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Exercise Induced Hyponatremia

John Anderson, MD and Rob Orman, MD
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When is hyponatremia not treated like the usual hyponatremia you see in Grandma from the nursing home?  When it is in a patient running 50 miles and drinking a LOT of water, that is when!


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Jacob D., MD -

Great info for my next endurance race. My triathlete coach in undergrad would recommend scheduled drinking with 1 bottle of electrolyte liquid per hour. He used to always tell us that by the time we feel thirsty during training or a race, we're already dehydrated. I'd be interested in a follow up podcast on the effects of dehydration during endurance events, as well as the cause of cramps (i.e. lack of O2, poor nutrition, dehydration, electrolyte imbalance, or simply lack of training?).

Jonah S., RN -

I'm a K-9 search and rescue handler and also perform the medical duties for my team. In a resource poor environment can I utilize sodium bicarbonate as a substitute for hypertonic saline from a bag? If so, how should it be dosed?

Heidi J., MD -

Hi Jonah-Thx for your question! The good folks over at EMcrit covered this issue recently...check out their site and tell them we say "hi!"

Jonah S., RN -

That answers the question wonderfully. The community ED at which I work doesn't stock any hypertonic fluids for ICP either, so this could work as a therapy for those patients as well. Thank you!

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Ear Pain is but a Memory Full episode audio for MD edition 183:12 min - 86 MB - M4AHippo Primary Care RAP December 2016 Summary 305 KB - PDF