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-   -   Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM (https://board.crossfit.com/showthread.php?t=86218)

Roy Anger 03-25-2014 07:03 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
[QUOTE=Lynne Pitts;1220322]To "sweeten the pot" :D CrossFit has 500 copies of Noakes' book available to give to interested parties; reply in this thread if you would like one. We'll grab your email from the admin side, so you don't need to post your email publicly, and our team will contact you for the rest of your information.
Requests so far - will keep this updated, so hit me if I miss you.


Kenny Markwardt[/QUOTE]

If there are copies left, I would love to get on the list.

[I][COLOR="RoyalBlue"]You're on the list - Regards,
Lynne[/COLOR][/I]

Russell Greene 03-25-2014 02:08 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Most popular wisdom about hydration is wrong; some is hazardous. Take pee. How many times have you heard that darker urine indicates dehydration, and that clearer urine is a sign of adequate hydration?

This one makes sense, at first. Darker urine levels indicate higher concentrations of urine solutes such as urea, uric acid, and creatinine. They do not, however, necessarily indicate blood solute concentrations. Source (w/f safe): [url]http://www.kickthecan.info/files/documents/Heneghan2012_BMJ_MythbustingSportsProducts.pdf[/url]

Darker, more concentrated urine does not necessarily mean dehydration. And clearer, less concentrated urine does not necessarily mean an athlete is hydrated . The British Medical Journal notes that, "vitamins and medicines interfere with the results by making urine darker, variations in diet and dietary supplements affect accuracy, and, if large volumes of hypotonic drink are consumed following exercise, copious volumes of dilute urine will be produced before normal hydration is achieved."

So, if you take a multivitamin with a glass of water, you may become more hydrated with darker urine. The most important exception to the urine color test, though, is hyponatremia.

Athletes with SIADH (syndrome of inappropriate antidiuretic hormone secretion), may have high antidiuretic hormone levels even though their blood sodium levels are low. They won't pee much, even though they should.

This means that people with SIADH may have darker urine despite being severely over-hydrated and suffering from hyponatremia. If they drink more because of their darker urine, they will worsen their hyponatremia and put themselves at risk for hyponatremic encephalopathy.

In Waterlogged, Noakes explains that "because they have SIADH, athletes with EAH typically excrete concentrated urine even though they are severely overhydrated with blood osmolalities that are greatly reduced (and should be excreting very dilute urine)."

(I don't have my hard copy at hand, so please excuse my lack of page number).

So, what to do? I think Tim Noakes' advice is the best: "You lose water, you get thirsty, you drink. End of story."

No need to stare at urine - unless you're into that sort of thing.

Robert D Taylor Jr 03-25-2014 05:06 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
The difference in color from vitamin pee and "dehydrated" pee is clear.
I wouldn't call the urine color thing an exact measurement, more of a general guide.

I concur with the drink if you're thirsty thing, generally.

Thank you for the book. I look forward to reading it.

Russell Greene 03-26-2014 09:41 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Robert,
I didn't realize that about vitamin pee. It doesn't affect the main point about urine color, though. Of what value is a "guide" that works in reverse when it matters most?

The urine color guide does not work for people at risk for low blood sodium, i.e. those with SIADH. This is a significant portion of the exercising population - it could be around 13%.

Source (w/f safe):
[url]http://www.nejm.org/doi/full/10.1056/NEJMoa043901#t=articleMethods[/url]

I'm looking forward to hearing your thoughts on the book.

[QUOTE=Robert D Taylor Jr;1225569]The difference in color from vitamin pee and "dehydrated" pee is clear.
I wouldn't call the urine color thing an exact measurement, more of a general guide.

I concur with the drink if you're thirsty thing, generally.

Thank you for the book. I look forward to reading it.[/QUOTE]

Robert D Taylor Jr 03-26-2014 06:18 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Guides are useful if they are kept in context. There are many reasons for urine color hydration being one of them. These guides are useful in like a military gym where folks often believe hoo-yah surpasses hydration. I have genuinely seen people genuinely not know they were thirsty, and it's easy to get too busy while working etc. to drink enough water on say a flight deck. Checking their pee is a good reminder and indicator to drink. I know that overlooks more serious conditions, but the guide is for horses not zebras.

Excellent hydration never helped my work or fitness performance, but dehydration certainly hurt it.

Matt Solomon 03-27-2014 05:05 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Hey Lynne,
any copies of the book still available?

Many thanks

[I][COLOR="RoyalBlue"]You're on the list - Regards,
Lynne[/COLOR][/I]

Kevin Keast 03-29-2014 05:04 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
I got my book in the mail today, thanks!

Craig Copeland 04-04-2014 06:49 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
If there are any copies of "Waterlogged" still available, I would greatly appreciate a copy. Thanks to all who have posted info, guidance, science, links, and comments here.

[I][COLOR="RoyalBlue"]You're on the list - Regards,
Lynne[/COLOR][/I]

Alden Hingle 04-06-2014 12:30 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
I am really enjoying the book. Good science presented in an easily understandable manner. Thanks again for providing these to us!

Phil Washlow 04-08-2014 11:56 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Lynne if there are copies of the book left I would love one, thanks!

[I][COLOR="RoyalBlue"]You're on the list - Regards,
Lynne[/COLOR][/I]


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