The dipsomania of great distance: water intoxication in an Ironman triathlete

Of 371 athletes (62% of all finishers) whose weights were measured before and after the 226 km South African Ironman Triathlon, the athlete who gained the most weight (3.6 kg) during the race was the only competitor to develop symptomatic hyponatraemia. During recovery, he excreted an excess of 4.6...

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Bibliographic Details
Published in:British journal of sports medicine 2004-08, Vol.38 (4), p.e16-e16
Main Authors: Noakes, T D, Sharwood, K, Collins, M, Perkins, D R
Format: Article
Language:English
Subjects:
Adult
Athletes
Auscultation
Bicycling - physiology
Blood pressure
Case Report
Creatinine
Diuresis - physiology
Drinking Behavior - physiology
Edema
fluid overload
Humans
hyponatraemia
Hyponatremia
Hyponatremia - etiology
Hypotension
Ironman triathlon
Male
Marathons
Physical Endurance - physiology
Risk Factors
Running - physiology
Sodium - blood
Swimming - physiology
Triathlon
ultra-endurance events
Urine
Water Intoxication - etiology
Water-Electrolyte Imbalance - physiopathology
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Summary:Of 371 athletes (62% of all finishers) whose weights were measured before and after the 226 km South African Ironman Triathlon, the athlete who gained the most weight (3.6 kg) during the race was the only competitor to develop symptomatic hyponatraemia. During recovery, he excreted an excess of 4.6 litres of urine. This case report again confirms that symptomatic hyponatraemia is caused by considerable fluid overload independent of appreciable NaCl losses. Hence prevention of the condition requires that athletes be warned not to drink excessively large volumes of fluid (dipsomania) during very prolonged exercise. This case report also shows that there is a delayed diuresis in this condition and that it is not caused by renal failure.
ISSN:0306-3674
1473-0480
DOI:10.1136/bjsm.2002.004614