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Original article
Serum sodium changes in marathon participants who use NSAIDs
  1. Steven Whatmough1,
  2. Stephen Mears2,
  3. Courtney Kipps1
  1. 1 Institute of Sport, Exercise and Health, University College London, London, UK
  2. 2 Loughborough University, Loughborough, UK
  1. Correspondence to Dr Steven Whatmough; steven.whatmough{at}nhs.net

Abstract

Introduction The primary mechanism through which the development of exercise-associated hyponatraemia (EAH) occurs is excessive fluid intake. However, many internal and external factors have a role in the maintenance of total body water and non-steroidal anti-inflammatory medications (NSAIDs) have been implicated as a risk factor for the development of EAH. This study aimed to compare serum sodium concentrations ([Na]) in participants taking an NSAID before or during a marathon (NSAID group) and those not taking an NSAID (control group).

Methods Participants in a large city marathon were recruited during race registration to participate in this study. Blood samples and body mass measurements took place on the morning of the marathon and immediately post marathon. Blood was analysed for [Na]. Data collected via questionnaires included athlete demographics, NSAID use and estimated fluid intake.

Results We obtained a full data set for 28 participants. Of these 28 participants, 16 took an NSAID on the day of the marathon. The average serum [Na] decreased by 2.1 mmol/L in the NSAID group, while it increased by 2.3 mmol/L in the control group NSAID group (p=0.0039). Estimated fluid intake was inversely correlated with both post-marathon serum [Na] and ∆ serum [Na] (r=−0.532, p=0.004 and r=−0.405 p=0.032, respectively).

Conclusion Serum [Na] levels in participants who used an NSAID decreased over the course of the marathon while it increased in those who did not use an NSAID. Excessive fluid intake during a marathon was associated with a lower post-marathon serum [Na].

  • Exercise-Associated Hyponatremia
  • EAH
  • Non-Steroidal Anti-Inflammatories
  • NSAID
  • Fluid

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjsem-2018-000364

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    Footnotes

    • Contributors SW: data collection, analysis and article write up. SM: data collection and review/editing of article. CK: supervisor, review/editing of article.

    • Funding This project received funding from the University College London (UCL) and the British Association of Sport and Exercise Medicine (BASEM).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval UCL Research Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All collated data are available to all researchers who provide a methodologically sound proposal and have the appropriate approval. Data will be available immediately following publication, for 5 years. Proposals should be directed to steven.whatmough@nhs.net. To gain access, data requestors will need to sign a data access agreement.