Drinking too much water on the trail?

Can you drink too much water while hiking? I feel I need to drink lots of water on a long day of hiking, because I sweat a lot and have always followed the conventional wisdom - drink, drink, drink! On a warm summer day I can drink water or Gatorade all day long and hardly ever feel the need to pee.
Now, along comes a report from the New England Journal of Medicine that too much drinking can be dangerous and even deadly for endurance athletes.

An AP article on the study states that:

Runners, hikers, bikers, even soldiers on long maneuvers should think twice before reaching for that water bottle: A study confirms that drinking too much can be dangerous, even deadly, for endurance athletes.

Researchers who studied 488 runners in the 2002 Boston Marathon found that 62, or more than one in eight, had a serious fluid and salt imbalance from drinking too much water or sports drinks. Three of them had extreme imbalances.

Click to expand...

That's a pretty scary statistic. Runners who drank more than three liters, ran over 4 hours and gained (water) weight during the marathon were most at risk. Sports drinks aren't the answer, because they contain a lot more water than salt, and can contribute to the imbalance.

''More is definitely not better when it comes to fluids, but it's a hard message to get across,'' said Leslie Bonci, director of sports nutrition at Pittsburgh Medical Center.

Click to expand...

Bonci and Almond said a good way to prevent problems is for athletes to weigh themselves before and after training sessions. If they gain significant weight, they should cut back on water intake until they find the right balance -- long before race day.

The goal is simply to replace water lost to sweating.

Click to expand...

Severe cases are believed to have become more common with the growing popularity of endurance sports. In recent years, hyponatremia has killed several amateur marathon runners, as well as competitors in the Marine Corps Marathon.

Click to expand...

This article was written ahead of the Boston Marathon, which is on Monday.

The study was based on marathon runners, but is useful information for all endurance athletes. The study concluded that hyponatremia occurs in a substantial number of non-elite marathon runners.

So, when you're out there on those death marches or trail running this summer, drink up, but not so much! Drink just enough to replace your sweat loss, if you can figure out what that is.

A classic was to disqualify oneself from combat duty was to overhydrate (aka water poisoning) prior to the physical exam, or so some about to be drafted into the Vietnam war thought. I believe it worked on at least a few occasions, though.

It takes all kinds...

I used to work in a psychiatric hospital that had a hyponatremia ward. These individuals would intentionally drink large quantities of water because when it throws your sodium level off, you feel "high." However, it's a pretty precarious balance between that "high" and major system failure! For many with this disorder, it becomes an addiction. But the standard we used to assess folks was if they drank enough that they would "gain" 15% of their body weight we would start monitoring for physical effects. That's a lot of water! And generally it was much more than that before you would see someone show symptoms.

Sometimes after a long hard hike I wake up to find I'm retaining water - with swollen hands and ankles. It goes away after a day or so, but I've always wondered why that would happen. I too always believed that if you don't pee freely, you're not taking in enough.

Sure, it can happen, but...

(Hours hiked) times (beefiness of hiker) times (amount you sweat) times (some fudge factor)=amount of water you need. Marathon runners are at high risk of overhydration, relatively speaking, because they tend to be small and skinny (hence less "total body water" to begin with) and they "only" exercise for a few hours as compared with us crazies who are on the trail for 8+ hours typically. So, less risk. Just don't go nuts and drink 3 liters in the first 3 hours, and you should be fine.

I wouldn't worry too much about over drinking. As some of the others have pointed out, you'd have to drink WAY too much before you'd have a problem.

Swollen hands is not a symptom of systemic water retention. Rather, it's a symptom of inadequate local lymphatic return, due to the hands being "down" all day. Easy prevention for that is to hold your hands over your head and open and close the fingers for a minute or two once every couple hours while hiking.

I haven't experienced the swollen anlkes. Maybe if you put your feet up for a minute when you stop to eat it would help?

Balance is the key. I always have my 3L platypus on tap, drawing on it every few minutes. Every once in a while I take a swig from the nalgene with concentrated gatorade in it (1.5-2 qt worth of powder in 1 qt bottle.) Salty snacks like combos and nuts help return sodium to the system. Oh, and yes, my pee is mostly clear.

My understanding is that eating, and especially eating salty foods, helps to ward off hyponatremia.

So GORP apparently is natures cure for this problem.

It's not that there's necessarily a problem with drinking too much water, it's that by doing so you tend to flush out sodium and other electrolytes that are essential to the body. Hyponatremia is an abnormally low concentration of sodium in the blood. So if you drink a lot of water (too much) you flush out the sodium, thus potentially creating the situation. The key is to replace that sodium. Endurance athletes can do that by eating salty snacks prior to a race (or even during) to build sodium reserves or replace lost salt.

Hyponatremia is a rare condition for most everyday exercisers. It does become a potential issue for endurance athletes - i.e., marathon runners and ironman triathletes).

The symptoms of hyponatremia are similar to the symptoms of heat illness and include fatgue, lightheadedness, nausea, weakness, cramping, dizziness, headache, confusion, fainting, disorientation, weight gain, bloating.

For those of us who hike, I suppose it could be a probem. However, I usually bring salty snacks with me when I hike or go for long bicycle rides, so I don't think that this is an issue for me - or for most of us, for that matter. It is worth pointing out, however, that taking over the counter pain medications or certain prescriptions may reduce the body's ability to conserve sodium. (You might want to check with your doctor on that issue).

Overall, I think it's good to be aware of hyponatremia, but certainly you wouldn't want to cut back too much on your water consumption since then you may be faced with dehydration. Guess the real key (as in everything it seems) is balance.

On long, hot strenuos hikes I too was concerned about hyponatremia and actually tried to find some NaCl pills at the drug store(unsuccessful). Then came a breakthrough when my son's friend brought along a cannister of Pringles on a hike up the Scenic Trail on Sawteeth! No more hyponatremia worries!

Neil said:

On long, hot strenuos hikes I too was concerned about hyponatremia and actually tried to find some NaCl pills at the drug store(unsuccessful). Then came a breakthrough when my son's friend brought along a cannister of Pringles on a hike up the Scenic Trail on Sawteeth! No more hyponatremia worries!

Click to expand...

I just found this article, which, if accurate, lays out the issues quite nicely. I was surprised to see that pain relievers such as IB and Tylenol can actually contribute to the problem. There is also a cautionary note about tablets.

http://www.rice.edu/~jenky/sports/salt.html

rhihn said:

http://www.rice.edu/~jenky/sports/salt.html

Click to expand...

Nice reference.
Didn't know about the NSAID interaction.

Hyponatremia is primarily a problem of exercising in the heat--eg in the desert. You sweat the salt out and don't have enough left in your blood for proper functioning. (A certain concentration of sodium ion is required for proper functioning of nerves and muscles.)

My personal experience is that I become slightly dehydrated because I tend to sweat too much salt out, and then, even though I drink plenty of water, piss out too much water in order to maintain an adquate concentration of sodium. If I eat enough salty snacks or drink electrolyte I'm ok. (Winter or summer--the key item seems to be how much I am sweating.)

It appears there is significant individual variation so everyone has to learn how to handle his own body. There is also acclimatiztion--exercising in the heat for a week of so tends to reduce the concentration of salt in sweat.

Nice little contradiction here:
* too much sodium and you can become dehydrated (because you discard too much water when eliminating the excess sodium). (The "don't drink seawater in a survial situation" problem.) Seabirds have a salt gland--we don't.
* too little sodium and you can become dehydrated because you have to eliminate water to keep the concentration of sodium up.

Shameless plug: I posted a recipe for homemade (ie cheap) electrolyte drink in an earlier thread. http://www.vftt.org/forums/search.php?searchid=97158

Doug

Electrolyte drink

DougPaul said:

Shameless plug: I posted a recipe for homemade (ie cheap) electrolyte drink in an earlier thread. http://www.vftt.org/forums/search.php?searchid=97158

Doug

Click to expand...

Thanks for the link to the recipe. I missed it before. How is the taste? Do you add anything to make it more palatable - like lemon or another flavoring? I've been hooked on Emer'gen-C for use during hiking. It has 200mg potassium and 60 mg sodium for every packet, plus Vitamin C, etc. I use 2-3 packets a liter.

I would also suggest an after-hike recovery beverage. My post Great Range/Presi Traverse beverage of choice is a liter of margaritas with plenty of salt. The combo of salt/sugar/lime/tequila never fails to facilitate my recuperation.

beverly said:

Thanks for the link to the recipe. I missed it before. How is the taste? Do you add anything to make it more palatable - like lemon or another flavoring? I've been hooked on Emer'gen-C for use during hiking. It has 200mg potassium and 60 mg sodium for every packet, plus Vitamin C, etc. I use 2-3 packets a liter.

Click to expand...

The taste is (surprise!) sweet-salty. Fairly mild--I like it. Try it and see for yourself.

One of the recipes that I read suggested adding kool-aid for flavoring. Try unsweetened lemon-aid mix. Add whatever flavor suites your fancy. Add color if you wish. (On July 4th, you can bring red, white (clear?), and blue.) Just take into account any salt, posassium, or sugar contained in the flavoring when making up the mix.

The Lite Salt is the most important ingredient, so I carry a small bottle of it whenever I hike. If I find myself sweating more than anticipated, I just put some in my drinking water. In summer, I usually carry full mix and have electrolyte already in some of my water bottles. For a long trip, just carrying an appropriate amount of Lite Salt may be more practical than worring about the other ingredients.

Until you have some experience with any electrolyte, I recommend that you carry both electrolyte and pure water. If you get a stomach ache from too much sugar (food+drink), just switch to the water. If you bring some powdered mix, you can always add it to the water. (Water is also preferable for first aid purposes and washing anything.)

Doug

Stinkyfeet,
Would this also apply ot some one who is not a ultra marathoner , i tend to sweat alot except out west. But I feel very thisty hiking here in the east with more humidty or even working, I work out doors cutting either cord wood or specialty timeber . and it is grueling work. I might use some equipment But 1 guy with a chainsaw , sometimes a Bobcat . It is grueling i have drank over a gallon in less than 8 hopurs ans i know i losat a lot to sewat but i do not want ot end up in the ER. I do slow downb working or hiking if I feel to tierd or sore.
BTW I aree about the Ibuprofen.
One thing I do want to say , I have Seizures anb ifyou do take meds as I d,o take them if you are feeling bad trun around or rest. . The mountain will be there. never stop taking a perscription med. .
ANy MDS on te list I am wondering if to much souduim would inerfear with a person on Nuerological medication especialy seizures?

Apparently, the study found no difference between those runners who drank water and those that drank sports drink (at least according to the "expert" on TV this morning - I haven't actually read the study). So switching to gatorade doesn't fix the problem.

I find it interesting that the study found that the people at risk for this actually gained weight while running. When I first heard about this problem I had assumed that the problem was sweating out all the salt. But they can't be big sweaters if they are gaining weight.

Actually, I believe in the context of this discussion, Gatorade doesn't really contain enough sodium, only 440 mg. per liter.

And I would think that a person could indeed be gaining weight and sweating profusely at the same time IF they're drinking a lot of fluid. Couldn't they?

DougPaul said:

Nice reference.
Didn't know about the NSAID interaction.

Shameless plug: I posted a recipe for homemade (ie cheap) electrolyte drink in an earlier thread. http://www.vftt.org/forums/search.php?searchid=97158

Doug

Click to expand...

Hey DP
That formula worked great and I will take it along on hikes. Thanks for the info.

Jasonst said:

That formula worked great and I will take it along on hikes. Thanks for the info.

Click to expand...

Glad you like it. Been using it for several years myself.

It also gives one a starting point from which to custom taylor a drink to one's own needs.

And the price isn't too bad either...

Doug

IMHO the risk of overhydrating is almost insignificant compared to the risk of underhydrating. Any kind of snacks (or electrolyte replacement drink) will do the trick.

Then again, a short term slight dehydration is not that big of a concern, biggest concerned is usually on multiday trips.

Prevention here should play a larger role, if one is going to hike to or near hisl evel of exhaustion maybe cutting the distance or effort down would be a better solution than speculating on how to beat hyponatremia.

Saw a commercial yesterday on a "new" Gatorade product specifically designed for endurance athletes... some interesting info (discounting the commercial slant) on hydration etc. can be found on the "gatorade science institute" web site

such as this