A Quick Read on Hyper Hydration From Dr. Allen Lim

Posted on November 11, 2013 by Allen Lim, PhD | 3 Comments

The Back Story:

For the last two years, we’ve been making a secret drink mix that is extremely high in sodium to over-hydrate or “hyper-hydrate” athletes immediately before they put themselves in grueling situations where they end up sweating more than they can possibly drink.

Given its purpose, we called the product our Hyper Hydration Drink Mix and kept access to it limited to only our most hot and sweaty customers – NASCAR drivers, fire fighters, and a handful of professional runners and cyclists. We weren’t trying to be elite by limiting the product’s access. Rather, we had legitimate concerns about the product’s taste and worried about what might happen if the product was used inappropriately or without hands on instruction.

So for almost two years, we tinkered, studied, and worked carefully with a cast of characters – some very fast, others slow, but all extremely smart & sweaty - to evolve our formula until we reached a point that we felt, when used as directed, the product was safe, effective, and palatable for the general athletic population to use as a method to preemptively hydrate before events known, or with the potential, to elicit severe dehydration.

It took us a while, but we felt it important to take the time and care. As part of that diligence, we want to emphasize that our Hyper Hydration Drink Mix is not a sports drink or a “use every time you exercise” product. More to the point, this product is not intended for casual hydration. In fact, we encourage you not to use our Hyper Hydration Drink Mix until you finish reading this blog, talk to your coach, health care professionals, visit google, and give your individual situation and this product some real consideration. It may not be for you. But if you decide it is, then our experience has been that it’s probably exactly what you’ve been looking for. 

 First, a Review of Sweat – Water & Salt:

 When it’s hot or more appropriately when we get really hot, whether it’s through intense exercise or from baking under a garish sun, we sweat to cool our bodies. Without that sweat and the evaporative cooling that comes with it we can overheat and literally start cooking ourselves from the inside out, which isn’t exactly good for either performance or one’s health. Unfortunately, as we sweat we also dehydrate, losing precious water and salt, both of which are critical for normal bodily functions. It’s a bit of a catch 22. Either overheat or dehydrate or both – all of which are bad.

 While the body is almost 60% water by weight, a 70 kg person doesn’t have 42 liters (1 kg of water = 1 L of water) of water to spare to keep them cool. Depending upon the situation (airflow, temperature, work intensity), exercise performance can suffer with as little as a 2-3% drop in body weight due to dehydration. By the time someone loses 10% of body weight from dehydration (7 kg or 15.4 lbs for a 70 kg or 154 lb person), it’s likely that they are critically ill or very close to it. Unlike stored fuel in the form of carbohydrate or fat, we’d kill ourselves before we even came close to tapping into all of our water reserves.

 In addition to thinking about total body water, it’s also important to realize that the water stored in our body isn’t all in one big reservoir. About two-thirds (2/3) of it is inside our cells (intracellular space) while the other one-third (1/3) is outside of cells (extracellular space). Of the water outside of the cells only one-fifth (1/5) of it is in the circulatory system as plasma in the blood (intravascular space), while the other four-fifths (4/5) lies in the space between blood vessels and cells (interstitial space).

The net result is that for an average person our blood volume is only about 5-6 liters, with only about 2.5-3 liters of that being water or plasma. Because maintaining that small plasma volume is critical to keeping our cardiovascular system functioning and precious oxygen flowing to our cells, it’s very easy to see how quickly even a small amount of dehydration can affect performance and thermoregulation (i.e., the maintenance of a stable body temperature).  Although, our body can quickly shift water from one body space to another to maintain central blood volume and blood pressure, in the heat or during heavy exercise, sweat rates can easily reach rates as high as 2-4 liters per hour, which puts an incredible strain on our total body water reserves and on the availability of water in our cardiovascular system. One way to think of it is that in an hour or two of intense exercise in the heat, our bodies need to find a way to replace almost all of the water in our blood.

Equally important, however, is the fact that the water in our plasma or blood isn’t just water – it’s more of a salty soup, containing about 9 grams of sodium chloride per liter (3.5 grams from sodium and 5.5 grams from chloride) – an amount that is similar to the sodium concentration in chicken noodle soup which comes in at 3 to 4 grams of sodium per liter.  Since the water in our bodies or more specifically in our plasma is so salty, the fluid that enters any one of the two million sweat glands across our skin is also salty. In fact, while a number of electrolytes like potassium, calcium, and magnesium are also lost in sweat, sodium chloride makes up the overwhelming majority of the electrolyte loss in sweat. For this reason, electrolyte loss in sweat is really synonymous with salt loss. More importantly, it’s the loss or dilution of sodium, not chloride, that negatively affects our physiology – a phenomenon called hyponatremia that can result in a host of problems that range the gamut from fatigue, confusion, headache, nausea, muscle cramps, seizures, and in rare cases death. Because of these potential issues, getting a handle on the concentration of sodium in sweat (i.e., “sweat sodium”) and replacing that sodium in addition to water, instead of water alone, when dehydrated from heavy sweating is paramount to performance and survival.  

 Unfortunately, getting a handle on the amount of sodium we lose in sweat isn’t that easy. Unlike the relative ease of estimating water loss through changes in body weight using a simple bathroom scale, measuring sweat sodium requires expensive and less accessible equipment. When sweat sodium is measured, however, incredibly large differences between individuals are found, with sodium concentrations ranging from 300 to 2000 mg per liter of sweat with a median somewhere between 700 to 800 mg per liter. The bottom line is that the sodium concentration of sweat is not a “one size fits all” phenomena.

The reason behind this massive sweat sodium range is primarily genetic. When sweat first enters the sweat gland it has the same sodium concentration as blood at 3500 mg per liter (3.5 g/L). But as that sweat moves through the duct or lumen of the sweat gland towards the surface of the skin, small channels inside the duct reabsorb, on average, two-thirds of the sodium. But like many physiological attributes, the number and performance of these sodium specific channels is highly individual with a genetic basis that explains most of the extreme range in sweat sodium concentration. Non-genetic factors, however, can also affect sweat sodium. These factors include heat acclimatization (spares sodium), training (spares sodium), the sweat rate in and of itself (increases in sweat rate increase sweat sodium loss), body weight and shape (a low body surface area to mass requires more sweat), and dietary sodium intake (increases in dietary sodium increase sweat sodium loss). 

 Together, these genetic and non-genetic factors explain why some of us are consistently covered in white salt at the end of a long day of exercise while others are not. They may also explain why some more easily exhibit signs associated with severe dehydration and hyponatremia like cramping, nausea, fatigue, heat stress, and headaches after a prolonged period of heavy sweating despite the use of a sports drink.  Ultimately, whether someone knows their sweat rate or sweat sodium, these collective signs are a real world and real time barometer that are extremely important to pay attention to and understand.

The Problem:

 If you’ve paid enough attention to yourself during prolonged endurance exercise or during any activity that causes you to sweat at unreasonably high rates then you probably already have a pretty good sense of whether or not your current hydration strategies are adequate. But as a point of self-review, ask yourself the following questions:

  1. Do you find yourself in situations where you sweat way more than you can drink?
  2. Are you having problems figuring out how you’re going to get enough fluid during an event?
  3. Do you compete in very intense events where you simply can’t get anything to drink?
  4. As a result of sweating way more than you can drink or not having enough to drink, do you find yourself losing an excess amount of body weight (e.g., more than 5-7% in a single bout)?
  5. Do you end up feeling like total crud, especially relative to others, during or at the end of sweaty exercise in the heat? Feeling like crud might include headaches, nausea, irritability, muscle twitches, uncontrollable cramps, and poor performance and excessive fatigue.
  6. Are you covered in a lot of white crusty salt or more white crusty salt than others at the end of a long workout? For example, do dogs love to lick you and only you after a workout?
  7. Do you think or do people tell you that you sweat a lot more than everyone else around you? For example, has any ever asked you, “Why are you sweating so much?” Usually, little kids ask this a lot.
  8. Do you get really light headed all the time when you’re training hard and suffer from excessively low blood pressure?
  9. Do you feel better when you’re constantly popping salt pills during an endurance event and are you getting tired of popping all those salt pills? Would you rather eat a bag of chips, drink miso soup, or gnaw on pickles? Seriously, are you always craving salt?
  10. Is it common for you to get so dehydrated that you end up in a medical tent or a hospital getting IV hydration?

There’s a possibility that you think these questions are crazy and that you answered “no” to most of them. If that’s the case and none of the issues listed above are a problem for you, then you can stop reading. Our Hyper Hydration Drink Mix isn’t for you and you don’t need to waste your time and money to try it.

On the other hand, if these questions resonate with you and you feel like you’ve just locked eyes with someone standing off in the distance - someone who really understands you, then we may be on to something. Despite our irrevocable propensity for jocularity (i.e., we like to laugh at ourselves & keep things funny), this really isn’t a laughing or joking matter. Severe dehydration resulting in both water and sodium loss can be very dangerous. But so can loading up on a lot of water and sodium that you don’t need, which is essentially the solution that we’ve come up with to help all of the folks out there who do answer the questions above with a definitive “yes.”

 The Solution (Common sense, inspiration, and the formula):

 One thing to realize is that, despite the product we’ve developed, there is no one simple solution to all of the problems listed above. Ultimately, common sense and safety during any activity needs to rule supreme. So as a reminder, realize that you still need to take care of yourself with proper nutrition, sleep, and training. No single product will ever make up for self-awareness and consistent preparation. With that in mind, also realize that science is not a set of facts, it’s the testing of theories. And in the realm of your personal performance, you are the experiment, which requires a level of precision, care, and honesty that may lead you to conclude that our Hyper Hydration Mix does or doesn’t work for you. Ultimately, knowing how something works for you as an individual is far more important than knowing how it works for others, despite the fact that every bit of data informs our personal decisions.

That all said, the basic question we’ve been working on is how to safely and effectively maximize the water and sodium reserve within the body, in particular the volume of the intravascular space (i.e., the water & salt in the cardiovascular system, aka, vascular space or plasma volume), to preemptively combat dehydration. Obviously, one strategy is to simply drink more water and increase dietary salt intake in the week or days before an event. Many bowls of miso soup come to mind.  In addition, another practical idea is to dramatically increase the intake of carbohydrate in the week or days before an event, since stored carbohydrate in the form of muscle glycogen contains a significant amount of water. If these two strategies are implemented properly, many athletes will gain anywhere from 3-5 pounds of water weight – an indication that they are properly tapered and nourished before an event.

 While there are a host of other techniques that have been used, with varying efficacy, to hyper hydrate the body immediately before exercise, we’ve drawn inspiration for our Hyper Hydration Drink Mix from the most effective and commonly used technique for treating severe dehydration and for increasing intravascular volume - IV hydration using normal saline. Normal saline, also known as an isotonic saline solution, has the same osmolarity and the same sodium chloride concentration as the plasma in the vascular space, making it a perfectly balanced solution to quickly rehydrate the body.

As a point of education or review, osmolarity refers to the number of molecules per liter of solution and can be thought of as analogous to the number of total passengers on a plane. This is different than concentration, which accounts for the mass or weight of those molecules in a given liter of solution and is analogous to the weight of the passengers on a plane. It’s the osmolarity of one solution relative to another that determines the movement of water across a membrane. In order to keep water within the vascular space, the osmolarity needs to be kept constant. Otherwise water would shift from an area of low osmolarity or osmotic pressure to an area of high osmotic pressure.  Likewise, the concentration of sodium also needs to be kept constant since most physiological functions depend on a stable sodium concentration. For example, if the concentration of sodium where to decrease in the blood, also resulting in a drop in the osmolarity of blood, water would begin shifting out of the vascular space, into the interstitial or intracellular space, essentially dehydrating the cardiovascular compartment. At the same time, water would also be excreted by the kidneys to help return the concentration of sodium back to normal - a situation that would further dehydrate the body as a whole. Ultimately, osmolarity and concentration rule supreme. An ideal sports drink, for example, needs to have the same sodium concentration as sweat and a very low osmolarity compared to blood so that water in the gut can rapidly move into the blood stream. Similarly, the ideal solution to increase total body water, especially in the vascular space before sweating ensues, needs to have the same sodium concentration as blood or plasma as well as the same osmolarity making it “isotonic.”

Under the right circumstances, IV hydration with normal saline is safe and effective. But the use of IV hydration immediately before an athletic event in an otherwise healthy individual is not the right circumstance for a number of reasons. First, it’s just not practical or efficient. In fact, a number of studies have demonstrated that in patients that are conscious and free of gastro-intestinal problems, oral rehydration is easier and faster than IV rehydration. Second, the use of IV hydration is cost prohibitive for most athletes, though there are a number of reports that in some sports like American football, that the use of IV hydration pre-game is common practice, especially for athletes known to have issues with dehydration. Whether this is ethical or not is its own and final debate against IV hydration as a pre-exercise hyper hydration technique.  

More importantly, however, there’s a very specific reason why normal saline is generally infused and not ingested orally. That reason is because it’s nearly impossible for someone to rapidly ingest a large volume of normal saline because of it’s taste and because of the irritation caused by the large chloride concentration. Anyone willing to drink a liter or more of a normal saline solution would likely end up feeling nauseous and vomiting. It’s that bad, so we’ve been told by our local ER doctors. Our experience with athletes has always been that when too much sodium chloride or table salt was put in solution, the chloride could be a major irritant. That said we never experienced problems with sodium chloride when it was paired with real food. It’s a funny thing but perhaps a sign that we are not yet smarter than nature when drinking a bowl of salty soup is soothing while a saline solution with the equivalent amount of salt is not. Go figure.

Based on all of this, we formulated our Hyper Hydration Mix to have the same osmolarity and sodium concentration as blood at 3.5 grams per liter. But, instead of using sodium chloride, we paired the sodium in our solution with citrate, which is essentially a neutralized fruit acid or citric acid, the primary ingredient in lime juice. One of the major benefits of using sodium citrate instead of sodium chloride is that sodium citrate is very easy on the gut. The second benefit is that citrate, unlike chloride ion, can be consumed as a substrate or fuel source for energy creating metabolic pathways, specifically as a metabolite in the Citric Acid Cycle (aka, Kreb’s Cycle), a critical pathway for the conversion of sugar and fat into energy. Finally, sodium citrate is a very strong buffer. When it comes to the control of our body’s acidity level (i.e., acid-base balance), increasing positively charged sodium ions and decreasing negatively charged chloride can actually help to buffer or make the body less acidic – an idea known as the “Strong Ion Difference.” Ultimately, this buffering capacity may have positive consequences during intense exercise, especially in the first 5 to 10 minutes, though the performance literature supporting this is mixed. 

 Beyond the use of a large quantity of sodium citrate instead of sodium chloride, our Hyper Hydration Mix is also paired with a small amount of cane sugar and glucose. Water movement across the small intestine can be facilitated by the co-transport of sodium and glucose, where the pairing of 1 glucose molecule to every 2 sodium molecules allows the movement of 210 water molecules across the intestine via a specific sodium-glucose transporter. This co-transport is in addition to the passive movement of water across the intestine via osmosis. Because of this mechanism, we added enough glucose to the formula so that every sodium molecule could be used to maximize the movement of water into the body.

Finally, we struggled to make this high sodium drink palatable. The answer finally came to us in the form of a mango, or more accurately, in the form of many mangos. Putting aside the science hat for a moment and considering the problem from a culinary perspective, we realized that many cultures use mango to cut the saltiness of a dish. To our happy surprise, it worked. But, it took a lot of mangos. The total number of mangos, not the science, is the real secret behind the formula, so we’ll keep that to ourselves for now. Just know that it’s the most expensive ingredient in the entire product. In fact, you’re not really buying a lot of sodium, you’re buying a lot of mangos. Still, with the lower sugar and the extremely high sodium content, there’s no way that we could ever make this product taste even close to our line of Exercise Hydration Mixes. Compared, however, to normal saline and many other sports drink on the market, we feel pretty good about where we landed, especially since we were still able to solve the problem at hand with a bare minimum all-natural approach.

Based on the number of total mango molecules, sodium molecules, and sugar molecules, we pretty much had to stop there to keep the drink isotonic at 280 mOsm/L. Although, we tried throwing more ingredients in the mix, experimenting with different levels and types of sodium salts, percentages of carbohydrate, and fruits we found that the less is more approach worked the best. For example, any more sodium or additional ingredients and we risked making a solution with too high of an osmolarity which could result in significant gastro-intestinal distress and even diarrhea. In contrast, any less sodium than what’s found in blood and we wouldn’t maximize the amount of fluid retained in the vascular space before the kidneys would filter the excess water because of changes in blood pressure or sodium concentration. 

In the end, this product is intended for one specific purpose – to maximize hydration before an event that’s about to punish the participant with a heavy dose of dehydration.  Our solution was to create a product that increases the total sodium and water reserve within the body. Not only is this useful for athletes who know they won’t be able to drink enough to match their sweat losses, it’s also been extremely useful for athletes who know that they lose more sodium that our Exercise Hydration Mix provides them. Ultimately, dehydration is about a loss of both water and sodium and our Hyper Hydration Mix helps athletes to maintain both.  And since it’s sometimes hard to get a handle on how much sodium or water you’re about to lose, then sometimes the simplest solution is to just start with more of what you know you’re going to lose and that you know you can’t afford to lose.

Concerns with the Solution:

What’s ironic about all of this is that the high sodium content that forms the basis of our solution for extreme sweat rates is also the biggest single risk and problem with the solution. At 1700 mg for a single 500 ml serving (3.5 gram per liter), our Hyper Hydration Drink Mix is inappropriate for casual exercise use. A single serving, is similar to the amount of sodium that you’d find in two slices of Pizza Hut Supreme pizza (1720 mg Na+) or six slices of bologna (1850 mg Na+), or two cups of miso soup (2000 mg Na+).  Despite the fact that all of the foods listed above are commonly consumed and thought of as safe, like our Hyper Hydration Drink Mix, they can lead to the potential for an unsafe increase in blood pressure, especially in physically inactive individuals.  Thus, our biggest concern is that someone who is not healthy or is not intending to use the product mistakenly uses it, putting an inadvertent strain on their cardiovascular system. 

Beyond the potential for an elevation in blood pressure, there’s also the risk that sodium sensitive individuals who don’t lose a remarkable amount of sodium in their sweat or who are already adequately hydrated will experience bloating and excessive water retention with the product. For most in this category this will lead to a little discomfort and the knock to their vanity from not looking as ripped or vascular. At some point, the excess fluid will be relieved by excess urination, which in and of itself can be a hassle or concern, especially if occurring in the middle of a workout or ride.

Another concern is that because our Hyper Hydration Drink mix already has a very high sodium concentration and osmotic pressure equal to blood, if very sweet or salty drinks and foods are paired with the product, especially in the presence of a lot of caffeine, then there is a risk that the combined osmotic pressure could overwhelm a person’s gut and cause diarrhea. So it’s important that the drink is used by itself on a relatively empty stomach.

For some, a real valid concern is that they won’t enjoy the taste. If that’s the case, we’d suggest not using it and trying to drink 2-4 bowls of miso-soup right before a grueling event with minimal access to hydration.

Finally, some athletes that we worked with were concerned that the extra water weight would hurt their power to weight ratio. While too much fuel on a helicopter can definitely keep it from flying, when it comes to performance in very intense and hot situations, despite the increase in water weight, it’s unlikely that there would be any hit to that all too precious power to weight output. If anything, the improvement in cardiac output will likely enhance performance, especially relative to competitors who are more dehydrated late in a race or event.

Practical Advice on Experimenting & Usage of Hyper Hydration:

Like most ideas concerning training and nutrition, we are all individuals and responses will vary from person to person. As a generic recommendation, we advise the following directions for use:

  1. Only use our Hyper Hydration Mix before situations where you know you are about to experience intense exercise that will elicit extremely high sweat rates. If you use it before a casual training ride with your buddies, for example, you’ll likely just end up holding up the ride because you’ll end up needing to urinate frequently throughout the ride.
  2. Only use our Hyper Hydration Mix if you are healthy enough to experience intense exercise in situations that will elicit extremely high sweat rates. Consult with your health care professional if you have any questions or concerns about this.  
  3. Start by drinking 1 to 2 servings (1 serving =’s 1 packet mixed with 500 ml of water) about 30 minutes prior to exercise, finishing about 10 minutes before the start of exercise. A good starting point is to goal to consume a total of 10 ml per kg of body weight before exercise.

Based on these generic recommendations, the athletes we have worked with to develop this product have adopted varying personal strategies for the use of the product. Many find that it’s helpful to “top themselves off” the morning of an event by drinking 1 to 2 servings of Hyper Hydration Mix a few hours before competition. If they are already dehydrated from training or the previous days competition, they’ll tend to hold most of the extra fluid they consume and not urinate a lot of it away. If, however, they are adequately hydrated, then using the drink in the morning gives them time to urinate any excess fluid away before competition.

Other athletes have reported that they have good success when they begin using the Hyper Hydration Mix the day or night before a very important event as part of their taper.  While simply increasing their water and dietary sodium intake might work equally as well, for some using our Hyper Hydration Mix is a simple and convenient way to bolster their water and sodium reserves. That said, it’s by no means the only way. In fact, we’ve found that some athletes simply use our product because they are unsure of where they are with respect to their hydration status on any given day. One way to get to know where your hydration stands is to get familiar with your morning body weights as well as the changes in body weight caused by training or competing in different environments. Large or sudden drops in weight are likely due to dehydration.

For athletes, who know that they are adequately hydrated, they have found that our Hyper Hydration Mix becomes more effective when they consume it closer to the start of exercise. This is because if they drink too far out from exercise, the sudden increase in blood pressure simply causes them to urinate most of the extra water away. By waiting until just before exercise, blood flow is redirected away from their kidneys while sweating begins to pull away the excess water and salt reserve. This typically creates the biggest increase in performance relative to their non hyper-hydrated competitors. That said, it only works in very hot environments and for very intense bouts of exercise or competition.

The most important thing to remember is that our Hyper Hydration Mix has very specific use parameters. It’s not a drink anytime sports drink and needs to be used carefully and sparingly with real attention to how you feel and respond. Everyone is different and what works for one person may not work for you. Be willing to experiment and test and above all else use common sense. Less is often more, especially with a product that already has more in it. 

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3 Responses

jason
jason

April 10, 2014

Viv: Sorry for the slow reply! If it’s really hot/humid while you’re outside for 10-12 hours you might find that one serving of hyper helps to preload your bodies hydration. But yes, you will still want to consume Exercise Hydration throughout the day. Please send us an email info@skratchlabs.com if you’d like more info.
thanks!

Viv
Viv

March 31, 2014

Hi there, would this be appropriate for 2-3 wks of walking/standing 10-12h / day in tropical heat & humidity? I’ve acclimatized and have low blood pressure and low heartbeat rate (appearing like a fit athlete) even though I don’t really work out. Am 5’7, 126.5 pds, late 30s, female.

And with this, do I then skip the Exercise Hydration mix? The above period is for a mission-critical project, so I really need to know the optimal hydration product. Thanks!

Pls advise. Thanks!

jason
jason

November 20, 2013

Mr Nedbot, very nice work sir, you are absolutely correct, 10 ml’s per kg is the amount we are after. Second, good job getting that far in the post, we are glad you found it stimulating! Thanks for catching that for us, and for all your support, please don’t hesitate to get in touch if you have anything else to add.

~Jason and the Skratch Team

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