hyponatremia – a condition characterised by abnormally low blood-sodium levels caused by drinking too much water – can be life threatening because it can cause brain swelling. Here’s how to safely quench your thirst during and after a race.

1 TUNE IN
“A cup of sports drink and water at each station is too much,” says Dr. Maharam. Drink according to thirst, and consume only sports drinks for their electrolytes.

2 DOWN SODIUM
Toss back at least two salt packets and eat salty foods after the finish. During and after a marathon, “blood gets redirected to your legs and away from the kidneys,” says Dr. Maharam. “You pee out salt and maintain free water” that can increase hyponatremia risk.

3 CARRY ELECTROLYTES
On hot and humid runs or races, bring electrolyte pills in addition to salt packets and take two caps an hour.

4 MAKE A PLAN
Following a post-race recovery plan will avert mindless behaviour like drinking too much, says Eiring. Your routine should encompass nutrition and hydration requirements, a mental review of your race, and a cool-down. With practise, your recovery will become automatic.

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