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Case series: hyponatremia associated with moderate exercise

J Zelingher1, C Putterman, Y Ilan

  • 1Division of Internal Medicine, Hadassah University Hospital-Ein Kerem, Jerusalem, Israel.

The American Journal of the Medical Sciences
|February 1, 1996
PubMed
Summary
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Life-threatening exercise-induced hyponatremia can occur during moderate exercise, not just extreme endurance sports. This condition can cause severe neurological symptoms like confusion and seizures, even in non-athletes.

Area of Science:

  • Sports Medicine
  • Endocrinology
  • Neurology

Background:

  • Exercise-induced hyponatremia is typically associated with extreme physical exertion.
  • Previous literature has not described cases of hyponatremia complicating moderate exercise.

Observation:

  • Seven patients presented with life-threatening hyponatremia after mild to moderate exercise.
  • Symptoms included nausea, vomiting, agitation, confusion, and seizures in five patients.
  • Laboratory findings revealed severe hyponatremia (as low as 115 mEq/L) with high urine sodium and elevated serum creatine kinase.

Findings:

  • Moderate exercise can precipitate severe exercise-induced hyponatremia.
  • Neurologic manifestations, including seizures, can be a consequence of exercise-induced hyponatremia.

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  • The underlying mechanism may involve inappropriate antidiuretic hormone secretion.

    • Implications:

    • Clinicians should consider exercise-induced hyponatremia in patients presenting with neurological symptoms after moderate physical activity.
    • This finding broadens the understanding of exercise-induced hyponatremia beyond endurance athletes.
    • Further research is needed to elucidate the precise mechanisms and develop preventative strategies.