Excessive sweating may cause heart palpitations.

What is the best solution?

Heart palpitations (also known as irregular heartbeat) may have multiple causes and are a type of heart arrhythmia. Causes of irregular heartbeat may include and be signs of cardiovascular, respiratory or neurological disorders. However, occasional heart palpitations are rather common, not life threatening and may simply reflect electrolyte deficiency resulted from excessive physical activity and excessive sweating. This is especially true if a person is physically active for a prolonged time in a hot environment like the heat of a summer and drinks pure water instead of electrolytes. This latter case is the topic of this discussion.

Certain types of jobs require workers to be exposed to a summer heat and physical activity for hours at a time causing excessive sweating and thus, not only loss of water, but also loss of salts causing what is known as electrolyte imbalance or deficiency. These concerns may be directly relevant to construction workers, delivery drivers, military personal, athletes and anyone else exposed to extreme conditions causing excessive sweating such as heat and physical activity.

Sweating = loss of water + loss of salts

The loss of water during sweating (i.e., dehydration) reduces blood volume and, thus, may increase heart rate (a condition known as tachycardia). As the body has less blood to deliver oxygen and nutrients to vital organs, it has to compensate for this deficit by increasing the heart rate to pump the remaining blood more rapidly. Tachycardia may cause heart palpitations.

On the other hand, sweat contains high amounts of salts, such as sodium chloride. The loss of salts during sweating results in electrolyte deficiency, where physiological processes cannot proceed normally. A key salt lost during sweating is sodium chloride. The sweating-induced deficiency in sodium is called hyponatremia ("natrium" is Latin for "sodium" and so, hyponatremia means low sodium). One manifestation of electrolyte deficiency and hyponatremia is heart palpitations.

Therefore, both the loss of water and the loss of salts during excessive sweating may cause heart palpitations.

Are Heart Palpitations Always Noticeable?

The answer depends on the person and the severity of the palpitations. Some people may sense even a few palpitations, while others are less sensitive and may not detect even frequent palpitations unless they are severe. In the case of severe palpitations, the blood flow to the brain is reduced, which may result in insufficient oxygen supply to the brain, causing dizziness, fatigue, anxiety, and even loss of consciousness.

Prevention Of Sweating-Induced Heart Palpitations

Sweating causes a loss of both water and salts. Drinking pure water during excessive sweating would only replenish water loss, not salts. In fact. drinking a lot of water during physical activity on a hot day may even facilitate the loss of salts due to sweating. The simplest way to avoid sweating-induced heart palpitations is to drink electrolytes in a hot environment during physical activity. For example, Powerade and Gatorade would do the job as both of these drinks contain high amounts of sodium (220-260 mg), potassium (80-120 mg), and calcium (5-7 mg) per 20 fluid ounces (~600 ml). On the other hand, BodyArmor is rich in potassium (700-800 mg) and relatively low in sodium (30-40 mg) per 20 fluid ounces (~600 ml). Thus, people with chronically elevated blood pressure may prefer a BodyArmor Lyte because of its low sodium content.

Please note that Powerade, Gatorade, and BodyArmor contain high amounts of sugar so, if calorie intake needs to be monitored then, consider Powerade Zero, Gatorade Zero and BodyArmor Lyte.

What If Palpitations Are Present, But Electrolyte Drinks Are Unavailable?

If electrolyte drinks are unavailable, occasional heart palpitations due to excessive sweating can be prevented or eliminated by drinking V8 Vegetable Juice, Tomato Juice or eating a couple of whole pickles or a dozen of stuffed olives.

Please note that while effective in providing salts, pickles, olives, tomato juice and vegetable juice do not replenish lost water and additional fluids are needed.

Conclusion

While heart palpitations may be a sign of cardiovascular, respiratory or neurological disorders, in most cases, occasional heart palpitations are not dangerous, they resolve themselves within a few hours without treatments and should not cause worries. In the discussion above, we focused on a specific type of heart palpitations that are caused by excessive sweating directly related to physical activity in a hot environment. This type of heart palpitation can be prevented and/or eliminated by replenishing lost water and salts with electrolytes in salty drinks and/or salty foods.

For those who want to delve deeper into the topic, a detailed discussion of heart arrhythmia and its treatment can be found in Chapter 10 of "Introduction to Clinical Pharmacology: From Symptoms to Treatment." This resource provides a comprehensive understanding of the condition, ensuring you are well informed and supported in your health journey.

All the best,

Dr. U