Article Text

Download PDFPDF

Statement of the 3rd International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015
  1. Tamara Hew-Butler1,
  2. Mitchell H Rosner2,
  3. Sandra Fowkes-Godek3,
  4. Jonathan P Dugas4,
  5. Martin D Hoffman5,
  6. Douglas P Lewis6,
  7. Ronald J Maughan7,
  8. Kevin C Miller8,
  9. Scott J Montain9,
  10. Nancy J Rehrer10,
  11. William O Roberts11,
  12. Ian R Rogers12,
  13. Arthur J Siegel13,
  14. Kristin J Stuempfle14,
  15. James M Winger15,
  16. Joseph G Verbalis16
  1. 1Exercise Science Program, Oakland University, Rochester, Michigan, USA
  2. 2Division of Nephrology, University of Virginia Health System, Charlottesville, Virginia, USA
  3. 3Department of Sports Medicine, West Chester University, West Chester, Pennsylvania, USA
  4. 4The Vitality Group, Chicago, Illinois, USA
  5. 5Department of Physical Medicine and Rehabilitation, VA Northern California Health Care System and University of California Davis, Sacramento, California, USA
  6. 6Family Medicine Residency Program, Via Christi Hospitals Wichita, Inc, Wichita, Kansas, USA
  7. 7Department of Sport and Exercise Nutrition, Loughborough University, Leicestershire, UK
  8. 8Athletic Training Program, Central Michigan University, Mount Pleasant, Michigan, USA
  9. 9Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
  10. 10School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
  11. 11Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
  12. 12Department of Emergency Medicine, St John of God Murdoch Hospital and University of Notre Dame, Perth, Western Australia, Australia
  13. 13Department of Internal Medicine, Harvard Medical School, Boston, Massachusetts, USA
  14. 14Health Sciences Department, Gettysburg College, Gettysburg, Pennsylvania, USA
  15. 15Department of Family Medicine, Loyola University Chicago Stritch School of Medicine, Chicago, Illinois, USA
  16. 16Department of Endocrinology and Metabolism, Georgetown University Medical Center, Washington DC, USA
  1. Correspondence to Dr Tamara Hew-Butler, DPM, PhD, School of Health Science, Oakland University, Rochester, MI 48309-4482, USA; hew{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


The 3rd International Exercise-Associated Hyponatremia (EAH) Consensus Development Conference convened in Carlsbad, California, in February 2015, with a panel of 17 international experts. The delegates represented four countries and nine medical and scientific subspecialties pertaining to athletic training, exercise physiology, sports medicine, water/sodium metabolism and body fluid homoeostasis. The primary goal of the panel was to review the existing data on EAH and update the 2008 Consensus Statement.1 This document serves to replace the 2nd International EAH Consensus Development Conference Statement and launch an educational campaign designed to address the morbidity and mortality associated with a preventable and treatable fluid imbalance.

The following statement is a summary of the data synthesised by the 2015 EAH Consensus Panel and represents an evolution of the most current knowledge on EAH. This document will summarise the most current information on the prevalence, aetiology, diagnosis, treatment and prevention of EAH for medical personnel, athletes, athletic trainers and the greater public. The EAH Consensus Panel strove to clearly articulate what we agreed on, did not agree on and did not know, including minority viewpoints that were supported by clinical experience and experimental data. Further updates will be necessary to: (1) remain current with our understanding and (2) critically assess the effectiveness of our present recommendations. Suggestions for future research and educational strategies to reduce the incidence and prevalence of EAH are provided at the end of the document; areas of controversy that remain in this topic have also been outlined.

Consensus methodology

The 3rd International EAH Consensus Development Conference utilised National Institutes of Health guidelines, amended for a more holistic approach to fit the needs of both the group and the topic. Twenty-two individuals (17 accepted) were invited to participate in the consensus conference who: (1) have made scientific and/or clinical contributions to the topic …

View Full Text


  • Contributors TH-B, SF-G and MHR initiated and planned the consensus meeting. MHR chaired the workgroups and closed panel deliberations. JPD, WOR, TH-B, JGV and RJM served as workgroup chairs. All the authors drafted, revised and approved multiple drafts leading to the final document.

  • Competing interests RJM has received research funding and consulting fees from the food and beverage industry. He is currently Chair of the Science Advisory Board of the European Hydration Institute.

  • Provenance and peer review Not commissioned; internally peer reviewed.