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Life Time has partnered with the sports health experts at NYU Langone Health to provide insights into the common health issues that have the potential to prevent you from moving freely and functioning at your best.

Meet the Expert

headshot Julia Iafrate
  • Julia L. Iafrate, DO, sports medicine and rehabilitation physician and Sports Health expert at NYU Langone.

Q: It’s hot out! How can I stay safe while exercising in the heat?

A: After months of working out indoors, taking your fitness regimen outside during the summer season is an appealing option. But if you aren’t conditioned to exercise in higher temperatures and don’t take steps to keep cool, hot and humid workouts can be dangerous. Heat exhaustion and heat stroke send thousands of people to emergency rooms every year, with extreme heat-related illnesses — collectively known as hyperthermia — accounting for nearly 700 deaths annually.

“Hyperthermia refers to a continuum of ­responses to your body’s inability to cool itself,” explains Julia L. Iafrate, DO, a sports medicine and rehabilitation physician, as well as Sports Health expert, with NYU Langone. When overheated, your body sweats to release heat to your skin and evaporate it off, Dr. Iafrate explains. But in extreme conditions, your body can’t release heat fast enough, ­resulting in a rapid rise in body temperature.

At one end of the continuum is heat rash, a stinging irritation that turns your skin red, typically followed by heat cramps, which are painful muscle spasms. “These are the warning signs,” Dr. Iafrate notes.

Next comes heat exhaustion, with symptoms including fatigue, headache, nausea or vomiting, dizziness, and even fainting. “You most likely have cool and moist skin, indicating that your body is still able to cool ­itself but it’s not happening fast enough,” says Dr. Iafrate. Your pulse rate may be fast and weak, your breathing rapid and shallow.

Left untreated, heat exhaustion can progress to heat stroke, characterized by a body temperature above 103 degrees F. Your skin is red, hot, and dry, meaning that you’ve lost the ability to get rid of heat through sweat. “Basically, your body just tries to keep the function of your vital organs going,” says Dr. Iafrate.

Other symptoms include a throbbing headache, dizziness, nausea, confusion, and unconsciousness. “If your body temperature gets really high, that can damage your brain and cause multiple organ system failure and even death,” she says.

Who’s at Risk

Anyone can suffer from hyperthermia, but heat can exacerbate pre-existing conditions such as heart disease, respiratory disease, or lung disease, says Dr. Iafrate.

Taking certain medications also increases your risk. Diuretics will cause you to have less fluid to sweat out. Antihistamines, beta blockers, and laxatives can have a similar effect.

How to Prevent Heat Illness

If you train in the heat, staying hydrated is your No. 1 priority. Drink four to eight ounces of water every 15 minutes, even if you’re not thirsty, advises Dr. Iafrate.

Depending on how hot and long your workout is, consider an electrolyte sports drink. “We see people who drink so much water they become hyponatremic, meaning their sodium levels go too low,” she says. “They pee out all the salt in their systems and don’t replete it.”

Dr. Iafrate also recommends wearing a hat and loose, lightweight, light-colored clothing that wicks sweat from your skin. “You want to get the sweat off your body,” she says.

Overcoming Heat Illness

“As long as you’re still sweating, you’re OK, but if you’re getting light-headed, you’re not drinking enough fluid,” says Dr. Iafrate.

If you have heat-exhaustion symptoms that are moving toward heat stroke, consider going to the ER. “And if somebody has heat stroke — if they’re confused, slurring their speech, or unconscious, call 911,” says Dr. Iafrate, noting that they should get to the ER within 30 minutes.

If you’re with someone with heat stroke, cool the person down quickly. Move them to the shade. Put them in an ice bath if you can, or tuck ice packs into their armpits, behind their neck, and into their groin, where lots of sweat glands are. Blow cold air at them with a fan.

“Their skin needs to absorb the cold immediately,” says Dr. Iafrate. “Like yesterday.”


The Sports Health experts at NYU Langone have the multi-specialty expertise to provide coordinated, comprehensive care for all types of athletes. As an official healthcare partner, Life Time is able to offer its members exclusive concierge access to NYU Langone’s world-class orthopedic specialists and performance experts, who can help you meet your fitness goals. To schedule an in-person appointment or video visit with a Sports Health expert, visit nyulangone.org/lifetime.

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