My impression is that the salty sweater concept came from 1 of 2 places, maybe both:
1. From the people in Florida that invented gatorade for the football team that couldn't handle the heat
2. From the people who made actual sweaters.

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Take a short break from ST and read my blog:
http://tri-banter.blogspot.com/

I've never heard the term "salty sweater" before. It's not a very good name for the myth, because that part's not a myth. There's salt in sweat, and people sweat. Sometimes a lot.


I think the myth part may have more to do with the benefits of ingestion rather than loss through sweating?


Jonathan Toker, way back in 2009, did a good article on salt excretion, supplementation, etc.

I don't get what you are trying say. Are you agreeing that people aren't salty sweaters? Or are you saying that people are? Because I'm sweating right now and it is salty.

I'm not familiar with this term for a myth, but I do think people are too sensitive about salt and electrolyte intake. If someone wants to take a salt pill during long distance events that is fine, but the research is a tad dodgy about whether it really makes any difference. I rarely experience cramping (and when I do it is under conditions where nothing could prevent it) so I sympathize a bit with wanting to find something that works.

Also, I find the whole term "nutrition" to be absurd. Can we just agree to stop saying it? It is as if suddenly companies took basic carbs & protien, called it something else and then jacked up the price by 50%.

My attempt at understanding the OP:

Fact:

1. Sweat is salty. Sometimes close-to-zero, sometimes 50/50 (exaggerating)
2. When exercising, you sweat more.

Consequence of facts:

1. When exercising, you lose salt. (close to zero, or maybe a soup spoon full)

Myth:

1. Because you lose salt, you should supplement with salt.

Reality:

1. Your body is trying to maintain 6% salinity. (or maybe a soup spoon)
2. You're sweating water, so you'll sweat 6% salt.

Consequence of Myth:

0. You believe everything you read in forum.slowtwitch.com.
1. You consume salt when you're already above 6% salinity.
2. Your body sweats even more salt.
3. repeat.
4. eventually: your muscles stop being able to access water.

Consequence of Reality:

1. When you consume excess water, your sweat could be below 6% salinity. ('coz your body is trying to remove water)

All of this is to try and make sense of the OP. (I do believe triathletes consume too much salt in general, but that's a generalization.)

You are right for the most part but the amount of sodium lost varies from individual to individual (normal range is 500mg/L to 2g/L of sodium loss). I tend to be in the 1-1.25g/L range based on testing with a Sweat Analyzer and don't consume much salt in my normal diet so I do supplement otherwise my sodium levels will get low but it is different for everyone.

I do think people are sold the idea that you need to salt load or you're going to cramp or whatever the marketer determines will happen if you don't.

In reality you need to test things out for yourself and find out what works.

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Rodney
TrainingPeaks | Altra Running | RAD Roller
http://www.goinglong.ca

It's because people are looking for any answer to why they are performing poorly other than their own pacing and training mistakes.

The anecdotal evidence provided by others and the occasional positive experience with salt tablets is good enough for them.

While some electrolytes are necessary, more isn't always better and can lead to dumping of that extra salt so commonly found on their clothes.

I live in Tucson. Most of my running is done in the afternoons, early evenings, and mid-mornings. It is my belief that a body looses more than 1.25 gallon of water during the course of a 20 mile run on a 100 degree day. And that that water needs to be replaced. It was also my belief that replacing large amounts of water without replacing electrolites could lead to hyponatria.

Are we arguing that all salts (ie. Potassium, Magnesium, Zinc salts) are unnecessary or just sodium salt?
Are we arguing that in most cases "salts" are unnecessary? (Long summer runs in Tucson would be the exception).
I feel that potassium does work to reduce cramping and that drinking water with electrolite pills also make me feel less ill during long runs. "Feelings" can be misleading though.

Interesting study, but it's one study and the temperature during the study was cool. Additional studies would be needed to make the broad recommendation you're making. In addition hyponatraemia is a serious complication that can easily result in death and the time you are most likely to miss or ignore the warning signs are the final miles of an Ironman. IMO it is far safer for athletes to take in too much sodium than risk hyponatraemia. The statement "almost impossible" casually dismisses the very real threat under the guise that every westerner consumes enough sodium to survive 12 hours of vigorous exercise.

My n=1 is that during cooler weather and shorter duration training/races (under 3 hours) additional sodium is not needed. When temperatures and duration increase in the summer I need sodium, some of the reason is I lose desire to take in anything even slightly sweet (and thus stop consuming calories) and the other is I will (and have) started experiencing the first signs of hyponatraemia. I don't add sodium to my food so I think my sodium intake is lower than most westerners.

The study you quote has major design flaws and no conclusions can be drawn from it.

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Two wheels good. Four wheels bad.

Read Waterlogged by Tim Noakes.

All of those athletes appear to have supplemented their sodium intake. The placebo group just didn't do it in tablet form. You may or may not need to take salt tabs, this study does not answer that question.

"Fact is, the salty sweater is the person who has more than enough sodium. His sweat is salty because his body is dumping surplus sodium in his sweat."

This is your myth. The kidneys do a much better job of keeping electrolyte balance than your sweat glands.

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I'm beginning to think that we are much more fucked than I thought.

It is no myth, the sweat glands restrict sodium output as sodium is depleted. The rate of sweat is retained but the sodium content is reduced.

The kidneys do most of the job, but humans evolved so as not to sweat out sodium when levels get low.

Now that is a myth, if it were true Hyponatremia wouldn't be an issue but it is and can be deadly. When sodium levels get low your metabolism will adjust in an effort to not fully deplete itself but you will continue to lose sodium until your body shuts down and you end up in a coma or dead.

There is some good information here on sodium loss and hydration and you can see based on your sweat rate that the amount of sodium you lose can vary wildly from individual to individual.

http://fellrnr.com/wiki/Hydration_101


If you know your sweat rate you can get a pretty good approximation by entering your height and weight here and lining it up with your sweat rate. http://fellrnr.com/wiki/Sodium_Loss

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Rodney
TrainingPeaks | Altra Running | RAD Roller
http://www.goinglong.ca

"The kidneys do most of the job, but humans evolved so as not to sweat out sodium when levels get low."

But this is the inverse of what he is saying. He is saying that people who have excess salt have extra salty sweat. The kidneys are where the vast majority of this work is being done. Otherwise people who ate a lot of salt would die unless they worked up a sweat on a regular basis.

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I'm beginning to think that we are much more fucked than I thought.

That only happens if you drink too much water.

Hyponatremia only happens when you drink too much water? So now you are saying you need to consume sodium?

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Rodney
TrainingPeaks | Altra Running | RAD Roller
http://www.goinglong.ca

Maybe the comparison between electrolite products and sports nutrition products is valid. Both have a legitimate (but specific and unusual) "need" that they fulfill. Both are grossly oversold for extremely broad purposes. Racing an Ironman, or doing a 3 hour run in 100+ degree heat, ARE not the same thing as completing a 10k on a spring day.

No, I'm saying don't drink too much water even if the water contains sodium.

All this is in Waterlogged by Tim Noakes.

Oh you read a book :)

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Rodney
TrainingPeaks | Altra Running | RAD Roller
http://www.goinglong.ca

just curious, but is there really solid hard data on how much sodium one really needs?

For my n=1 I am on an extremely extremely low sodium diet (500mg/day usually), and I bike commute 2-2.5 hours every day, which of course implies quite a bit of sweating, especially in the summer, but I have had no adverse effects or felt really that much change compared to when I was eating a 'standard diet' in terms of sodium (which for sure was at least 2500mg/day, given how foods are nowadays) not to mention that of course just being a commute I am not drinking any fluids during it at all: it just seems interesting that I am eating easily 5-6x less sodium than before and haven't noticed much change at all in how I feel, so it makes me wonder how much sodium we really need during exercise.

+1

By western world, I suspect you mean USA?

I live in the Western World too, but outside the US.

I am a salty sweater. I eat almost exclusively home made meals from scratch. I don't add much if any salt to my food (during cooking or afterwards). I'm not a salt fan. I prefer subtle natural tasting food (chocolate excepted).

I'm on some heart and BP meds. Unlike beta blockers, mine (Cozaar/Losarten) actually strip salt out of my system. I have to be very careful to make sure I get enough salt in my diet.

While I agree with the general sentiment of your post, I think A) you need to realize the western world is more than just one country B) your sample set of N=1 can lead to increasing inaccuracy with extended extrapolation past N=1.

In general, generalizations are generally accurate, but........... :-)

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TriDork

"Happiness is a myth. All you can hope for is to get laid once in a while, drunk once in a while and to eat chocolate every day"

http://hwcdn.libsyn.com/...c8e1f76fe308b99f76e5

why are we talking about this study for 8 years ago? However, I agree that whether to use sodium pills and how much if you do are both interesting an controversial topics.

I think it more complicated than one study from 2006. Just a quick pubmed search shows this trial (http://www.ncbi.nlm.nih.gov/pubmed/23253191) where sodium + water was better than water alone on cycling performance in hot conditions . But
when a different group studied cycling in cool conditions (http://www.ncbi.nlm.nih.gov/pubmed/23731903) they found no effect of added sodium.

I agree 100% that our homeostatic mechanisms maintain serum sodium very well and that excretion of sodium is well controlled. But you have to factor in performance, since that's what (most) of us are interested in. I could spin the data differently. In some individuals, sodium supplementation forces a higher sweat rate and encourages more ad lib water drinking. During the race they consume more water and sodium, but also excrete more of each. At the end of the race their serum sodium , body wt, etc are unchanged. Then the question is did the higher sodium and water consumption and excretion lead to better performance in the athlete?

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Brian
“Eat and Drink, spin the legs and you’re going to effin push (today).” A Howe

"The sports drink industry has staked its claims on the principles of salt deficiency, proclaiming that the sodium consumed in a person's general diet is not enough and that sodium supplementation, via electrolyte containing sports drinks can prevent muscle cramps, heat illness, and sodium deficiency during long duration exercise. These claims ignore the body's exquisite regulations of sodium concentration and a wealth of research on the subject."

Dr Tim Noakes - Waterlogged.

Salty sweaters are people who have an excess of sodium which they excrete from the body via urine and sweat. Salty sweaters are the last people who need to supplement sodium intake.

Interesting reading.

http://www.ncbi.nlm.nih.gov/...articles/PMC2658915/

Cherry pick more.

X2, most Americans don't need to add salt to their diet....that include try-athletes.

I away laugh at the salt stain shorts at every event. Yea, you need more salt dude. Maybe, just maybe if you had less salt you wouldn't be all bloated and round and could run....or is it swim, bike, walk?

He doth protest too much methinks.


http://www.irunfar.com/...shattering-book.html

Dogma: Heavy sodium concentrations in sweat � evidenced by salt-staining on skin and clothing � identifies a person as a �salty sweater�, and that these people need even more sodium supplementation.
Science: The self-regulation of sodium concentration results in sodium excesses being secreted; salty secretions will cease when sodium balance is achieved.

I notice when I'm bloated and salt overloaded my sweat is super salty and I agree that everyone in the Western World eats more than enough salt

Several correct things have been said in this thread: we sweat salt, the western diet is high in salt, and short duration exercise generally does not need salt supplementation.


However, I went to Pubmed and read a few of Noakes' papers and none of them seem to recommend NOT taking in salt for hot and/or ultra distance races. In one paper, he suggests that the 5 hyponatremic athletes in his study at IMNZ were overhydrated. (Makes sense...it's probably very difficult to be hyponatremic and dehydrated). All of those athletes had also been drinking sports drinks in addition to water, so they were still taking in salt--just not enough compared to their fluid intake. There are 2 solutions to this problem: 1) drink less and 2) take in more salt. Option 1 may lead to dehydration if it's overdone. If option 2 is overdone, it won't have nearly the negative effect on performance and short term health than if too little salt is consumed. What's the better suggestion, then?

Take an athlete like me who can't seem to tolerate sports drinks during exercise, and where am I supposed to get that sodium, potassium, etc.? If I'm sweating, I'm losing fluids. Therefore, I need to replenish those fluids. During a race like IMTX, if I replenish solely with water and don't eat anything containing sodium, I will no doubt be hyponatremic by the end of the race.

"The body regulates itself" is certainly true as a general rule. However, at some point at which it no longer has the resources to operate within normal bounds, "regulation" means shutting down processes and transferring resources to other areas in order to survive. I would think that would have a negative effect on triathlon performance...

If you look at Noakes recommendations, they really aren't far out of line with normal recommendations. Yes, I do not believe it carrying a gallon jug with you at all times, but there is a bit of a straw-man here.

Remember that Noakes is looking for money just like everyone else. He has a book that needs to sell. He has research that needs to be funded.

---

I talk a lot - Give it a listen: http://www.fasttalklabs.com/category/fast-talk
I also give Training Advice via http://www.ForeverEndurance.com

The above poster has eschewed traditional employment and is currently undertaking the ill-conceived task of launching his own hardgoods company. Statements are not made on behalf of nor reflective of anything in any manner... unless they're good, then they count.
http://www.AGNCYINNOVATION.com

 Noakes argues the sodium content of drinks makes little difference but that it is the amount you drink that matters.

Drink too much and sodium levels drop. He advises drinking to thirst.

http://sweatscience.com/...-noakes-vs-gatorade/

The original article that was posted advises against SUPPLEMENTAL sodium intake during a race, meaning above and beyond what those athletes were already accustomed to taking in from food and sports drinks. I would imagine that, if you took a bunch of athletes who had spend a good portion of time training for an Ironman and who had their nutrition and hydration needs pretty much dialed in and then you gave them something extra on race day, there'd be a good chance that the study would show that the extra bit is unnecessary.
That "body regulates itself" thing mentioned earlier does apply to the fact that the body tends to crave what it needs. If I'm craving Fritos during a ride, I know I need more salt. If I'm craving chocolate...more sugar. I would guess that the athletes who got supplemental salt didn't crave it as much and therefore wouldn't be inclined to get it elsewhere, leading to the similarity in serum sodium concentration between groups after the race. The variability of temperature, wind, and other conditions on race day and during training forces athletes to listen to their bodies, so it wouldn't be an outrageous assumption that these athletes compensated for the supplements in some way.

Noakes recommend "To thirst". When individuals drink ad libitum they tend to consume 10-30ml / hr depending on individual variance, conditions, intensity etc.
ACSM recommendation is 20 to 40ml / hr. Really not a revolutionary difference for Noakes. Although, he is correct that you do not need to carry gallons of water with you at a time.

"need" and "optimal" are very different things.
Your body couldn't care less if you run that 5k 10 seconds faster. It wants to avoid dying.
There is plenty of research out there indicating that just relying on our cravings is not enough and leads us to sub-optimal consumption. Both in terms of choices and amounts of food and drink.
We can never feel hungry, yet swishing carbohydrate in our mouth and spitting it out improves performance. Did we have to consume? Nope. Did we even need to ingest? Nope.

But that doesn't mean we can't optimize what we do.

Adam St. Pierre previous wrote a blog post about Waterlogged.
http://www.bcsm.org/a-review-of-waterlogged-author-tim-noakes/

---

I talk a lot - Give it a listen: http://www.fasttalklabs.com/category/fast-talk
I also give Training Advice via http://www.ForeverEndurance.com

The above poster has eschewed traditional employment and is currently undertaking the ill-conceived task of launching his own hardgoods company. Statements are not made on behalf of nor reflective of anything in any manner... unless they're good, then they count.
http://www.AGNCYINNOVATION.com

First off, are you Noakes? I just want to understand since it's not clear and you have posted his information many times. Almost seems like a sales pitch.

Secondly, if you drink to thirst, it's too late, unless you are really slow at the event/effort. If I wait until I'm thirsty, I'm screwed. Period.

I have encountered the situation where I drank too much water leading to a 70.3 race without supplementing electrolytes. I got to into a hyponatremic state (or at least darn near it). Ended up in the med tent for over an hour. My caretakers even brought over the rookie caretakers to see what could happen to people when they were severely undernourished.


I received fantastic care (Racine 70.3) and 6 weeks later fixed my nutrition/hydration issues at IMKY when the temps were 92 during the run. I modified my full IM race based on what happened in Racine and I know it helped in IMKY.


Believe what you want but some of us have our own physical experiences to confirm the science.

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Loud pawls save lives

While this is true, there is no denying that Noakes' research is first and foremost that of a respected scientists, and his work is peer-reviewed. It is definitely NOT true to group his research with the hordes of pseudoscience claims out there that actually are motivated primarily by money, but have thin to no science to back it up.

Noakes' research is solid, and he has created a solid body of knowledge that has been extensively analyzed. It's not perfect, and no there's no single study that in itself tells it all, but it is cumulatively solid work.

This is actually the real problem with the internet. People get so jaded and misguided that they stop believing even the real scientists when they have good claims backed by good, published, peer reviewed data.

No I'm not Noakes.

Here is a rather long post he made on this forum some years ago. I quote him because I remember the years before energy drinks. No one had any problems, people drank when thirsty, just plain water worked fine.


""
Tim Noakes

Apr 21, 09 23:42

Post #6 of 231 (11948 views)
Re: Tim Noakes: we need you back for a moment [Slowman] [In reply to] Quote | Reply
Basic Physiology 1.

The textbooks say that sodium is the principal electrolyte in the extracellular fluid (ECF) which is a volume of 10-14 L depending on body mass. There is apparently little sodium inside cells. The measured concentration inside cells is about 5mmol/L versus 140mmol/L in the ECF. Indeed 40% of the energy we expend at rest is spent on pumping sodium to the outside of our cells. The amount of sodium in the ECF determines the ECF volume. This is because the body homeostatically regulates the osmolality of the body fluids so that there is a constant osmolality which produces a blood sodium concentration of about 140mmol/L in an ECF volume of 10-14 L. What the usual textbooks do not say is that whilst this relationship can well explain the ECF osmolality, it cannot explain the whole body osmolality. Thus in 1957 Edelman discovered that to explain the osmolality of the total body water (TBW - a volume of 35-42 L) there has to be substantially more sodium in the body than that measured in the ECF. But where is it since we �know� it is not in the cells (which are actively pumping sodium from the cells into the ECF to insure that the measureable intracellular sodium (Na+) concentration is very low)? Edelman used a radioactive sodium tracer and showed that the �sodium space� into which the tracer dilutes is much greater than the ECF sodium �space�. He called this new, previously undiscovered amount of sodium the �exchangeable sodium�. It constitutes about 50% more sodium than that present only in the ECF.

The next interesting observation is that in the 1950�s McCance produced a true state of sodium deficiency in humans. To my knowledge this is the only study in the published literature showing that a true sodium deficit can be produced in humans under experimental conditions. He had to go to inordinate lengths to achieve this. Three of the four subjects for his study had to live in his house whilst Mrs McCance fed them a sodium-free diet. Each day they sat in a hot room which produced prodigious sweating for 2 hours a day. By the fifth day they began to show evidence for a salt deficiency. The fourth subject a medical student at Oxford, a Miss Edwards, chose not to live in the McCance residence. A state of sodium deficiency could not be produced in her. Probably she was sneaking some extra salt in her diet.

The evidence for the salt deficiency was a set of symptoms that the subjects developed � absolute lethargy was a key factor � and a fall in blood sodium concentrations (hyponatremia). But the interesting observation was that to recover, the subjects needed to ingest far more sodium than the amount that would have been predicted on the grounds of the fall in their blood (and ECF) sodium concentrations. Thus it were as if something was preventing the fall in ECF sodium concentrations which should have fallen to much lower values based on how much salt the subjects had lost in their urine and sweat during the experiment. It were as if there was a store of sodium that had been called upon to maintain the ECF sodium at a higher concentration than in should have been if all the sodium in the body was only in the the ECF.

(For the purposes of this discussion we can ignore the fact that in the first few days of the experiment the blood sodium concentration was protected by the usual contraction of the ECF that occurs whenever there is an acute sodium loss from the ECF. But after day 4 the ECF began to expand despite an ongoing whole body sodium loss. This caused the blood sodium concentration to fall more sharply thereafter).

More recently there has been increased interest in this �hidden� sodium store. Balance studies of humans fed a very high salt diet showed that they were storing sodium in a site other than the ECF. Thus they did not simply excrete (in urine and sweat) the excess sodium in the diet; nor was it stored in the ECF causing an expansion of the ECF. It had gone somewhere else.

The authors proposed that the extra sodium is stored in the body in an �osmotically-inactive but exchangeable� form (Na) in which it is not measureable as ionic sodium (Na+) but where its presence can be detected by radioactive dilution techniques of the type undertaken by Edelman.

According to this theory there is a store of osmotically-inactive sodium (Na) in the body which can produce osmotically-active sodium (Na+) when it is required. Alternatively when the ECF Na+ concentration rises too high, there can theoretically be osmotic-inactivation of circulating Na+ which is then stored inside cells in the osmotically-inactive form (Na) to be returned to the ECF when it is required.

There are a number of modern observations that support McCance and Edelman�s findings that there must be more sodium in the body than is accounted for by the measured Na+ in the ECF.

For example, if subjects ingest less sodium and water than they lose in sweat during exercise, their blood sodium concentrations ALWAYS rise. This of course is not a fact that the sports drink industry wants you to know. Instead over the past 15 years that industry and its funded scientists have consistently argued that if you don�t replace all the sodium and water that you lose during exercise you will develop exercise-associated hyponatremia (EAH) (which can therefore only be prevented by ingesting a sports drink containing sodium (at low concentrations)). But this is simply not true. The blood sodium concentration ALWAYS rises under these conditions because sweat contains less sodium than does blood (and as I hope we will discuss in due course can contain essentially NO sodium in people living on a very low salt diet) so that more water is lost that salt. As a result the ECF contracts causing the blood sodium concentration to rise. Of course in a perfectly homeostatically regulated system this rise should not be more than a few mmoles/L but in some athletes in competition it can be up to 10-12mmol/L which is surprising and presently unexplained (although it might be explained by individual differences in the ability to osmotically-inactivate ECF Na+ as discussed below).

However we have shown that the change in blood sodium concentrations during exercise is highly individualized and cannot (probably) be explained purely by sodium losses in sweat and urine and changes in the ECF volume. Rather in our paper published in the Proceedings of the National Academy of Sciences in 2005 (and available for free from their website) we proposed that some of this variation must be explained by individual differences in the movement of sodium between the osmotically-active and inactive stores during and after exercise.

Interestingly the ability to deactivate Na+ during prolonged exercise and store it would delay the onset of thirst (which is stimulated by a rising ECF sodium concentration). Thus the presence of this store could have been a way in which our hominin ancestors were able to delay their thirst during long, hot, water-less hunts (see the thread on Why cannot scientists ever agree on anything?).

A tragic case supports this contention that there must be this internal sodium store. When Cynthia Lucero died after the 2002 Boston marathon because she had drunk too much of a sports drink (and retained that fluid excess within her body because she was also excreting too much anti-diuretic hormone � ADH), our calculations show that she simply could not have drunk sufficient to drop her blood sodium concentration as low as the value measured when she was admitted to hospital. Instead something else must have happened and one possibility is that she had also osmotically-inactivated some of her ECF Na+ at the same time transporting it into her cells causing her hyponatremia to be exacerbated. When we performed calculations on the data of fluid and sodium balance on patients treated by either ourselves or Dr Speedy in New Zealand for EAH, we came to the conclusion that some may have inactivated Na+ during the races in which they developed EAH with subsequent osmotic re-activation during recovery. But since we did not actually measure the process we cannot be sure.

What might this all mean. To return to the evolutionary perspective. It would make sense for humans evolving in a relatively salt-free environment to have an internal sodium store that could be filled in times of plenty and depleted in times of scarcity. Since salt is the most important regulator of the ECF volume and since if we cannot regulate the ECF volume accurately we die very quickly it makes sense to de-link regulation of the ECF volume from the daily sodium intake. How could we have survived if our lives depended on finding just enough salt each day in an environment in which salt was in scarce supply? Those who developed an internal sodium store under these conditions would be the most likely to survive.

If this store exists it might explain, in part, why it is so difficult to cause a true state of sodium deficiency in humans.

But more importantly, how does one measure a state of sodium deficiency in athletic humans? This is important since many contributors to this forum as do you yourself, believe that you develop cramps (or impaired performance) because of a sodium-deficit caused by large sodium losses in sweat. (Note that the model you use to explain this is catastrophic and non-homeostatic. It is based on the belief that the body has no ability to homeostatically regulate its losses and so will just continue to exercise until there is a catastrophic failure of function, in this case muscle cramps. But does it not make more sense to believe that evolution would have weeded out all these obvious system failures so that your problem is not likely caused by a system that is known to be homeostatically regulated and essential for life not just during exercise and the failure of which would have killed you long before you developed muscle cramps? Should we not look elsewhere for a better explanation than in a system that if it did not work perfectly we would not survive? Of course this is not how industry sees it. They want us all to believe that humans are weak and on the verge of a catastrophic biological failure that can only be prevented by the ingestion of their products, be they pharmaceutical products, sports drinks or other nutritional supplements).

The usual way to measure a sodium deficiency is by measuring the blood sodium concentration. But this is not fool proof since we know that the main cause of a low sodium concentration is a large increase in the ECF (and TBW) volume as occurs in EAH. Thus to prove a sodium deficiency you need to measure a low blood sodium concentration WITHOUT any increase in ECF volume. But this would not necessarily tell you what is the state of your internal sodium stores. The problem might be in the ability to activate intracellular osmotically-inactive Na.

But we can prove when a sodium-deficit does NOT explain your symptoms. Thus if you have symptoms and your blood sodium concentration is normal then BY DEFINITION your symptoms cannot be due to a sodium-deficit. Of course this is not something that you will hear from the sports scientists who acts as spokespersons for the sports drink industry. I recall hearing one well know (notorious?) such speaker for the industry say at a meeting in Australia that the presence of muscle cramps proved that the athlete had a sodium deficit even though the blood sodium concentration was normal. Of course this is not what we were taught in medical school. But then why cannot industry develop its own brand of physiology? Especially if it can find sufficient �scientists� to promote this novel brand of knowledge.

So the short answer to your question is the following: What was your blood sodium concentration at the time you developed your muscle cramps? If it was normal then the ingestion of salt either before or during exercise does not cure or prevent the condition by preventing the development of a sodium deficit. Rather it is acting in some other way that we currently do not understand.

That is enough for today. More on anther occasion. ""

http://forum.slowtwitch.com/...r_a_moment_P2297723/


And later in the same thread,

""
Re: Tim Noakes: we need you back for a moment [Tom A.] [In reply to]Quote |Reply

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No. What you are trying to do is to maximize your performance. All the published evidence shows that if you drink to thirst you will maximize that performance. If you want to maintain your ECF volume during exercise you have to drink way beyond thirst and ingest a large amount of salt, much more than is present in sports drinks. So you can't do it by just drinking a sports drink. We showed this years ago - published in the European Journal of Applied Physiology (B. Sanders et al).

So clearly the body does not need to maintain its ECF volume in order to maximize performance. Again the evidence is that the very best athletes are able to sustain large fluid losses during exercise (presumably with quite large drops in ECF volume) without any apparent impact on their performances.

More later.

"""

Uhhh, I think you explained your own mistakes above.

You can slightly lead thirst, but it is a grave error to drink by plan only and ignore thirst.

If you drank enough to actually get hyponatremic, you clearly GROSSLY ignored your thirst. This cannot happen by accident. The only way you get hyponatremic with normal kidneys is to ingest free water wayyyy over what your thirst mechanism tells you. If it were so easy to do this, the human race would have died off eons ago, since sodium balance is so crucial for metabolic functions in cells.

The thirst mechanism is one of the most powerful, crucial evolutionary traits we have. It is so accurate that it rehydrates your fluid levels down to the 1cc level reliably (we've tested this in class - people who are hydrated will drink exactly enough, and once fully hydrated, will pee out EXACTLY the extra fluid they've taken in, down to the 1cc, It's amazing, actually.)

Doing hard effort endurance sports in hot weather may allow for slight leading of the thirst (drinking early), but you clearly missed the boat on that if you drank so much you were actually hyponatremic. (Make sure you know you actually WERE hyponatremic before saying you were - that typically requires a blood electrolyte check - it's definitely not the same as just saying 'based on how I felt I know I was hyponatremic', since there are so many other factors that can land you in the med tent for an hour that are NOT hyponatremia.)

Actually when it comes to biking my body must want me to stop because it tricks me into not wanting to eat..... and the more bonky I get the harder it is for me to take food in. I have to make a concerted effort on longer rides early on to take calories in despite what my body is "telling" me.

There is regular conflation of ad libitum and to thirst. Gebreselaisse has been quoted as drinking around 2litres in the Berlin marathon (I'm guessing not particularly hot . . .) which I would imagine is part of his plan rather than spontaneous reaction to thirst, being close to gastric intolerance levels.
Noakes makes the point that sodium replenishment into the bloodstream is not a quick process, so if you are sweating lots of salt and replacing with liquid which even if laden with salts do not make it into the bloodstream quickly, you can induce hyponatremia. But that rather screws OP's viewpoint, as a salty sweater should react by sweating far less salt, no?

There is a difference between responding to thirst and "optimal" fluid intake, and a huge gulf between optimal and the sort of consumption that leads to hyponatremia. As such I find the panic and alarm unnecessary. I find the dismissal of undereplenishment as a compounding factor in some exercise deaths rather trite. In wintry conditions the elderly death rate increases - the deaths are rarely actually hypothermia, but it is to do with it being cold.

I assume the carbo-gargling works (but presumably not for ever . . .) because if the body is in "limitation" mode due to low reserves and the mouth receptors indicate (wrongly if you spit not swallow) that reinforcements are on their way, then the limitation is perceived as no longer necessary. A bit like driving on a near-empty fuel tank with no idea where the next fuel station is - you probably ease up a bit to reduce the chance of running dry, but as soon as you seen a sign saying "Gas 5 Miles" you know you can make it comfortably and press the pedal further.

I disagree with the above.

Thirst is EXTREMELY powerful and EXTREMELY accurate. It is required for human survival, as in the absence of water, humans will quickly die. We are constantly losing water respiring, and the thirst mechanism must be extremely powerful and accurate to keep our bodies in check.

People like to use 'reason' here and say that because there's a variation in how much people ingest, that thirst isn't so vital. Sorry, but it is. Yes, people drink variably, but their sodium levels are held in a VERY tight range. You have to really forcefully fight thirst (either over/underdrinking) to derange your sodium, as the thirst reflex is so powerful.

If confronted with your hydration plan vs thirst, ALWAYS go with thirst. A hydration plan is helpful in making sure you have enough ACCESS to fluids so you don't get overly thirsty, but drinking over thirst is rarely helpful. Again, I'm not saying you have to wait until you're parched, but if you have no desire to drink, but your plan says 'drink every X minutes', you should probably defer the drinking.

I thought Noakes was arguing the complete opposite - African hunters who go on "arduous" hunts (averaging 5-6mph or so) in the extreme heat of the day were capable of surviving with huge fluid loss until they eventually found a watering hole. In reality man's ability to cope with heat and dehydration is less impaired than that of the chosen prey, which somewhat undermines the "exquisite adaptation" type of soundbites.
Any simple control system has to find an optimal compromise between accuracy and stability. To draw an analogy with heart rate, you need the lag in response because otherwise the system would swing wildly and uncontrollably. Tiniest amount of oxygen debt, straight up to MHR. Back to full saturation, HR -> 0. Not a good idea.

The African hunters were not severely dehydrated despite the heat and length of the hunt. Probably to a similar extent as a person after a vigorous long workout.

But even those African hunters would have to pay close attention to thirst - even they would die if they ignored their thirst, and went chasing their prey at high speeds for hours across 90+F temps. Their slow hunt speeds help with slowing fluid losses as well, allowing them to go longer.

I guarantee that even if we took those very same 'uber-hunter' Africans, and used IV fluids to change their sodium from 140 to, say, 120 or 160 in a short period of time, they'd be just as delirious as if we did it to you. The difference is that due to their techniques, fitness, and planning, they can slow the metabolic derangements compared to someone like us who is not trained/experienced in hunting on their plains.

THIS. It took me two trips to the emergency room and two trips to med tents to figure my needs out, once in training and three in Ironman events. If I drink enough to ward off dehydration, even straight sports drinks, and don't supplement sodium during long activity, I go hyponatremic. I feels AWFUL and is dangerous.

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"I can eat 21 plus a deep-fried turkey!"

I'm not sure how the problem happened. It had never happened before and hasn't happened since. I've done several long events, including several 70.3s. This particular one was a few weeks before my first full IM so I was really trying to dial in my hydration plan. I live in the south and am a heavy sweater and during hot and humid times a very salty sweater. I like working in the heat and had trained in it so it wasn't as if I wasn't prepared for high temps and humidity.

I normally don't take in enough fluids, so the days leading up to the race and especially the day before I really drank a lot of water. I thought with my normal diet I wouldn't need to be consuming extra electrolytes. The day before the race I probably peed a dozen times or more and the color was clear. I thought that was a good sign but clearly I did something wrong, because I started cramping during the bike. Even my arms, shoulders and neck were cramping, in addition to my quads and calves. When I got off the bike I couldn't move. Literally. I had to stand there for a few seconds before I could take a step. It was one of the most painful experiences I've ever had - and I have an artificial hip so I know pain.

It's not like I exerted myself harder than before because I didn't. I put way more effort into the bike at Kansas and Branson the year before. My training didn't change and my diet didn't change except for drinking more water leading to this race. I took it as a good lesson and made changes for IMKY and had a successful race with zero cramps.

I don't know if I was hyponatremic or even how close I was but my research made it seem possible. I tried to add a qualifier but I guess I shouldn't have mentioned it. Regardless, it was a terrible experience and I'm convinced it was directly related to my hydration leading to the race.

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Loud pawls save lives

 i have read so much about this subject and agree with you on the reading. But on the field, it s a completely different game.

I cant live without having serious cramping/diarrhea issue if i don't supplement with electrolyte in racing. For me, the difference between taking 5-6 pills/h during a ironman and not taking any was a 2:5X marathon and passing everyone or collapsing to a terrible 3:30-45 marathon after a weak bike ride. Same with half ironman.... i would explode 3h into any race without sodium supplement.

Another athlete like me is Jordan Rapp...that is supplementing a lot and it s a difference between a great world class performance or a complete meltdown.

For me, i will also go in training, if i didn't supplement with lots of electrolyte, i would not be able to sustain any decent level of training without been sick or having serious issue.


On the other hand, my training partner for all those years, Sergio marques (2:43 in hawaii) as never show any sign of salt on him after hard session while i would be coated in white. he as never needed supplement and is diet and mine where pretty much the same living together.... training together..been 24/7 together

after working with countless age grouper, some of them improving there performance, becoming stellar runners at ironman distance... i ' m convenience of a few things:


-it s highly individual
-science doesn't understand yet the process of cramping...i don't either
-some people will be coated in salt after session....irregardless of there diet.
-the increase in performance in some athletes is so big with electrolyte supplement that for me, it s a easy recommendation for those people.... I have not seen negative effect so far.
-for those that done need it, taking more dosnt help them

I m not interested in trying to explain the concept, i have no pretension to understand it. I can only reflect what i have seen on the race course.

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Jonathan Caron / Professional Coach / ironman champions / age group world champions
Jonnyo Coaching
Instargram

If you say it this way, I actually doubt that hyponatremia was the sole cause of your problems. In fact, odds are FARRRRR more likely that the overall fatigue (multifactorial, but sheer fatigue being the most likely culprit) was the major factor, and that hyponatremia may have been a total nonissue given that you didn't say you were forcefully drinking against thirst.

Tough race and training days do happen. With certain conditions, you push harder than you're capable of. With Ironman, the intensity is low, so you might not think you're going hard, but in reality, compared to your fitness level for the time and with challenging conditions, you almost certainly went to blow up zone. Once' you're blown, everything can hurt. Even breathing can hurt.

But that does not mean you should invoke hyponatremia as the cause. Hypoonatremia is a real entity in endurance sports, but is still considered a rare event. Like 1 out of thousands, or less.

Ok. Taking hyponatremia purely out of the picture. I was in very good physical shape (for me). This race was a "training" race for me. I wasn't pushing hard at all. I was nowhere near going at a hard race pace. To blow up so early something had to be terribly wrong. It wasn't a matter of hurting. My body literally locked up over and over to the point where I couldn't move. I know you want to dismiss what I'm saying but it's the truth. I had cramps where I had never cramped before and haven't since but I will be sure to never use hyponatremia as a possible cause ever again.

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Loud pawls save lives

If you haven't already read this, it's probably worth reading for those following this thread. It's a discussion with Noakes and the Dr.'s at Ironman Hawaii among others...

https://ce.gssiweb.com/...;level=2&topic=6

"The majority of the hyponatremic athletes at the Ironman are markedly clinically dehydrated, and the mechanism for their hyponatremia would appear to be related to high sodium losses in association with inadequate sodium and fluid intake."

tj

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Badig| Strava

I believe those comments have been updated in the past 2 decades. Not completely revised, but there have been refinements to those claims made since. (Article is from 1993!)

(As an aside, I am aware you know of the bias inherent in the institute, but just to be explicit, I do not consider the Gatorade Sports Institute a legitimate unbiased institution.)

It might be old (1993) but people have been using salt for this purpose since the 1700's, so it's not a new discovery or concept.

Based on my own experiences with hyponatremia and dehydration (and the top docs at kona giving some stats), I think it's dangerous advice to tell someone to drink to thirst with little or no salt for a 90 degree plus Ironman. While GSSI might be biased, most everything in nutrition is. If you want to believe something..anything, you'll find the science to back it up.

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Badig| Strava

The GSI is a much more reliable source than Noakes.

I briefly worked for Pepsi Americas a few years ago (horrific job, but that is a different story). I worked on thee non-carbonated side of the business, so dealt with the Gatorade people a fair bit.

Since they were local, I went to GSSI one day (now renamed, BTW...but I can't remember the new name). Anyway, one thing is for sure....the people at GSSI take sports hydration VERY seriously. There is no hidden agenda, no master capitalistic plan to dupe society that they need sodium, sugars and anything else. Just a bunch of folks trying to make better product / help athletes perform better.

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Chicago Cubs - 2016 WORLD SERIES Champions!!!!

"If ever the time should come, when vain and aspiring men shall possess the highest seats in government, our country will stand in need of its experienced patriots to prevent its ruin." - Samuel Adams

I will still believe less biased sources like the British Medical Journal any day over a Gatorade-sponsored institute.

In 2012 the BMJ published a "scathing investigation" into this whole 'don't trust your thirst' issue. Sure, it's only one point of view of a two-sided debate about corporate funding for research, but I'm going to side with the noncorporate interests on this one.

(Article link here, but layman's summary here)


From the summary:
"

• Undermining the body's signals: Cohen claims that one of the greatest accomplishments of the Gatorade Sports Science Institute, established in 1985, was to convince the public that thirst is an unreliable indicator of dehydration. There is ample evidence of ways in which the experts who propagated this information were funded or "supported" by sports drinks companies, and while this in itself isn't necessarily wrong, she argues that researchers who have conflicts of interest are not objective enough to be writing guidelines, as is the case here. There is no good evidence to support the ideas, for example, that "Without realizing, you may not be drinking enough to restore your fluid balance after working out" (Powerade), or that urine color is a reliable indicator of the body's hydration levels."

I work in the sciences myself, and funding source is THE biggest source of bias. Even if you fully well believe and even go out of your way to do unbiased work, your work must be judged as potentially compromised if a primary funding source is from a direct financial beneficiary of your work. This is why all the leading scientific journals demand full disclosure of funding source and conflicts of interest before publishing. It does not mean all corporate sponsored work is worthless, but it does raise the bar for examination based upon the claims made and the potential commercial impact. Tobacco companies didn't need a hidden agenda in their early research as well - it was enough to put researchers on their payrolls, and that was enough to sway them to conveniently finding avenues of 'productive' research that wouldn't put them out of a job by tanking the industry. In fact, that's one of the best, well known ways to silence a strong critic who could destroy your industry - hire them as a consultant or researcher. You don't even need to tell them what to do or what not to do - just give them their paycheck, and odds are high things will go your way.

Diuretics not only promote water loss but the loss of sodium and other electrolytes in urine.

Diuretics are also used as masking agents to flush out performance enhancing drugs.

Anyone stupid enough to be abusing diuretics for weight loss or to mask performance enhancing drugs may well find they do need to supplement sodium and other electrolytes.

So...are you just trying to start a new conversation with this post? It seems kind of non sequitor. It also seems like you are implying that people who need to supplement their salt intake are abusing diuretics. I'm not sure where you think this is going.

from looking at many of his post, i think he is simply a troll because he clearly show poor understanding on the subject so far

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Jonathan Caron / Professional Coach / ironman champions / age group world champions
Jonnyo Coaching
Instargram

No, I was thinking more along the lines of educating people who may not understand that diuretics especially thiazide diuretics, make the body get rid of more sodium in urine and could cause hyponatremia.

Yes - we generally speaking have an over-supply of salt in our diets

Yes - there is some minor variation in individual sweat rates from person to person.

Yes - that variation can lead to some confusing results, due to the first, "yes"

No - generally speaking, you do not need to take in significant extra salt/sodium when training/racing.

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Steve Fleck @stevefleck | Blog

Let me be clear - I am not weighing in on any particular paradigm re: hydration. I am just stating, from experience, that GSSI is not the great Satan that some have purported it to be.

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Chicago Cubs - 2016 WORLD SERIES Champions!!!!

"If ever the time should come, when vain and aspiring men shall possess the highest seats in government, our country will stand in need of its experienced patriots to prevent its ruin." - Samuel Adams

It's not Satan, no.

But it's no different than self-interested corporate-sponsored science 'institutes'. It's less egregious to the public because it's just a sports drink, but had it been a tobacco company, oil company, or patent troll company, the problems with accepting this kind of research become much more obvious. Even if the scientists have legitimate credentials.

I went to my doctor before doing my first Ironman last year. It turned out she had volunteered as a course doctor for Ironman Canada for several years. She had one piece of advice for me: whatever you do, take an electrolyte supplement, and a lot of it - not just sodium, but a complete electrolyte, with potassium and magnesium as well.

Coming on to a triathlon forum and telling people they don't need sodium supplements is extremely, medically irresponsible.

My personal experience correlates very highly with what Jonnyo has said. After testing I found that I am on the very high end of the bell curve in terms of both sweat rate and sodium content of sweat. After numerous trial rides of the Whistler and Penticton bike courses I found that my performance suffered dramatically if I did not take in a lot of fluids combined with heavy doses of electrolytes. Does this apply to everyone? No. But for some people it is critical for performance, and for some could make the difference in surviving a long distance triathlon at all.

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Graham Barron Design: Custom west coast house design http://www.grahambarron.com/

Got through most of this thread, and Jonnyo hit the nail on the head. First of all, all human bodies do not react the same way in similar conditions. And there is a huge variance(just as with diets) in folks physiological responses to stress. You fail in your assertations from the very point that you do not recognize this one simple truth.

There will be a 100 people that can get on here and tell you that their experience is the exact opposite of what you propose. In my case if i had listened to you, i could be dead, almost was. There are just some people that are hyper excreters, and it is not because of too much intake. I listened to someone like you very early in my career and so i tried the low sodium diet, and for quite awhile. What happened was my already low blood sodium levels just got lower and lower. I did not adapt, my body did not make corrections, i just put myself in a place where i could do some serious heart damage if the right conditions were met. And it is not just sodium, but magnesium too. That one finally did me in, found out for no apparent reason, i pee out twice as much as a normal person. Got so low that those conditions did present themselves one day, and now i have permanent heart damage. Blood tests at the time showed me with dangerous low magnesium and very low sodium levels. I did not have the information at the time about salt pills which i knew i needed, and the no one even mentioned stuff about magnesium.

I have done dozens and dozens of trials and blood tests, and it appears that i'm like a lot of pros who suffer from this. It is really good that most now know they can do something about it, and they do, and it works. Like Jonnyo said, he does not know why or how, it just does. And don't give me any horses shit about placebo affects. If you have ever had a cramp, you know it is not in your head. I can be from things other than an electrolyte imbalance, but it could just also be that. And that one can be very dangerous if it is pushed too far..