Hydration: Pee on a Stick

Dr. Stacy Sims has changed the way many coaches and athletes approach their hydration and nutrition plans in long course racing. Her book Roar has helped female athletes train, fuel, and hydrate appropriately for the changing hormones throughout the menstrual cycle. Basically, she’s a badass who has extensive knowledge in the field of sports nutrition and hydration. I was fortunate enough to meet Stacy back before OSMO started. Her willingness to share her research allowed me to incorporate her strategies into my coaching. When I started incorporating urinalysis testing, I saw a marked improvement in athlete’s race day nutrition plans including reduced cramping, better overall outcomes, and a reduction in GI issues. I have used pee sticks for over three years with our athletes.

Most endurance athletes have heard the advice that ‘peeing clear’ means you are hydrated. The truth is, the color of your pee is not an effective or scientific way to monitor your personal hydration levels. I want to thank Dr. Sims for being so willing to share her science and methods over the years. Also, if you are a female athlete or if you coach female athletes, please do yourself a favor and buy her book, ROAR.


The urinalysis strips I recommend are Rapid Response Urine Dipstick 10SG 10 parameter. They are usually available on Amazon.com. I recommend testing first thing in the AM, before and after big or hot/humid training sessions, and before you go to bed. This gives an athlete a clear picture of how effectively they are managing their body water levels.


I do not use urinalysis with all of my athletes. Some athletes suffer from data anxiety and will be negatively affected or influenced by what the urinalysis strips show. If you are a coach, KNOW YOUR ATHLETES. If you’re an athlete, KNOW THYSELF. My protocol for testing windows is through the 8-10 week build up into an Ironman and it ends no less than three days out from race day. Once an athlete establishes their proper hydration plan, they really should not need to keep testing. That’s my goal as a coach – use the pee strips to set up an effective, personalized hydration/nutrition plan for race day. We prove it works in training so there is more confidence in the plan on race day.


When in high hormone phase of your menstrual cycle (about 10 days to 2 weeks leading up to your period) you may notice that you find it hard to hit prescribed intensities and also find recovering more difficult (i.e. your next workout is not as solid as you thought, etc). A few things can account for this: our internal temperature is raised, our body fluid balance is whacked out, our carbohydrate metabolism is compromised, and our body does not use protein as effectively for recovery. Our sleep is also likely to be interrupted or suboptimal. Check your hydration before a workout and then after the workout to ensure you are properly hydrating.


The common school of thought in the past about cramping was that it was due to “low sodium”. While sodium, magnesium, potassium and calcium are needed for muscle contraction and relaxation, it is important to note that it is not sodium in and of itself that you need to ingest (well, okay I’m over simplifying -you do but just pounding sodium isn’t going to fix the cramping.) The body must be able to ABSORB the fluid we drink into our vascular space to remain hydrated. Plain water is not effectively drawn into the vascular space, the liquid needs a little bit of carbohydrate and some electrolytes. So here’s the ‘sell’ on Osmo/Nuun Endurance/Skratch or any other 3% isotonic solution. These products are designed to hydrate you quickly and effectively.

Whenever I work with an athlete on their nutrition plan for race day the most important factor is keeping the blood plasma volume up (hydration). The second focus is calorie consumption / g CHO consumed per hour. Remember that as your blood plasma volume drops your Vo2 max potential also drops and it can take hours to days to recover from but if you’re low fuel or low on calories you can recover from that within about 15-20 minutes by consuming a high concentration of carbohydrate.

As I mentioned earlier, Dr. Sims work is worth digging into for yourself. You can purchase her book, Roar, here. (I get no commission if you buy this book. You’d be an idiot not to read it though.)


Review the strip and compare the colors to the bottle to find the range/measure of the reagent. Then compare it to the list below. Disclaimer: This is not a method of diagnosing or treating any medical illness.

Reagent Normal Not Normal Traning Scope Notify Coach?
Leukocytes (LEU) No change in color If positive, the reagent   will turn the color purple. The severity of leukocyte presence will be indicated by the darkness of the purple. The day after a hard training day indicates inadequate recovery. Take an easy day. General positive test indicates onset of illness (bacterial or viral). Sleep, hydrate, increase vitamins and minerals, and monitor HR and Leukocytes Yes
Nitrates (NIT) N/A N/A for training scope N/A No
Urobilinogen (URO) N/A N/A for training scope N/A No
Protein (Pro) Yellow Any green indicates positive for protein presence. This is normal within a few hours after exercise. If STILL positive in the AM post training, it indicates inadequate recovery. Increase protein intake  across the day, take an easy aerobic or active recovery day to facilitate   blood flow and recovery Yes
pH 6.5-8.5 In the AM humans are   usually slightly acidic           (pH= 6.5-7.0) and generally becomes more alkaline      (pH= 7.5-8.0) by evening. If you use OSMO Preload there can be a buffering effect so pH may sit between 7-9. pH can also change  based on food choices No
Blood (Blo) Negative Any green spots/color   development on reagent area within 60 seconds indicates the presence of   hemoglobin.  Females may see this up to 3 days before their period begins. Muscle and cellular damage. RARE occurrence so BACK OFF training intensity. Yes if not female or not   near period
Specific Gravity (SG) 1.005-1.015 Distilled water sits at 1.000. Normal body water/hydrated status in humans is 1.005-1.015. When you   reach 1.020 this indicates low body water (1% body water loss), and greater indicates dehydration. 1.020 will hinder your ability to reach the 3 p’s: Power, Pace, Potential Note in training log.
Ketones (KET) Negative Not usually present in urine. If so, indicates poor carbohydrate metabolism Indicates poor aerobic fueling/fuel utilization Yes
Bilirubin (BIL) N/A N/A for training scope N/A No
Glucose (GLU) N/A N/A for training scope N/A No



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