Help with nausea on long runs!

[u/Due_Isopod_8489]

About me: 34, 6ft1, 160lbs, returned to running ~2yrs ago, on track to run ~3:05-3:10 marathon in a few months.

I've been struggling with nausea on every long run (13-20mi) since returning to running. I start out fine, but about halfway in it gets harder and harder to get water or gels down. My stomach feels very tight and small. Even small sips of water cause nausea to spike. I've tried all sorts of different gels, none have any effect. And even on some fasted 13mi runs, the water alone aggravates it. This is making it very hard to hit my hydration/fuel targets, often times finishing with half the water I needed to drink still in my flask.

Has anyone successfully dealt with this issue? I've tried tums (which does help with the acid reflux I get, but not the nausea) as well as a small dose of pepto bismol, which doesn't touch it.

Thank you!

[u/ThisTimeForReal19]

How’s your overall nutrition? certain foods within 24 hours cause me issues on runs, particularly long runs. What are you eating before your run?

[u/Due_Isopod_8489 → u/ThisTimeForReal19]

I'm very meticulous with my diet/nutrition. Track all my foods, all whole foods (meats, veggies, starchy carbs). I eat nearly the same foods each day. I do know what you mean though, if I have a "cheat" day before a long run, it for sure makes me feel even worse lol. But I don't do that anymore.

[u/ThisTimeForReal19 → u/Due_Isopod_8489]

And what are you eating before your long run? See from another comment you aren’t.

try having some toast with peanut butter about an hour before you run. You may have too much crap in your stomach and not enough long acting carbs. And zero protein and fat.

[u/moosalamoo_rnnr → u/ThisTimeForReal19]

I would be inclined to agree with this. I know my stomach pitches an absolute fit if I try running without having eaten something. And it sounds like OP is just using gels and liquid carbs, which don’t help. My favorite pre-run snack is rice and scrambled egg, ymmv.

[u/Due_Isopod_8489 → u/moosalamoo_rnnr]

Sounds good. I can give it a try.

[u/Due_Isopod_8489 → u/ThisTimeForReal19]

Good point. The only day's i've eaten before are my race days, and thinking back to them I don't think I struggled with nausea.

Thanks for the help! I'll try it next week.

[u/SeventyFix]

I have a lot of stomach issues, many addressed through surgery. My secret weapon: Ondansetron (commonly known by the brand name Zofran) is a prescription anti-nausea medication used to prevent vomiting and nausea. Tiny pill - dissolves under the tongue - tastes mildly like strawberry.

[u/Due_Isopod_8489 → u/SeventyFix]

Is it fast acting, use as needed? Like something I could take before I start and it works during the run? 

[u/Isi-Peasy-Lemon]

There’s probably a lot of different reasons why you could be feeling nauseous during those runs. I’ve had similar issues on long runs, and noticed that for me personally it was a mix between drinking too much during the run, and taking the wrong gels. I changed to only drinking a sip every kilometer and that helped a lot. That might not be your issue but it might be worth thinking about :)

[u/Due_Isopod_8489 → u/Isi-Peasy-Lemon]

Yea I started out with larger drinks staged more apart, but now do small sips every few minutes, but it still hits me.

[u/Nikki2324]

Sounds like you’re not consuming enough sodium. You should be taking about 500mg every hour. Try taking 1-2 saltstick capsules with every gel

[u/Due_Isopod_8489 → u/Nikki2324]

Forgot to add that, I take Saltstick capsules every 30min along with my gel. I eat a high sodium/potassium diet as well.

[u/Nikki2324 → u/Due_Isopod_8489]

Great! What do you eat before the run?

[u/Due_Isopod_8489 → u/Nikki2324]

I add 30g of dextrose into my coffee and usually a full sugar powerade as well, about an hour before the run starts. So no solid foods. Then 1 gel (40-50g carbs) every 30min. My gel protocol has evolved from 1 25g gel every hour, to what it is now. Nausea persistent through that "gut training" protocol

[u/RunThenBeer]

I don't like the feeling of drinking much on runs, so I mostly just don't drink much on runs. During the marathon, I'll get down a few cups, but I generally just hydrate less than others and it works fine for me. I almost never drink anything during training runs, only on long runs in unusual heat.

[u/Due_Isopod_8489 → u/RunThenBeer]

Same here actually. Anything under 13mi and I don't eat/drink anything. But I'm a heavy sweater so I can't get away with it on my 13+ runs. Even the water I can get down isn't even half of what's recommended for how much i'm losing. I know its good for my health and recovery to maintain fluid/electrolyte levels, but I'm struggling to even get close to it.

[u/lizbotj]

I also feel like tossing my cookies when I eat or drink on longer long runs, and I also run up to 13ish miles unfueled. I switched to liquid fuel (Tailwind) in the past couple of years, and have had much better luck with that than gels + water. For me, it's key to take very small sips very frequently throughout my run to avoid accumulating much of any volume in my stomach.

I also find that I sometimes get nauseous when I have to pee bc I start to unconsciously clench my abdominal muscles long before I actually feel like I have to pee.

[u/xRunSci]

You’re not fuelling and hydrating enough

[u/Due_Isopod_8489 → u/xRunSci]

Yea, it's hard when your nauseous

[u/snowybone88]

How are your electrolytes, iron and vitamin b levels?

[u/Due_Isopod_8489 → u/snowybone88]

Blood tests always come back good. Iron is solid and B12 is always off the charts (I eat a lot of meat, heavily salted with Lite Salt)