Cynthia Leeder sent me this link yesterday: A description of “hyponatremia,” which happens when the body has too much water and not enough salt. An excerpt:
Ultra endurance events including marathons, triathlons and even the popular “eco-challenges” are seeing an increase in incidents. Last year, there were 30 documented cases of exertional hyponatremia, seven of which were admitted into the icu with intracranial pressure (icp). Although most of these occur with hikers, passengers on commercial/ private river trips have also developed hyponatremia.
When your salt balance gets out of whack, water can build up in your stomach and you can drink like crazy and never get hydrated. Oddly enough, the treatment for heat exhaustion — rest and fluid restoration — actually makes people worse if they’re suffering serious overhydration and salt depletion.
Prevention is the key.
Stay hydrated and nourished. Once hiking, keep a steady intake of water or electrolyte replacement drink and eat. I cannot emphasis this enough. Sport physiologists assume people are eating and therefore do not need commercial electrolyte replacement. The truth of the matter is that people don’t eat when they are hot, and they don’t eat once they become dehydrated and sick. Gatorade, which contains the highest sodium concentration, doesn’t even come close to the 35 mEq/liter/ hour needed to replace lost salt through sweat. What kind of food, my personal preference is salty snack food. This is not a time for power bars. Leave the health food behind. Junk food is great. Stock up. The rangers now routinely give out saltine crackers, pretzels and cheezits. Stay ahead of the sodium curve!
I’ve gone on a few summer hikes that left salt stains on my backpack’s straps. This is probably nature’s best signal that salt is leaving the body but isn’t going back in.
Read the whole thing — it might save your bacon.
This was one of the better articles on this topic I’ve seen. Planning to do the Na Pali coast in September so managing salt and nourishment is going to be key to getting to Kalalau in one day..thx!
Interesting, didn’t know things could get so bad when you think you’re hydrating enough. In a couple of weeks a friend and I are going trekking for 5 days and we’re taking along some tablets called Nuun. I’ve never tried them before so I can’t recommend them. I do know they contain substantially more sodium than Gatorade, at least from the information I found on the web. We shall see. I hate the idea of pretzels or cheetos. tortilla chips and goldfish are good.
Thanks for posting this, good to know.
The nuun tablets are essentially the same thing as Airborne. I compared the ingredients a while back and I don’t recall noticing a big difference. I use both on the trail when I’m sweating a lot – the nuun tastes better, but the (generic pharmacy brand) Airborne is far less expensive.
This topic came up last Saturday while hiking Los Vaqueros trails with my favorite ultra – marathoner. She just started using salt to help stabilize and utilize fluids, and recommended I try it. I’m searching for the right salt product to keep with me. The article provides quite a bit of useful information
Remember that this is rare compared to dehydration, and that many foods have enough salt to do the trick; I doubt junk food or gatorade is necessary unless everything else in your pack is absolutely unsalted. I’ve adapted to the NOLS method of on-trail nourishment: eat a handful of snacks (like nuts or crackers, not powebars) during short breaks, rather than stopping for one long lunch. My favorite long-haul food is tamari roasted almonds – enough salt for sure.
Well, this is something I have been wondering about and when I saw the article pointed out by a hike leader from the Stanford Outing Club, it looked like a good one to me. Sooo, on my way home from work this evening I stopped by the store and bought pretzels and nuts (almonds, peanuts, and sunflower seeds) and yes, Cheezits! OK, I’m silly, I freely admit it but I am one of those loons who likes Cheezits. But I do suspect nuts are especially good as when you look at the label, it includes potassium along with the sodium.
Otherwise, I have been on a few hikes at Henry Coe where I found myself gagging, two steps from throwing up and of course feeling anything but hungry or thirsty. And I sweat so much on the trail that my face usually ends up caked with the white stuff all over it, my clothes drenched and streaked with the white stains. I don’t know that I have approached a danger point, but just perhaps I ought to watch it.
This is something I have never heard of but I can understand how it can happen. I thank both of you for sharing this and I will be passing this along to the scouts and my friends who I share the outdoors with. Thanks again.
One thing many people don’t think about is potassium!
If that gets low symptoms can be where you feel tired, lethargic, sleepy, horrible cramps, inability to think clearly….
Hence, if you want advice: carry a bag of good quality kettle cooked potato chips. You get a huge dose of potassium naturally plus sodium. Most people don’t need a ton of sodium-what you get in your food is usually quite enough-but, without your electrolytes being in line, you won’t absorb everything.
If you can, carry OJ or a banana for snacks as well.
Cheezits rock!!
Hi Tom – thanks for the post. I believe I got slightly hyponatremic while hiking the Panorama Trail in Yosemite last year. Even though it’s not a horribly exhausting hike, it took all day and it was hot. I drank only water, and even though I was eating sandwiches and power bars, by the end of the hike I was shaking, nauseated, and didn’t want to eat a thing. Luckily, I was with my parents who are both doctors, and they recognized the symptoms. Even though I could barely choke it down, my mom forced me to eat mashed potatoes with a whole lot of salt poured onto them. Within a half hour I was back to normal. It was a scary experience, to be sure.
I WAS TOLD TODAY THAT I HAVE HYPONATREMIA AND THERE DOING THEIR TEST, IN THE MEAN TIME I HAVE BEEN TRYING TO FIND OUT A LITTLE MORE. IF YOU KNOW WHAT I MAY HAVE TO DEAL WITH PLEASE EMAIL ME AT deja1713@yahoo.com I’M NOT SURE WHAT THIS TRULY MEAN’S FOR MY LIFE, I JUST KNOW THIS IS THE FIRST TIME IN MY LIFE, THAT SOMEONE TOLD ME NOT TO DRINK ANY WATER TILL THEY GET THE TEST RESULTS BACK FROM MY BLOOD WORK,WHO DON’T DRINK WATER AND WHY?