"Water intoxication: A potentially life-threatening condition caused by drinking too much water, which leads to hyponatremia and may result in seizures, coma, and death." (from Gale Encyclopedia of Medicine)

"Water intoxication: an increase in the volume of free water in the body, resulting in dilutional hyponatremia. Common causes are excessive ingestion of water, increased infusions of hypotonic IV solutions, or excess secretions of antidiuretic hormone. Clinical manifestations are abdominal cramps, nausea, vomiting, lethargy, and dizziness. It can potentially lead to convulsions and coma." (from Mosby's Medical Dictionary)

They call it "water" intoxication, but does this really mean an excess of ANY water-based liquid? Chicken soup? Orange juice? GatorAde?

I must not be asking Mr. Google the right question.

Sue

Sue

teh google search tips

water intoxication site:.edu
water intoxication site:.gov
water intoxication site:webmd.com

usually i find it easier to look it up in encyclopedia
and then follow up on the references

http://en.wikipedia.org/wiki/Water_intoxication

basically, liters of water, without electrolytes , bad for you

if its got flavor, its usually chock full of electrolytes

on a related note,
http://en.wikipedia.org/wiki/Oral_rehydration_therapy

Theoretically, I imagine that someone could drink enough, say, decaf coffee to trigger hyponatremia (I only say "decaf" to exclude any effect of caffeine--some Brit did actually kill himself by OD'ing on caffeine just the other day). But plain water would be the easiest to cause this problem since it contains little in the way of electrolytes. I think Gatorade would not because it contains too much of various electrolytes, such as sodium. If you didn't get nauseous and throw up from trying to overdose on Gatorade, then I think you'd actually be facing hy-PER-natremia, rather than hy-PO-natremia.

Some casual runners in marathons have a tendency to fall victim to hyponatremia because they drink too much water during the race because they've always heard to drink often and drink a lot. Over the course of 5+ hours on the course, they can drink much more plain water than they are sweating out. But the common wisdom in sports hydration has become more refined over the years. If you watch elite marathoners, they drink very little during the race even though they are working very, very hard.

We drink 50/50 Gatorade and water on summer hikes precisely to avoid getting sick. A hard-learned lesson as early on in our Shenandoah hiking adventures a friend and I each drank a gallon of water on a steep 9-mile hike on a 90-degree humid day.

We were sweating so much we didn't pee any of that water out.

Afterward, she was quite nauseous and had a severe headache. I was fine but we learned about hyponatremia and, as I noted, ever since we go 50/50 on pure water and Gatorade.

We also carry a salty snack.

NO. If you're getting sodium with it you should be OK. Yes, you can get hyPERnatremic if you lose more water than you replace, but you get hyPOnatremic if you drink free water (ie, no electrolytes).

Personally, I don't condone watering down sports beverages. After all, they ARE designed to replace electrolytes.

Sucks how head exhaustion sounds an awful lot like hyponatremia, huh?

Actually, I understand Gatorade has a bit too much sugar for optimum water absorption from the digestive tract (article in Runner's World many moons ago). There was then a replacement drink called ERG, about half the concentration of Gatorade. I got nauseated drinking Gatorade in competition, but not with Erg. I often cut my Gatorade in half when hiking and it works just fine.

you wouldn't be diagnosed with hyponatremia for drinking too much of anything else like coffee mentioned above. It is specific to too much water replacement and not enough sodium replacement. This is a condition whose median is age group endurance athletes, typically marathoners. Furthermore it is predominantly a lower weight female condition. Because men weigh more it is more difficult for them to reach the condition.

Though this is a condition that can be fatal, it is rare. The media has like much else sensationalized it for their purpose. Furthermore it is a race day problem that can be easily controlled by simple steps like using a sport drink, gel or electrolyte replacement pill.

Hikers, who populate this forum more than endurance athletes, should have no problem with this whatsoever. Our meals are overly salted. I might guess as little as a couple cheeks of beef jerky is enough for a day of our movement to stave this off. Though I use electrolyte replacement pills (I use Endurolytes by Hammer)in my endurance training and hiking.

Same here. I thought that formula was similar to oral rehydration salts mixture.

Has anyone here carried the Gatorade single Qt powder packets, 8 for $5 at W-M. I an thinking about using one of my Nalgenes to hold 1 Qt. and the other to hold some packets, but I want to know how many, and if the packets are durable. P.M. me to prevent thread hijacking...

What I do is buy gatorade powder in the little orange canisters and then fill either water bottles or smaller containers with the powder as I need it. I haven't seen those 1 qt packets in a while; I am not sure they are durable enough to ride around in a pack for a long time....

I don't see a reason why only plain water would cause hyponatremia, although practically speaking, plain water is probably the only low-sodium beverage that people would commonly guzzle in large enough volumes to cause dilutional hyponatremia. It's the effect on serum sodium levels that matters, not how you get there. There are multiple mechanisms that can lead to hyponatremia.

Guzzle enough decaf coffee and I see no reason why that could not also cause hyponatremia. Switch to the caffeinated version and then you will induce diuresis and could possibly trigger a sodium imbalance that way, too. Well, on a hot summer day, someone could conceivably guzzle a lot of plain iced tea in one sitting, too. That's another low-sodium beverage. After a long day of working in your yard, losing sodium in your sweat all day, that pitcher of iced tea you gulped down could certainly lead to dilutional hyponatremia. Likely? Not really, but I think it's certainly conceivable IMO.

Certain folks, like exercise physiologists, have been saying this about Gatorade since sometime in the 80's. To me, Gatorade is a beverage first, a sport drink second. All the sugar and sodium are there primarily to enhance its flavor and sell more Gatorade, not to be the best sports drink. I also have problems drinking a large amount of Gatorade, and other ETS members have mentioned a similar experience over the years. I recall someone mentioning their Gatorade experience while deployed in Iraq and how they feel bloated. That happens to me, too.

If I'm drinking Gatorade for serious hydration purposes, I also dilute it by half with plain water. But ideally, I would drink something else. My personal favorite is Vitalyte.

Folks,

Some INPORTANT information, Yes, too much water without electrolytes (saltS) can be a problem, but a much larger problem is DEATH from too much sweating and too much Gatorade!! It has happened a number of times, and Gatorade is banned from some sports events.

Gatorade was designed at the University of Florida for football players in hot weather. It was NOT designed for hydration, but to solve electrolyte imbalance. It was administered by trainers, EMT's or physicians to those who showed the proper symptoms. WATER was given to those who were dehydrated!

Since the patents were sold, there has been a great push to use Gatorade for rehydration, but it has more salt than the human body. The first thing that happens is that it takes water OUT of the body to lower the salinity (osmosis). If you are already severely dehydrated this can cause the heart to stop.

Anyone who is eating normally (especially hikers munching on trail mix, nuts and jerkey and eating packaged foods) has little to worry about with water intoxication. They do need to consider the potential for problems if they get dehydrated and drink (uncut) Gatorade. If you like it, do the 50/50 mix or drink a similar bottle of water for every bottle of Gatorade. Stay hydrated and it is no problem. If you are showing signs of dehydration, drink water.

Respectfully,

Jerry

Just my $0.02, someone mentioned ERG. That has been renamed to Vitalyte. Vitalyte is amazing. I've used it when ill and during hot weather and I've found it to be one of the best ways to rehydrate without feeling bloated, etc...

Sean

This used to be a problem in the days of Ebeneezer Goode but became less of a problem when the Salmon Dance became more popular.

There is some good and bad information in this thread. As the EMS director for the Javalina Jundred and other ultra-marathons here in Arizona, the topic of proper hydration and nutrition are pretty important to me.

Typically the phrase "Water Intoxication" is used as a layman's term for hyponatremia due to excessive water intake.

Hyponatremia is a condition where there is an imbalance of water and sodium in the body with sodium levels being abnormally low. While there are many causes of this, it has become a topic of much discussion in the endurance sports community for a few years now. First coming to light in the 1982 Boston Marathon. Cynthia Lucero died in the last miles of the marathon, her death was linked to hyponatremia. Although reports vary, it seems she drank an excess of water and Gatorade during the marathon with little to nothing to eat. In the years since, multiple deaths and hospitalizations at endurance events, specifically events where athletes are participating for greater the 4 hours, have been linked to hypothermia and pour hydration/nutrition plans.

While it is possible to drink enough water while not exerting to drop your sodium levels to the point of danger, it would be somewhat difficult. Drinking that much water fast enough would make most people throw-up due to the significant change in stomach content osmolality. It is much easier to cause you sodium level's to drop due to sweating and exertion while drinking water or hypotonic electrolyte solutions and not replacing electrolytes.

No here is the big issue, most people cannot tolerate drinking isotonic (same concentration as the body) or hypertonic solutions during exertion. All "sports drinks" on the market are Hypotonic electrolyte solutions, including Gatorade. When exercising in environmental conditions where hyponatremia is a danger, electrolyte replacement is virtually impossible using water and sports drinks alone.

On the topic of Gatorade, it does not have a higher concentration of electrolytes then out body does. In fact a few years ago Gatorade came up with a new formula called Gatorade Endurance which had more electrolytes then the original specifically to address Hyponatremia. The problem with Gatorade and other similar drinks is the amount of sugar, in this sense it is hypertonic and can cause a loss of fluids and electrolytes (this is where the cutting Gatorade 50/50 advice comes from).

The key is finding a balance between hydration and nutrition. Most endurance sports participants who encounter electrolyte imbalances haven't taken on too much fluid, but rather have not eaten enough, taken any electrolyte supplements or tried to take in too much and now have GI issues causing the imbalance.

The solution to all of this is actually pretty simple:

First - Have a hydration and nutrition plan before hand.

If you are going to be doing an endurance event (be it a marathon, triathlon, or simply a hike) that is going to take more then four hours, work out a plan for nutrition and hydration before hand. To do this right you need to have practiced some before hand to know how much water, electrolytes and food you will need. One of the best ways to maintain you electrolyte levels is to eat consistently throughout the event. Make sure your food source has some electrolytes, one of the issues many athletes run into is relying of energy gels for their nutrition and not realizing most have little or no electrolytes. Many companies are making electrolyte supplements in pill and powder form now, these can be a godsend if used right (read the bottle) or a curse that will find you vomiting on the side of the trail is not.

Second - Know you limitations both physically and nutritionally.

You need to know how much you can do, and how much you can take in before getting into trouble. Training is the key.

Third - Know the warning signs.

Long before you get hyponatremic, there are signs that can tell you that you are heading down the path to trouble. The first warning sign will typically be swollen hands. Have you had to loosen your watch because you hands are swelling? It's time to slow down or rest and eat something. Other signs to look for are abnormal sweating, cramping, dizziness, weakness, insatiable thirst, swollen feet and ankles, "sloshy stomach feeling" and GI distress.

Last - Once you think you are in trouble, take you time.

It takes a while to drop your electrolyte levels, it will take a while to bring them back up. One of the biggest mistakes people make is trying to get the electrolytes in too fast. I remarkable number of athletes come into the aid station at Javalina Jundred complaining of vomiting and weakness. After asking some questions we typically discover the athlete started to cramp or swell and they started to take in a lot of electrolyte supplements. Soon there after, they stared to vomit. Most of these athletes we lay down and allow them to slowly eat and drink until they feel better. 30-45 minutes later, they are back out on the course and most finish the 100 mile race.

Soooo, a lot of interesting and technical information in this thread. I'm an intermediate (5-10 miles) distance walker, not a runner. I'm wondering; does it all boil down to a time tested solution? GORP and water as needed?

Replace your electrolytes.

Alan,

Thank you for the correction on Gatorade, my understanding of the cause of water loss is significantly improved.

The best,

Jerry

The best advice I ever got on food consumption when hiking was, "Lunch begins immediately after breakfast, and continues in small bits throughout the day."

One small question - Is it even possible to become dehydrated in the Land of 1000 Lakes? Seems like there is water everywhere. Maybe Florida has more, but it would be close.....

Hike..sometimes in the land of lakes it's a water everywhere but not a drop to drink situation.not all of it is %100 pure,a dead moose up stream or pond filled with duckweed can really put you off. there is a spring at the end of my street here in South Minneapolis,Cold Water spring, that i would and have taken drinking water from before some of the beaver ponds i've paddled thru in the far north.the other dehydration problem is that it can sneak up on you.many years ago i was getting headaches during the day on canoe trips.i would take a Alka-Selzer for relief thinking it was brought on by eye strain,the long view over the lakes V.S. a close up computer screen.later i found out that headaches were the first sign of dehydration.after that i made a point of drinking lots of water,knocking back a extra gulp need it or not,the headaches went and never returned.and i guess it was the water and salts in the Selzer more than the aspirin in it that helped.

I think you would have to work at it a little in most areas. You could probably squeeze enough to survive out of your socks.

Seriously though, Canoedogs is right. Without a means of purification, you would have to decide if your situation warrants the risk of consuming unknown water. I have consumed untreated water from the middle of a BWCA lake with no ill effects, and I have consumed water from cold springs with no problems.

In the porous limestone Karst topography that dominates 2/3 of Minnesota, it is not uncommon for a stream to emerge from the ground, flow for a mile, and then disappear underground again. It might run through pristine meadows and woods, or through a barnyard. I don't recommend drinking unknown unfiltered water except for last ditch survival.

I haven't ever had to squeeze my socks, but on one trip we were squeezing water out of moss. Just closed my eyes and pretended it was instant tea.

That was one of those occasions where I realized that there might be Bad Things in the water, but that my first priority was to get back to town, whereupon the effects of the Bad Things could be treated. Actually, I have been fortunate, because I have never been sick from drinking "wild" water. But nowadays I tend to treat it.