Hyponatremia during long runs ?

FL_Hiker

Hi,
I’m curious if others have experienced hyponatremia during long runs? During my marathon around mile 20 I looked down at my hands and my fingers were swollen 3x their size, looked like balloon hands. I also threw up for the next 6 miles constantly. Kinda just figured this was normal but upon googling today sounds like I had a bit of a problem perhaps. After the race I didn’t want to eat anything. I recovered just fine on my own without any medical treatment and didn’t really think much of it until today. But does this happen often to marathon runners? How can I improve next time I do a long race and avoid this? I was taking caffeinated watermelon gu but around some mile my stomach became upset and I stopped taking them because they were just coming back up. Was it because of the caffeine maybe? I’ve trained with these same gu’s all my training runs and never had an issue before. Do most people alternate between caffeine gu and regular gu to keep their stomach settled? I skipped my last 3 Gu’s and was chugging only straight water the entire race assuming I was dehydrated. Curious to find out more..
Thanks!

Duck_Puddle

How many of your training runs were in that cold and rain? I know weather has an impact for me.

I have sometimes had an issue with nausea after long races where my fueling didn’t go quite according to plan-but that’s always been helped (some at least) by having some salty foods.

VioletRojo

I didn't throw up during my marathon, but my hands did swell, as they do after most long runs and all hikes. The swelling is because of how you hold your hands while walking and running, not because you've had too much to drink. I also didn't want to eat after my marathon. I was too tired to be hungry. It sounds like your issues aren't related to excess water, but just the norm for distance running. At least in my experience.

FL_Hiker

Duck_Puddle wrote: »

How many of your training runs were in that cold and rain? I know weather has an impact for me.

I have sometimes had an issue with nausea after long races where my fueling didn’t go quite according to plan-but that’s always been helped (some at least) by having some salty foods.

Pretty much none, that’s a really good point. I was used to running in mostly 90+ F weather with high humidity and the race it was in the 40’s-50’s I think and rain. I probably should have had a completely different fuel plan.

FL_Hiker

VioletRojo wrote: »

I didn't throw up during my marathon, but my hands did swell, as they do after most long runs and all hikes. The swelling is because of how you hold your hands while walking and running, not because you've had too much to drink. I also didn't want to eat after my marathon. I was too tired to be hungry. It sounds like your issues aren't related to excess water, but just the norm for distance running. At least in my experience.

I’ve ran this distance before and I hike a lot and I’ve never experienced swelling before.. this was something very new for me. Good to hear others have this issue though!

spiriteagle99

I get swollen hands when hiking in the heat, but not when running. How much water were you drinking on the course? Were you well hydrated before? When did you have your first gu? Just before my first marathon, I read that you should start taking in fuel earlier rather than later in the race. Once you start running hard, your body doesn't shunt as much blood to the stomach so it's harder to digest the sugar. If you start early, there is at least some chance that your body will divert what it needs to digest the gus, etc. That's why the directions on the packet say to take the first just prior to the race, then every 45 minutes thereafter. Did they have Gatorade on the course? I find that drinking that helps with electrolytes and a little extra energy. I do that every 4 miles. Especially toward the end of the race, when Gu tastes disgusting, it helps.

It might have been the caffeine or it might have been too much or too little liquid. I know racing is different from training runs because you are pushing so much harder. I tend to get cramps from food and drink, but mostly during my training runs because I wait too long to eat and drink.

After a hard race I am never hungry right away. I'll crave fruit and salt though, so usually some potato chips or Fritos and a banana will be all I can stomach for the first couple of hours. Even then, I am basically forcing myself to eat.

Duck_Puddle

FL_Hiker wrote: »

Duck_Puddle wrote: »

How many of your training runs were in that cold and rain? I know weather has an impact for me.

I have sometimes had an issue with nausea after long races where my fueling didn’t go quite according to plan-but that’s always been helped (some at least) by having some salty foods.

Pretty much none, that’s a really good point. I was used to running in mostly 90+ F weather with high humidity and the race it was in the 40’s-50’s I think and rain. I probably should have had a completely different fuel plan.

I know that I need less in the cooler weather-and if I don’t adjust down, then I do often feel ill (on training runs or races). I have some other blood sugar issues so I’m not sure how much that affects things though.

You’d have to drive up here to test a low temp fuel plan though lol.

FL_Hiker

spiriteagle99 wrote: »

I get swollen hands when hiking in the heat, but not when running. How much water were you drinking on the course? Were you well hydrated before? When did you have your first gu? Just before my first marathon, I read that you should start taking in fuel earlier rather than later in the race. Once you start running hard, your body doesn't shunt as much blood to the stomach so it's harder to digest the sugar. If you start early, there is at least some chance that your body will divert what it needs to digest the gus, etc. That's why the directions on the packet say to take the first just prior to the race, then every 45 minutes thereafter. Did they have Gatorade on the course? I find that drinking that helps with electrolytes and a little extra energy. I do that every 4 miles. Especially toward the end of the race, when Gu tastes disgusting, it helps.

It might have been the caffeine or it might have been too much or too little liquid. I know racing is different from training runs because you are pushing so much harder. I tend to get cramps from food and drink, but mostly during my training runs because I wait too long to eat and drink.

After a hard race I am never hungry right away. I'll crave fruit and salt though, so usually some potato chips or Fritos and a banana will be all I can stomach for the first couple of hours. Even then, I am basically forcing myself to eat.

I had my first gu at mile 6 and tried taking one every hour, I was chugging water and took every water station offered which was every mile or two miles. Towards the end I started grabbing two cups. I felt well hydrated before the race and days before I started drinking extra to make sure. That makes sense, I didn’t take a gu before the race because I never did in training. They did have Lemon Gatorade but I hate that stuff so I avoided it completely. Sounds like maybe next time I should try it instead of the gu the last few miles like you said. Live and learn 😉!

MeanderingMammal

FL_Hiker wrote: »

I had my first gu at mile 6 and tried taking one every hour, I was chugging water and took every water station offered which was every mile or two miles. Towards the end I started grabbing two cups. I felt well hydrated before the race and days before I started drinking extra to make sure. That makes sense, I didn’t take a gu before the race because I never did in training. They did have Lemon Gatorade but I hate that stuff so I avoided it completely. Sounds like maybe next time I should try it instead of the gu the last few miles like you said. Live and learn 😉!

That's not enough water for hyponatremia. It sounds like underfueled and perhaps a higher intensity than usual.

deannalfisher

are you taking in any kind of salt? at certain stages of endurance events your guts ability to absorb water starts to decrease because of the toll - salt can help with absorption - i use salt on course (BASE in my salt of choice, but there are other options); and in the couple days before, i add extra salt to my food

the lemon gatorade probably would have helped because of the electrolytes/salt in it

FL_Hiker

deannalfisher wrote: »

are you taking in any kind of salt? at certain stages of endurance events your guts ability to absorb water starts to decrease because of the toll - salt can help with absorption - i use salt on course (BASE in my salt of choice, but there are other options); and in the couple days before, i add extra salt to my food

the lemon gatorade probably would have helped because of the electrolytes/salt in it

I used Gu but at some point I stopped taking them during the run because I couldn’t keep them down. That makes sense, I just got bloodwork done before the race and my salt was low. It’s crazy because I put so much salt on my food! Thanks for the recommendation.

deannalfisher

if you are going to run more marathons - def. something to consider as you ramp up training - there are salt pills, salt tabs, loose salt; you can use gatorade, tailwind (liquid nutrition), infinite (liquid nutrition)

personnally I use tailwind naked flavor and then base hydro (similar to gatorade but less sugary) and then salt mixed it - and i take a sip every mile; i carry a pre-mixed bag so that way if i run out i can mix up more at an aid station

Machka9

I've had hyponatremia in the middle of a very long bicycle ride. Couldn't finish the ride. I've used electrolyte pills on long rides since then.

My hands swell when I run on hot days. I think that part might be normal.

When I ran my half-marathon in mid-January (a warm day), I drank well the day before, then the day of the run, I took a couple electrolyte pills before the run. During the run, I drank a small cup of sports drink and a small cup of water that they handed out at each drink station. I ate Clif Shot Blox (or whatever they're called) now and then through the run. At the end of the run, I drank a bottle of sports drink and a bit of water.

earlnabby

I can only address the finger swelling. I hike, not run, but have had my fingers swell on longer hikes or hot days. Keeping your hands above the level of your heart and opening and closing them helps. If I wear a backpack, I hold on to the straps near my collarbone as much as I can. Usually I just accept that it is going to happen and I take my rings off before I go.

Also, anything with caffeine is not the ideal. We have had hiking club members end up in the hospital because their "hydration" had it. They had symptoms like yours. Water, electrolyte drinks, etc. are better.

Typically after a long hike (12 miles or more) I don't want to eat until several hours later so your lack of hunger doesn't seem too worrying.

eleanorhawkins

Like others I can't comment on the marathon/fueling, but my fingers often swell on long hikes (I also have learned to leave rings off) and it's happened to my teenaged daughter a few times too. Trying to make sure we move our arms and hands instead of just letting them hang seems to help, but I guess running you're swinging your arms anyway...

spiriteagle99

Were you actually thirsty when you were drinking that much? I can see doing that during a hot race, but not so much on a cold one. You probably had a lot of water just sloshing around, not being absorbed because your body didn't need it. For my training I usually drink every two miles. Many of my races have water stations every 2-2.5 miles so that's what I train for. The only race where I felt like I was really thirsty was in Arizona with temps around 70 and full sun. (They put the water at the end of a long long line of helpful volunteers offering bacon, oreos, etc. I was dying!)

FL_Hiker

spiriteagle99 wrote: »

Were you actually thirsty when you were drinking that much? I can see doing that during a hot race, but not so much on a cold one. You probably had a lot of water just sloshing around, not being absorbed because your body didn't need it. For my training I usually drink every two miles. Many of my races have water stations every 2-2.5 miles so that's what I train for. The only race where I felt like I was really thirsty was in Arizona with temps around 70 and full sun. (They put the water at the end of a long long line of helpful volunteers offering bacon, oreos, etc. I was dying!)

No I wasn’t thirsty, but something felt “wrong”. Since I live in FL dehydration is always a fear, despite it being freezing out I thought maybe I was just dehydrated and I could jug a lot and make me feel better. In hindsight that was probably a really stupid idea, hypnatremia didn’t even occur to me at the time. My brain was pretty foggy and I wasn’t thinking. That makes sense. Aw man bacon and Oreos that sounds awesome lol!

thinbybday

What color was your urine? This may give a better idea of hydration/salt balance.

Hyponatremia can be fatal.

Get your fuel/hydration plan dialed in through further training. Keep notes on weather and intake/urine color/etc. Seems like a lot of Gu for a marathon, but ymmv.