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Thirty competitors in the Hawaii Ironman Triathlon were prospectively studies to determine whether fluid and electrolyte disturbances were causes for seeking race-day medical care. Athlete weights were significantly (p<0.0001) decreased during the race, but decreases were not different in treated (n = 11; %Δ - 2.3 ± 2.9) versus not treated (n = 19; %Δ −2.0 ± 1.9) athletes. Hyponatremia occurred in nine athletes (30%), and hypomagnesemia in six (20%), but only half of athletes were either electrolyte imbalance sought care. Although athletes receiving medical care may have fluid and electrolyte problems, these abnormalities may also occur in healthy athletes.