Paper about exercise prompts exchange of letters-to-the-editor

Often one can gain a unique perspective on a research project when a peer-reviewed journal article prompts an exchange of letters-to-the-editor. Such is the case with a paper co-authored by recently-hired Assistant Professor Tamara Hew-Butler of the School of Health Sciences, titled Exercise-Associated Hyponatremia: Overzealous Fluid Consumption (Wilderness and Environmental Medicine, Volume 20, Pages 139-143, 2009). The hypothesis of this paper is that hyponatremia (a lower than normal sodium concentration in the extracellular fluid) can be caused by athletes drinking too much water during exercise. The problem is further complicated by exercise-induced stimulation of the secretion of arginine vasopressin (AVP), the body’s main antidiuretic hormone, reducing the body’s ability to rid itself of excess water. The authors suggest one treatment is intravenous administration of hypertonic saline (really salty water).

In response to this paper, Donald Watenpaugh, of the University of North Texas Science Center, wrote a letter to the editor, titled Medicinal Alcohol for Exercise-Associated Hyponatremia? (Wilderness and Environmental Medicine, Volume 21, Page 278, 2010). Watenpaugh writes “Alcohol (ethanol) is a well-established and potent inhibitor of AVP secretion, and circulating AVP is rapidly catabolized. Therefore, I write primarily to hypothesize that oral ethanol consumption may provide a hyponatremia treatment alternative worth investigation.” Letters to the editor are typically serious, but as you read on, you can’t help but wonder if this one was written at least partly tongue-in-check. Watenpaugh suggests that hard liquor would work best because of its lower water content, and he “suggests tequila shots with the customary salt” to counter the hyponatremia. Often a reply to a letter-to-the-editor can sound defensive, but Hew-Butler and her co-author take this one in stride. They point out that ethanol treatment might take an hour to take effect, which would be too long in many cases. It is comforting to know that scientists can debate rigorously an important medical issue without taking themselves too seriously.