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Electrolytes: Why Plain Water Sometimes Is Not Enough

When training is long, sweat is heavy, or the day is hot, sodium and potassium become as important as the water you drink.

By Elements84 Medical Editorial TeamFeb 6, 2026 5 min readReviewed by
Electrolytes — ctrolytes not just water illustration

The hidden risk of pure water

In typical day-to-day life, plain water and a regular diet handle hydration fine. But during prolonged endurance work, in hot environments, or when sweat losses are heavy, drinking large volumes of plain water without electrolytes can dilute the blood's sodium concentration — a condition called exercise-associated hyponatremia.

It is rare but serious. Symptoms blur with dehydration (headache, nausea, confusion) which is why some athletes drink more water and make things worse.

A simple electrolyte strategy

Under 60 minutes of moderate activity: plain water works. 60–90 minutes: add a pinch of salt to your bottle, or include a salty snack at the halfway point. Over 90 minutes, or in heat: aim for 300–700 mg of sodium per litre, with some potassium and magnesium.

Off the field: most adults get enough sodium from food. Potassium and magnesium are where many fall short — leafy greens, beans, nuts and fruit close that gap quickly.

When to involve a clinician

Persistent muscle cramps that hydration does not solve, irregular heartbeat, or extreme thirst with high urine output deserve a blood test, not a sports drink. Electrolytes are personal — don't over-supplement.

ElectrolytesSodiumHyponatremiaEndurance

Evidence Snapshot

This snapshot shows verified evidence records matched to this article. It is not a diagnosis or personal medical advice.

Strong evidenceSupported

The serum anion gap is a calculated value derived from measured electrolytes, most commonly as sodium minus the sum of chloride and bicarbonate, and reflects the balance between measured and unmeasured ions in blood.

Limitation. The anion gap is calculated and therefore inherits any measurement error in sodium, chloride and bicarbonate; laboratory reference ranges also vary.

Strong evidenceSupported

Serum magnesium reflects only a small fraction of total body magnesium, most of which sits inside cells and bone, so a normal serum magnesium value does not by itself exclude tissue-level magnesium depletion.

Limitation. Tests that better reflect intracellular magnesium exist but are not part of routine panels and may not change routine practice.

Strong evidenceSupported

Serum osmolality is influenced most strongly by serum sodium and its accompanying anions, with smaller contributions from glucose and urea in most adults.

Limitation. Additional osmoles from ingested substances such as alcohols are not captured by the standard calculation and can produce an osmolal gap.

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