Hyponatremia: Consumption of Too Much Water
In a previous workout tip about proper hydration, I mentioned that hyponatremia is a topic I would revisit later. Hyponatremia is something to be aware of but not something to be worried about. It is something that is all the rage in the media these days as something to warn people about, and yes, it can be dangerous. It is just such an easy thing to avoid that a little knowledge and a smattering of common sense can make it a non-issue.
I was reminded I needed to write about this topic after reading another scary article about hyponatremia over at the Health and Fitness blog that comments on a New York Times article about it.
This excellent NYT article recaps this very real threat to athletes, primarily marathoners. The article sagely notes that there are no recorded deaths from dehydratrion in world running but deaths from hyponatremia have occurred. The articles quotes the a rule of thumb that eight ounces of fluid every 20 minutes is plenty.
Making broad statements like that is more dangerous to a marathoner, especially an inexperienced marathoner, than the condition itself. While it is possible they somebody may overhydrate themselves, it is far more likely that they will underhydrate themselves. While I am sure that a 0.5% chance of dying is bad, is it really worse than bad advice causing a 50-70% chance of heat exhaustion*?
There are two things to bear in mind when hydrating for any sort of endurance event.
- Be sure to consume plenty of water and to eat plenty of food.
- Do not do anything on marathon/race day (or the day/s preceding it) that you have not already done in training.
Being properly hydrated involves drinking plenty of fluids, especially water, and especially for the day or three preceding your event. As I mentioned in my previous tip, you want to make sure that your urine is a very pale yellow or almost clear color. If it is completely clear, you may be slightly overhydrated, but probably not at a dangerous level. Which means, rather than not drinking anything else, which would be a mistake, you should drink a sports drink or fruit juice and eat some food. Eating is just as important as drinking for any sort of endurance event. In the case of a marathon, where you will be performing for 3 or 4 hours, you will have used up all of your body’s readily available fuel that has been stored up by the time you are ½ to ¾ of the way through the race. You should be sure to top your tanks off before you begin, and you should replenish your tank as you go along so that at no point are you running on empty. Following that one simple concept will make it next to impossible for you to suffer from hyponatremia.
Do not do anything on race day that you have not practiced in training. That includes what you decide to eat, how you decide to fuel yourself and hydrate yourself, and what you consume on the race course while you are out there. Gel packs are easily carried, and most major races include at least one or two water stations that have gel packs, and many have water stations that serve sports drinks. Buy some gel packs ahead of time, and practice consuming them every 20 minutes to half an hour during your long runs. They will replenish the vitamins, minerals, and salts in your system that water will not, which will not only make sure you do not hit the wall as hard as you otherwise might, but will keep you going strong your entire race and will make it so that you do not have to worry about having a drink water for fears of hyponatremia. When you take gel packs, however, make sure you wash them down with water. Your stomach will not be able to process them correctly without it. When in doubt, read the package labels.
*Note: I made those numbers up off the top of my head to illustrate a point; they are not based on any scientific data.
- This Week Last Year: Golf Cheats, Soccer Cheats, and Drugs, Oh My!
- Workout Tip #2: Proper Hydration
- This Week Last Year: Marathons and Brain Hemorrhages
- How to Hydrate
- Marathon Preparation: 9 things you must do the week before your race

















October 21st, 2006 at 9:05 am
[...] I described hyponatremia and discussed how I do not believe that it is as large of a problem as everybody makes it out to be. [...]
January 10th, 2007 at 9:26 pm
[...] My thoughts on drinking water are to always drink as much as you can manage in any given day. You should never rely on thirst as an indicator of how hydrated you are. While hyponatremia is certainly more dangerous than being dehydrated, I eat constantly throughout the day and am not worried in the least about it. A well balanced diet will easily make it so that you never have to worry about it. [...]
July 10th, 2008 at 2:04 pm
You mentionned in your previous post about hydration that caffeine is a no-no in order to remain well hydrated. Do you use caffeine free gels?
July 10th, 2008 at 2:20 pm
Yes, I avoid caffeine like the plague. It is one of the 2 major catalysts for my getting a migraine, and I don’t enjoy going blind, so I eliminated it from my diet about 10 years ago.
That’s one of the reasons that I like using Crank Gels - no caffeine in them.
July 10th, 2008 at 3:02 pm
I get the PowerBar Caff free Vanilla flavored gels that I get at Hannaford or Target (convenient for a Mom-on-the-go) but I have never seen Crank Gels during my regular shopping.
Where do you buy them?
July 10th, 2008 at 3:06 pm
I used to get them at Peak Performance Sports when they were still located on Middle Street, but these days I just buy them online at cranksports.com - they ship them to my house. Much easier.
July 10th, 2008 at 3:58 pm
I just ordered a trial pack. Thanks for the link!
I just noticed that my PowerBar Gel contains 70 mg of Chloride. Do you know what that is and what are the benefits of that substance?
Thanks!
July 10th, 2008 at 4:04 pm
Chloride is half of the chemical makeup of salt, and is an electrolyte that helps control the flow of body fluids through your veins. It bonds with sodium and potassium, usually, and will also make you thirsty to ensure that you drink enough water.
July 10th, 2008 at 4:09 pm
WOW! Thanks!