Risedronate prevents exercise-induced hypercalcemia but not nausea or vomit in humans: a double blind randomized...

Area of Science:

• Exercise Physiology
• Bone Metabolism
• Pharmacology

Background:

• Post-exercise nausea and vomiting have been linked to elevated blood calcium levels and increased bone resorption.
• Understanding the relationship between exercise, calcium metabolism, and gastrointestinal distress is crucial for athlete health.

Purpose of the Study:

• To investigate the effect of risedronate, a bisphosphonate, on post-exercise calcium levels and associated symptoms.
• To determine if risedronate can mitigate exercise-induced hypercalcemia and its potential link to nausea or vomiting.

Main Methods:

• A randomized, double-blind, placebo-controlled trial involving 104 healthy males undergoing heavy exercise.
• Participants received either risedronate (17.5 mg) or placebo before a 5-hour exercise session.
• Assessed primary outcomes (nausea/vomiting severity) and secondary outcomes (serum calcium, bone resorption markers, heat illness symptoms).

Main Results:

• Risedronate significantly reduced post-exercise serum total calcium (tCa), ionized calcium (iCa), and tartrate-resistant acid phosphatase 5b (TRACP-5b) levels.
• The incidence of post-exercise hypercalcemia and the urinary calcium/magnesium ratio were significantly lower in the risedronate group.
• No significant difference in nausea or vomiting severity was observed between groups, despite biochemical changes.

Conclusions:

• Risedronate effectively reduces post-exercise hypercalcemia by inhibiting bone resorption.
• Post-exercise hypercalcemia appears to be a consequence of, rather than the cause of, exercise-induced nausea or vomiting.
• Bisphosphonates may play a role in managing metabolic disturbances following strenuous physical activity.