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Dewey Oxberger 07-22-09 10:21 PM

Watch out for low sodium
First, let me say over the years I've learned a lot from this forum. Thanks to everyone for all the great posts.

I've been a clyde-commuter for 18.5 years now. 41,000 miles so far. For the last 12 years I've had an increasing problem with what I thought was hypoglycemia. I would bonk at the drop of a hat. Heat kills me. I get heat stroke just thinking about a hot day.

Well, twelve years of wondering what broke finally came to an end. It's such a simple solution for me I thought I'd pass it on and hope it helps someone else:

My symptoms (or things I've noticed about how I feel):
1) I sweat way more than the average person. I drink tons.
2) I get heat stroke easier and easier as the years go by. It seems like the more I drink the easier I get it.
3) I seem to always have that brain-fuzzy bonk feeling. It seemed like my blood sugar was always out of whack.
4) Loads of muscle twitches. Drove me crazy.
5) Muscle cramps everywhere, and I do mean everywhere - places that shouldn't cramp because you can't uncramp them when they do :eek:
6) Tired all the time.
7) I also am experiencing low blood pressure. When I stand up I just about black out.

It occurred to me the symptoms are worse as the heat of the summer really comes on. By late summer I'm toast. I starting thinking about sweat. I started wondering if I was low in sodium or maybe potassium. I decided Morton Lite salt is cheap so I got some and took 1/8 tsp per day (it has sodium and potassium). After two days all my symptoms cleared up. Every last one of them. Twelve years seems fixed overnight. It has been two months now and I'm still humming right along. No muscle cramps, no twitches, brain is working great. I've dropped to about 1/10 a tsp and I'm still working just fine.

I've been trying give myself heat stroke (working the yard at noon for two or three hours) and I'm back to my old self - no heat sensitivity.

From a few hours with google it seems sodium, heat stress, and blood sugar are all related.

Anyway, if you sweat like crazy it might be something to think about.

FZ1Tom 07-23-09 12:15 AM

You wanna be careful about that.....hematology (blood medicine) is quite complex, and there's a lot of balancing acts going on, all intertwined with one another too.

You should see a doc once in a while, and he should order some blood tests (CBC, CMP, others) which would tell you your sodium and potassium levels. I've had low levels of both before at one time or another and it's not fun. Oddly, low sodium is usually due as much to excessive fluid intake as it is to fluid loss. Assuming you eat a reasonably balanced diet it's very unlikely that you should have to eat table salt, of all things, to resolve your symptoms.

I'm thinking you REALLY should see your doc about your long term symptoms, particularly your sweating and subsequent thirst - could mean many things, but diabetes and diabetes insipidous in particular. Good luck!


DennyV 07-23-09 07:47 AM

I found the same thing you talk about. It's called Hyponatremia, but I only take extra salt when I will use it, i.e. hot and humid days when I'm riding more than an hour. I had been taking an over the counter product called Thematabs which is a new version of the old Salt Tablets that used to be everywhere. However lately it's just been a $1 bag of Potato Chips. This summer hasn't been very hot and humid so far. Chiips have salt, potassium and carbs, oh and a fair amount of fat....ummmm fat.
I also have been using gatoraid powder that I mix about twice as strong as recommended. The stuff you buy in the store has too little salt for the fluid you have to intake to get it.
If you do the research you'll find a 240 pound male can expend over 600mg of salt an hour on a hot day. Drinking just water or sports drink will not replace the electrolytes. I think gatoraide is formulated for people around 160 pounds, so there isn't too much of anything.
I know Salt is vilified in the press and Doctors are cautious about it, but it is an important component in the body.
The fact is I ride and feel much better, when I replenish the salt I use.
A recent story: Last month I rode on an 8 man Race Across America team. We were in Arizona out near Sedona. It was very hot, and dry. After several hours I started feeling like crap. I had been taking a Supplement popular with bike riders, so I thought I would be ok. Finally I read the bottle and found that there was only about 40mgs of salt in one capsule, I know from experience this was not enough. We stopped at a convienience store and I bought a BIG bag of potato Chips and I downed several good big handfuls. In minutes I was back to normal, or as normal as I get. From that point we were never without a bag of chips or pretzels or some salty snack for the rest of the race.
BTW I'm Type 2 diabetic, and it is easy to confuse the two symptons as was previously mentioned.

lmxloco 07-23-09 07:57 AM

You know, for as much as I ride and as much as I sweat it never crossed my mind about the extra sodium my body was losing through sweating. I sweat a lot...more than I care to admit (I weigh 195 or so, but can sweat just tooling around a parking gets annoying)...but after riding I only try to replace fluids (gatorade/water/protein shakes, whatever)...never once thinking my occasional dizzy spells from getting up quickly, or my dizzy spells during rides could be a problem of anything other than lack of fluids (I do drink a ton of water, though).

My recent bloodwork came back fine, so I know I don't have any major problems, but I might try adding a bit more sodium to my diet to see if that corrects any heat issues I have.

bautieri 07-23-09 08:40 AM

Well, if nothing else I guess you don't have to worry about goiters anytime soon.

Thanks for sharing!

Dewey Oxberger 07-23-09 09:15 AM

See a doc is good advice for sure.

I've been to the doc several times in the last 12 years. I even changed docs because I wasn't happy with the level of thought being put into diagnosing this problem.

No matter what doc I go to they all focus on hypoglycemia. I get a blood sugar test (always normal). Even get glucose stress tests (some docs won't do them, some will, always normal). Nobody every talked about sodium.

I made it clear to all the docs that I cycle to work, I sweat a lot, the problem is seasonal, it peaks in August, I'm fine in January, I even insisted it seem related to cycling.

I always get, "Just eat smaller meals, more times a day."

It was a total dead end.

The only doc who check sodium and potassium levels did so in early January (they were at the low end of the normal range but were considered okay).

As for diet, I wasn't adding any salt to anything ever. I don't cook with it. I don't put it on anything. I started doing that about 16 years ago.

I'm ramping down the salt to see how little it really takes to keep me functioning. It sure isn't much.

LandKurt 07-23-09 09:47 AM

I sweat a good deal also, always have. So I worry about my hydration and electrolytes when I cycle. I'm not sure I've got it right yet. I probably need to carry more than the two bottles I take with me on a ride. That's just not enough if I push on for a few hours.

For electrolytes I use nuun tablets in one water bottle. That doesn't have any sugars just electrolytes and some flavor. If I want energy I eat something. You got me wondering about sodium so I looked it up. Nuun contains 360 mg of sodium per tablet to go in 16 oz of water. It also has 100 mg potassium and some calcium and magnesium. Seems like a reasonable mix for heavy sweating. I should probably work on drinking more of it during my rides and see if I can push farther.

I do have to wonder if blood tests would be very useful. It seems to me like electrolyte imbalance would be a fairly temporary thing unless there was a dietary or metabolic problem. A blood test right after a ride would show how bad things got, but I'd think that days later things would even back out.

con 07-23-09 10:09 AM

I sure know my night time muscle cramps went away the moment I started putting about ľ teaspoon of salt in my water bottles every ride.

Iím also very aware that I handle heat far better since I started doing this.

Important note; I donít have any blood pressure or heart conditions that preclude me from doing this; so, it works great for me.

dgrenthum 07-23-09 10:47 AM

hmmm, i am glad you posted this. Salt has been so demonized that i refuse to put it on anything. I play basketball on saturdays for about 3 hours and i always take a gallon of water that i usually finish while out playing. Regarless some days i would finish up with a mild headache and then end up with debilitaing heat stroke. I figured that couldnt be right becasue i drink and rest plenty between games. After talking to my dr. buddy (physical therapy dr. not MD) he said it could be becasue of lack of electrolytes. So i started drinking 4-32oz gatorades while playing and i havent had a problem in the last two months.

By the list the OP has up there i have about 4 of those symptoms on a weekly basis. My doc says my normal blood work is fine. I wonder if adding some salt might help out, it did with the Bball. Thanks Dewey for the post

DX Rider 07-23-09 11:02 AM


Originally Posted by Dewey Oxberger (Post 9334992)
2) I get heat stroke easier and easier as the years go by.


Heat exhaustion maybe, but heat stroke is extremely serious. You would need to be hospitalized,since you're core temperature would have exceeded 105 degrees, and you will need to be immersed in an icebath in order to rapidly lower that temperature. It's not something that is cured by a cool cloth and a couple of sips of a water bottle.

Heat stroke victims often lapse into a coma, or at the very least lose conciousness, since the brain is overheated. The result being either death or mild to severe brain damage.

Heatstroke isn't something that you just walk off.

hammond9705 07-23-09 12:03 PM

I won't comment on your specific case, but the great majority of Americans already get too much salt from their regular diet. For long (90 mins or longer) rides in the summer it makes sense to get electrolytes from Gatorade or something similar.

therhodeo 07-23-09 12:11 PM

I used to do about 80-90 baseball games a summer and when you're playing double headers on 100 degree July days and wearing knee high socks, sliding shorts, pants, 2 shirts, and a wool blend hat you lose alot of fluids. I always felt like crap if I didn't eat sunflower seeds while I was out there. You can only sweat out salt and intake only water for so long.

Rhodabike 07-23-09 12:26 PM

Calcium and magnesium can also be lost with copious sweating, and a deficiency of them can also cause muscle cramps. This is believed to be the reason why pro bike racers often have shockingly low bone density. So have a big glass of milk with your pretzels!

DX Rider 07-23-09 12:39 PM


Originally Posted by Rhodabike (Post 9338951)
Calcium and magnesium can also be lost with copious sweating, and a deficiency of them can also cause muscle cramps. This is believed to be the reason why pro bike racers often have shockingly low bone density. So have a big glass of milk with your pretzels!

+1 on the calcium, it's also an essential if you're trying to lose weight.

CliftonGK1 07-23-09 01:15 PM

LandKurt mentioned NUUN, and I've gotta give a +1 to that. Not only because it's a local company, but because their stuff works. I first tried it out on the Tour de Cure last year, and have been using it ever since. (But I don't trust some of the flavours they've come up with! Tri-berry or lemon-lime is fine by me.)

The other one I've found to be a grand help since I started with long and ultradistance riding has been Endurolytes (Hammer Nutrition). It's the only thing from Hammer I can actually use. Like a few other people, I've got some over-productive sweat glands and need to keep things replenished even on the coolest of days. I'll take between 1 and 3 Endurolyte caps every 60 - 90 minutes when I'm out on a long ride.

djnzlab1 07-23-09 05:21 PM

Most problems are K or potassium
all foods we eat that are processed have to much sodium, the problem lyte is K or potassium, when we run low on that are bodies can have problems with muscles cramps and Abnormal heart beat. and calcium and Magnesium are critical for muscle function. We need to invent a Bicycle related Stevia based beverage
that has more K,than NA, Ca, Mg now that would be the ideal drink
SO I also like the non-glucose hydrating powder you add to water most have 3 times the sodium to K except for a few sold in running stores I forget their name and they have the new natural sweetner(Stevia) thats considered to be safe where many of the diet drinks actually have a by product that can be toxic or carcinogenic. and that gatorade has way to much sugar that can make you puke or gain weight..

found a link to best beverage for exercise I ve found

signs and symptoms of heat problems.

Finally once you have had a sever episode of over heating people tend to reoccur more easily, it was so bad
when I worked in a dispensary at Paris Island they would discharge a young marine if he ever had a sever occurance of heat stroke due to the fact ,some people overheat easily and tend to have reoccurance of problems in high temps.
Think of a marine in battle gear in the desert wearing a gas mask for a couple hours.

deraltekluge 07-23-09 09:27 PM

Your body needs only about 500 milligrams (mg) of sodium (about one-quarter of a teaspoon of salt) each day. The Dietary Guidelines for Americans recommend that you eat no more than 2300 mg of sodium each day. (One teaspoon of table salt contains about this amount.) If you have high blood pressure, the recommendation is to reduce the amount of sodium in your diet to 1500 mg each day or less. The average American adult eats quite a bit more sodium than this--often between 4000 and 9000 mg of sodium daily.

LandKurt 07-24-09 08:54 AM


Originally Posted by deraltekluge (Post 9342565)
Your body needs only about 500 milligrams (mg) of sodium (about one-quarter of a teaspoon of salt) each day.

That is likely the correct amount for an average sedentary adult. If you're spending hours in the heat sweating heavily you're going to be in a completely different category. The only reference I can find says that sweat typicaly contains 900 mg sodium per liter and 200 mg of potassium per liter. Cycling for a few hours I suspect I sweat out a liter or two based on the amount of fluids I need to consume during and after the ride. That's a lot of salt to replace. It would be unhealthy to stick to a low salt diet under those conditions.

lutz 07-24-09 01:10 PM

As said before, salt has been demonized endlessly in the last decades. AFAICS, because of the potential relation to hypertension. However, only about one 1/5th or 1/3rd of the US population are estimated to have sodium sensitivity ("significant" rise of blood pressure with sodium consumption).
Many people likely would not have to worry about salt dangers.

redvespablur 07-26-09 03:43 PM

I never usually think about salt - but out doing 64K in heat today and faded badly down stretch. Got home fine but thighs ached and dizzy etc fading fast no appetite. 2 x 710ml Gatorade and right as rain pdq. Will make point of bring saltier drinks on ride b/c the salted cashews halfway was not enough

LandKurt 07-26-09 09:05 PM

I did 52 miles this afternoon in 85 degrees and high humidity. I took three bottles of water and went through it all. Out of curiosity I got on the scales right after getting home and found I weighed seven pounds less than this morning. That's a lot of water weight to sweat out. Maybe I'm just not drinking enough.

Neil_B 07-26-09 09:18 PM


Originally Posted by LandKurt (Post 9360079)
I did 52 miles this afternoon in 85 degrees and high humidity. I took three bottles of water and went through it all. Out of curiosity I got on the scales right after getting home and found I weighed seven pounds less than this morning. That's a lot of water weight to sweat out. Maybe I'm just not drinking enough.

You should have had at least twice as much water. I'm getting cramps just reading your post, Landkurt.

LandKurt 07-26-09 10:29 PM

Luckily I didn't have any problems with cramps, but I was fairly exhausted by the second half of the ride. Think I pushed too hard the first half. I'm just pointing out how much you can sweat out during a ride. I drank nearly half a gallon (64 fl oz) during my almost four hour ride. The seven missing pounds implies nearly another gallon not replaced. I lost a lot of salt through all that sweat. Salt drying on my face. Salt whitening my cycling shorts. Salt and other electrolytes that need replacing.

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