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  • Too much water?

    I saw this story on the news and online. Drink lots of water or too much water is bad? I'm confused. I'll stick to beer.
    .... What you think, Doc?

    Too much water during exercise riskier than dehydration, study says
    Endurance athletes have fallen ill, died after diluting blood
    - Gina Kolata, New York Times
    Thursday, April 14, 2005

    After years of telling athletes to drink as much liquid as possible to avoid dehydration, some doctors are now saying that drinking too much during intense exercise poses a far greater health risk.
    An increasing number of athletes -- marathon runners, triathletes and even hikers -- are severely diluting their blood by drinking too much water or too many sports drinks, with some falling gravely ill and even dying, the doctors say.
    New research on runners in the Boston Marathon confirms the problem and shows just how serious it is.
    The research, reported in today's New England Journal of Medicine, involved 488 runners who participated in the 2002 marathon. The runners gave blood samples before and after the race. While most were fine, 13 percent -- or 62 of them -- drank so much that they had hyponatremia, or abnormally low blood sodium levels. Three had levels so low that they were in danger of dying.
    The runners who developed the problem tended to be slower, taking more than four hours to finish the course. That gave them plenty of time to drink copious amounts of liquid. And drink they did -- an average of three liters, or about 13 cups of water or a sports drink -- so much that they actually gained weight during the race.
    As more slow runners entered long races, doctors began seeing athletes stumbling into medical tents, nauseated, groggy, barely coherent and with their blood severely diluted. Some died on the spot or in the hospital.
    In 2003, USA Track & Field, the national governing body for track and field, long-distance running and race walking, changed its guidelines to warn against excessive intake of liquids.
    Marathon doctors say the new study offers the first documentation of the problem.
    "Before this study we suspected there was a problem," said Dr. Marvin Adner, the medical director of the Boston Marathon, which is Monday. "But this proves it."
    Hyponatremia is entirely preventable, Adner and others said. During intense exercise the kidneys cannot excrete excess water. But as people keep drinking, the extra water moves into their cells, including brain cells. The engorged brain cells, with no room to expand, press against the skull and can compress the brain stem, which controls vital functions like breathing. The result can be fatal.
    But the marathon runners were simply following what has long been conventional advice: avoid dehydration at all costs.
    Doctors and sports drink companies "made dehydration a medical illness that was to be feared," said Dr. Tim Noakes, a hyponatremia expert at the University of Cape Town in South Africa.
    "Everyone becomes dehydrated when they race," Noakes said. "But I have not found one death in an athlete from dehydration in a competitive race in the whole history of running. Not one. Not even a case of illness."
    On the other hand, he said, he knows of people who have become sick and died from drinking too much.
    Hyponatremia can be treated, Noakes said. A small volume of a highly concentrated salt solution is given intravenously and can save a patient's life by pulling water out of swollen brain cells.
    However, he said, doctors and emergency workers often assume the problem is dehydration and give intravenous fluids instead, sometimes killing the patient. Noakes and others advise testing the salt concentration of a sick athlete's blood before starting treatment.
    For their part, runners can estimate how much they should drink by weighing themselves before and after long training runs to see how much they lose -- and thus how much water they should replace.
    Adner said athletes also should be careful when a race is over. He advised runners to wait until they start to urinate before drinking any more fluids.
    The paper's lead author, Dr. Christopher S.D. Almond, a cardiology fellow at Children's Hospital, said he had first heard of hyponatremia in 2001 when a cyclist drank so much on a ride from New York to Boston that she had a seizure. She eventually recovered.
    Until recent years, the condition was all but unheard of because endurance events like marathons and triathlons were populated almost entirely by fast athletes who did not have time to drink too much.
    In a letter, also published today in the journal, doctors describe 14 runners in the 2003 London Marathon with hyponatremia who waited more than four hours on average before going to a hospital. Some were lucid after the race, but none remembered completing it.
    I do not have a psychiatrist and I do not want one, for the simple reason that if he listened to me long enough, he might become disturbed.
    "Life can keep providing the rain and I'll keep providing the parade."
    "I would just like to say that after all these years of heavy drinking, bright lights and late nights, I still don't need glasses. I drink right out of the bottle."
    "Whatever guy said that money don't buy you pleasure didn't know where to go shopping"

  • #2
    yeah, ive seen a girl on ecstasy who drank to much water and overdosed on it, the ambulance came and took her away, i heard she died, wow. you can od offa anything cant you?
    "Life is a run. In attack we run, in defense we run. When you can no longer run, time to die" - Shichiroji "Seven samurai"

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    • #3
      well they don't call it "overdosing" when you drown yourself. but effectively, yes.

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      • #4
        You can die from breathing in an atmosphere with too much oxygen.

        In general you shouldn't be drinking during heavy excercise, at least not more than an occasional sip of water. You should eat and drink your fill AFTER any strenous excercise though, and follow the meal with a nap.
        Show me a man who has forgotten words, so that I can have a word with him.

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        • #5
          Originally posted by Rob1357
          yeah, ive seen a girl on ecstasy who drank to much water and overdosed on it, the ambulance came and took her away, i heard she died, wow. you can od offa anything cant you?

          I don't think it was the water she OD'd on.
          I do not have a psychiatrist and I do not want one, for the simple reason that if he listened to me long enough, he might become disturbed.
          "Life can keep providing the rain and I'll keep providing the parade."
          "I would just like to say that after all these years of heavy drinking, bright lights and late nights, I still don't need glasses. I drink right out of the bottle."
          "Whatever guy said that money don't buy you pleasure didn't know where to go shopping"

          Comment


          • #6
            It probably was the water although I doubt the person would have died had they not been on E at the same time. There was a famous case in the UK many years ago about a girl who took a pill and died but it was actually due to drinking too much water so she effectively drowned. I don't pretend to know the medical reason for this but I'm sure Doc could enlighten us on that. To my knowledge though it's fairly common for people who die from exctasy to be as a result of too much water or not enough.

            Still, makes the governments use it as a case against the drug. They forget that millions of people take it every weekend without major issue with the death toll relatively low. Compared expecially with the drinking deaths or even simply the social and medical costs of all drinking related illness and violence as a result of drunks. I'm not advocating the use of E, I just think people don't know enough and its easy to condemn all drugs and lump them together while forgetting about the "legal" drugs.

            Sorry this probably isn't the place for getting on a soap box to discuss drugs.

            R

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            • #7
              I've heard of a few different times that people have sort of ODed on water. One is the classic girl on E. The other was a group of kids that would drink so much water it would give them the intoxicated feeling they were looking for. In both cases it supposedly thinned out their blood so much it couldn't carry enough carbon dioxide out of there body, or oxygen into their body.
              practice wu de

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              • #8
                This is nothing new. Hyponatremia is a well known occurence, especially found in people that exercise too much. Rehydration with plain water can dilute the sodium concentration in the blood, the result of which can lead to brain edema. You have to think of sodium (the one half of table salt, the other being chloride) as a particle in the blood, that attracts pure water in the blood serum. Water follows sodium, sodium keeps water with it. Blood has a certain concentraion of sodium, which is maintained at proper levels by the kidneys. If kidney disease, or, with overhydration using pure water, you can add more water to the blood than sodium. The result is a lowered sodium concentration in the blood.

                The problem is, the sodium concentrations in the tissues don't change that fast, so, the extra water in the blood, not being held back by the sodium, crosses the blood brain barrier and joins with the normal sodium in the brain. The result is, more water in the brain than the brain is used to, and, can accomodate. Eventually, because of the extra water in the brain, neurological impulses get inhibited, resulting in changes in mental state. And, extra fluid in the brain is called cerebral edema; the swelling of the brain in the enclosed space of the skull, can result in diminished blood perfusion, ultimately leading to neurological deficits.

                This is why things like Gatorade became popular. In fact, hyponatremia was a common problem during my first trip to Shaolin, when just about all of my companions, drinking solely pure water (and sweating profusely on a regular basis), developed problems. I got everyone to start salting their food more than usual, and, asked the chef's to provide us with bananas. The loss of potassium, and lowered potassium levels in the blood, and ultimately the muscles, also commonly occurs in these situations. This is why I suggest, in the Survival rules, that people bring powdered Gatorade with them to Shaolin. Or, make sure that you get enough salt and potassium in your diets.
                Experienced Community organizer. Yeah, let's choose him to run the free world. It will be historic. What could possibly go wrong...

                "You're just a jaded cynical mother****er...." Jeffpeg

                (more comments in my User Profile)
                russbo.com


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                • #9
                  doc has saved the day... again
                  "Life is a run. In attack we run, in defense we run. When you can no longer run, time to die" - Shichiroji "Seven samurai"

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