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HeatstrokeHeatstroke is when the body's internal temperature has climbed to 104°F or higher for a sustained period and the body has lost its ability to cool itself. Without rapid treatment—typically an ice bath, placing ice packs in key regions of the body, or other cooling steps—it can result in multi-organ failure and death. It's the top cause of US death in natural disasters, and mounting research shows that more extreme heat days are putting Americans at elevated risk of developing heatstroke and other heat-related illnesses. Young children and the elderly are particularly at risk because their bodies are not as adept at regulating heat. But exertional heatstroke, from exercising in extreme heat, is a top killer of athletes and soldiers-in-training. When the body can no longer cool itself, in the short-term that can lead to cell degradation and an inflammatory response that damages organs, including the kidneys, liver, and brain. Recent research also furthers the idea that this condition causes longer-term epigenetic changes that predispose people to other future health complications.Explore Heatstroke

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Heatstroke is when the body's core temperature becomes dangerously high—and needs to coolWarning signs that the body is overheating include rapid breathing, cramps, heavy sweating, nausea, and feeling lightheaded. Drinking plenty of fluids, seeking shade, and cooling the body down as quickly as possible with icepacks can help reduce the risk of heatstroke. BBC Earth Science Supplements ahead of exertional heatstroke helped protect mice against brain damageIn the lab, mice dosed with probiotics prior to inducing exertional heatstroke, had better cognitive outcomes. This evidence underscores the links between the gut microbiome and the brain, at least in rodents. National Library of Medicine Heatstroke treatment guidelines were built almost exclusively on research in menProtocols for the standard treatment recommendation for heatstroke—whole-body cold water immersion—were built based on studies almost entirely in men. The research wasn't replicated in women, who typically cool faster than men during cold water immersion, raising questions about standard protocol safety for women, due to the risk of overcooling. Frontiers in Physiology Heatstroke is sometimes missed because the patient is really sweatySince the condition involves losing the ability to cool oneself, clinicians sometimes see someone who has exertional heatstroke—like a high school athlete who is really sweaty—and don't realize the heat-related illness has already progressed to heatstroke. Classic heatstroke typically occurs among the very young or the elderly. (Some users may encounter a paywall.) EMRAP Certain medications that affect blood flow or mood boost the risk of heatstrokeDrugs that narrow blood vessels, beta blockers that regulate blood pressure, diuretics, antidepressants, and antipsychotics can all affect the body's ability to regulate its internal body temperature, and so individuals taking these medications need to take special care in extreme heat and when exercising in hot conditions. NBC News 67 US high school athletes died from exertional heatstroke between 1982 and 2022Many of those deaths were from football specifically, where student athletes play in hot conditions while wearing heavy protective gear. Few states mandate heat guidelines for school athletes, and this article says that's of increasing concern with more high heat index days. Atmos Heatstroke can reprogram your DNA, putting survivors at risk of future health problemsSevere illness from extreme heat exposure can alter DNA through epigenetics—turning genes "on" or "off" to shape disease risk. These changes can place an organism at greater risk of future health complications—unlike the epigenetic changes produced by moderate, repeated heat exposures. National Library of Medicine How the gut microbiome can affect heatstroke riskSome research suggests that our gut microbiome influences our risk of exertional heatstroke. If exercise boosts our body temperatures to unsafe levels, increasing gut permeability, that can cause a "leaky" gut—allowing bacteria and other gut microbes to leak into the bloodstream and potentially trigger endotoxemia, a potentially life-threatening inflammatory response that can occur with heat exhaustion and heatstroke. Mysportscience Heatstroke deaths may be massively undercounted—perhaps by a factor of 10One often-cited average estimate of annual American heat deaths — roughly 1,200 per year—is based on death certificate data, but it may be a significant undercount because heat kills through cardiovascular, kidney, and respiratory causes that are more likely to be cited on those documents. (Separate analysis that looked at data from 1999 to 2023 found that the highest number, in 2023, was 2325.) Yale e360 Exertional heatstroke is a top killer of athletes and soldiers-in-trainingOften characterized by collapsing while exercising in the heat with intense sweating, this type of heatstroke among otherwise healthy people occurs when the body loses the ability to cool itself during intense exercise and the body's core temperature has risen to 104°F or higher and cannot cool itself. If treated quickly, it's often survivable, though it can cause lasting damage. CBS Mornings How heatstroke—from overexertion or extreme heat—affects the bodyWhen core body temperature soars to 104°F or higher and remains there for about 30 minutes, it sets off a cascade of problems in the body. Proteins and cell membranes can degrade and begin to leak, potentially leading to liver damage, blood clots, GI tract damage, and organ failure, among other issues. TED-Ed Heatstroke occurs when the body reaches 104°F or higher and can't cool itselfUntreated, this medical emergency can result in permanent disability or death. Someone suffering from heatstroke—defined as a core temperature of 104°F but sometimes as high as 106°F—may appear confused and require immediate cooling, ideally with an ice bath. US Centers for Disease Control and Prevention Heat exhaustion is the most likely diagnosis if someone is talking clearlyHeatstroke, true to its name, looks more like a stroke. Its symptoms include severe disorientation, irritability, and seizures, among others. A patient does not need to have collapsed in order to have exertional heatstroke, but if someone is talking clearly, they likely have heat exhaustion, and it hasn't progressed to heatstroke. Rapid Response RN Heat-related complications are of greater concern for distance runners than cardiac threatsAnalysis of more than 130,000 runners in Tel Aviv events during a seven-year period indicated that the runners were 10 times more likely to experience heatstroke than serious cardiac problems. Scientists suggest that runners should take 10 to 14 days to acclimate to a hot climate before tackling a serious run. The Weather Channel The gray area that makes PEDs seem like leveling up to hardcore athletesDoping in sports is broadly condemned as unsafe and unfair. Significant controversies in major sports, including baseball and cycling, have been prompted by the widespread use of performance-enhancing drugs, which are described as clear-cut dangers and abuses of the rules. But to many competitors, the line between a PED and the next smart technique to adopt is unclear. This podcast episode explores that gray reality. Freakonomics Feels-like temperature indicates how our skin will feelWhen the wind is moving faster, we tend to feel colder due to the so-called "wind chill," which cools our bodies by moving heat away from them and making water evaporate faster. On the other hand, high levels of humidity can make us feel 10 degrees warmer at times. Popular Science

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