How common is symptomatic hyponatremia in endurance athletes?
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Among trained athletes completing a major endurance event such as a marathon, triathlon, or 100-mile bicycle ride, 2% to 22% will develop a serum sodium concentration <135 mmol/L and approximately 1% will have exercise-associated hyponatremic encephalopathy (EAHE) (SOR A, based on multiple cohort studies). Avoiding weight gain (a sign of overhydration) during an event should reduce the risk of EAHE (SOR C, based on expert opinion).
Evidence Based Practice 11(6): 04.