Exercise-Associated Hyponatremia

Excerpt

Exercise-associated hyponatremia (EAH) is defined as a serum sodium level below 135 mmol/L that develops during or up to 24 hours after physical activity. EAH was previously thought to occur only in extreme endurance athletes; however, its incidence is increasing among various athletes presenting with a wide spectrum of symptoms.

Prompt differentiation of EAH from other exertional illnesses is critical, as isotonic fluid administration that may be given for other exertional diagnoses can worsen EAH, resulting in life-threatening sequelae of hyponatremia. EAH is treated with fluid restriction or sodium replacement, depending upon severity. Avoiding overhydration can prevent EAH. Athletes, coaches, healthcare providers, and athletic event staff must be educated on EAH prevention strategies and presenting symptoms to decrease athletes’ risk of development and progression to hyponatremic encephalopathy, coma, or death.