Monthly Archives: June 2019

Drugs! Are you on Diuretics? – Part 2

natrilixThis is Part 2 of Drugs! Are you on diuretics?  Part 1 is here  and here is Part 3 and Part 4. Following on from all the reasons why you should not take a diuretic, I want to add a caveat about the administration of diuretics with regard to a type of blood pressure known as malignant hypertension.

Malignant hypertension

Malignant hypertension is a life threatening condition where blood pressure spikes really high and very quickly and can be an extreme medical emergency.  Severe symptoms of intense headache, cognitive disruption, visual disturbances, walking problems and speech difficulties are some of the complication of this condition.  Emergency use of diuretics for the short term is not challenged here.  Note though, that this is a very rare type of hypertension.  Most sufferers of high blood pressure are not this severe and many don’t even know they even have high blood pressure.

Diseases prescribed diureticsCHF diuretics

So lets go through a few scenarios of when diuretics are given.  I list below a few of the most common conditions for which these drugs are prescribed.

  • Hypertension or high blood pressure
  • kidney disease/failure
  • Cirrhosis of the liver and ascites
  • Congestive heart failure
  • Venous insufficiency
  • General Oedema.
Hypertension or high blood pressure.

Most people don’t feel sick with BP so there’s not usually a general medical emergency associated with it.  As we age, BP is often raised a little by the body in response to stiffness and inflexibility and helps to keep the blood flow strong, sounds good to me!

bp table120/80 is just an average

If your BP is slightly over or below the norm, or you have exhibited a higher reading than you do normally at home, you may erroneously be prescribed a diuretic. Diuretics are the number one hypertensive drug to be prescribed.  It inevitably won’t work and so it leads nicely onto the patient being prescribed a 2nd drug for hypertension to go with the diuretic. Now you’re on 2 drugs.  This is a common scenario.

We’re not all the same

Anyway, who says everyone’s BP has to be 120/80.  A little give or take in a reading is normal, isn’t it? Our bodies are not all exactly the same. As for treatment of this common condition, there is nothing better than a good supplement of Magnesium (Mg).  As we age our Mg levels will deplete and at the same time our Calcium (Ca) levels will increase.  If Ca levels are much higher than Mg then the body is Mg deficient by default.  Excess Ca can lead to devastating problems including coronary calcium deposits.

Common side effects

A common side effect with BP drugs is fainting, dizziness or falling when the drug lowers the BP too much.  This is a real problem for the elderly who only need to fall once to break a hip.  Mg will not interfere to the extent of dropping your BP below optimum levels for your body.

Dehydration is another side effect that is more serious than most realize, depleting precious minerals such as Mg and Potassium (K) and upsetting your electrolytes.  This can be dangerous for the heart with arrhythmias being a common side effect. Taken optimally, Mg will hydrate the body and alleviate so many symptoms, you wouldn’t believe.  Many of which you are probably suffering from right now!

Kidney disease and kidney failure.

How can these drugs help when it is known that they can actually cause kidney disease?  As I said in Part 1 of this article, the kidneys are very delicate and their filtration processes very complex and balanced.  Any drug that changes that balance and upsets the process will compromise the kidneys.  Without healthy kidneys your life will be problematic and studies have shown that diuretics are not beneficial to kidney function and can in fact shorten the life of a sufferer. –  The use of diuretics in critically ill patients with acute renal failure was associated with an increased risk of death and nonrecovery of renal function.” (from part 1).

toxic to kidneysKidneys have to deal with all drugs

Remember, all drugs end up getting processed through the kidneys and these toxic concoctions should only be used as a last resort, when all else fails.  So what can we do to help our kidneys function properly without drugs?

Lifestyle changes have to be made to keep yourself fit and healthy.  This is difficult I know because when you’re already under the weather, it takes a strong mentality to pick yourself up and start making those changes that you know you need to do.

But if you don’t want to end up having a miserable unhealthy life, you have to change your paradigms.  Make sure you don’t end up with kidney disease.  If you already have it, then taking a diuretic will not help.  Let nature help you and give yourself the nutrients needed to mend your body.

Cirrhosis of the liver…

Again, diuretics will put a strain on the liver as well as the kidneys. Why would we want to exacerbate an already damaged organ? When the abdomen swells because of liver disease, there are many things you can do to help your liver recover naturally.  You MUST be aware of your lifestyle.  Your eating habits, your drinking habits, drugs, smoking, lack of exercise.  Get these under control and you will be on the way to reducing your symptoms.

and ascitesascites

“Ascites is the accumulation of protein-containing (ascitic) fluid within the abdomen. Many disorders can cause ascites, but the most common is high blood pressure in the veins that bring blood to the liver (portal hypertension), which is usually due to cirrhosis.”

A swollen belly is worrisome and distressing and you definitely want to reduce it.  Be positive and use it as a barometer of how your new lifestyle is improving your health.  This symptom is seldom painful and when you see your stomach slowly diminishing, you will be so proud of the changes you have made to your life and you won’t want to go back.

Congestive heart failure

If your heart is failing it will not be helped by taking a diuretic.  Improve heart function naturally.  When your legs puff up from right sided heart failure, taking a diuretic is not going to strengthen it.  However, with left sided heart failure, fluid  may accumulate in the lungs (pulmonary oedema).  Breathing can become difficult causing an emergency situation.  A diuretic in this case could not be contested, often an IV diuretic is administered, but it will only be a temporary fix.

YOU will change your health not drugsJunk Food

It is only YOU who can strengthen your heart with a good diet of whole foods and plenty of vegetables and some specific fruits. Avoid junk food like the plague along with junk fats and diet sodas.  Start an exercise regime, gently does it and work up slowly.  You’ll be surprised how much you will improve when you regularly exercise.

Magnesium magic

Magnesium is an essential key to a healthy heart.  It will help avoid heart attacks and lower blood pressure.  It will stop painful muscle cramps and relieve digestive problems.  It will ensure restful and beneficial sleep and alleviate insomnia and you are bound not to be getting enough of this amazing mineral.  Most importantly, it will keep Ca dissolved in the blood which will help disable calcification in the soft tissue.

Your heart has the highest requirement for magnesium than any other organ in theMg glass body with the left ventrical needing the most. “Magnesium shines brightest in cardiovascular health. It alone can fulfill the role of many common cardiac medications: magnesium inhibits blood clots (like aspirin), thins the blood (like Coumadin), blocks calcium uptake (like calcium channel-blocking drugs such as Procardia) and relaxes blood vessels (like ACE inhibitors such as Vasotec)” According to the Western A Price Foundation

Venous insufficiency

This is caused when the venous valves are inefficient at allowing blood back to the heart.  It causes swelling in the legs and ankles and can cause pain whilst walking.  The skin often is brown usually near the ankles.  There is a tendency for varicose veins and leg ulcers.

dog walkingDiuretics? Why not try walking!

Diuretics will likely be prescribed to take down the swelling.  A better and more natural way would be to do more walking.  Do you have a dog?   If not, how about giving a rescue dog a home and start your walking regime with him.  Many patients who have venous insufficiency are overweight and a healthy diet and exercise can do nothing but improve these symptoms.  A diuretic will just mask the condition but will not cure it.

You can do it!

Walk as much as possible.  Wear supportive tights or socks.  Raise the foot of the bed a little.  Put your feet up when resting but don’t stay there too long!  Get up regularly and walk about.  Set your alarm clock or buy one of those ‘fitbits’ to make sure you move every hour and keep a check on your movements.  Walk around the house or around the block.  Take the dog out, anything to keep you moving.

Diet, diet, diet!

Again, diet is paramount.  Plenty of veggies and for fruit eat berries such as blueberries and strawberries.  Avocado is a super fruit although many don’t like it including me.  Even so I only use avocado oil for cooking it has a very high smoke point so is not damaged by heat.  It also has a very delicate flavour that does not taint the food.

General oedemaoedema

We all get a little puffy sometimes, perhaps from sitting too long or being too hot or during a long flight.  There are healthier ways to deal with it than stressing your kidney function and depleting your nutrients and electrolytes with a diuretic.

Ches PowerIn Part 3

In Part 3 we will summarize the important bits we’ve covered and also go through how you can reduce any oedema with a particular way of eating which has a great side effect of weightloss!

Drugs! Are you on Diuretics?

Lasix
One side effect: can cause irreversible hearing loss

This class of drugs is often the first medication you will be prescribed if you are deemed to have high blood pressure.  I will explain why diuretics should not be prescribed to the majority of the population and especially not to the elderly.  There are certain extenuating circumstances when diuretics may be of value but these will be rare.  Other examples of when this drug will be prescribed is for kidney failure, liver disease, congestive heart failure and all types of oedema.  See Part 2 and Part 3 and Part 4 of this article.

At what cost?

These drugs increase your output of urine but at what cost?  When the kidney is working without drugs it does its job with a sophisticated filtration system through a special cluster of high pressure capillaries known as a glomerulus.

kidneysHow your kidneys function

The function of kidney filtration starts with blood passing through the glomerulus.  The high pressure forces water and other dissolved substances out of these special capillaries and into a capsule which surrounds the glomerulus.  This is known as Bowman’s capsule.  This capsule now contains all water, salt and dissolved substances, but the water and dissolved substances are then ‘reclaimed’ or reabsorbed by passing through a second filtration system known as the renal tubule system.  This insures that vital nutrients are not lost during the filtration process.

Nephrologynephron

This whole filtering system is known as a nephron, hence the name nephrology, the branch of medicine to do with the physiology and diseases of the kidneys.  Each kidney has around a million of these nephrons.

The reclaimed nutrients include much of the salt and water, glucose, amino acids, lactate, magnesium, phosphate, calcium bicarbonate and uric acid.

urine formationThe result of filtration = urine

After the process of filtration and reabsorption, the resulting urine is expelled from the body.  It contains around 95% water, urea and other substances including chloride, sodium, potassium, creatinine and metabolic waste and toxins all in varying degrees, depending on diet and health.

Ambush!

Now what diuretics do is to ambush the second reclamation filtering system so that much more of the initial filtrate from the glomerulus goes to the bladder.  Thus this filtrate still has vital nutrients within it.   This means more water and more minerals, such as magnesium, potassium and sodium, are sent to the bladder instead of being reclaimed.  Reclamation is a vital process which avoids depletion of necessary nutrients.

Different types of Diuretics

There are different kinds of diuretics which work in slightly different ways.  They each interfer in different areas of the kidney filtration system.  Loop diuretics for instance, undermine reabsorption at the ascending loop (see the diagrams) while thiazide diuretics undermine the system at the distal convoluted tubule.

Thiazide diureticsamiloride

  • chlorothiazide (Diuril)
  • chlorthalidone (Hygroton)
  • hydrochlorothiazide (Hydrodiuril)
  • indapamide (Lozol)
  • methyclothiazide (Enduron)
  • metolazone (Zaroxolyn, Diulo, Mykrox)

Loop diuretics

  • bumetanide (Bumex)
  • ethacrynate (Edecrin)
  • furosemide [(Lasix)
  • torsemide [(Demadex)aldactone

Potassium sparing diuretics

  • amiloride hydrochloride
  • spironolactone (Aldactone)
  • triamterene (Dyrenium)
Now you know, you can decide

Yes, I know it’s a bit heavy going but if you understand a little of what’s going on, it will give you the reasons why these drugs are not good for you and allow you to make an informed decision as to whether you want to take them or not.

acid-baseKidneys and hormones

Remember that kidney function is extremely delicate and complex.  It is fine tuned to do a delicate balancing act.  As well as producing its own hormones, the kidneys are influenced by other hormones produced by glands such as the adrenals and the pituitary.   Your kidneys have the important and complicated task of controlling your pH system to maintain correct acid-base balance.

Diuretics do not improve your kidneys

Those who are prescribed diuretics probably think they are improving kidney function.  Nothing is further from the truth.  Your kidneys will be undermined by these drugs. They interfer with their proper function and do nothing to help the original condition.

Now you have 2 problemseinstein quote

In fact now you have two problems.  One is the condition you started with and now you have another abnormality to the one you already have because of pharmacological interference.  All a diuretic does is feign improvement.  It does not cure anything.  It won’t fix your problem but it will camouflage the original condition to the extent that when your condition worsens, the drug will not be blamed.  Your body will be blamed for not responding well to the medication.  So you now have two diseases, the naturally occuring one you started with and a second which is drug induced.

A medical manoeuvre

Yes, your swelling may go down, but any improvement that may appear to come from taking this drug is false.  It does not mean you’re getting better.  You, as well as your doctor are being tricked by a dishonest medical manoeuvre.  Nothing will be resolved by taking a diuretic but something will increase…and that’s the profits of the pharmaceutical industries that produce this drug.

side effectsCavalier tinkering

Taking a diuretic will just exacerbate the original problem.  Cavalierly tinkering with this delicate, finely tuned and amazingly complex filtration system will only make matters worse and complicate your condition by further compromising the already upset biological system. What it will do is put you on the road to being a permanent visitor to the doctor’s office or worse to the hospital.

Research

There have been a number of studies done about diuretics.  I will quote a passage from a study from the JAMA (Journal of American Medical Assn) titled: Diuretics, Mortality and Nonrecovery of Renal Function in Acute Renal Failure

Conclusions  The use of diuretics in critically ill patients with acute renal failure was associated with an increased risk of death and nonrecovery of renal function. Although observational data prohibit causal inference, it is unlikely that diuretics afford any material benefit in this clinical setting.  In the absence of compelling contradictory data from a randomized, blinded clinical trial, the widespread use of diuretics in critically ill patients with acute renal failure should be discouraged”.

Renal failure from drugs?Diuretics side effects

I really would like to know how many patients actually get to a stage of renal failure.  Could it be anything to do with pharmaceutical drugs taken over a period of time.  Could these drugs compromise kidney function to the extent that kidney failure is possible, if not inevitable, as the patient ages?

It is incredulous to me that this class of drugs known as diuretics, has escaped much of the criticism that some of our prescription drugs rightly receive.  If you can understand what it actually does to the body, you will wonder why it is so readily prescribed, especially when there are other ways of removing excess water, other ways that are safe and have no side effects.

Why not ask why?

Getting rid of excess water by using a drug is not a good idea and will likely compromise your kidney function and put undue stress on your kidneys.  All we know is that if we take a diuretic, we will want to use the loo more because the drugs are getting rid of the excess water in our bodies, but at what cost?

Ches PowerNobody seems to ask the question: Why do I get puffy ankles and feet.  Why is it I am bloated and can’t get into my clothes.  Answer this question and you’re half way to understanding what you need to do to alleviate the condition, without drugs.

In Part 2 of this post I will try and answer some of these questions.