Exercise-Associated Hyponatremia
Open accessAbstract
Exercise-associated hyponatremia (EAH) is defined by an acute fall in the serum or plasma sodium concentration to below 135 mmol/L that occurs during or up to 24 hours after prolonged physical activity. EAH has been reported in nearly every form of endurance activity and has a common pathogenic feature of excessive water intake which is usually coupled with elevated vasopressin levels. Symptomatic EAH is uncommon but can be a cause of mortality in otherwise healthy adults and children. Rapid recognition and appropriate treatment with hypertonic saline are essential to maximizing outcomes and preventing death.
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Aging is associated with a higher baseline plasma osmolality, coupled with an age-related blunting of thirst sensation during exercise (and water deprivation), the usual thirst mechanism that occurs with a drop in fluid volume (dehydration) is impaired.
“Aging is associated with a higher baseline plasma osmolality, coupled with an age-related blunting of thirst sensation during exercise (and water deprivation), the usual thirst mechanism that occurs with a drop in fluid volume (dehydration) is impaired [278].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [278]
The higher overall fluid retention from estrogen-based hormone replacement therapy is not due to increased free-water retention, but rather increased sodium retention- the synthetic estrogens inducing a reduction in sodium excretion, eliciting a slight reduction in the hyponatremic risk.
“However, the higher overall fluid retention is not due to increased free-water retention, but rather increased sodium retention- the synthetic estrogens inducing a reduction in sodium excretion [278,281], eliciting a slight reduction in the hyponatremic risk.”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [278]
Estrogen-based hormone replacement therapy results in an increased basal plasma osmolality, plasma volume expansion, and an earlier osmotic threshold for arginine vasopressin release (e.g. 280 vs. 285 mOsmol/kg H2O), but a reduction in urine output, resulting in greater overall fluid retention.
“Estrogen-based hormone replacement therapy results in an increased basal plasma osmolality, plasma volume expansion, and an earlier osmotic threshold for arginine vasopressin release (e.g. 280 vs. 285 mOsmol/kg H2O), but a reduction in urine output, resulting in greater overall fluid retention.”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [278]
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References 100 · Cited by 15
- Authors
- Rosner, M. H., Bennett, B., Hew-Butler, T., & Hoffman, M. D.
- Affiliations
- University of Virginia (US)
- Uniformed Services University of the Health Sciences (US)
- VA Northern California Health Care System (US)
- Corresponding author
- Rosner, Mitchell H.
- Venue
- Hyponatremia
- Publisher
- Springer New York
- Published
- 2013
- Volume
- 130
- Pages
- 175-192
- PMC
- PMC6735969
- OpenAlex
- W2982558207
- Cited by
- 15
- References
- 100
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 3 · 2022: 2 · 2020: 1 · 2016: 1 · 2014: 2 · 2013: 1
- FWCI
- 7.11
- Type
- book chapter
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Springer eBooks (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Keywords
- exercise-associated hyponatremia, serum sodium, plasma sodium, endurance exercise, water intake, vasopressin, hypertonic saline
- MeSH terms
- Arginine Vasopressin, Drinking Behavior, Fluid Therapy, Humans, Hyponatremia, Saline Solution, Hypertonic, Exercise, Asymptomatic Diseases, Drinking Water
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