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

Russell Greene 02-26-2014 01:03 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Sorry, the ignominious 2007 "Manufactured arguments" letter was by Bob, not Billy, Murray.

Mark Lamoree 02-26-2014 01:11 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
This is an interesting discussion, although I must admit that I don't feel educated enough to comment. The first question that came to mind for me is, "How does consuming gatorade, which should at least be isotonic, if not hypertonic, lead to sodium loss?" I presume that the excretion of excess fluid pushes out more salt than is being taken in, but I'm not sure what the mechanism would be.

Given that, I'd like to educate myself with a copy of the book, if any are available. Please and thank you.

[COLOR="Blue"][I]on the list - Lynne[/I][/COLOR]

Brian Chontosh 02-26-2014 01:37 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Gatorade is 'hypo' tonic. More so than a standard IV; which itself is an issue when treating EAH and EAHE.

This simple confusion right here is what has masses of athletes so easily confused. It really falls right into the strategy of the sports drink industry.

For a solution to be 'hyper' tonic it would be beyond tolerable taste thresholds. Thus necessitating intravenous administration.

Christopher Morris 02-26-2014 01:41 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Perfect! I've glanced over these links, and there will be some interesting discussion points, for sure.

I'm going to do some reading...

Mark Lamoree 02-26-2014 01:43 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
[QUOTE=brian chontosh;1221227]Gatorade is 'hypo' tonic. More so than a standard IV; which itself is an issue when treating EAH and EAHE.

This simple confusion right here is what has masses of athletes so easily confused. It really falls right into the strategy of the sports drink industry.

For a solution to be 'hyper' tonic it would be beyond tolerable taste thresholds. Thus necessitating intravenous administration.[/QUOTE]

That makes sense. I've tasted isotonic 0.9% NS IV fluid (I'm a curious guy), and found it way too salty. I presumed that the boatload of sugar in Gatorade was meant to cover that taste.
Thanks for the info.

Russell Greene 02-26-2014 01:51 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
[QUOTE=Mark Lamoree;1221222]This is an interesting discussion, although I must admit that I don't feel educated enough to comment. The first question that came to mind for me is, "How does consuming gatorade, which should at least be isotonic, if not hypertonic, lead to sodium loss?" I presume that the excretion of excess fluid pushes out more salt than is being taken in, but I'm not sure what the mechanism would be.

Given that, I'd like to educate myself with a copy of the book, if any are available. Please and thank you.[/QUOTE]

Gatorade is hypotonic.

As Gatorade's Bob Murray has said, "overdrinking is the root cause of most cases of exercise‐associated hyponatraemia." Source (w/f safe) [url]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658914/[/url]

Overdrinking of both Gatorade and water can dilute blood sodium levels below 135mmol/L, causing hyponatremia and possibly killing the athlete.

For example, excessive Gatorade consumption killed Cynthia Lucero. Source: [url]http://www.apnewsarchive.com/2002/Fluid-Cited-in-Marathoner-s-Death/id-424edce6ed89d8adcb14d4d97c0448a3[/url] (w/f safe)

Greg Whitekettle 02-26-2014 03:54 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
This is a really interesting thread / topic. I would love to get a copy of Waterlogged if there are any still available.

Thank you!

[COLOR="Blue"][I]on the list - Lynne[/I][/COLOR]

Alden Hingle 02-26-2014 07:24 PM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
I've been following this thread with great interest and remembered today that we lost a Marine at Quantico to overhydration in 2001. I looked it up and learned that three service members are among the documented deaths. An Air Force member in 1999, a Soldier in 2000 and the Marine in 2001. The deaths were documented in "Military Medicine" 2002; 167: 432-434.

Christopher E Bloom 02-27-2014 12:47 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
[QUOTE=Russell Greene;1221182]Here are some sources that may enlighten the debate.[/QUOTE]

Russell,
Thanks for the great references. I'm in a Graduate Sport and Health Science program and this is some excellent discussion material for my class!!! I'm sure this will prompt some enlightening conversations among my classmates!

-Chris

Andy Shirley 02-27-2014 02:15 AM

Re: Exercise Associated Hyponatremic Encephalopathy, Gatorade and the ACSM
 
Gatorade is pretty isotonic. So is 5%dextrose in water, with absolutely no sodium at all. The relative amounts of sodium are what are relevant for cerebral edema(hyponatremic encephalopathy), which is why in my earlier post I said we consider Gatorade to be roughly equal to water in our patients on fluid and free water restrictions.

Hypertonic fluids are pretty foul, but not that bad. I've tasted 3% saline and 23% hypertonic saline(normal saline is 0.9%). Hypertonic solutions also cause terrible diarhea when consumed PO(by mouth) from the osmotic gradient, which is one reason why they are given IV.

Normal saline is slightly higher than serum sodium at 154meq/liter, compared to normal serum sodium of 135-145.

[QUOTE=brian chontosh;1221227]Gatorade is 'hypo' tonic. More so than a standard IV; which itself is an issue when treating EAH and EAHE.

This simple confusion right here is what has masses of athletes so easily confused. It really falls right into the strategy of the sports drink industry.

For a solution to be 'hyper' tonic it would be beyond tolerable taste thresholds. Thus necessitating intravenous administration.[/QUOTE]


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