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The practice of extreme sports is becoming more and more common. Despite physiological adaptation, people who intensively exercise are exposed to exercise-associated complications, including hyponatraemia. Exercise-associated hyponatraemia seems to be a consequence of alteration of water regulation, particularly by excessive expression of vasopressin, sodium mobilisation, and interleukin-6 production by muscular cells. Preventing overhydration, both before and during effort, and prohibiting hypotonic solutes during treatment are the leading interventions to correct hyponatraemia.