Treating Hyponatremia, Training with Low TSS, EPO and more – Ask a Cycling Coach 271

How to quickly recognize and treat hyponatremia, how to get faster with a low TSS training plan, how EPO and your hematocrit affect your performance and more in Episode 271 of The Ask a Cycling Coach Podcast.

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Really looking forward to this episode.

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As an endurance MTB rider with a low Threshold ability but high endurance power profile and high impact of caffeine endurance effect I’m very interested in this,

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Lance is really interested in this episode


@Tucker, not to be pedantic, but you might want to update the intro page on the YouTube feed - it shows the previous episode number

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Thanks! We just now got that updated. So it should be all fixed now. :+1:


Not sure why but when I tried to post a question on the live chat ,it would not appear, and the arrow was not light up to click on to send message. Is this my slow computer, or do i have to register my self to get on here. I am a TR subscriber

Are you trying to add the live question on YouTube?
If so, you need to be registered on YT.

The is no connection or restriction whether you are a TR user or not.


While the best place for questions is in the YouTube Live Chat (if not earlier submitted to the podcast), you’re welcome to post your questions here and I will make sure the hosts see it.

If you’re looking to sumbit your questions for a later Ask a Cycling Coach Podcast, you can submit them by going to and clicking on the “Ask a Question” button.


For some reason my brain combined a few lines and saw

Effect of Pepi’s Tire Noodles on athletic performance: a systematic review and meta-analysis

when I was reading the agenda and I was incredibly impressed that someone published that paper :laughing:


Genetics impact if caffeine helps or hurts you

They teased this episode to include topic of “Why FTP is not everything” but I never heard that discussed. Curious as to why, as I was looking forward to that discussion, especially because I’m exploring assessment tools in addition to Ramp Test, which I think discriminates against older cyclists whose VO2 max is limited, but can still churn out some diesel power above their Ramp Test FTP.s

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If I remember correctly, Hamilton’s co-writer mentioned that Hamilton likely did get a bigger boost from EPO than others because he had a lower hematocrit before taking EPO. It wasn’t a tested hypothesis of course.

I could be wrong about what was said in The Secret Race… And it sounds like the authors of the book were wrong based on the content of the podcast.

Ok XC nerd here, you sold me on the tire inserts. Anyone know where to get Pepi’s in the US? I’m only seeing UK sites for it. Lots of Cush Core available but the XC nerd side doesn’t like that weight. I’d also rather not go back to home brew tire stuff. I got my fill of that in early tubeless days.

I spent all day looking for a US source for PTN’s. No go! I just installed Cush Core XC’s. It wasn’t my first choice but sometimes if you cant love the one you want, love the one you’re with.

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Hi All,

Are they any update notes on the new calendar updates with timing etc?

I would love to know how to set a time for bulk workouts not just individual workouts.



As a doctor I cringed a bit at the section on hyponatremia. It is true that sweat is mostly water and far more dilute than your blood, so it’s impossible to get hyponatremic just from sweating because you lose more water than electrolytes. If your kidneys work correctly you should always become hypernatremic from sweating, even if you are a “salty” sweater.
The only way people become hyponatremic while exercising is they take in more water than they are losing in sweat and urine. Hyponatremia is NOT a lack of salt. It is too much water diluting the concentration of electrolytes in your blood. So taking more salt in the form of salt tablets is not a great solution (for hyponatremia). Stop drinking water and it just takes time for your kidneys to get rid of the extra water. Adding more salt when you are already water logged may just make you retain more fluid.
If you have become seriously hyponatremic in a short amount of time, that can cause your brain to swell and in that case we would give concentrated IV solution. But for the most part the safe thing to do is let your kidneys get you back in balance.
Taking pain killers from the NSAID class (ibuprofen, naproxen, etc.) affects how your kidneys work and predisposes you to hyponatremia. So that’s risky.
Many episodes ago someone asked if it wouldn’t be ideal to drink just enough so that you didn’t need to urinate during an Ironman. Kidneys only work when fluid is flowing through them. If you haven’t urinated in 12 hours you are in kidney failure. Your kidneys regulate your fluid balance, your blood pH, get rid of some waste products, and balance your electrolytes. You don’t want to restrict your fluid intake so much that none of that happens. It’s annoying, but you should be urinating during long exercise bouts.
In summary, sweat is mostly water and usually drinking water is fine to replace what you lose by sweating. If you are sweating a lot over a long period of time and just taking water you can “run out” of electrolytes and taking some is a good idea but you always need more water than salt; e. g. you aren’t trying to take in fluid that is as salty as your blood. Hyponatremia usually happens only when people are drinking when they aren’t thirsty.


I found these from Germany but they ship DHL to the USA. About $119 total for a set including shipping to the US.