Exercise-Associated Hyponatremia in Endurance and Ultra-Endurance Performance–Aspects of Sex, Race Location, Ambient Temperature, Sports Discipline, and Length of Performance: A Narrative Review
Abstract
:1. Introduction
2. First Description and Definition of Exercise-Associated Hyponatremia
3. The Pathogenesis of Exercise-Associated Hyponatremia
4. The Clinical Presentation of Exercise-Associated Hyponatremia
5. The Prevalence of Exercise-Related Hyponatremia
Risk Factors for Exercise-Associated Hyponatremia
6. The Prevalence of Exercise-Associated Hyponatremia by Sports Discipline
6.1. Swimming
6.2. Cycling
6.3. Running
6.4. Triathlon
6.5. Multi-Stage Events
7. Prevalence of Exercise-Associated Hyponatremia Regarding Ambient Temperatures
7.1. The Aspect of Heat
7.2. The Aspect of Humidity
7.3. Exercise-Associated Hyponatremia in the Cold
7.4. Exercise-Associated Hyponatremia in Moderate Ambient Temperatures
8. Female Sex as Risk Factor for Exercise-Associated Hyponatremia
9. The Prevalence of Exercise-Associated Hyponatremia (EAH) by Region Where the Race is Held
10. Prevention of Exercise-Associated Hyponatremia
11. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Fast Development (Brain Edema) |
Headache |
Nausea |
Vomiting |
Dizziness |
Weakness |
Adynamia |
Fatigue |
Tremor |
Epileptic seizures |
Muscle cramps |
Increase in body weight |
Swelling of hands and feet |
Somnolence |
Coma |
Slow to chronic development |
Fatigue |
Disorientation |
Lethargy |
Confusion |
Inappetence |
Change of personality |
Gait disturbance |
Attention deficit disorder |
Athlete |
Female sex (especially menstruating) |
Short stature |
Heavy and excessive drinking (seen as weight gain during exercise) |
Low body weight |
Low BMI |
Weight gain during exercise |
Slow running pace |
Low competition experience |
Intake of NSAIDs |
Event |
Duration of four hours and longer |
High availability of fluids |
Extreme heat |
Extreme cold |
Race | Prevalence of EAH |
---|---|
Houston Marathon 2000 [90] | <1% |
Zürich Marathon [59] | 3% (five of 167 subjects) |
Boston Marathon 2001–2008 [138] | 4.8% (in 1319 collapsed runners) |
Marathon [82] | 5.6% |
Boston Marathon [61] | 13% |
Houston Marathon 2000–2004 [123] | 22% (21 of 96 subjects) |
Ultramarathon | Distance | Prevalence |
---|---|---|
Below 100 km | ||
Six Foot Track Marathon, New South Wales, Australia [145] | 45 km trail | 0% in 9 subjects out of 775 starters |
Two Oceans 56-km ultra-marathon, Cape Town, South Africa [146] | 56 km | 0% |
Cradle Mountain Run, Tasmania, Australia [147] | 85 km | 2% of 41 subjects |
100 km | ||
100 km Lauf Biel, Switzerland [132] | 100 km | 0% of 50 men |
100 km Lauf Biel, Switzerland [148] | 100 km | 0% of 11 women |
100 km Lauf Biel, Switzerland [149] | 100 km | 4.8% of 145 subjects |
100 km Lauf Biel, Switzerland [150] | 100 km | 5% in 19 women and 11 % in 24 men |
100 km Lauf Biel, Switzerland [126] | 100 km | 5% of 95 men |
100 miles | ||
Western States Endurance Run, California, USA [151] | 100 miles | 5.8% of 207 subjects |
Western States Endurance Run, California, USA [152] | 100 miles | 6% of 207 subjects |
Western States Endurance Run, California, USA [83] | 100 miles | 6.6% of 157 subjects |
Western States Endurance Run, California, USA [57] | 100 miles | 15.1% of 669 subjects |
Western States Endurance Run, California, USA [153] | 100 miles | 16% of 373 subjects |
The Great North Walk 100s, New South Wales, Australia [55] | 100 miles | 26.7 % in 4 of 15 subjects |
Western States Endurance Run, California, USA [56] | 100 miles | 30% of 47 subjects |
Western States Endurance Run, California, USA [130] | 100 miles | 30% of 47 subjects |
Rio Del Lago 100-Mile Endurance Run Granite Bay, California, USA [154] | 100 miles | 51.2% |
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Knechtle, B.; Chlíbková, D.; Papadopoulou, S.; Mantzorou, M.; Rosemann, T.; Nikolaidis, P.T. Exercise-Associated Hyponatremia in Endurance and Ultra-Endurance Performance–Aspects of Sex, Race Location, Ambient Temperature, Sports Discipline, and Length of Performance: A Narrative Review. Medicina 2019, 55, 537. https://doi.org/10.3390/medicina55090537
Knechtle B, Chlíbková D, Papadopoulou S, Mantzorou M, Rosemann T, Nikolaidis PT. Exercise-Associated Hyponatremia in Endurance and Ultra-Endurance Performance–Aspects of Sex, Race Location, Ambient Temperature, Sports Discipline, and Length of Performance: A Narrative Review. Medicina. 2019; 55(9):537. https://doi.org/10.3390/medicina55090537
Chicago/Turabian StyleKnechtle, Beat, Daniela Chlíbková, Sousana Papadopoulou, Maria Mantzorou, Thomas Rosemann, and Pantelis T. Nikolaidis. 2019. "Exercise-Associated Hyponatremia in Endurance and Ultra-Endurance Performance–Aspects of Sex, Race Location, Ambient Temperature, Sports Discipline, and Length of Performance: A Narrative Review" Medicina 55, no. 9: 537. https://doi.org/10.3390/medicina55090537