Mt. Whitney Portal Store & Hostel Forums General Mt. Whitney Portal Store Message Board Too Much Water

Has anyone heard about or had a problem drinking too much water on the Whitney hike? Apparently it's a risk for slow marathoners, so it's likely to turn up on Whitney as well.

The Washington Post has a good article on the topic:

http://www.washingtonpost.com/wp-dyn/articles/A9158-2003Oct23.html

Do a search on this site for hyponatremia. A hiker was evacuated from trail camp last month after suffering from that condition and spent three days in a coma in a Bishop hospital.

Thanks, WhitWalker. I've heard of people dying from extreme over-drinking of water, but never about "hyponatremia." You've added a new word to my vocabulary. The Washington Post article you refer to is quite a warning to all of us.

There is an old saying in medicine, "If you hear hoofbeats, think horses, not unicorns." When I heard the story about a woman on the mountain a few weeks ago who had to be rescued, it seems that the hoofbeats are being assigned to a unicorn. The differential diagnosis of hyponatremia requires lab tests that were unlikely to be administered on the mountain, so it was unlikely a confirmed diagnosis (which is to say that it is an unconfirmed rumor). The symptoms for hyponatremia (which is very rare and requires a combination of a lot of sweating and drinking a LOT of water - for eaxmple, a marathoon a hot day) are very similar to the symptoms for severe AMS or cerebral edema. The main problem that hyponatremia causes is pressure on the brain. That is precisely the problem caused by cerebral edema. In the mountains, cerebral edema is more likely the horse we hear vs. the unicorn of hyponatremia. In addition, dehydration is a far greater risk in climbing than hyponatremia since we carry our water vs. the frequent drink stations on an organized run. The only way I can imagine someone really ending up with hyponatremia on Whitney is to run to the summit, then stop at a creek or lake and drink many gallons of water on the way down.

Let's not send the message to climbers that they should start consuming less water on Whitney. That misinformation will be the cause of much more harm than good.

If I read all the posts correctly regarding the woman on the mountain a few weeks ago, the diagnosis of hyponatremia was not simply based on a diagnosis done on the mountain, but was based on the diagnosis done at the hospital. I don't know whether the information passed along was correct, but to suggest that the diagnosis was incorrect because it can't be done on the mountain is a misleading suggestion when the diagnosis was allegedly based on test done at the hospital.

If the diagnosis based on the bloodwork done at the hospital was hyponatremia, then it does not seem that it was the case of assigning hoofbeats to a unicorn. If doctors at a hospital diagnosed it after doing bloodwork, who are we to dispute it? If the odds against something are one in a million, if the clear and convincing evidence is in front of our eyes that we have a one in a million case, do we deny what we see just because it is unlikely? That seems like bad medical practice.

I would agree, however, that hyponatremia on Whitney seems highly unlikely. Dehydration is a far greater concern. A variety of factors, including all the ones mentioned by Sierra Sam, make hyponatremia highly unlikely. Additionally, the eating of food is not exactly common in the case of a marathon, but who consumes only water up and down the mountain? Most hikers even without having considered hyponatremia, will eat foods that will make getting hyponatremia virtually impossible in doing Whitney even if they "overhydrate."

I don't think it hurts to be aware of the potential for hyponatremia if one is not foolish about it. Have absolutely no fear of staying well hydrated, rather have a healthy fear of dehydration, but do consume something other than water -- salty trail mix, sports drinks, and whatever else one is used to eating to fuel the hike.

Also, I have never heard anyone suggest a danger of hyponatremia overhydrating before commencing an activity. Maybe someone knows better than I, but I haven't seen anything that would make me do anything but be well hydrated before starting. Not beyond common sense, but well hydrated. I then drink regularly, and drink just a little more (but not a lot more) than I think I want, and stay well hydrated.

There is really no good reason anyone should suffer from either dehydration or hyponatremia doing an activity like Whitney. Nonetheless, in a place like Whitney, dehydration is common, and hyponatremia is probably incredibly uncommon, even if it actually has happened to someone. Use common sense, neither should happen, but if you are going to worry, worry WAY more about dehydration than hyponatremia.

Bob T- Please show me where you found the evidencce for this being a hospital-based diagnosis. The post that I read said that it was based upon observation on the mountain. By the time the medevac guys were done giving IV fluids (I'm just guessing that they did), there would be nothing to measure upon arrival at the hospital.

As you point out in your post, the combination of limited water + some food makes hyponatremia "virtually impossible" on the mountain.

I believe I am the source for much of the information on the hyponatremia case. I was hiking into trail camp about a month ago when I came across a hiker and two rangers helping a female hiker who was in obvious distress. I asked if they needed and help and was told that they'd called in a helicopter and had everything under control. The "on the spot" diagnosis made by the rangers was AMS or diabetic shock. This was told to me when I asked if they needed help. The helicopter picked her up a few minutes later and we were left wondering what happened to her.

One of the guys on my trip is a friend of a friend of the victim. We did not know the victim or the group she blonged to prior to the trip and it was only by coincidence that we heard about her condition after she was airlifted out.

I was told that she suffered from water intoxification, spent three days in a coma in a Bishop hospital, and was expected to make a full recovery. After I posted an update in the thread "Drama at Trail Camp," others posted additional information about the condition. Prior to this event I had never heard of water intoxification or hyponatremia.

In my limited research (Internet and talked to a friend who is an exercise physiologist) I have heard that it is rare and usually suffered by people who are engaged in activities causing them to sweat profusely and where they are not replacing electrolytes lost in their sweat. Under normal athletic activities most people should not worry about this condition. If you are sweating profusely and drinking copiuous amounts of liquids then make sure that you include some type of electrolyte replacement. In the old days people would use salt tablets for this purpose. Nowadays there are numerous sports drinks that accomplish the same goal.

IMHO hyponatremia is not something that people should be overly concerned with. Most people know to include some form of electrolyte replacement when hiking and this event should only reinforce that point.

Do you know which hospital she was taken to? I'd like to call them and get more info since I'm still very skeptical that hyponatremia was really the diagnosis. If she was given IV fluids during her rescue, as often happens, there would be no way to diagnose hyponatremia since the IV usually contains electrolytes which would interfere with the lab tests.

I am not expert on hyponatremia, although I have heard it has "happened" at the Grand Canyon. I think Sierra Sam has a good point....it is the wrong message to send the average person they can drink too much water while up on Whitney. I have always tried to drink enough to ppeeee clear but never have been able. When I get back off the mountain I am always dehydrated. Stick to 1 quart per hour and you will never have to worry about it.

I'm not sure which hospital treated her. She is a firend of a friend of a friend so I don't know if I'll be able to get much more information. I don't know if she had a pre-existing condition that would make her more susceptible to hyponatremia. If I get more information I will post it here.

I agree with SpankyBob, hyponatremia does occur in people who drink too much water and flush the electrolytes out of their system. That's why athletes use sodium caps when engaged in endurance activies usually greater than marathon distance. I for one have suffered a mild case of water intoxification, too much water prior to a marathon with a delayed start. You don't have to drink gallons and gallons of water to get hypoantremia, one or two will do the trick.

I don't think the poster can call the hospital and get patient information due to privacy laws and I do belive that hyponatremia can be diagnosed even after an IV is given.