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Cyclists And Hyponatremia. Or Why You Might Need To Eat And Drink More Salt On The Bike

And why you shouldn’t just rely on water when on a hard ride

Many of my readers will remember Ron Mollinga, who has written articles for this site before. Ron suffers from Epilepsy, and is also a cyclist. Here’s one of his articles detailing his battle with his disease, and incorporating cycling into his life. That’s Ron on the bike, below.

Now Ron has contacted me with some more details of a more recent series of events he has experienced. A new type of seizure that he has experienced while on the bike, several times.

And he has worked out why he has had these seizures on the bike, and what to do about it.

And he offers us some advice taken from his own experiences.

Here’s Ron’s most recent experiences with Epilepsy on the bike, and his conclusions about a cause, together with some advice for other cyclists that might be well worth remembering.

Take it away Ron.

 Cyclists And Hyponatremia. By Ron Mollinga

“911, Fire, Police or Ambulance?” was the call made from my cellphone after my head was pulled out of the water on the side of Highway 19 on Vancouver Island. I remember waking up in an ambulance as it was pulling into the Emergency section of the hospital and wondering where I was. What happened? I asked the ambulance attendant who said, “Lay still, you’ve had a seizure.”

“What, a seizure?” How could this be? After all, I had had a major operation two and a half years earlier to rid me of my petite mals and nothing of the likes had showed up since.

“No, this was a grande mal seizure.” Said the ambulance attendant. “And you’re very lucky to be alive.” A grand mal seizure? I’ve never had those. And besides, why would I go from having petite mals to all of a sudden having grande mals?

After being released from the hospital the next morning with fortunately nothing more than a few scratches, I had dozens of questions going through my mind. The most important one was, why would this happen while riding my bike? Nonetheless, I kept riding with the ever present question of, should I keep riding, or is this too dangerous?

My wonderful wife was now worried more than ever of me going out by myself. For 10 years I was used to going out by myself and riding around the block hoping not to have a petite mal. However, now it seemed like I was getting grande mal seizures.

And, bang! Another grande mal seizure happened almost a month later while riding my bike. This time I was once again fortunate that there was someone nearby to call for help. What could possibly be going wrong while riding my bike? This time, my family doctor was on call that evening in Emergency and he and my wife watched me while I was unconscious and twitching on one of the beds. As a result of blood tests that were taken that evening things started to click.

The next morning, my doctor came to my bed and said, “You’ve got to start eating more junk food. Believe it or not, I’m actually telling you to do this. Your blood sodium level last night was 125 mEq/L. It should be between 135 and 145.” I was suffering from hyponatremia which is an extremely low level of sodium in one’s blood system.

After getting this lecture by my bedside, I went through a lot of tough times over the remainder of the summer. Prior to my first seizure in June, my wife had planned out a wonderful camping trip where we were going to do a lot of fun cycling. The weather was beautiful but on every ride in those summer months we were extremely apprehensive about not being near a hospital.

Unfortunately, I gained a fair amount of weight over the summer trying to get my sodium level back up. I had no idea how to do this other than to eat food with lots of salt. However, I thought about the previous summer’s rides and why seizures didn’t happen then. Finally, things started to click again when I simply looked at what I was drinking and eating.

About a year ago, I started only riding with straight water and often with no food intake prior to or during rides. I was probably a little possessed about keeping my weight down. Furthermore, I found out that one of the medications I’m on, Tegretol, has a side effect which is hyponatremia. After being on this medication for over 25 years, I was never told this and found out only by looking online. Regardless of being on this med, I have gone through something many athletes have and everyone needs to keep in mind when doing any activity where you sweat.

Generally speaking, hyponatremia is fairly easy to avoid as long as you’re eating and drinking properly while doing highly intensive exercise. Cycling is one of those activities where you should get something with sodium in it prior to riding, during riding and even after riding. This goes for all the important electrolytes including potassium, calcium, and magnesium, to name just a few.

Since learning about this the hard way, I haven’t had a seizure since July. For the next little while I’m going continue getting weekly blood tests to make sure my sodium level is normal. If you haven’t had this done in a long time, maybe it’s time to have it checked. I was very lucky to have someone looking out for me when I rode off the highway back in June and into a swamp. The couple apparently pulled my head above water so I wouldn’t drown. I hope you think about this on your next ride now knowing how easy it is to avoid.

One Response to Cyclists And Hyponatremia. Or Why You Might Need To Eat And Drink More Salt On The Bike

  1. Rovo Johnson 21/08/2015 at 8:08 am #

    Peter – I glad to hear you haven’t had a seizure since last July. I sincerely hope that continues for you!

    I know all too well about the “water only” method. On the surface, it’s easy to think that drinking water should be enough to keep you in the game, so to speak. It’s easy to get obsessed about water and lose sight of the electrolytes, etc.

    By the way, I’m loving your blog — I recently graduated to the 40 club. 🙂



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