Archive for the ‘heat stroke’ Category

This Sunday, 4 Sep, it will be the half marathon, leading to the full marathon end of the year.

Again, I have to warn participants out there especially the newbies and the slower runners who have plenty of time to drink along the course.  If they are only drinking just plain water.


Watch the first video of the two seasoned women triathletes, Sian Welch & Wendy Ingraham – crawling to the finish line during the 1997 Ironman World Championships when they lack salt and having the effects of brain edema (water retention) without knowing that the latter is the one that can kill them. Ignore the first video commentator comments as he obviously knows very little.  The second video comments is the one to take serious note despite the spoof on the first video in the later segment. Quite hilarious but a serious matter nonetheless.

and the second video when Sian Welch, acknowledged that she had no electrolytes and that she lost her salt packs.

In the words of the two participants, available in the Youtube video, both did not plan their hydration properly.

31-year-old San Diego resident, Sian Welch, who was fifth, found herself vomiting during the 112-mile bike ride.  She said “I had no electrolytes and was only drinking Coke and water.” found herself vomiting during the 112-mile bike ride.

Meanwhile, Ingraham also revealed that her salt tablets fell out of her wrist band on the run, and that created problems for her.  “I need a lot of sodium in my body,” she said. To make sure she doesn’t lose all of her tablets, she said she will tuck them various pieces of clothing on her person.  Ingraham was leading the women’s race until the 15th mile when the loss of her sodium tablets caused the cramps to begin.” (link)

If it happens to seasoned athletes, imagine what it can do to newbies or the ill-advised.

Hence since 2003!!!! US Track and Field (USATF) had issued a new hydration guidelines that recommend distance runners or those in arduous events lasting long durations to replenish their electrolytes.  Importantly, the recommendation is to drink only when thirsty and not to drink ahead and load the body with too much fluid.  In long distance running when the body lost too much salt, or rather use too much salt, it will secrete a hormone to retain water to preserve the remaining salt necessary for your heart beat (since the heart is a muscle) and other muscle to contract.   Those walking the long journey will have plenty of time to drink alot of PLAIN water and this will cause the body to retain the water in a effort to CONSERVE the salt.  So your body will bloat and it is ok but when your brain bloat, it will crush against the unbloatable skull and you will die in excruciating pain.  So remember to drink enough electrolytes during the long journey but again too much electrolytes will also retain excessive fluid and cause brain edema too.  So the guideline is to be slightly dehydrated for optimal performance.

So if the medic comes up to you to force you to drink more water when you collapse due to water retention.  I can only say, good luck.  Likewise trying to use sprinkler to contract a hot and bloated body and skull is pretty scary and antagonistic to me too.

Do read up on the latest findings.  It is your responsibility too. Our guidelines given in the major papers are at best for casual reading and should be read with a pinch of salt.  Seriously, some of those writers, never run at all.  One even wanted the entire population to take less or even no salt.  Obviously he was thinking for himself in his posh office and not caring for those who run or force to run long distance.  Even uneducated trishaw pullers in the good old days knows how to mix salty soya sauce with rice for both electrolytes and carbohydrates.  The reason why they squat on stool during lunch breaks is not due to their low-class status as many parents warned their children during that era but rather a clever body response  to stretch their tired and sore contracted calves and leg muscles during breaks.

I also notice that many women who drink copious amount of water to flush out whatever toxins they think they have, often have bloated bodies and legs.  This is also the same body response to retain the water to prevent unnecessarily lost of electrolytes (sodium, potassium, calcium and magnesium).  Notice that women likes to salty preserved plum and other salty sweets to compensate for electrolyte loss due to water intoxication and during their periods.  Further loss of electrolytes during their menstruation also lead to cramps and bloatiness  if they continue to binge on water alone to flush out whatever toxins.  I find this rather perplexing.  So they becomes bloated with high blood pressure and doctor or sinseh will advice them to take less salt and leading to a spiraling vicious cycle that could cause failure of the entire body system leading to shutdown, failed birth conception and delivery etc and other complications like kidney failure etc.  So everything must be balance including water intake ladies!  Not sure if the authorities care to comment on this.

Likewise heavy beer drinkers have bloated bodies too without electrolytes compensation.  Taking salty peanuts with beer have its own reasons too.  I am a bit tired to elaborate.

Take care.



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It is very saddening to hear about young people dying from “heat stroke” and we should try to not only to seek ways to detect and prevent such untimely deaths but especially to try novel approaches in treating those “fallen” victims.

I noticed that many such deaths do precede with splitting headaches, disorientation and nose bleeds.  This is perhaps nature of telling us that the person could may not be “dehydrating” as generally belief but could be suffering from brain edema (swelling).

This is when the body having lost alot of salt will initiate its bodily defence mechanism to secrete vasopressin to prevent urinating or even sweating to prevent further loss of salts through these channels.    So instead of giving the “heatstroke” potential victim enough electrolytes (salts) to promote sweating, they are given more water and hence their body and particularly their blood vessels will become BLOATED.  If you drink two water bottle, about 3 litres, and suffering from water intoxication, preventing sweating and urinating, then your body weight should increase by 3kg. Right?

So nose bleed is a possible first indication that your blood pressure is perhas too high from too much fluid retention.  In your brain, it will bloat against an “unexpandable” skull and this will seriously damage your brain tissue.  My wife’s friend, Poh Ling, says her son has nose bleeding and their doctor says it is good, meaning his body is strong.  I do not know what to say when I heard this.  I have since warned my son to ensure that if he drinks a lot of plain water in hot weather, be mindful of having adequate salts too.  He agreed.

I also do find it rather lucridous for a “heatstroke” victim to be put under a “water sprinkler” system, to cool his body since this will only cool the skin surface and his body will response by further closing his sweat pores to prevent further heat loss.  Likewise his blood vessels below the skin will also contract upon the false “cooling” sensation detected.    Instead the poor victim should be brought to a dehumidified area to facilitate sweating.   Maybe there should be immediate infusion of diuretic compound or medicine to allow his body to sweat.

I have proposed about it sometime last week that maybe we should try a novel method, that is to do some form of “blood letting” at specific parts of the body vascular system to allow the bloated vascular system to “deflated” and rapidly reduce the pressure on that had reached bursting point especially at the capillaries in the vital organs.   In any edema, speed is vital to prevent total organs breakdown.  Thus “blood letting” would be like mimicking the natural body defence mechanism of “nose bleeding” to reduce pressure to the brain.  Right?  Of course, you are telling me that the bleeding is actually a hemorrhage bleeding from dengue etc.   I do not think so, logically to speak.

At for preventive approach, I always said that for those taking endurance events must remember to balance and replenish their electrolyte.  Trying to lost weigh and be physically fit, is unfortunately antagonistic to each other, especially in a short timeframe.   Too take very little salt and then try to run or partake in endurance physical events and then drinks lots of water is almost like putting your body to the extreme.  Imaging having cramps from all the way from your calf towards your heart (a biological pump) that require optimal balance of salt (sodium, potassium, calcium and magnesium) to function.  To say that the victim could have some underlying heart conditions that may not have been detect is also true, but did we really provide the poor soul with adequate electrolyte.  I understand that the US soldiers carry electrolyte replenishment packs as part of their combat ration and perhaps we should introduce this to our schooling kids as well to educate about  the importance of electrolyte balance.

However, for the adults who may be taking too much salt in their normal diet, then they need not drink too much isotonic drink either for their fun run.  But to deprive the youngsters and those doing serious training from having adequate salt when we ask them to partake in endurance event is, perhaps, a bit too selfish.

Lastly, I now begin to wonder if those people who goes in to emergency ward with high blood pressure will find their pressure lessening is probably because after having so much vials of blood withdrawn for testings, one should not be surprise if their pressure actually drop to a decent level and hence be discharged.  However, this is another issue that I may want to write about later.  Maybe I should donate more blood to lower my pressure too!  Hee Hee!

Do take care!


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Yeah. You probably would say that I am being naggy again to harp on the importance of Magnesium again. Well you are right! Anyway, it was because I have borrow this book “The Health Detective’s” from the Woodland Library (written by Nan Kathryn Fuchs, Ph. D) and it seemed to confirm those things that I have been telling others about the marvel of this essential mineral.

However, to make things simple (as compared to my earlier postings),

Do take Magnesium if you want:

a. A restful sleep (since it helps to regulate heart beat)

b. A performance edge in endurance run (like marathon) since the the current isotonic is (purposely) missing this performance addition to keep the masses from maybe achieving peak performance.

c. Prevent osteoporosis (as it makes bones flexible as compared to calcium that makes bones brittle)

d. Prevent arteriosclerosis (since it removes excess calcium in blood stream from depositing onto the arterial walls and the narrowing would lead to hypertension itself)

e. Prevent child birth delivery deaths since the poor mothers are usually in a edema (water retentive) state with hypertension. The long contraction period in deliveries are like running a full marathon on ends. Maganesium sulphate were used long ago but superceded by “new” medicines that actually are expensive and does nothing really.

f. Higher survival rate in the event of a heart attack. (As written in Nan Kathryn Fuchs’, Ph. D book, she quote a magnesium expert who suggested having immediate intravenous magnesium for those whilst still on the ambulance on their way to hospital). I think it should be done immediately for those who collapse during arduous runs possible from water retention and brain edema.

g. Prevent heat stroke death, since magnesium regulate heart beat and prevent brain edema as stated above. At least the person would survive and not be in a vegetative state if the brain is not bloated.

Okay, so do not go running out now for your magnesium tablets. I have actually brought a bottle of just magnesium only from GNC store. However, my qualms is that why is it the GNC people have to purposely include a pill (tablet) whitener, like Titanium Dioxide just to make the pill looks WHITE! Are we overly obsessive with being white. Does white equate to pureness? I am confused. Titanium dioxide had also recently been classified by the International Agency for Research on Cancer (IARC) as an IARC Group 2B carcinogen possibly carcinogen to humans. It had been test carcinogenic on animals. I think that there are many tablet out in the pharmacies including government hospitals that are coated with titanium dioxide to make the tablets looks nice. For what? I would be writing to GNC to get some answer. Not sure if I had written to them earlier or that I had gotten any reply.

Anyway, I am now getting my magnesium supplement from another brand “Nature Essense” that is in the combination of Magnesium, Calcium, Potassium, Zinc, Boron and Vitamin D. Seemed pretty good but could have been better if the calcium were omitted. Why? Well, since we are either easily getting calcium from our diet, as evident in the bountiful of people with arteriosclerosis, of that the calcium are not finding their ways to the bones. But first thing first, we should be taking the magnesium to offset, I mean to remove the excess calcium in the blood from depositing on the arterial walls. Anyway people are getting smarter nowadays and are taking calcium scoring medical screening to pre-empt if indeed there are too much calcium are residing in the blood stream rather than where they are needed. In the bones.

By the way, do read my earlier post on the importance of having enough muscle to lift your frail skeleton frame as you age. Strong bones means nothing if you do not have the muscle that goes wasted if not worked upon. (Marathon, muscle atrophy and sarcopenia)


Have a good night sleep. Counting sheeps do not really help. Try magnesium instead. You may have been working or training too hard and lack this essential mineral to prevent irregular heartbeat (Cardiac arrhythmia).

Earlier postings:

Magnesium Sulphate to prevent brain edema (swelling) injuries and childbirth deaths

How to spot a potential “heat stroke” or “sudden death” victim.

Defibrillator for marathoners to include electrolyte jabs




To maintain cerebral vasculature, thus lowering the risk of a cerebral aneurysm or hemorrhagic stroke, the following supplements should be considered:
Magnesium, 1500 mg daily.
Arginine, 4-5 grams daily.
Calcium, 1000 mg daily.
Grape-seed skin extract, two 200-mg capsules daily.
To enhance vasodilation and improve the health of vessels, consider the following:
Potassium, 500 mg daily.
Hydergine, 5-20 mg daily. (Hydergine may be obtained by prescription or from offshore pharmacies.)
Antioxidants scavenge free radicals and protect against underlying factors that lead to cerebral vascular disease:
Vitamin E containing tocopherols and toco – trienols provide the most broad spectrum protection, 1-2 softgels daily of Gamma E Tocopherol/Tocotrienols. (Provides 210 mg of gamma – tocopherol and full spectrum tocotrienols.)
Vitamin C, 2000-5000 mg daily.
For more information

Contact the National Institute of Neurological Disorders and Stroke, (800) 352-9424.


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The US Commander of the US Army Center for Health Promotion and Preventive Medicine (USACHPPM), Brigadier General Michael B. Cates had on 20 Apr 2007 sounded out a warning in his memorandum on “Heat Injury Prevention Policy” for military commanders to be on the alert for water intoxication or hyponatremia:

This was stated in paragraph 5 of the “Information Sheet: Heat Injury Prevention Program”

” 5. A number of deaths occurred in the Army due to water intoxication or hyponatremia. Proper water consumption guidelines4 should be followed in order to prevent overhydration. Fluid needs can vary based on individual differences (± ¼ qt/hr) and exposure to full sun or full shade (± ¼ qt/hr). Hourly fluid intake should not exceed 1 ½ quarts and daily intake should not exceed 12 quarts.” (link)

Comments: Water intoxication does not simply implies drinking alot of water at one go but also continuously  without adequate replacement of electrolytes.

Of interest would be paragraph six:

“3. Newly mobilized personnel, especially those from cool climates, are more at risk of becoming a heat casualty when exposed to hot weather and not properly heat acclimatized. Training in a compressed timeframe before deployments increases the risk. The 2003 Ranger and Airborne School Students Heat Acclimatization Guide2 provides practical guidance for optimal heat acclimatization to both maximize
performance while minimizing the risk of becoming a heat casualty.”

Comments: I would extrapolate the “cool climate” in the paragraph 3 to students here who been studying in air-conditioned classroom for umpteen years before suddenly thrust onto a regime of intense physical training and weigh loss program, both totally antagonistic to each other. Why antagonistic? Well, for one intense physical training needs to constant isotonic replenishment to prevent the heart from beating erratically or even stopping. On the other hand, to suddenly attain an ideal weight could lead to desperate measure on the student to take slimming pills or diuretics compound to could exacerbate loss of water and thus further loss of precious electrolytes that are sorely needed to maintain proper heart beat. Thus if the weight loss program would include reduction of salt intake from their diet, then it could lead to further reduction in the availability of electrolytes when they also have to embark on intense physical activities. This antagonistic combination may have a disastrous impact for our over-eager students to attain both ideal standards; a good physical test result and ideal height-body weight ratio. Given the intense competitive nature of over achievement in today’s society, it would be wise to reconsider the fully understand the importance of proper electrolyte balance at all times for not only peak performance but to substain life at the very least. This would augur well towards a healthy workforce with our utmost care and considerations.

Take Care


Note: For those who would like to read more about heat intoxication in earlier postings:

a. How to spot a potential “heat stroke” or “sudden death” victim. (link)

b. Changes in running speed in a 100km ultramarathon race (link)

c. Too much water can burst your brains out and constant severe headaches (link)

d. Cut Salt to keep children thin? (Not for our tropical climate) – (link)

e. By the way, I wonder why when athlete collapsed and had their heart stopped during marathons and likes, and whether if Defibrillator works in such instance given that the poor athlete, probably highly deficient in potassium, sodium and other essential electrolytes could really have their heart “jump start” again. It is just like trying to jump start a depleted battery. I am not sure if giving a quick injectio n with the proper electrolyte to the heart region might help (maybe someone could comment on this). – link

f. Defibrillator for marathoners to include electrolyte jabs (link)

g. Magnesium Sulphate to prevent brain edema (swelling) injuries and childbirth deaths – link


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This article “Changes in running speed in a 100km ultramarathon race” dated 2004 found that the fastest group had a smaller deviation in running speed as compared to the slowest group that had the greatest deviation in running speed is actually quite pretty obvious but the research here does establish my synopsis.

My synopsis here is that faster runner usually are better prepared and trained for the event. Importantly, they had few stops for drinks and know what to drink be it water or isotonic. Slower runners groups who showed the greatest speed deviations tend to have more time to drown themselves in loads of water or isotonic, and which could be disastrous like a resultant brain edema (see my earlier articles). I am not asking you to run faster but rather be mindful of your water/isotonic intake to prevent bloating of the brain. (more…)

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In my own course of research on the effect of Magnesium, I chanced upon the compound Magnesium Sulphate (commonly known as Epsom salt) for treating both brain edema injuries and also to prevent child birth deliveries deaths. So what is the link between both supposedly different topic? Well you see, for brain edema here, I am referring to long period of physical exertion that result in the depletion of essential electrolytes, of which water retention is the body own self defence mechanism to conserve electrolytes. Prior to reaching this critical stage, the person would have experienced very severe muscle cramps creeping from the lower limbs towards the heart causing heart arrhythmia (abnormal heart beat), bloating of the body and eventually the expanding brain squeezing against the non-expandable skull.

Similarly childbirth is comparable to a marathon, with severe muscle contraction (convulsions) lasting many hours too and which could affect both mother and child drawing upon the draining essential mineral electrolytes. The focus on magnesium here is to highlight the increasing absence of this essential mineral in our diet or lifestyle that necessitate physical endurances. Isotonic drinks in particular are lacking in this area whilst having too much sodium to promote thirst instead. This is also the same for potassium which could be an oversight reduction from the food chain. (more…)

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As I have often harped on the importance of adequate electrolytes for the health being of the general populace, I often wondered if those running a marathon and being a victim of brain edema through excessive water intake without adequate electrolytes, then using a defibrillator may actually be of no use since that poor guy would already have no ions to jump-start his heart. Perhaps, just perhaps, maybe the medical personnel on standby could be equip with electrolyte jabs (probably a mixture of potassium, sodium, magnesium and maybe calcium) to jump-start that stalled motor (I mean the HEART). (more…)

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