See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog

The summer of 2025, the US has experienced record heat. Most Americans have been under a severe heat warning for months, which has caused me to review the symptoms, prevention and treatment for Heat Stroke. This summer's heat was unusual, however it may recur in the future, so we must learn to deal with the effect of prolonged exposure to dangerous heat.

Heat stroke is not classically a stroke as you know it, however heat stroke is a condition of a different kind, but no less deadly. The conditions that can lead to heat stroke are listed below. Please think of these signs of Heat Stroke before you go outside in severe heat.

At Risk Conditions for heat Stroke:

• High ambient temperature
• High body temperature (body temp of 104 or more)
• High humidity,
• Prolonged sun exposure (more than an hour at a time)
• Dehydration
• Loss of electrolytes through sweating which can result in heart attacks, seizures delirium and can lead to death.

The hot weather we have been experiencing has been prolonged and has all the qualities described above that may lead to heat stroke: Temperatures above 90 degrees Fahrenheit, High Humidity (over 50%), Bright sunshine, causing body temp to rise rapidly and continue for a long time even after a person has gone inside to cool off in air conditioning.

You Should be aware of the beginning signs of heat stroke so you can remove yourself from the heat before it becomes an emergency, and you can protect your family from heat stroke.

The early signs/symptoms of heat stroke include:

• Heavy sweating/ or no sweating at all
• Thirst
• Weakness of muscles
• Headache
• And Dizziness

When you develop these symptoms, please listen to the signs your body is sending you and seek a cool place inside away from heat and sunlight. If the symptoms don't resolve quickly, then take the steps below to prevent progression of symptoms to result in heat stroke.

• Lie down (heat stroke can cause you lose consciousness and hurt yourself if you pass out)
• Drink cool but not cold water continually
• Drink Electrolytes (preferably products that contain Potassium, and sodium, chloride, magnesium) with every other 12oz of water. If you don't have electrolytes, Gatorade can be substituted for electrolytes (It is only Potassium). If you are unprepared and away from civilization, put several shakes of salt into a glass of cool water and drink it.
• Apply icepacks on the areas of the body that can cool you quickly: Underarms, groin, and neck. This will cool your body down faster than just sitting in a cool space.
• Don't be alone. Ask someone to sit with you in case you pass out or seize, and they can call 911 to take you to the ER. They can also make sure you continue to drink water and take electrolytes.
• If you feel your headache or weakness getting worse call 911 yourself. That is a late sign of Heat Stroke.
• Lastly, Heat stroke can make a person act out, with a temporary personality change. The affected person can hit and push the people trying to help him or her. That means they are in the late stage of heat stroke, and they need IV fluids a cooling blanket and Medical help.

Remember, heat stroke can be deadly, and immediate action must be taken.

If you or someone else has the following symptoms, then Call 911:

• passes out or seizes,
• gets confused and wanders around,
• acts out and hits or pushes
• has a rapid heart rate,
• has a bounding pulse,
• has either hot dry or very damp skin,
• complains of a headache or dizziness,
• nausea, vomiting
• rapid shallow breathing, like panting
• Often, they will complain of feeling cold and they shiver even though the temperature is very hot.

Don't Wait! call 911! In these cases, tell the 911 operator that you suspect heat stroke.

So how do you prevent heat stroke? There are many ways to prevent heat stroke, if you recognize the conditions outside will put you at risk.

1. First determine whether you are at high risk (below are the risks). Anyone can get heat stroke but people with the following conditions will develop heat stroke faster and more severely than healthy young individuals. The following conditions should best be treated by staying in a cool area inside away from the sun.
2. Know the Symptoms of heat stroke and follow the directions listed above.
3. Prepare yourself for heatstroke by carrying electrolytes more water than you think you will need, plastic zip locks to put ice in if needed

High Risk Medical Conditions and Medications

Previous History of a Heat Stroke

The biggest risk for heat stroke is having had it in the past. People who have a history of heat stroke should be extra careful to avoid going outside or exercising in the heat and humidity. They should stay inside during the heat of the day or on days that put them at risk.

If you have almost had a mild form that you acted promptly and were able to avert the severe symptoms, that still makes you at risk for heat stroke.

Heart Disease or other Circulatory medical conditions

Diseases of the circulatory system place you at risk for getting a more severe form of heat stroke more quickly, so limit your time in the heat.

Sympathetic and Parasympathetic Imbalance, from genetics or medications

Disease of the sympathetic and parasympathetic nervous systems that cause excessive fluid loss due to sweating or increased body heat can cause you to develop heat stroke with less time in the heat and sun. These conditions affect your ability to sweat, which is the way humans cool themselves down. Patients with these diseases don't sweat to cool yourself down like other people. Stay inside until the temperature and humidity is safer.

Age above 50

We all know that we are not as physically able as we age, even if we use testosterone pellets, so older age is a risk factor. Please limit your time outside in dangerous conditions to one hour at a time with 10 minutes or more inside a cool place before going back outside.

Medications that put you at risk for heat stroke when exposed to heat and humidity

You may be unaware of the risk that some medications have when it comes to heat stroke. Medications are part of our lives and most of the time we don't think about them causing problems or side effects, but many types of relatively safe medications can cause you to have heat stroke when the other folks around you are completely normal.

My Experience with Heat Stroke

I was playing golf in August in St. Louis, when the starting temperature at 8:30 am was 88 degrees F, and the humidity was 65%. Being me, I thought to myself," Well I'm in good shape because I have minimal body fat and good muscles, I should be able to golf with 3 other women even in this heat." That day the humidity increased to 80% and the temp was over 90.

Then the Pro announced that we had to stay on the cart path. Well that makes golf a lot harder…,it takes twice as many steps during a round and it requires even more exertion than walking the course and dragging a bag behind you….but I'm not a quitter (but clearly I was not thinking about being sick and taking my life in my hands)…which means I was stupid! I want all of you to be smarter than I was!

Right away I started sweating profusely so much so that I had to change my golf glove three times in 6 holes. I still felt ok, but I couldn't hit the ball as far as usual, and I continued to sweat. Despite 7 bottles of water, 2 with electrolytes, I started getting a headache, and then I couldn't make contact with the golf ball. My balance was off…." Uh-oh," I thought, "it's happening"….At that point I knew I had to go inside but was far away from the club house. I continued one more hole and I was dizzy and had poor balance….so I quit, and I drove the cart back to the club house not finishing the 9 holes.

I sat inside, drank water took another packet of electrolytes and put ice packs under my arms and laid down in the women's locker room until my headache was bearable, but I knew I was not going to be productive the rest of the day. It took 24 hours of lying down in a cool room, drinking quarts of water and taking electrolytes, putting ice around my neck and head, and doing nothing else!

I kept thinking "why did the heat and humidity affect me and not the other 3 women?" We are all in good shape for our ages 60-70, and we all exercise and lift weights as well as play golf a few times a week, so I thought about what my risk factors were.

Finally, I checked out all the medications and supplements I am on and found that some of them put me at risk! This incident made me look up the all the meds that can impact people and increase their risk of getting heat stroke.

Medications That Increase Risk of Heat Stroke

• Diuretics- Spironolactone is a diuretic given to all women who take T pellets to prevent facial hair and acne. It can cause dehydration in hot weather unless enough water, and electrolytes are taken to replenish body fluids. Other reasons for taking a diuretic is hypertension, heart disease, swelling, and poor circulation. eg Hydrochlorothiazide (HCTZ) and Maxide are diuretics.
• Beta Blockers- such as Metoprolol, Propranolol slow down the heartbeat and reduce blood pressure. The actions of Beta blockers slow the cooling mechanism of the body.
• Antidepressants- There ae many types of antidepressants but the "Serotonin-reuptake-inhibitors" such as Lexapro, and Wellbutrin can increase the risk of Heat Stroke, but the mechanism is not known.
• Amphetamines like ADD medicine, Sleep Apnea drugs, and old-fashioned weight loss pills speed up the heart rate, increase baseline body temperature and decrease the body's ability to cool itself.
• Thyroid Replacement-Thyroid replacement increases the heat produced by muscle tissue therefore it increases body temperature. This causes a patient on thyroid to have fewer degrees to get to a critical body temperature.

I will leave you with the warning that hot weather can kill you and knowing the signs and symptoms of Heat Stroke is the first step toward helping yourself and others avoid the worst consequences. If you have medical conditions or take medications that increase your risk of developing heat stroke you should spend most of your time indoors staying cool when heat and humidity is highest.

I will leave you with the warning that hot weather can kill you and knowing the signs and symptoms of Heat Stroke is the first step toward helping yourself and others avoid the worst consequences. If you have medical conditions or take medications that increase your risk of developing heat stroke you should spend most of your time indoors staying cool.