The making of PRECISION HYDRATION
Electrolytes are a key component of every triathlete’s nutritional strategy and are especially important for long-distance racing in the heat. One of the main players are sweat specialists, Precision Hydration
Since 1981, 14 deaths have been attributed to hyponatremia during sporting events, including one at Ironman Frankfurt in 2015. The issue of hyponatremia pops up occasionally in 220 and is the medical term to describe low blood sodium levels. Causes are many but, seen though a triathlon prism, it’s often driven by excessive drinking and is exacerbated by the loss of sodium in sweat during prolonged exercise.
Ironman races have a 17hr cut-off time, with temperatures over 30°C at events such as the Ironman World Championships in Hawaii providing optimal hyponatraemic conditions – top GB pro Jodie Swallow, for example, collapsed with hyponatraemia at 20km on the run at Kona in 2013. In short, sodium matters.
That’s why I’m chatting with the sweat expert Andy Blow, where he’s just finished second at the hugely enjoyable 17km Maverick New Forest trail event in Dorset (we’re happy with our 58th-place finish some 25mins later) – an event series that Precision Hydration partner with (more at maverick-race.com).
CHANNELING WATER
Among many functions, sodium helps to maintain blood plasma volume and transport water from the bloodstream to working muscles. If the triathlete’s drink contains water with little sodium, the body won’t retain it and it’ll just be leached out into their soggy chamois. Sweat contains salt, comprising 40% sodium and 60% chloride, so the more you sweat, the more sodium you lose. That’s where Blow’s company, Precision Hydration, comes in.
Since 2011, the Dorset-based outfit has been solving elite and recreational athletes’ hydration
“BLOW BECAME FRIENDS WITH HEART SURGEON DR RAJ JUTLEY, WHO INTRODUCED HIM TO THE IDEA OF SWEAT-TESTING. THE CONCEPT OF PERSONALISED SODIUM PRESCRIPTION WAS BORN”
issues the world over. Their product range is appreciatively simple, including tablets that contain 250, 500, 1,000 or 1,500mg of sodium as either standalone or in low-calorie options. All of the different strengths come in a very mild citrus flavour. How to determine your sodium requirements is the reason I now take my weary, post-Maverick race limbs to Precision Hydration’s Christchurch offices and undergo a sweat test.
The test is pretty simple. While I cast my eye over the museum’s worth of signed tops from teams that Precision Hydration has worked with – including Premier League and Major League baseball outfits – Andy calibrates the sweat analyser with a sodium solution. He then places two electrodes, which contain gel discs saturated in the chemical pilocarpine, on my arm before strapping them down. Andy switches on the ‘sweat inducer’ and an electric current flows through the wires…
“You might feel a tingle but it’s nothing,” says Blow. It really is nothing: I don’t feel a thing. The charged pilocarpine stimulates localised sweat production, which takes about five minutes. Andy then replaces the gel discs with a sweat collector. It contains a blue dye so the practitioner can observe it reaching a third full, enough to fill the analyser. I say ‘practitioner’ as Precision Hydration has around 100 of these units at home and abroad. “They’re in a mixture of sports-science labs, physio clinics, universities, hospitals, independents, a few in retailers,” Blow says.
This is the ideal way to gauge your sodium levels and respective PH remedy, but impractical for many. However, you can also complete an online questionnaire. “We make a recommendation on whether you’re low, medium, high or very high,” says Blow. “It’s akin to either having a Retül bike fit or simply seeking the advice of an experienced bike-fitter. The former’s more accurate, but the latter will take you 80% of the way. That’s a good base for trial and error.”
After 20mins, the dye has been fully cast. Andy connects the collector to the analyser and, after a degree of mathematical wizardry, it transpires I’m a moderate sodium sweater, coming in at 1,024mg/l (milligrams per litre). Andy hands me a card. Very low is 200-300mg/l; very high is just over 2,000mg/l. “I’m around 1,800mg/l,” says Andy. “The average is about 970mg/l.”
That’s not the end of the sodium-replenishing equation. I’m surprised at that number as I’ve always been a heavy sweater – my wife refuses to hug me after even the shortest of runs. But that figure does not, of course, account for sweat rate. As Verle Valentine pens in his legendary (in sodium circles) paper The Importance of Salt in the Athlete’s
Diet, “Each athlete must be treated as an individual. An athlete exercising 4hrs a day who has a sweat rate of 3l/hr with a sweat sodium concentration of 80mmol/l will lose 12l of fluid and 960mmol of sodium in one day. This equates to over 22g of sodium or over 55g of salt. At the other end of the spectrum, an athlete with a sweat rate of 1.5l/hr with a sweat sodium concentration of 25mmol/l exercising for 4hrs will lose only 6l of fluid and 150mmol of sodium. That’s 3.5g of sodium or 8.6g of salt.” Based on my moderate exercise regime, I’m prescribed the 1,500mg product before exercise, followed by the 500mg offering during training and racing.
CRAMPING BACKGROUND
It’s this individualisation that sowed the seed for Precision Hydration. Blow raced to a high level, with top-10 Ironman finishes to his name. He’d suffered badly with cramping and other hydrationrelated issues. After years of trial and error, he’d figured out what sodium and fluid levels worked for him. Around the same time, Blow became friends with heart surgeon Dr Raj Jutley, who introduced him to the idea of sweat-testing. The concept of personalised sodium prescription was born. But they faced problems. The first? We’re brought up to think that sodium-containing salt is up there with the devil. The second was about finance.
Similar to Inov-8 (who we featured last issue), it would require organic growth and attending as many races, such as Maverick, and expos as feasibly possible. Word of mouth proved to be the primary weapon. But it hasn’t been easy.
Co-owner and former world kayaking champs medallist Jonny Tye picks up the story...
“I joined in 2013. At the time, Precision Hydration were based in Brighton as one of the former directors lived there. But they were looking to move onto other ventures. Andy lived here [Dorset] but went over twice a week; I was based in Guildford. We’d little finance so consolidated everything and moved down to Andy’s Dorset garden shed!
“We then discovered that a well-intentioned-but-misguided member of staff had hidden a supplier debt from us, which nearly finished us off. We negotiated with a Major League Baseball team, who’d been using our product, to pay their season’s product upfront. That dug us out of that hole.”
They continued to trade but sought further investment. “Over an 18-month period, we were close to securing three investors, but they fell through,” says Tye. “The last one was particularly stressful. Andy phoned me up, said the deal’s off as this bloke is bankrupt. I phoned him back and said, sod it, let’s remortgage, borrow some money and go for it.”
At the time, their business model focused on the professional side, they’d carved a growing niche in American team sports, especially in the sunshine states. “But it’s volatile,” says Tye. “If a baseball team has a bad year and the owner sacks one of the backroom staff, you could lose that contract.”
They continue to work with pros in many sports but have evolved the e-commerce side, talking directly to the customers. Those customers are relatively serious athletes, whether it’s triathletes, runners or cyclists. Numerous small transactions
stabled the ship. They also recruited e-commerce specialist Dave Colley, who transformed the newsletter into a community-based communication rich in content and full of heart. “That athlete interaction was key,” says Tye. “It became a rule that we responded to every query.” The reward for Precision Hydration is a flourishing business. They’re on the verge of moving offices, they ship to 60 countries and have distribution warehouses all around the world, from Canada down to Australia.
FAVOURITE OF THE PROS
The direct-to-consumer model is working well. As is the professional link-up. “We work with over 50 teams in the UK and US but can’t publicly name many of them or many individuals,” Blow says, pointing at a whiteboard that lists an upcoming itinerary in the US where they’ll sweat test numerous baseball and basketball teams. “Wolves are a visible partner and we work with Team Sunweb cycling, too.”
Triathlon is core to their business and their learning. “We work with pro triathletes Emma Pallant and Claire Cashmore. We seek feedback after every race, ideally as soon as possible. How many litres did you consume? How much sodium? How many calories? And how does that tally with the plan we laid about before the race? Overdo it? Underdo it? Would we repeat it?
“We also work with Sarah Crowley. She finished third in Kona in 2019 – that race suits her well. She sweats a lot, but it doesn’t contain much sodium, so she’s naturally adapted to hot conditions. Of course, there are many things that forge a champion – mindset, fitness, swagger – but for a race like Hawaii, a low sodium level arguably helps. The rumour is that Patrick Lange loses very little sodium, which is why he races so well in Kona.”
Blow raced competitively “but something I didn’t have a handle on was drinking and feeding,” he says. “I’d talk to other athletes and seek confidence in what they were doing. I remember asking Tim Don about his electrolyte intake and it was low. I thought, I’m overdoing it. But years later, we sweat tested him and his natural levels were low.”
EQUIVOCAL CAUSES
What causes this variation isn’t fully understood. The fact that low-sodium sweat is arguably more conducive to racing faster and longer in the heat suggests triathletes of, say, an African lineage would require a ‘low’ product. But, says Blow, their research doesn’t necessarily support this. “We know that there’s a genetic component, but to what extent we’re unsure. We also know that everyone’s blood-sodium levels are at around 3,600mg/l; everyone’s blood is pretty salty. It’s also regulated tightly, so if you eat a high-sodium meal, you’ll pee out a lot of salt.
“So urine controls things nicely. But where we feel levels change is in the sweat gland. Ion reabsorption channels claim back some of the electrolytes because your body doesn’t want to lose all of its salt. That looks like it’s key. Some, like me, either lack the absorption capacity or just aren’t that efficient compared to someone like Sarah Crowley.”
A lot of this knowledge derives from work with cystic-fibrosis (CF) sufferers, whose reabsorption channels barely function at all. “We’ve learnt a lot from CF doctors and, to be fair, they’ve learnt a lot from us working with athletes,” says Blow. “The machine we use is also adapted from work with CF patients.”
Beyond the office move, Precision Hydration continue to stretch their athlete base around the globe with a nominal product range, because this outfit has heart. Expanding choice for the sake of it isn’t on the horizon – and now dehydration and hyponatremia is looking less likely, too.