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Tamara Hew-Butler

Tamara Hew-Butler

Associate Professor of Exercise Physiology

313-577-8130

tamara.hew-butler@wayne.edu, gr7894@wayne.edu

Office Hours: By appointment.

Education Building, Lower Level #55

Tamara Hew-Butler

Degrees and Certifications

Doctor of Podiatric Medicine (DPM), specializing in sports medicine
Philosophy Doctor (PhD), specializing in the endocrine regulation of fluid balance
Fellow of the Amercican College of Sports Medicine (FACSM)

Responsibilities

  1. To lay the foundation of Exercise Physiology, in both theory and practice, to learners who wish make a positive difference in our community.
  2. To inspire the joys and benefits of regular, life-long, exercise.
  3. To stimulate cutting-edge research which advances our knowledge in exercise science and sports medicine.
  4. To enhance health and peak performance in athletes.

CV (Last update: February, 2024): T. Hew-Butler

Academic Interests

Exercise endocrinology, fluid balance, and thermoregulation
Exercise is Medicine

Biography

Dr Tamara Hew-Butler is a podiatric physician and associate professor of Exercise and Sports Science at Wayne State University in Detroit, Michigan. She obtained her BS in Kinesiology at the University of California at Los Angeles, CA; Doctor of Podiatric Medicine (DPM) at Temple University in Philadelphia, PA; and Philosophy Doctor (PhD) at the University of Cape Town, South Africa. Dr Hew-Butler is a Fellow of the American College of Sports Medicine (FACSM) and specializes in both sports medicine and exercise physiology. Her expertise is in exercise-associated hyponatremia and the endocrine regulation of water and sodium balance. Her scientific work has been highlighted on radio shows (Science Friday, National Public Radio), television (The Weather Channel), podcasts (CJSM), newspapers (New York Times, Washington Post, CNN), a comic strip (xkcd) and reality television show (Adam Ruins Everything).

Dr Hew-Butler is an avid runner and sports fan. She enjoys spending time with her husband, Bill, and pet ducks on their hobby farm.

Area of Expertise

Hyponatremia
Fluid regulation and dysregulation

Research Interests

Hyponatremia
Water and sodium homeostasis (dehydration and overhydration)
Sodium storage and bone
Exertional rhabdomyolysis
Overtraining and peak performance

Featured publications

Longitudinal Changes in Fat and Lean Mass: Comparisons between 3D-Infrared and Dual-Energy X-ray Absorptiometry Scans in Athletes

VanSumeren M, Weber S, Civelek J, Sabourin J, Smith-Hale V, Hew-Butler T. Longitudinal Changes in Fat and Lean Mass: Comparisons between 3D-Infrared and Dual-Energy X-ray Absorptiometry Scans in Athletes. Int J Exerc Sci. 2022, 15(4): 1587-1599. 

Keywords

Body composition
DXA scan

Our student-led research team demonstrated that a 3D infrared body scanner overestimated lean mass while underestimating body fat (%), compared with a dual energy x-ray absorptiometry (DXA) scanner, in a cohort of well-trained athletes. These results raise caution against comparing body composition variables obtained from different pieces of equipment.

Four Cases of Acute Kidney Injury Requiring Dialysis in Ultramarathoners

Pasternak A, Newkirk-Thompson C, Howard J, Onate J, Hew-Butler T. Four Cases of Acute Kidney Injury Requiring Dialysis in Ultramarathoners. Wilderness Environ Med 2023 in press.

Keywords

Kidney injury
Rhabdomyolysis
Ultramarathon

We detail four ultramarathoners who developed hyponatremia, rhabdomyolysis, and acute kidney injury who required (protracted) dialysis treatment after two hot marathon races. The potential contributions of global warming on renal health and disease requires more urgent investigation in athletes training and competing in the heat. 

Vitamin D Supplementation and Body Composition Changes in Collegiate Basketball Players: A 12-Week Randomized Control Trial

Hew-Butler T, Aprik C, Byrd B, Sabourin J, VanSumeren M, Smith-Hale V, Blow A. Vitamin D Supplementation and Body Composition Changes in Collegiate Basketball Players: A 12-Week Randomized Control Trial. Journal of the International Society of Sports Nutrition (JISSN) 2022; 19(1): 34-48.

Keywords

Vitamin D
Basketball players
Bone

Vitamin D promotes bone and muscle growth in non-athletes, suggesting supplementation may be ergogenic in athletes. Our primary aim was to determine if modest Vitamin D supplementation augmented favorable body composition changes and performance in collegiate basketball players following 12-weeks of standardized training. 23 members of a men’s and women’s NCAA Basketball team were recruited. Volunteers were randomized to receive either a weekly 4000IU Vitamin D3 supplement (D3) or placebo (P) over 12-weeks of standardized pre-season strength training. Eighteen of 23 players completed the trial (8 females/10 males). Modest (~517IU/day) vitamin D3 supplementation did not enhance favorable changes in total body composition or performance, over 3-months of training, in collegiate basketball players. We alternatively exposed the potential role of sodium on bone metabolism. More practically speaking, weight training provides a robust training stimulus for bone and lean mass accrual, which likely predominates over isolated supplement use with adequate dietary intakes.

Too Tall for the DXA Scan? Contributions of the Feet and Head to Overall Body Composition

Hew-Butler T, Jurczyszyn H, Sabourin J, VanSumeren M, Smith-Hale V. Too Tall for the DXA Scan? Contributions of the Feet and Head to Overall Body Composition. Journal of Clinical Densitometry: Assessment and Management of Musculoskeletal Health. in press available online 24 November 2021.

Keywords

Basketball players
Foot mass
Head mass

Accurate assessment of total body composition in tall (>1.96m) individuals using dual energy x-ray absorptiometry (DXA) scans is problematic due to current height restrictions of the scan table. The aim of this investigation was to quantify absolute and relative contributions of fat, bone and lean mass, of the feet and head regions, to whole-body composition DXA scan totals. Removing the feet from whole-body composition analyses reduces lean, fat and bone mass compartment totals by 3%-5%. Removing the head region reduces body composition compartments by 6%-19%, from whole-body DXA scan totals.

Pandemic-Induced Reductions on Swim Training Volume and Performance in Collegiate Swimmers

Perez GM, VanSumeren M, Brown M, Hew-Butler T. Pandemic-Induced Reductions on Swim Training Volume and Performance in Collegiate Swimmers. International Journal of Environmental Research and Public Health. 2022; 19(1):164.

Keywords

Swimming
COVID-19
Swim performance

The reduced, pandemic-induced swim training volumes positively impacted sprinting performance, while negatively impacting long-distance swim performance in a cohort of midwestern NCAA D2 swimmers. Swim performance declines during the pandemic were mostly evident in female swimmers competing at regional championship events. The average swim performance was largely unaffected at the national level (in a pandemic versus non-pandemic year). While a substantial (23%) number of swimmers dropped out during the pandemic season, our overall COVID-19 transmission rates were low, with all (2%) COVID-19 positive swimmers recovering without ill effects.
 

Women’s Lives Matter—The Critical Need for Women to Prioritize Optimal Physical Activity to Reduce COVID-19 Illness Risk and Severity

Garcia-Pelagio KP, Hew-Butler T, Fahlman MM, Roche JA. Women’s Lives Matter—The Critical Need for Women to Prioritize Optimal Physical Activity to Reduce COVID-19 Illness Risk and Severity. International Journal of Environmental Research and Public Health. 2021; 18(19):10271.

Keywords

COVID-19
Females
Exercise

Physical activity (PA) is beneficial for the health and wellness of individuals and societies. During an infectious disease pandemic, such as the one caused by COVID-19, social distancing, quarantines, and lockdowns are used to reduce community spread of the disease. Unfortunately, such nonpharmacological interventions or physical risk mitigation measures also make it challenging to engage in PA. Reduced PA could then trigger physiological changes that affect both mental and physical health. In this regard, women are more likely to experience physical and psychological distress. PA is a safe and effective nonpharmacological modality that can help prevent and manage several mental and physical health problems when performed correctly. PA might even confer benefits that are directly related to decreasing COVID-19 morbidity and mortality in women. In this review, we summarize why optimal PA must be a priority for women during the COVID-19 pandemic. We then discuss chronic COVID-19 illness and its impact on women, which further underscores the need for worldwide preventive health strategies that include PA. Finally, we discuss the importance of vaccination against COVID-19 for women.

Depression in Collegiate Runners and Soccer Players: Relationships with Serum 25-Hydroxyvitamin D, Ferritin and Fractures

Tomlinson, Devin C.; Eschker, Evan; Callan, Jade; and Hew-Butler, Tamara (2021) "Depression in Collegiate Runners and Soccer Players: Relationships with Serum 25-Hydroxyvitamin D, Ferritin and Fractures," International Journal of Exercise Science: Vol. 14 : Iss. 5, Pages 1099 - 1111.

Keywords

Vitamin D
Depression
Student-athletes

The main purpose of this study was to evaluate relationships between depression versus serum 25-hydroxyvitamin D (vitamin D), serum ferritin (ferritin), and fractures across a competitive season. The authors conducted a prospective observational study (both pre- and post-season testing) on 51 collegiate soccer and cross-country athletes from a Midwest University. Our main outcome measure was depression, measured using the Center for Epidemiological Studies Depression Scale (CES-D). A CES-D score ≥ 16 represented the threshold value for clinical depression. Secondary outcome variables included vitamin D, ferritin, and fractures. Two athletes (3.9%; one female) pre-season while seven athletes (13.7%; five females) post-season demonstrated clinically relevant depression (CES-D score ≥ 16). Depression scores increased from pre- to post-season (6.0 to 8.9; p = 0.009; effect size = 0.53; n = 51). A medium effect noted for depressed athletes vs. non-depressed athletes (n = 7; post-season) to have lower pre-season serum vitamin D (38.4 vs. 50.2 ng/ml; p = 0.15; effect size = 0.68) with a small overall correlation effect (r = -0.08; p = 0.58). A medium correlation effect was noted between p.

Paradoxical Relationships between Serum 25(OH)D and Ferritin with Body Composition and Burnout: Variation by Sex and Sports Team

Hew-Butler, T.; Aprik, C.; Byrd, B.; Landis-Piwowar, K.; Smith-Hale, V.; VanSumeren, M.; Sabourin, J.; Byrd, G.; Martin, J. Paradoxical Relationships between Serum 25(OH)D and Ferritin with Body Composition and Burnout: Variation by Sex and Sports Team. Endocrines 2021, 2, 320–333. https://www.mdpi.com/2673-396X/2/3/30

Keywords

Vitamin D
Student-athlete

Adequate serum vitamin D and iron levels are thought to influence physical training adaptations and mood positively. The primary purpose of this prospective, observational study was to investigate relationships between serum 25-OH vitamin D/25(OH)D and serum ferritin levels with body composition and athlete burnout symptoms. Seventy-three collegiate athletes (female: n = 49; male: n = 24) from indoor (swimming, basketball) and outdoor (soccer, cross-country) sports were tested pre-season and post-season for serum 25(OH)D and serum ferritin (nutrient biomarkers) via venipuncture; body composition (total lean mass, bone mineral density/BMD, and % body fat) via dual energy X-ray absorptiometry (DXA) scans; and athlete burnout symptoms (post-season) via the athlete burnout questionnaire (ABQ). When male and female cohorts were combined, significant correlations (Pearson’s r) were noted between pre-season serum 25(OH)D versus the change (D: post-season minus pre-season) in both BMD (r = 􀀀0.34; p = 0.0003) and % body fat (r = 􀀀0.28; p = 0.015). Serum ferritin D was significantly associated with lean mass D (r = 􀀀0.34; p = 0.003). For burnout symptoms, serum 25(OH)D D significantly exp.

A Field Study on Runners Participating in a 161-km Footrace

Hew-Butler T. Chasing Hyponatremia: A Field Study on Runners Participating in a 161-km Footrace. SAGE Research Methods Cases: Medicine and Health Part 2. 2020.

Keywords

Hyponatremia
Ultramarathon

Exercise-associated hyponatremia (EAH) is a life-threatening electrolyte imbalance, biochemically defined by a blood sodium concentration ([Na+]) below 135 mmol/L. Because athletes die from brain swelling (encephalopathy) associated with severe EAH, most institutional review boards will not allow researchers to induce hyponatremia in laboratory settings. Accordingly, researchers must target athletes in field settings to investigate the risk factors, pathogenesis, and treatment of EAH. One-hundred-mile (161 km) mountain footraces, held in hot climates, provide the most favorable conditions for development of EAH. We thereby undertook an ambitious series of sodium balance studies during a 161-km ultramarathon to investigate the pathophysiology of EAH. The methods described in detail suggests that research teams can salvage novel findings when they embrace foresight, teamwork, and resilience during extreme circumstances.

Wilderness Medical Society Clinical Practice Guidelines for the Management of Exercise-Associated Hyponatremia: 2019 Update

Bennett BL, Hew-Butler T, Rosner MH, Myers T, Lipman GS. Wilderness Medical Society Clinical Practice Guidelines for the Management of Exercise-Associated Hyponatremia: 2019 Update. Wilderness Environ Med. 2020 Mar;31(1):50-62.

Keywords

Hyponatremia
Exercise
Hydration

The Wilderness Medical Society (WMS) convened an expert panel in May 2018. The panel was charged with updating the WMS Practice Guidelines for Treatment of Exercise-Associated Hyponatremia (EAH) published in 2014 using evidence-based guidelines for the prevention, recognition, and treatment of EAH. Recommendations are made based on presenting with symptomatic EAH, particularly when point-of-care blood sodium testing is unavailable in the field. These recommendations are graded on the basis of the quality of supporting evidence and balanced between the benefits and risks/burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians.

Is Exercise the Best Medicine during a COVID-19 Pandemic?

Hew-Butler T, Smith-Hale V, Van Sumeren M, Sabourin J, Levy P. Is Exercise the Best Medicine during a COVID-19 Pandemic? Comment on Constandt, B.; Thibaut, E.; De Bosscher, V.; Scheerder, J.; Ricour, M.; Willem, A. Exercising in Times of Lockdown: An Analysis of the Impact of COVID-19 on Levels and Patterns of Exercise among Adults in Belgium. Int. J. Environ. Res. Public Health 2020, 17, 4144. Int J Environ Res Public Health. 2020 Aug 8;17(16):5730. doi: 10.3390/ijerph17165730.

Keywords

Exercise
COVID-19
Sports

The authors editorialize whether or not all exercise (i.e. sports competition) is safe during a pandemic. The literature confirms that regular moderate exercise has clear mental, physical and metabolic health benefits, including immunological benefits in the face of communicable disease. Conversely, excessive and/or intense competitive exercise has been shown to negatively affect immune function which may exacerbate infection as well as overall SARS-coV-2 contagion. The question of whether exercise - particularly the resumption of competitive sports - is healthy during the COVID-19 pandemic remains a (hot) topic. The authors emphasize that the boundaries between safe and unsafe exercise warrants further investigation, and a Special Issue in IJERPH has been created to address this question more critically (with Hew-Butler as Guest Editor)

Publications

 VanSumeren M, Weber S, Civelek J, Sabourin J, Smith-Hale V, Hew-Butler T. Longitudinal Changes in Fat and Lean Mass: Comparisons between 3D-Infrared and Dual-Energy X-ray Absorptiometry Scans in Athletes. Int J Exerc Sci. 2022. In press

Hew-Butler T, Aprik C, Byrd B, Sabourin J, VanSumeren M, Smith-Hale V, Blow A. Vitamin D Supplementation and Body Composition Changes in Collegiate Basketball Players: A 12-Week Randomized Control Trial. Journal of the International Society of Sports Nutrition (JISSN) 2022; 19(1): 34-48.
https://doi.org/10.1080/15502783.2022.2046444

Perez GM, VanSumeren M, Brown M, Hew-Butler T. Pandemic-Induced Reductions on Swim Training Volume and Performance in Collegiate Swimmers. Int. J. Environ. Res. Public Health 2022’ 19(1), 164; https://doi.org/10.3390/ijerph19010164

Hew-Butler T, Jurczyszyn H, Sabourin J, VanSumeren M, Smith-Hale V. Too Tall for the DXA Scan? Contributions of the Feet to Overall Body Composition. J Clin Densitom 2022, Jul-Sep;25(3):384-391. https://doi.org/10.1016/j.jocd.2021.11.008

Garcia-Pelagio KP, Hew-Butler T, Fahlman MM, Roche JA. Women’s Lives Matter—The Critical Need for Women to Prioritize Optimal Physical Activity to Reduce COVID-19 Illness Risk and Severity. International Journal of Environmental Research and Public Health. 2021; 18(19):10271. https://doi.org/10.3390/ijerph181910271

Martin J, Byrd B, Hew-Butler T, Moore EW. A Longitudinal Study on the Psychological and Physiological Predictors of Burnout in NCAA Collegiate Swimmers. JASP published online Sept 24, 2021 https://doi.org/10.1080/10413200.2021.1974603

Khodaee M, Saeedi A, Harris-Spinks C, Hew-Butler T. Incidence of exercise-associated hyponatremia during a 161-km ultramarathon at high altitude. Physical Activity and Nutrition 2021; 25(3):016-022. https://doi.org/10.20463/pan.2021.0016

Hew-Butler T, Aprik C, Byrd B, Landis-Piwowar K, Smith-Hale V, VanSumeren M, Sabourin J, Byrd G, Martin J. Paradoxical Relationships between Serum 25(OH)D and Ferritin with Body Composition and Burnout: Variation by Sex and Sports Team. Endocrines 2021, 2, 320–333. https://doi.org/10.3390/endocrines2030030

Tomlinson D, Eschker E, Callan J, Hew-Butler T. Depression in Collegiate Runners and Soccer Players:
Relationships with Serum 25-Hydroxyvitamin D, Ferritin and Fractures. Int J Exerc Sci. 2021: 14(5);1099-1111. https://digitalcommons.wku.edu/ijes/vol14/iss5/3

Stojanović E, Radovanović D, Hew-Butler T, Hamar D, Jakovljević V. Vitamin D in basketball players: current evidence and future directions. Sports Health. 2021 Jun 4;19417381211019343.
doi: 10.1177/19417381211019343. Online ahead of print.

Rengers, TA, Orr S, Marks C, Hew-Butler T, Choi M, Butcher S, Drignei D, Brown E. Effects of High-Intensity Interval Training Protocols on Liver Enzymes and Wellness in Women. Journal of Sports Medicine. vol. 2021. https://doi.org/10.1155/2021/5554597

Lipman GS, Hew-Butler T, Phillips C, Krabak B, Burns P. Prospective Observational Study of Weight-based Assessment of Sodium Supplements on Ultramarathon Performance (WASSUP). Sports Med Open 2021 Feb 17;7(1):13. doi: 10.1186/s40798-021-00302-0

Arena SK, Jones S, Munoz AM, Murley M, Strudwick Melton C, Sakyi K, Hew-Butler T. Resting Blood Pressure in Collegiate Swimmers During a Competitive Season: A Prospective Observational Study. Cureus. 2020 Dec 28;12(12):e12340. doi: 10.7759/cureus.12340.

Hew-Butler T, Smith-Hale V, VanSumeren M, Sauborin J, Levy P. Is Exercise the Best Medicine during a COVID-19 Pandemic? Comment on Constandt, B.; Thibaut, E.; De Bosscher, V.; Scheerder, J.; Ricour, M.; Willem, A. Exercising in Times of Lockdown: An Analysis of the Impact of COVID-19 on Levels and Patterns of Exercise among Adults in Belgium. Int. J. Environ. Res. Public Health 2020, 17, 4144. Int J Environ Res Public Health 2020 17(16):5730. DOI: 10.3390/ijerph17165730.

Hew-Butler T. Chasing Hyponatremia: A Field Study on Runners Participating in a 161-km Footrace. SAGE Research Methods Cases: Medicine and Health. SAGE Publications Ltd. June 2020. https://dx.doi.org/10.4135/9781529741070

Arena SK, Ellis E, Maas C, Pieters A, Quinnan A, Schlagel R, Hew-Butler T. Orthostatic Hypotension and Urine Specific Gravity Among Collegiate Athletes. Cureus 2020 June 12(6): e8792. DOI 10.7759/cureus.8792

Bennett BL, Hew-Butler T, Rosner MH, Myers T, Lipman GS. Wilderness Medical Society Practice Guidelines for the Management of Exercise-Associated Hyponatremia: 2019 Update. Wilderness Environ Med 2020 Mar 31(1): 50-62. https://doi.org/10.1016/j.wem.2019.11.003

Bridges E, Altherwi T, Correa J, Hew-Butler T. Oral Hypertonic Saline Is Effective in Reversing Acute Mild-to-Moderate Symptomatic Exercise -Associated Hyponatremia. Clin J Sport Med. 2020 Jan;30(1):8-13. doi: 10.1097/JSM.0000000000000573.

Hew-Butler T, Smith-Hale V, Pollard-McGrandy A, VanSumeren M. Of Mice and Men – The Physiology, Psychology, and Pathology of Overhydration. Nutrients 2019 Jul 7;11(7). pii: E1539. doi: 10.3390/nu11071539.

Rider BC, Coughlin AM, Carlson C, Hew-Butler T. Exertional (Exercise-Induced) Rhabdomyolysis. ACSM's Health and Fitness Journal 2019 May/June 23(3): 16-20.

Rusnak M, VanderMeulen M, Byrd B, Byrd G, Rusnak R, Martin J, Hew-Butler T. Muscle Damage, Soreness, and Stress during Pre-season Training in Collegiate Swimmers. Clin J Sport Med 2019 Mar 1. doi: 10.1097/JSM.0000000000000736. [Epub ahead of print]

Hew-Butler T, Angelakos K, Szczepanski J. Sodium Loading, Treadmill Walking and the Acute Redistribution of Bone Mineral Content on Dual X-ray Absorptiometry Scans. Am J Physiol Regul Integr Comp Physiol. 2019 Jan 1;316(1):R59-R67. doi: 10.1152/ajpregu.00227.2018.

Nolte H, Nolte K, Hew-Butler T. Ad Libitum Water Consumption Prevents Exercise-Associated Hyponatremia and Protects Against Dehydration in Soldiers Performing a 40-km Route-March. Military Medical Research. 2019 Jan 6:1. Doi.org/10.1186/s40779-019-0192-y.

Brown E, Hew-Butler T, Butcher S, Marks C, Choi M. The Impact of Different High-Intensity Interval Training Protocols on Body Composition and Physical Fitness in Healthy Young Adult Females. Biores Open Access. 2018 Dec 28;7(1):177-185. doi: 10.1089/biores.2018.0032.

Hew-Butler T, Eskin C, Bickham J, Rusnak M, VanderMeulen M. Dehydration is how you define it:
Comparison of 318 blood and urine athlete spot checks. BMJ Open Sport Exerc Med. 2018 Feb 1;4(1):e000297. doi: 10.1136/bmjsem-2017-000297.

Lewis DL, Blow A, Tye J, Hew-Butler T. Considering Exercise Associated Hyponatremia as a Continuum. BMJ Case Rep. 2018 Mar 9;2018. pii: bcr-2017-222916. doi: 10.1136/bcr-2017-222916.

Arena S, LaBelle L, Larsen J, Palomino L, Hew-Butler T, Peterson E. Description and Comparison of Pre and Post Season Blood Pressure Measures among Collegiate Athletes: A Prospective Observational Study. Cardiopulmonary Physical Therapy Journal. June 13, 2018. [Epub ahead of print] doi: 10.1097/CPT.0000000000000085

Hew-Butler T. Response to Letter-to-the-Editor “The Presented Evidence to Support Symptomatic Hypovolemic-Associated EAH Is Not Convincing’’. Curr Sports Med Rep. 2017 Nov/Dec;16(6):467-468.

Delang M, Kondratek M, DiPace L, Hew-Butler T. Collegiate male soccer players exhibit between-limb symmetry in body composition, muscle strength, and range of motion. Int J Sports Phys Ther. 2017 Dec;12(7):1087-1094.

Hew-Butler T, Hamilton R, Hamilton B, Colesa Z. Special Communication of a case of hypovolemic-driven EAH: Lessons learned during recovery. Curr Sports Med Rep. 2017 July/Aug:16(4):289-293.

Hew-Butler T, Loi V, Pani A, Rosner MH. Exercise-Associated Hyponatremia: 2017 Update. Front Med (Lausanne). 2017 Mar 3;4:21. doi: 10.3389/fmed.2017.00021. eCollection 2017.

Magrini D, Khodaee M, San-Millán I, Hew-Butler T, Provance AJ. Serum creatine kinase elevations in ultramarathon runners at high altitude. Phys Sportsmed. 2017 May;45(2):129-133.

Tan DW, Yap SH, Wang MC, Fan WPP, Teo YS, Krishnasamy P, Krishna L, Hew-Butler T, Lee KWJ. Body Mass Changes Across a Variety of Running Race Distances in the Tropics. Sports Med Open 2016 Jul 19;2(1):26.

Bailowitz, Z, Grams R, Teeple D, Hew-Butler, T. Exercise Associated Hyponatremia in a Lactating Female. Clin J Sport Med 2017 Jul:27:e55–e57

Stanfa MR, Silles NN, Cooper A, Arena S, Landis-Piwowar K, Banner-Aprik C, Hew-Butler T. Risk factors for collegiate swimmers hospitalized with exertional rhabdomyolysis. Clin J Sport Med. 2017 Jan;27(1):37-45.

Cairns RS and Hew-Butler T. Proof of concept: hypovolemic hyponatremia may precede and augment creatine kinase elevations during an ultramarathon. Eur J Appl Physiol. 2016 Mar;116(3):647-55. doi: 10.1007/s00421-015-3324-4.
Hoffman MD, Hew-Butler T, Roberts WO, Rogers IR, Rosner MH. Is Postevent Intravenous Hydration an Appropriate Service at Endurance Competitions? Wilderness Environ Med. 2016 Mar;27(1):7-9.

Stuempfle KS, Valentino T, Hew-Butler T, Hecht FM, Hoffman MD. Nausea is Associated with Endotoxemia during an ultramarathon. J Sports Sci. 2016 Sep;34(17):1662-8.

Hew-Butler T, EAH Consensus Group. Inadequate hydration or normal fluid homeostasis? Am J Public Health, 2015 Oct;105(10):e5-6.

Hew-Butler T, Rosner MH, Fowkes-Godek S, Dugas JP, Hoffman MD, Lewis DP, Maughan RJ, Miller KC, Montain SJ, Rehrer NJ, Roberts WO, Rogers IR, Siegel AJ, Stuempfle KJ, Winger JM, Verbalis JG. Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, CA, 2015. Clin J Sports Med 2015; 25(4):303-320 and Br J Sport Med 2015;0:1–15. doi:10.1136/bjsports-2015-095004

Byrd B, Hew-Butler T, Martin JJ. The Effects of a Running Intervention on the Physical Self-Concept of Novice Female Runners. Women in Sport and Physical Activity Journal 2016; 24:54-59.

Hew-Butler T, Landis-Piwowar K, Byrd G, Seimer M, Seigneurie N, Byrd B, Muzik O. Plasma irisin in runners and nonrunners: no favorable metabolic associations in humans. Physiol Rep. 2015 Jan 19;3(1). pii: e12262. doi: 10.14814/phy2.12262. Print 2015 Jan 1.

Nolte HW, Hew-Butler T, Noakes TD, Duvenhage C. Fatal exertional heatstroke with hyponatremic encephalopathy. Phys Sportsmed. 2015 Feb;43(1):93-8. doi: 10.1080/00913847.2015.1001714.

Hew-Butler T, Holexa BT, Fogard K, Stuempfle KJ, Hoffman MD. Comparison of body composition before and after a 160km race using dual energy x-ray absorptiometry, bioimpedance spectroscopy and bioelectrical impedance analyses. Int J Sports Med. 2015 Feb;36(2):169-74. doi: 10.1055/s-0034-1387777.

Cairns RS and Hew-Butler T. Incidence of Exercise-Associated Hyponatremia and its Association with Non-Osmotic Stimuli of Arginine Vasopressin in the GNW100s ultraendurance marathon. Clin J Sport Med. 2015 Jul;25(4):347-54. doi: 10.1097/JSM.0000000000000144.

Bennett BL, Hew-Butler T, Hoffman MD, Rogers IR, Rosner MH; Wilderness Medical Society practice guidelines for treatment of exercise-associated hyponatremia: 2014 update. Wilderness Environ Med. 2014 Dec;25(4 Suppl):S30-42. doi: 10.1016/j.wem.2014.08.009.

Hew-Butler T, Hummel J, Rider BC, Verbalis JG. Characterization of the Vasopressin 2 receptor on fluid balance and performance. Am J Physiol Regul Integr Comp Physiol. 2014 Aug 15;307(4):R366-75. doi: 10.1152/ajpregu.00120.2014. Epub 2014 Jun 18.

Rider BC, Coughlin A, Hew-Butler T, Darr K, Goslin BR. Effect of Compression Stockings on Physiological Responses and Running Performance in Division III Collegiate Cross Country Runners during a Maximal Treadmill Test. J Strength Cond Res 2014; Jun;28(6):1732-8. doi: 10.1519/JSC.0000000000000287.

Owen BE, Rogers IR, Hoffman MD, Stuempfle KJ, Lewis DL, Fogard K, Verbalis JG, Hew-Butler T. Efficacy of oral versus intravenous hypertonic saline in runners with hyponatremia. J Sci Med Sport. 2014 Sep;17(5):457-62. doi: 10.1016/j.jsams.2013.09.001. Epub 2013 Sep 18.

Lewis DL, Owen BE, Rogers IR, Hoffman MD, Stuempfle KJ, Fogard K, Verbalis JG, Hew-Butler T.
The Need for Salt: Does a Relationship Exist between Cystic Fibrosis and Exercise-Associated Hyponatremia? J Strength Cond Res. 2014; Mar;28(3):807-13. doi: 10.1519/JSC.0b013e3182a35dbd.

Hew-Butler T, Stuempfle KJ, Hoffman MD. Reply to letter to the editor by Hind et al. Horm Metab Res. 2014 Oct;46(11):821-2. doi: 10.1055/s-0034-1374632.

Hew-Butler T, Stuempfle KJ and Hoffman MD. Bone: an acute buffer of plasma sodium concentration during exhaustive exercise? Horm Metab Res. 2013; Sep;45(10):697-700. doi: 10.1055/s-0033-1347263. Epub 2013 Jun 21.

Winger J, Hoffman MD, Hew-Butler T, Stuempfle KJ, Dugas J, Fogard K, Dugas L. Physiology and hydration beliefs change race behavior but not post-race sodium in 161km ultramarathon runners.
Int J Sports Physiol Perform. 2013; Sep;8(5):536-41.

Bennett B, Hew-Butler T, Hoffman MD, Rogers IR, Rosner MR. Wilderness Medicine Society Practice Guidelines for Treatment of Exercise-Associated Hyponatremia. Wilderness Environ Med. 2013. Sep;24(3):228-40. doi: 10.1016/j.wem.2013.01.011. Epub 2013 Apr 13.

Khodaee M, Luyten D, Hew-Butler T. Exercise-Associated Hyponatremia in an Ultra-endurance Mountain Biker. Sports Health. 2013 Jul;5(4):334-6. doi: 10.1177/1941738113480928.

Hoffman MD, Hew-Butler T, Stuempfle KJ. Exercise-associated hyponatremia and hydration status in 161-km ultramarathoners. Med Sci Sports Exerc 2013; Apr; 45(4):784-91. doi: 10.1249/MSS.0b013e31827985a8.

Stuempfle KJ, Hoffman MD, Hew-Butler T. Gastrointestinal Distress in Ultramarathoners is Associated with Race Diet. Int J Sport Nutr Exerc Metab. 2013; Apr; 23(2):103-9. Epub 2012 Sep 19.

Hoffman MD, Stuempfle KJ, Fogard K, Hew-Butler T Winger J, Weiss R. Urine Dipstick Analysis for Identification of Runners Susceptible to Acute Kidney Injury following an Ultramarathon. J Sports Sci. 2013; 31(1):20-31. doi: 10.1080/02640414.2012.720705. Epub 2012 Oct 4.

Hew-Butler T, Boulter J, Bhorat R, Noakes TD. Adding insult to injury – correct management of sick female endurance athletes. SAMJ 2012; 102: 927-930.

Coler C, Hoffman MD, Towle G, Hew-Butler T. Hyponatremia in an 85 year old hiker: When depletion plus dilution produce delirium. Wilderness Environ Med 2012; 23: 157-157.

Courses taught by Tamara Hew-Butler

Winter Term 2024 (current)

Fall Term 2023

Winter Term 2023

Fall Term 2022

Winter Term 2022

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