Hyponatremia: How To Recognize, Treat And Prevent It

Summary
The key is prevention. Determine your fluid and sodium requirements and follow them. Remember

• A bloated athlete is overhydrated, the exact opposite of dehydrated.
• Bloating is a red flag for hyponatremia.
• Mental changes plus bloating in an athlete indicate hyponatremia with brain swelling, and represent a dire medical emergency.
• Don't be fooled by a bloated athlete who is not urinating: he/she is overhydrated and on the way to hyponatremia if not already there.
• Don't be fooled into thinking that an athlete who is throwing up is becoming dehydrated. Vomiting is frequently a symptom of hyponatremia.
• Do not give a bloated athlete any fluid (except as a vehicle for salt).
• Give a bloated athlete salt.
• When it is hot and an athlete is distressed, do not automatically conclude that the cause is dehydration and the remedy is fluid ingestion.
• Sweat typically has 1000 mg sodium/quart; a typical sports drink has 440 mg sodium/quart. If during a sufficiently long ride, you ingest nothing but sports drinks, you will become hyponatremic at some point.