TT080: Dangerous Hyponatremia After a 70.3 Half Ironman

Colin Pugh had a dangerous case of hyponatremia that could have resulted in death.  Hydration expert Andy Blow joins us to review his case.  In Colin’s words, here is what happened:

“On Aug 14th I did my first Half Ironman (Stealhead – Benton Harbor MI). I ran a pretty decent race and finished in a time of 5hrs 47 mins. After the race I was about a 3 hour drive from home in Milwaukee WI. I was over there on my own as my girlfriend was working that weekend. Based on the fact I couldn’t stand up without cramping I made the decision to hold up in a hotel for the night and make my way home on the Monday morning. I got to the hotel grabbed a shower and then started to become obsessed with the fact that I hadn’t taken a pee all day and started taking on water (a lot of water!). This was quiet the mistake……..

I then remember only a few things. I remember walking across to the gas station to buy more water and being completely out of it in my mind like kind of drunk feeling. Then I went to bed and woke up at 11pm and proceeded to throw up all a lot of that water back up which wasn’t pretty.

I woke up the next day feeling really rough and text my girlfriend to say I’m not driving until I get kicked out of the hotel at Noon. Then the next thing I know is I’m at the breakfast table grabbing breakfast and all packed up and I had no idea how I got there. Then the last thing I remember on Monday morning was getting on to the highway at my intersection in Michigan and then the next recollection I had was waking up in the ICU on Wednesday morning in Chicago………….

What happened? It turns out that I must have had the sub conscious thought to get to the Emergency Room. Because when I crashed my car into a truck I was only 6 blocks away from the University of Illinois Chicago Medical Center in downtown Chicago. But I had managed to drive over 70 miles without remembering a thing and then passed out behind the wheel. When the cops came up on my accident they said they found me having a seizure in the driver’s seat and then proceeded to smash me out of my car and get medical help.

Then I got to the ER by ambulance and my girlfriend was calling my phone. The ER doctor answers the phone and tells her what they think is going on. My girlfriend is actually a doctor herself, she completely gets what the ER doc tells her and starts freaking out and gets in the car and starts driving the 1-2 hrs down to Chicago to be with me.

So what was going on? Typical human blood has 140-145 mol/liter of Sodium in it. Anything less than 120 mol/liter is classed as serve. On my first blood work when I got to the ER it was at 113 mol/liter and that’s why I kept having seizures. I had Hyponatremia where you drink too much tap water and in essence dilute your blood. I was then admitted to the ICU early Monday and over Monday/Tuesday given fluids and monitored closely until I woke up on Wednesday morning very confused. While I was out I wasn’t being very cooperative it seems……..I had to be tied down feet and hands to stop me from beating all the people up which wasn’t great for my girlfriend to see.

After waking up I had no idea what year it was, what had happened, where I had raced, who the president was…….nothing…….and that was very worrying. But I quickly started to get it all back come Thursday and Friday. I was then discharged from the ICU to home on Friday.

Quiet the experience that I need to get follow up appointments to completely figure out if I had a Kidney issue or if I just put myself in trouble by drinking so much water instead of something with electrolytes in it. In the meantime I’m back to work and doing fine, getting my car fixed up and taking it easy for a little while and deferring a few races that I was booked into for the rest of the season.”

TT079: Hydration With Andy Blow (You’ll Definitely Learn Something New)

Former elite triathlete Andy Blow struggled in hot races.  He cramped and had to figure out a solution.  He retired from triathlons in 2006 but that problem led to his post-racing career.  He is the founder of Precision Hydration and has become an expert on hydration.   In addition to Andy Blow Transalpineendurance athletes he’s worked with NBA, NFL, and professional soccer teams.

Regardless of what you already know about hydration, you will learn more during this interview.

Topics discussed:

  • For most people drinking to thirst will work, but many athletes need to follow a plan to make sure they don’t forget to drink.  A range of 16-28 ounces of fluid replacement per hour is adequate in most cases, but some athletes have much higher sweat rates and will require more
  • Over-hydration before a race can negatively affect performance
  • The sodium concentration in your sweat is relatively static over many years and many different conditions
  • Your body reabsorbs some of the sodium lost through sweat before it reaches the skin
  • Caffeinated drinks don’t result in a net fluid loss
  • And way more than I included here

During the interview I didn’t ask Andy specifically how much fluid loss is allowable for half and full Ironman distance races, so I followed up via email and this was his response:

“the data I’ve seen suggests the fastest finishers of those kind of races can lose between 2 and 6% on average (which tallies with personal experience for me). There may be some people who suffer at that kind of level of loss, and others who can tolerate a bit more (e.g. Gebrselassie who lost 10% during some marathons) but my best guess is that around 2-6% is in the zone for most people if they start the event very well hydrated.

I don’t think the length of race matters so much as even in hot Olympic races people can lose considerable amounts of weight – it’s more how quickly you allow the weight loss to occur (i.e. in long races you have to drink more to mitigate the fluid lossses from earlier on).”


Free online sweat test

Precistion Hydration Testing Centers

TT078: Cody Beals – Canadian Ironman 70.3 Pro

Cody Beals is a third year Canadian pro specializing in the Ironman 70.3 distance.  His results this year include two victories and no worse than a 7th place finish in seven Ironman 70.3 events.  Later this month he will race the ITU Long Distance Triathlon World Championships in Cody BealsOklahoma.

His website,, details his training, finances, physical challenges (low testosterone), and more. Cody is very open about his life and that makes for a good interview.



TT077: The Olympic Experience & Mental Toughness With Olympian Joanna Zeiger

Joanna Zeiger, the 4th place finisher at the 2000 Olympics, discusses the 2016 Olympic triathlon, her Olympic experience, her extensive racing career, triathlon income, drug use, statistical consulting, and more.

Joanna competed at the first ever Olympic triathlon for the USA.  Five weeks later she followed Joanna Zeigerthat with a 5th place finish at the Ironman Hawaii World Championships.  She’s also competed in the Olympic Trials for swimming and the marathon.

Her new book, The Champion Mindset, is scheduled for release in February 2017



The Champion MIndset  – Joanna’s new book scheduled for Feb 14 2017 release

TT076: Justin Daerr Two Years After First Ironman Win

Boulder based professional triathlete Justin Daerr returns to the show two years after his firstProfessional Triathlete Justin DaerrIronman win at Ironman Boulder in 2014.

Since that time he’s had several top 5 Ironman finishes, including 2nd at Ironman Mount-Tremblant in 2015 and 4th at Ironman Canada in 2016.

At age 35 he’s started 36 Ironmans and finished 32.



TT075 Training Experimentation, Ketogenic Diets & MMA Fighting

Hillary Spires makes her third appearance on the show to talk about her experiments with her training and diet and the much faster run times she has achieved.

Her 5k time dropped from 24 minutes to 20:19 and her 10k time dropped from 47 minutes to 42:30.  She has resumed her triathlon training in prep for a half ironman.  Hillary Spires Muay Thai

Last fall she started training for Muay Thai, a form of MMA fighting.  She also switched to a ketogenic diet (high fat/low carbohydrate).  When she returned to running she had huge drops in her time despite very little run training and some very high intensity workouts.

Hillary was on episode 55 talking about her first year of racing as she prepared for Ironman Canada, and she returned on episode 64 after she completed Ironman Canada.  

Links/Show Mentions

Hillary’s MMA Fight

Torbjorn Sindballe on low fat diets – Triathlete Training Podcast episode 14

Netflix documentary on Barkley Marathons

Hillary’s High Intensity Workout
Incline 10
Per Hillary, level 7 is an 8:30 mile, level 9 is a 6:40 mile, level 10 is 6:00 mile, and level 11 is a 5:30 mile

90 seconds level 7
90s rest (stand on rails)
4 sets

60 seconds level 9
60 seconds rest
4 sets

30 seconds level 10
30 seconds rest
2 sets

30 seconds level 11
30 seconds rest
2 sets

Hillary ran a 20:19 5k after this.  This is a very high intensity and difficult workout. Slower runners should reduce the speed and/or incline for this workout.

TT074: Runner Preparing For First Sprint Triathlon

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Kate Maas of Switzerland is an experienced runner preparing for her first sprint triathlon.  It’s a 500 meter swim, 40k bike, and 5k run triathlon on June 20.  She’s done several marathons and an ultra, and while she’s had a desire to do a triathlon for a while, she didn’t start training until she recently registered for the race.

Topics discussed include:

  • Open water swimming
  • Intervals
  • Pedal stroke
  • Transitions
  • Yoga

Eric’s Heart Rate Zone Summary 

An illustration of force applied to pedals, from Joe Friel’s Triathlete’s Training Bible.

From "Triathlete's Training Bible"

TT073: Talking Physical Health With Chris Kelly

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Chris Kelly, founder of, joins the show in a wide ranging discussion on health.

Some of the topics we cover include:

  • iron overload in men
  • sleep
  • cortisol levels
  • diet
  • Chris Kelly




TT072: Triathlon 2.0: Data Driven Performance Training w/Jim Vance

Coach Jim Vance joins the podcast as a repeat guest to talk about his new book, Triathlon 2.0: Data-Driven Performance Training.

Jim worked on this book for 4 years before it’s release in early 2016. It’s a detailed book for serious athletes willing to look at their training data and use it to improve.  Jim was a former professional triathlete and now, as a well known coach, he has become an expert in analyzing training data.    Triathlon 2.0

This book builds on concepts in Joe Friel’s Triathlete’s Training Bible and uses charts and graphs to show how to use and understand your data.

Even if you don’t use a power meter, and most experienced athletes should, you can still learn how to use data from your GPS unit to improve your running.

I feel confident in saying this will be one of the most useful books for serious triathletes.

Does Running Shorten Your Lifespan?

TT071: Oceanside 70.3 As First Half Ironman

Weston Titus is a 6’5”, 225 pound, former basketball player who attempted his first 70.3 Half Ironman in Oceanside on April 2, 2016.  This episode includes an interview three days before the race and an interview 3 days after the race.  

Part 1  

He has completed five sprint triathlons but this will be his first half ironman.  He is also preparing for Ironman Arizona in November.  We covered:

  • His transition from a more random training routine to a more structured schedule
  • What books he used to prepare, and which single book was most useful
  • The test workouts he used to gauge his progress
  • His nutrition plan for the race
  • His race goals

Part 2

Weston had a successful race.  Tune in to the second half of the podcast to find out how he did it.  He consumed roughly 45-50 ounces of fluid (1.5 liters) per hour on his 3:14 bike and about 400 calories per hour during the bike.  Even accounting for his larger size (225 pounds), those are higher than normal numbers, but it was within the range of what he trained and he didn’t notice any negative effects from that consumption level.  His splits are listed below: