Heat Illness (Muscle Cramps, Heat Exhaustion, Heat Stroke)

"Heat illness was the third leading cause of death amoung high school athletes in 2004.”

Summer is in full swing and the temperatures are rising. By 7:00a.m. the sun is already out and the thermometer can read 80 degrees, with 70% relative humidity. Workouts in the heat can be challenging and dangerous if you don’t take steps to help your body adjust. You could suffer some form of heat illness that could lead to heat exhaustion or worse, heat stroke. Heat edema, heat cramps, heat syncope, heat exhaustion, and heat stroke are the five common types of heat illness typically associated with strenuous activity in hot, humid weather (Marsh and Jenkins (2002)). Heat exhaustion is a condition whose symptoms may include heavy sweating and a rapid pulse, a result of your body overheating. It's one of three heat-related syndromes, with heat cramps being the mildest and heatstroke being the most severe (Mayo Clinic). Heatstroke, a result of the escalation of heat cramps and heat exhaustion, is a life-threatening condition that occurs when your body temperature reaches 104 F (40 C) or higher.

Many people comment that workouts in hot conditions are tougher, they get tired faster, and they can’t last as long. Much of this can be attributed to the increased work the body has to go through to cool itself while you workout. These are early symptoms of heat exhaustion. When you exercise, your body temperature rises. To help cool itself down, your body sweats. You will notice in heat, that your body begins to sweat more and sooner than when you exercise in cool weather. To help keep yourself cool, wear lighter fabrics and lighter colors. Also, use a hat, one that has breathable fabric, to keep your head and your face cool.

Your body also looses more water due to the increase in sweating. As a result, you may experience heat cramps. Signs and symptoms of heat cramps usually include heavy sweating, fatigue, thirst and muscle cramps. Immediate attention usually prevents heat cramps from progressing to heat exhaustion. Be sure to hydrate, drinking 6-8 oz of water or sports drink every 15-20 minutes. (If you are working out for less than 80 minutes, you can just drink water, but it is recommended that you do a mixture of sports drinks and water). You can carry a bottle with you or plan your routes so that you are passing by water fountains frequently. If you will be working out in the same place for extended periods of time, bring a cooler to keep water cold. Be aware that even with these precautions you may experience muscle cramps.

Ways to avoid heat illness:

• Always wear sunscreen, even underneath clothing and remember to reapply if you will be outside for an extended period of time.
• Wearing sunglasses will help reduce damage to your eyes and keep you from squinting.
• Stay hydrated. Dehydration impedes your ability to sweat.
• Avoid alcohol use. Alcohol can result in dehydration, along with other adverse effects on performance.
• Be smart. Reducing the intensity of your workout, or easing into workouts in heat, can also help your body regulate and get used to the higher temperatures. Don’t expect to be able to do the same workout in 85 degrees that you could in 40 degrees.
• Avoid stimulants before workouts. Stimulants often speed metabolism, heart rate, and blood pressure. This increased activity in the body produces extra heat (especially in hot and humid conditions). Under these conditions the blood vessels in the skin constrict, preventing the body from cooling itself efficiently. By making the user feel more energetic and less fatigued, stimulants keep users exercising longer. This can set the stage for heat illness, heat stroke and sudden death in certain situations.

Heat exhaustion and heat stroke are very dangerous conditions. If you start to feel dizzy or nauseated, stop what you are doing and move to a shaded, cool area or head inside. Use cool towels and washcloths to cool your skin slowly.

Ultimately, both exercise related heat illness and sunburn are preventable injuries. Consequently, it is the responsibility of those caring for athletes, the parents, coaches, trainers, and team doctors, to ensure that athletes are educated in preventative strategies and are properly monitored during training or competition in the heat.

References:
Coris EE, Ramirez AM, Van Durme DJ. Heat illness in
athletes: the dangerous combination of heat, humidity and
exercise. Sports Medicine. 2004; 34(1):9–16.

Wendt D, van Loon LJC, van Marken Lichtenbelt WD.
Thermoregulation during exercise in the heat: strategies
for maintaining health and performance. Sports Medicine.
2007; 37(8):669–682.

Marsh SA, Jenkins DG. Physiological responses to the
menstrual cycle: implications for the development of heat
illness in female athletes. Sports . 2002; 32(10):601–614.

Noakes TD. A modern classifi cation of the exercise-related
heat illnesses. J Science and Medicine in Sport. 2008;
11:33–39.

Recognizing Risky Supplements

Millions of people around the world rely on dietary supplements because they believe they are not capable of consuming enough nutrients through a proper diet. Athletes in particular believe the claims made by supplement companies; that their products will increase muscle, speed recovery, and help athletic performance. Americans, including athletes, spent 23.7 billion dollars in 2009 on scientifically unproven dietary supplements.

Every day, the Resource Exchange Center is asked about a new product or a new company. Athletes are presented with a multitude of information about supplements, from the manufacturer, online, at a gym, or through friends and family.

How do you decide which ones to try? While the REC does not recommend the use of any supplement because there is no guarantee that they are safe or effective, we want to give you some RED FLAG indicators to watch out for when you are considering the use of a product.

RED FLAG 1: Natural testosterone booster that increases testosterone levels.

• Legal steroid
• Alternative steroid
• Test Booster

REC Stance: Elevated testosterone levels can be the cause of a failed drug test. We most often see this statement made with products that contain tribulus. Tribulus has not been scientifically proven to have the capability to increase testosterone levels.

RED FLAG 2: Natural estrogen reduction. (aromatase inhibitor, estrogen blocker, anti-estrogens)

REC Stance: Anti-Estrogens can cause a positive drug test. Anti-Estrogens are often times used by anabolic steroid users to offset the adverse reaction know as Gynecomastia (man boobs).

RED FLAG 3: Your friend recommends a product, or you buy a product before researching it, but you can’t seem to find this particular product on the manufacturer’s website or the website at all.

REC Stance: We often get asked about products that companies no longer list on their websites or claim they do not produce. We see this when a company has been asked to pull their product from the market “voluntarily” by the FDA because of post market analysis. The product may also have been pulled by the company but distributors failed to pull it from their shelves. Lastly, your product is produced outside the US or is being sold illegally through third party shippers.

RED FLAG 4: You can’t find Supplement Facts and label information on the manufacturer’s website.

REC Stance: What are they trying to hide? If the manufacturer doesn’t want to list the label information on their website, they may have reasons to keep this information hidden or difficult to find.

RED FLAG 5: You see these listed ingredients or anything that resembles them:
7-Keto (DHEA)
Andro
Synephrine
Ephedrine
ma haung
Diuretic
Etioallocholen
Etiocholan
Estra
Colostrum (bovine)
Superdrol
Tren
Dianabol
Prohormone
Anything that is the purposeful misspelling of any of the above or any steroid, plus many more.

REC Stance: These are all ingredients that can be found in many nutritional supplements. Many sport governing bodies ban all of these substances including the NCAA, MLB, NFL, PGA TOUR, etc…and you will fail a drug test if you consume a product containing one. A number of health risks can be associated with many of these substances as they are related to anabolic steroids.

RED FLAG 6: You see any of these endings or prefixes:
Trione
Dione
17beta-hydroxy
17a-methyl
Andro
Androstene

REC Stance: If a product starts or ends with any of the above, you have a chance of testing positive on a drug test. You will want to avoid any products with ingredients containing these.

RED FLAG 7: If the product has been recalled by the FDA in the past or present including:
Products recalled on BodyBuilding.com
Weight loss supplements
Ephedra products

REC Stance: It was recalled because it posed a threat to the general public. The majority of these products can cause a positive drug test and adverse reactions.


Common Myths about Dietary Supplements

If a substance is natural, it must be safe. NOT TRUE
If a substance is natural, it must be healthy and beneficial. NOT TRUE
More is better. ALMOST NEVER TRUE
Athletes are deficient in important compounds. ALMOST NEVER TRUE

Remember: Athletes should consume a diet that includes a variety of foods to optimize vitamin and mineral intakes rather than dietary supplements. (The American College of Sports Medicine’s stance on dietary supplements)

Adderall: Performance Enhancing Drug for the Brain?

The use of prescription stimulants as a study and test aid for students is an increasingly popular trend. The most common of these drugs is Adderall, a stimulant of the central nervous system that is used as a medication for those with ADHD. It increases alertness and concentration, overall cognitive performance, and decreases fatigue. Adderall is classified as a Schedule II drug under the Controlled Substance Act because of its potential for abuse and dependence and yet many college students are using this drug as a study and test aid unworried about the potential consequences.

60 Minutes featured a story on Adderall, focusing on how healthy students use the drug to boost their brain power. The use of what scientist call cognitive enhancers is becoming more common among college and high school students. One study estimated that 6.4% of college students are using stimulants non medically, a number that the Partnership for Drug Free America believes is closer to 25%.

Student interviews and a study at the University of Kentucky-Lexington seem to support these higher numbers. In an interview with Katie Couric, students stated that it was very common to see other students using the pills when they needed to turn out a final paper or cram for an exam. Students commented that taking the drug made them more focused, more interested, and more detail oriented when reading and studying material. A study at the university suggests that around 34% of students are using a stimulant to help them academically.

The big question is; is using Adderall or Ritalin to focus and study longer using a performance enhancing drug for the brain? About 43% of these students think they are increasing their overall grades by at least one letter. Does that mean these drugs are an unfair advantage for students who do not need them medically?

We can draw parallels to the debate against the use of PEDs in sport. There is a pressure for students to get good grades and there is an air of competition in collegiate academics. Students want the best internships and jobs and being the top of the class can give them an extra edge. If half of students improve their grades using drugs, will the other half be forced to use as well to keep up? Will the demand for non-prescription stimulants increase, causing them to become more expensive and to be sold and traded on the black market?

According to the Substance Abuse and Mental Health Services Administration, students who use Adderall nonmedically are more likely to be binge drinkers or heavy drinkers and use illicit drugs when compared to their non-Adderall using peers. This is consistent with what we see with students who use steroids as well.

And of course, like steroids, there are potential consequences that are related to the use of the drug. Side effects of taking Adderall include loss of appetite, insomnia, abdominal pains, temporary increase in blood pressure, weight loss, mood swings, vomiting, dizziness, weakness, increased heart rate, fever and infections. Psychosis is also a side effect of the drug. Volkow, the director of the National Institute on Drug Abuse stated that these stimulants can be addictive and can lead to heart and blood pressure problems. The long term effect on people without attention disorder is also an unknown.

There are arguments that it comes down to a moral belief. Should we use drugs to enhance the abilities of otherwise healthy individuals? What about those who need Adderall because of attention disorder? This drug is supposed to help them function like everyone else. If someone who isn’t afflicted takes Adderall, they again have an advantage.

It is clear that education on the use of drugs needs to be expanded beyond the traditional drugs of abuse (alcohol, marijuana, cocaine, etc.). Those students who believe they are taking a harmless drug that will improve their cognitive abilities need to be aware of the side effects. Also, Adderall is not a miracle drug and cannot replace time in a classroom, or attending lectures.

There is no such thing as a magic pill.

A word of warning: There are serious consequences if you are in possession of the pill without a prescription or if you are caught selling Adderall. It is illegal and can result in jail time.