Dr. Roach: For some athletes, too much water can be bad

Keith Roach
To Your Health

Dear Dr. Roach: I have read that many runners drink too much water and that this can be dangerous. What are the signs of drinking too much?

H.C.

Dear H.C.: Exercise-associated hyponatremia (“hypo” means “too little,” and “natremia” means “sodium in the blood”) is common for endurance athletes, such as long-distance triathletes and marathoners. It is caused by losing salt and water, mostly through sweat, and replacing it with only water. Most cases are mild and have few symptoms, but if there are symptoms, they are most commonly weakness, headache and dizziness. Severe cases cause disorientation and can lead to seizures and death. In a study of the Boston Marathon in 2002, 13 percent of finishers had hyponatremia, but only 1 percent had critical levels.

To avoid hyponatremia, you need to ignore advice to “drink as much as possible” during exercise. Also, most sports drinks don’t have enough sodium to protect against hyponatremia. As simple as the advice is, drinking when thirsty when you exercise is the best way of preventing hyponatremia and volume depletion or dehydration.

Dear Dr. Roach: My husband has heart disease. He’s tried every statin drug to lower his cholesterol. He cannot tolerate any of them. His cholesterol remains high, even with proper diet and exercise. I’ve heard that CoQ10 works well for lowering cholesterol. Is this true?

Anon.

Dear Anon: CoQ10 (ubiquinone) does not affect cholesterol itself. It does allow some people tolerate statins who otherwise wouldn’t. I think it is worth a try, especially for someone like your husband, who has coronary heart disease and who would get much benefit from a statin.

Dear Dr. Roach: I just read your column on the shingles vaccine. I am an insurance agent who is often asked about coverage for the shingles vaccine. The Affordable Care Act includes this under preventive care for those 60 and over. Preventive care is covered at 100 percent for health plans not grandfathered. (Grandfathered health plans are plans that have been continued virtually unchanged since 2010. They are not required to comply with all aspects of ACA, so these plans might not provide this service.)

You also may be interested in knowing that, in our area, the Department of Health clinic offers the shingles vaccine for a fee of $5 for individuals over the age of 50 who do not have it covered under a health plan.

A. Men

Dear A. Men.: Thank you for writing in. Others wrote to me that their Department of Health paid for most or all of the cost. Some said they could get the vaccine covered at a pharmacy, but not at physician’s offices.

Email questions to ToYourGoodHealth@med.cornell.edu.