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The Truth Behind the Dangers and Benefits of Diuretics

Our bodies are delicate systems. When they’re operating as they should be, we don’t think about how the systems work. However, if there is a disruption in balance, the effects can be at the least annoying and at the most dangerous or deadly.

Though it isn’t something you think about very often, there’s a careful equilibrium with the fluids in the body. If too much fluid builds up, then our bodies naturally excrete it in urine. Diuretics increase this urination and thus decrease fluid retention.

General Overview of Diuretics

What is a Diuretic?

Diuretics, often called water pills, are medications or natural substances used to increase the amount of urine you make and increase the frequency with which you urinate. When taking a diuretic, any excess salt (sodium) is picked up by the kidneys and then excreted. This process adjusts the body’s homeostasis by decreasing the total fluid amount in the body.

Answering the question, “what is a diuretic?” is not easy because the drugs and supplements vary widely in how they work and what they’re used to treat. The examples of diuretics is potentially a long list, but all have the same function – increase urinary output – though each category works uniquely. 

Bottom Line: Diuretics alter the body’s fluid balance, so speak with your healthcare provider about safety and potential side effects before making any change.

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What are Diuretics Used For?

Diuretics are often prescribed to treat high blood pressure. High blood pressure is also known as hypertension. The diuretic lowers blood pressure by reducing the fluid amount held by the body and by excreting extra sodium. As a diuretic lowers blood pressure, the threat of stroke, heart failure, heart attack, and death are also reduced.

 Diuretics work by widening the blood vessels, which allows blood to flow more easily. When you combine lower sodium intake with diuretics, the effect on blood pressure tends to be positive.

Diuretics are also prescribed for the treatment of heart failure. Heart failure causes the heart to weaken over time, and as such, it struggles to remove excess water from the body. This results in the tissues soaking up the fluid, which causes edema or swelling, difficulty breathing, and weight gain, among other side effects. 

 Diuretics are used for more than just easing symptoms, however. When used for heart health, diuretics are often coupled with lifestyle changes and medications to slow the progress of heart disease.

There’s also some precedence in using diuretics for kidney and liver disease. Other uses have included the treatment of drug overdose or poisoning.

Liver disease, kidney disease, and heart disease affect millions of people. As lives extend, and people live longer, the diseases tend to grow more common. Because of the increased commonality, the use of diuretics will become more prominent in the coming years. 

Bottom Line: Prescription diuretics are commonly used to treat high blood pressure and heart failure, among other fluid-related diseases and conditions.

The Difference Between Noom and Other Plans and Programs

When it comes to learning how to eat and how to live for weight loss, Noom works from a psychological perspective. According to the Chief of Psychology for Noom, Dr. Andreas Michaelides, “By understanding the past behaviors and attitudes of all types of users, we know the best way to meet our users where they are in their journey to help them maximize their change of long-term weight-loss success.” Noom, as a weight-loss platform, uses the power of food logging, among other advanced technologies, to teach simple, key behaviors for lasting change. Behavior changes that include self-efficacy, motivation, and knowledge are just the start of how psychology can interact with food, so you lose more weight in a way that lasts a lifetime.

Noom works with tech-based tools partnered with support from real-life coaches in a structured program that connects the user with the social support and positive reinforcement needed to change behavior in a way that increases the likelihood of success.

Not all dietary changes are for everyone, and no two weight-loss plans should be the same, which is precisely how Noom works.

By identifying specific areas where changes can be made to reach goals of weight loss and health improvement successfully, users realize where their best changes are to be made and how those changes are incorporated into a lifestyle they can adopt for the long-term.

Types of Diuretics

Diuretics are often classified into three groups: thiazide, loop-acting, and potassium-sparing diuretics. Less common types include calcium sparing, osmotic, and carbonic anhydrase inhibitors. Each exerts a different effect on the body.

Thiazide diuretics are the most common. They are prescribed to treat high blood pressure (HBP) because of their ability to relax muscles in blood vessel walls. This increases blood flow. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends thiazide diuretics be the initial treatment for HBP.

Loop-acting diuretics increase urine flow from the kidneys. This reaction has the effect of reducing water retention. They tend to be effective in the treatment of impaired kidney functions.

Potassium-sparing diuretics promote increased urination while leaving potassium levels unaffected. The potassium-sparing variety is used if other, more commonly used diuretics, cause mineral loss.

Sometimes patients are prescribed multiple types of diuretic pills at once or a combination of diuretics and other medication. This is a normal part of treatment. One diuretic is sometimes not sufficient on its own, so it might take some experimentation or trial and error before settling on a proper treatment.

Bottom Line: Because all diuretics have a different effect, the best diuretic really depends on what is suitable for your particular health condition.

Are There Any Diuretics Side Effects?

Since diuretics induce urine secretion, a common side effect is the loss of critical minerals from the body, including sodium, calcium, and potassium. Low levels of minerals in the blood are a serious medical problem, but not all mineral deficiencies are the same. Each one leads to a vast array of different symptoms, so it’s important to talk with your healthcare provider about potential problems.

Mineral loss is a very common side effect. Still, some diuretics may actually lead to the exact opposite problem: an excess amount of minerals in the blood. For example, potassium-sparing diuretics are meant to treat low levels of potassium in the blood. Still, if not carefully monitored, they may instead cause the retention of too much potassium, unless they’re taken with some kind of medication that counteracts the effect.

Another major side effect of fluid loss is dehydration. Usually, this is not an issue at low doses. Still, if you’re consuming a high dose of diuretics, it’s very possible to accidentally lose too much water through the urine. People on diuretics should always make sure they are staying properly hydrated, especially during intense physical activity or on a hot summer day.

Because the diuretics side effects are so broad, it’s difficult to generalize across all types of diuretics. But if you’re experiencing any kind of unusual symptoms, including headaches, dizziness, muscle cramps, weakness, vomiting, skin rash, numbness, diarrhea, joint disorders, irritability, incontinence, and impotence, then you should call your healthcare provider immediately. Do not stop taking your diuretic medications without explicit instruction from your healthcare provider, as it may make the problem worse.

Bottom Line: Diuretic use can upset the homeostasis and mineral balance in your body, so always follow explicit instructions from your healthcare provider and try to avoid taking an OTC diuretic for serious conditions.

Does a Natural Diuretic Exist?

Diuretics do exist in nature, and in theory, they have the same qualities and effects as a “synthetic” diuretic. Dandelions, ginger, parsley, hawthorn, and juniper, many of which are sold as supplements, are all examples of diuretic that occurs in nature. These are what’s known as an herbal diuretic, but many of them are poorly studied or less effective overall than normal medication.

There are two problems with taking an herbal diuretic or any other over the counter (OTC) diuretic. First, an OTC diuretic may not be effective enough to treat an underlying medical condition such as kidney or heart disease. Second, according to Katherine Zeratsky, a licensed dietician, “Some herbs and supplements can worsen medical problems you have or interact with medications you take.”

The caffeine in tea and coffee is also a “natural” diuretic. So if you have ever wondered, “Is tea a diuretic,” the answer is yes, but only a mild one. It’s a common belief that the consumption of caffeine increases the expression of urine, but the evidence for it is mixed.

In 2014, Claudia Hammond, a BBC journalist, reviewed the scientific literature for evidence of caffeine’s diuretic effect. The evidence suggests that caffeine and diuretic drinks do not have a very pronounced diuretic effect, as the expression of urine stayed mostly the same. Subjects in the study who drank a lot of caffeine and diuretic drinks also did not appear to be any more dehydrated than those who drank water alone.

Because diuretics alter the fluid balance in your body, it is not a good idea to consume supplements without knowing the possible effects. You may simply be putting yourself at risk of dehydration. If you’re hoping to lose water weight, you should focus instead on eating a healthier diet and increasing your physical activity.

Even though there are no diuretic foods that occur naturally (or at least diuretic foods that have been well-studied), it is possible to grind up diuretic pills and put them in foods if you have problems swallowing them.

Bottom Line: Taking a natural diuretic may help treat mild fluid retention, but you should talk with your healthcare provider before buying any herbal diuretic or natural over the counter diuretic.

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What is the Recommended Dose for Most Diuretics?

There is no recommended dose for most diuretics. Depending on the particular medical needs of the patient, diuretic use will vary from person to person.

The treatment goal with diuretics is almost always to achieve a healthy blood pressure or fluid level at the lowest possible dose. Your healthcare provider will first assess how much you need. Then he or she may adjust and fine-tune the dose multiple times during the treatment based on the reaction and side effects, with dehydration usually being the most common problem.

Diuretics do not linger very long in the body, so they are usually taken twice a day. They should generally be taken around the same time each day, so your body can adjust to their usage.

It is generally not recommended to take them at night before you sleep since they increase the expression of urine. Morning is typically the best time to take your first dose of the day.

During the course of your treatment, your healthcare provider will most likely schedule regular checkups so he or she can check minerals levels and monitor how your kidneys are working.

Bottom Line: Because the dose is based on healthcare provider discretion and not a common formula, you should take them exactly as you have been told.

Are There Any Drug Interactions I Should Be Aware of?

Diuretics do negatively interact with other drugs, but once again, it depends on the type and dose of the diuretic. You should generally avoid taking diuretics with digitalis and digoxin, lithium, antidepressants, and cyclosporine.

You should also avoid taking certain mineral supplements. For instance, you would want to avoid consuming extra potassium supplements if you are also taking potassium-based diuretics, as it might raise blood potassium levels too high.

Bottom Line: Diuretics are often taken in conjunction with other medication to treat serious medical conditions, so they are generally safe in most cases.

Is It Possible to Develop a Resistance to Diuretics?

In a minority of patients, resistance to diuretics does appear to develop as the kidneys adapt to chronic diuretic use. It seems to be more common in patients with congestive heart failure. Congestion persists despite the continuation of diuretic use.

Resistance to diuretics is not entirely understood, but when it does develop, combining two different diuretics together, like a loop-acting diuretic and thiazide, may be an effective treatment.

Bottom Line: Resistance to diuretics is difficult to treat and may require higher doses to achieve the same effect.

What Should I Tell My Healthcare Provider?

You should provide your healthcare provider with a full medical history and a list of prescriptions, and over the counter medications, you are taking. Also, you should prepare a diuretic list of any past diuretics you have taken. This will influence the course of your treatment.

Tell your healthcare provider about any past or present medical conditions, including diabetes, pancreatitis, lupus, gout, or menstrual problems. Diuretics can make each of these problems worse.

Tell your healthcare provider if you are pregnant, want to become pregnant, or are breastfeeding your baby. Tell your healthcare provider if you dehydrate easily or if you are allergic to any diuretic medications. Any of these issues may increase your sensitivity to diuretics.

Bottom Line: Your healthcare provider will recommend a suitable diuretic based on your medical history, medication, and diuretic list.

A Detailed Look at Diuretics

A diuretic is a medication, herb, or natural substance that facilitates diuresis. Diuresis is also known as the production of urine. There are several types of diuretics, including loop-acting diuretics, potassium-sparing diuretics, and thiazide diuretics. These three diuretics are by prescription only. There is also a long list of foods, drinks, and supplements that also work as diuretics, though mostly on a smaller scale.

You do not need to take diuretics for weight loss. You can pick up healthy lifestyle changes with Noom that last a lifetime.

Types of Diuretics

Prescription Diuretics

Loop Diuretics

The term loop diuretics actually does refer to a loop in your body. The loop of Henle is a part of your kidney where water and salts are reabsorbed into the bloodstream.

Loop diuretics work by binding to carrier proteins in the loop of Henle. This prevents the loop from absorbing salt and water as it would normally. Your body needs a way to deal with those excess salts, so the materials are flushed through urination instead.

The final benefit of loop diuretics is that they reduce the oxygen dependency of the organs they interact with. This makes the cells less vulnerable to failure.

Bumetanide (Bumex)

Bumetanide is a popular diuretic that’s used to treat fluid retention that might be caused by heart, kidney, or liver problems. In some cases, it’s also prescribed for high blood pressure.

Bumetanide takes the form of an oral tablet that needs to be taken once a day. Additional doses may be prescribed to treat extreme swelling.

Ethacrynic Acid (Edecrin)

Like other diuretics, ethacrynic acid is frequently used to treat fluid problems associated with the heart, kidney, and liver. However, this diuretic can also be used to treat patients with diabetes that may not be responding to other medications.

Furosemide (Lasix)

Furosemide is a classic diuretic that’s used to treat high blood pressure and kidney-related issues. Furosemide is usually prescribed as a tablet, but it can also come in the form of an oral liquid or even an injection.

Torsemide (Demadex)

Torsemide is another diuretic used directly to treat fluid retention. Although it can treat high blood pressure on its own, torsemide is often used in conjunction with other medications. Although side effects can occur when two diuretics are used together, some doctors prescribe both to ensure that the medication has a strong enough impact to help with your medical condition.

Thiazide Diuretics

Thiazide diuretics also work by inhibiting salt absorption in the kidney; the main difference is that the targeted area is the distal convoluted tubule. This tubule contains thiazide receptors, which can be inhibited by both thiazide and thiazide-like diuretics.

Thiazide diuretics are typically used to treat hypertension, also known as high blood pressure. Thiazide diuretics may also be used to reduce calcium levels, which helps treat kidney stones.

Chlorothiazide (Diuril)

Chlorothiazide is a medication that’s used to treat fluid retention caused by a variety of issues. You might take chlorothiazide if you have heart problems, kidney failure, or even swelling caused by increased hormone levels. Like other diuretics, chlorothiazide can cause problems if you already have low blood pressure or gout.

Chlorthalidone

Chlorthalidone is another popular diuretic used to treat high blood pressure. Chlorthalidone may also be used to reduce the symptoms of kidney or liver disease. Finally, some doctors prescribe chlorthalidone to help drain excess fluid from the lungs.

Hydrochlorothiazide (Microzide)

Hydrochlorothiazide is used to treat high blood pressure and swelling related to fluid retention. Hydrochlorothiazide might be prescribed for people with heart conditions, liver problems, kidney failure, or artificially inflated hormone levels.

Indapamide

Indapamide is a relatively new diuretic with effects comparable to both thiazide and loop diuretics. Unlike other diuretics, indapamide does not seem to raise cholesterol levels. Indapamide is used to treat hypertension, fluid retention, and similar medical conditions.

Metolazone

Metolazone is a standard diuretic used to treat fluid retention and high blood pressure. Metolazone is often prescribed to reduce the risk of a stroke or to assist with physical symptoms related to heart, kidney, or even lung conditions.

Potassium-sparing Diuretics

One of the main problems with diuretics is that using them can drastically reduce your body’s potassium intake. That’s why many doctors will prescribe the aptly-named potassium-sparing diuretics in addition to other diuretics to treat conditions like hypertension or heart failure.

If you’re using potassium-sparing diuretics, it’s important to make sure that you’re not taking a potassium supplement at the same time. This will increase your risk of hyperkalemia, or extremely high potassium levels in your bloodstream.

Amiloride

Amiloride is a diuretic used for patients who have low potassium levels in addition to high blood pressure or heart problems. Amiloride is typically prescribed alongside stronger diuretics and should not be taken by patients with high potassium levels.

Eplerenone (Inspra)

Eplerenone is a substance that blocks aldosterone, the hormone that typically causes your kidneys to reject potassium and retain sodium. When patients take eplerenone, potassium is retained, and sodium is rejected instead. Eplerenone is prescribed for heart conditions and high blood pressure.

Spironolactone (Aldactone, Carospir)

In addition to the normal effects of a potassium-sparing diuretic, spironolactone can be used to reduce the effects of hyperaldosteronism or the excessive production of aldosterone by the adrenal gland. Spironolactone can be prescribed on its own or in addition to other diuretics.

Triamterene (Dyrenium)

Triamterene is a classic diuretic that is typically prescribed to reduce the swelling caused by heart, kidney, or liver conditions. Like other diuretics, triamterene can cause dehydration symptoms; make sure to drink plenty of water.

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Carbonic Anhydrase Inhibitors

As the name suggests, carbonic anhydrase inhibitors block the body’s absorption of carbonic anhydrase, an enzyme that helps carry carbon dioxide through the blood. Carbonic anhydrase inhibitors have some impact on the kidneys, but they also prevent bicarbonate absorption in other parts of the body.

Carbonic anhydrase inhibitors are a weak diuretic typically used for the treatment of glaucoma or high blood pressure behind the eyes. You might also take a carbonic anhydrase inhibitor to treat epilepsy, high altitude sickness, and similar problems related to your internal fluid levels.

Acetazolamide

Acetazolamide decreases fluid production inside the eye. This medication is typically used to treat altitude sickness and can reduce symptoms like dizziness or nausea. Acetazolamide can also be prescribed alongside other medications to reduce swelling. In some cases, acetazolamide can be used to reduce the risk of seizure.

Dichlorphenamide

Dichlorphenamide is a unique carbonic anhydrase inhibitor that is used to treat an inherited muscle condition called primary periodic paralysis. Patients with this condition suffer from random attacks of muscle weakness, but taking dichlorphenamide can reduce the frequency and severity of the attacks.

Methazolamide

Methazolamide is another carbonic anhydrase inhibitor that is primarily used to decrease ocular fluid production. Methazolamide can reduce headaches and is often used to prevent long-term vision loss caused by high pressure in the eyes.

Over the Counter Diuretics

Caffeine

Caffeine is a stimulant found in more than 50 plants around the world. On some labels, caffeine may be listed as 1,3,7-trimethylxanthine. When you take into account how many people use caffeine on a daily basis, it is considered the most used psychoactive drug of all time. The most common sources of caffeine are tea, coffee, and soda. After taking or drinking caffeine, the effects will only last up to three hours. Along with being used in weight loss and weight control supplements, caffeine is also found in over the counter diuretics. 

What does science say?

Caffeine may have a diuretic effect, but the effect is mild, at best. When caffeine is taken before exercise, the effect is negated. Women often see better diuretic results when taking caffeine than do men.

Pamabrom

There’s very little information on pamabrom. We know it works as a diuretic or water pill, and it can be used for the natural treatment of a variety of illnesses, with the permission of your healthcare provider. However, the most common use for pamabrom is as a diuretic in over-the-counter water pills. 

What does science say?

We were unable to find research that showed any proven connection between pamabrom and diuresis. We know the drug has been used since the 1950s to treat fluid retention, but the science just doesn’t support this use.

Natural and Herbal Diuretics

Dandelion

Dandelion is more than just a weed growing in your yard. This plant is packed with healthy vitamins and nutrients, and just about every part is edible or usable in supplement form. In terms of diuretic effects, there’s not a lot of research out there on humans. However, dandelion remains one of the most commonly used natural diuretics.

What does science say?

T. officinale ethanolic extract shows promise as a diuretic in humans. Further studies are needed to establish the value of this herb for induction of diuresis in human subjects.”

Uva Ursi

Uva ursi is a shrub found in Europe and North America. The plant is also known as bearberry because bears are fond of the fruit produced by the plant. The history of the use of uva ursi dates back to Native American interactions with settlers. There’s tons of information and advice on how uva ursi is used for diuresis and how long it’s been used (more than 1000 years). But, is there any science to back up these claims, or are they anecdotal?

What does science say?

Science doesn’t appear to focus on the use of uva ursi as a diuretic. Instead, it appears that it is more commonly used to treat or as an adjunct treatment for urinary tract issues.

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Horsetail Stem

Three hundred million years ago, there was a huge plant that was the ancestor of today’s horsetail stem. You can choose to purchase horsetail as a tea or supplement. Often, over-the-counter herbal diuretics include horsetail as an ingredient. Though the plant has been around for millions of years, what has science proven?

What does science say?

“The E. arvense extract produced a diuretic effect that was stronger than that of the negative control and was equivalent to that of hydrochlorothiazide without causing significant changes in the elimination of electrolytes.”

Juniper Berry

The juniper berry is the fruit from a plant that looks similar to a pine cone. The plant is often used as a spice for cooking, but there are also uses in natural medicine that have been explored. The berry is often used in herbal diuretics to increase urine output. Does science support this use?

What does science say?

Though the effect of taking juniper berries as a diuretic has not been validated by clinical research, there is research that shares how the herb has been used for many years throughout the world, including countries like Turkey and Romania.

Stone Root

Stone root falls into the same category as mint. But, the root doesn’t smell anything like mint. Noted for its foul smell, the herb is typically used as a natural treatment for urinary problems and edema – excessive fluid retention. 

What does science say?

Science doesn’t say anything about stone root. We were unable to find any research on animals or in humans that showed any health benefits.

Hawthorn Berry

There’s not much more today about hawthorn berry other than it’s in the rose family and has been used as a natural treatment for centuries. You can find hawthorn berry in a wide range of natural supplements, including diuretics. The berry is also used to brew tea. 

What does science say?

Like many other natural diuretics, there’s little research definitively linking the herb to water loss. However, we did find some research showing that hawthorn can lower blood pressure. Diuretics are often prescribed for the treatment of high blood pressure, so there could be a connection there.

Parsley Leaf

Parsley leaf is a plant you’d think of as a garnish for food before thinking of it as a natural medicinal treatment. However, parsley has been used for decades for fluid retention. Does this herb work as well for diuresis as it does for garnish? 

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What does science say?

Research published in 2002 verifies that parsley does work as a diuretic. More recent research, this time published in 2017, came to the same results, as shared in the American Journal of Clinical and Experimental Urology.

Buchu Leaf

Buchu leaves grow on shrubs found in South America. The leaves are leathery with oily undertones. Natural medicine has been using buchu for kidney and urinary disorders, cystitis, gout, and other conditions. Buchu has also been used, often in combination with other herbs and extracts, as a natural diuretic. 

What does science say?

“Buchu remains a popular ingredient in over-the-counter herbal diuretic preparations. Despite the lack of evidence, buchu is still used today in western herbal medicine for urinary tract ailments, cystitis or urethritis prophylaxis, and prostatitis. It also is used in combination with other herbs such as cornsilk, juniper, and uva-ursi. Buchu also is listed in the German Commission E Monographs to treat inflammation, kidney, and urinary tract infections and also is used as a diuretic, but the monograph explains that the plant’s activity in these claimed uses has not been substantiated.”

Celery Seed

You can use celery seed in cooking, but did you know it’s also used as natural medicine? Though used for thousands of years for everything from arthritis to muscle spasms to inflammation, the most common use remains as a diuretic. 

What does science say?

We found plenty of information on how celery seed is used as a diuretic, but science is lacking. There is research into one area often related to diuretics – high blood pressure. According to research on rats, celery seed significantly reduces blood pressure. “It can be concluded that celery seed extracts have antihypertensive properties…”

Goldenrod

“Goldenrod has also been used to treat tuberculosis, diabetes, enlargement of the liver, gout, hemorrhoids, internal bleeding, asthma, and arthritis. In folk medicine, it is used as a mouth rinse to treat inflammation of the mouth and throat.

A few animal and test-tube studies suggest goldenrod may help reduce inflammation, relieve muscle spasms, fight infections, and lower blood pressure. It does seem to act as a diuretic. It is used in Europe to treat urinary tract inflammation and to prevent or treat kidney stones. In fact, goldenrod is often found in teas to help “flush out” kidney stones and stop inflammatory diseases of the urinary tract.”

What does science say?

Science says goldenrod works well as an antioxidant and antimicrobial but says nothing about use as a diuretic. However, like other natural diuretic ingredients on this list, it has been used in natural therapies for high blood pressure. Diuretics are often used for this purpose.

Bladderwrack

Bladderwrack is a form of seaweed used in traditional and natural medicine. Typically, the extract is used for thyroid issues, but it has also been used for “obesity, arthritis, joint pain…atherosclerosis, digestive disorders, heartburn…constipation, bronchitis, emphysema, urinary tract disorders, and anxiety.”

There are so many potential uses for bladderwrack, but what about using this extract as a natural diuretic? 

What does science say?

We did not find a single bit of research on bladderwrack. This is a little surprising because this ingredient is used in hundreds, if not thousands, of supplements. 

Couch Grass

Couch grass is considered a weed over anything else. Categorized as an invasive weed, it takes control of the entire area around where it’s growing, often killing other plants in the process. Despite the harshness of the natural actions of couch grass, history shows it is commonly used to treat a variety of conditions such as “constipation, cough, bladder swelling (inflammation), fever, high blood pressure, or kidney stones. It is also used for water retention [as a diuretic].”

What does science say?

Again, like far too many natural diuretics, there’s no research indicating couch grass should be used for any health condition. This includes water retention, edema, high blood pressure, or other conditions.

Hibiscus

Hibiscus is a flowering plant often associated with the Hawai’ian islands. The colorful flower, also known as rosemallows, is found throughout the world in warm and tropical regions. 

What does science say?

Recent studies of Hibiscus sabdariffa Linn. have demonstrated that it presents diuretic, natriuretic, and potassium-sparing effects.”

Further research claims, “The compound presents in Hibiscus sabdariffa as quercetin had effect on the vascular endothelium causing oxide nitric release, increasing renal vasorelaxation by increasing kidney filtration. Therefore, the diuretic effect of Hibiscus sabdariffa may be mediated by nitric oxide release.”

Asparagus

Asparagus is a healthy vegetable that’s packed with nutrients. Though thought of first as food, asparagus has also been used as a natural treatment for urinary conditions and as a natural diuretic. 

What does science say?

“Asparagus contains high levels of the amino acid asparagine, making it a natural diuretic. In other words, eating more of the spears can help flush excess fluid and salt from your body, which may help prevent urinary tract infections.”

If you’re having trouble losing weight and you’re thinking about turning to diuretics for weight loss, why not take a little time to talk with your own personal coach at Noom.

You can talk about the best ways to lose weight that don’t involve the potential risk that comes with these pills and supplements. 

Diuretic Supplements and Electrolytes

“Diuretics are commonly used to treat high blood pressure (hypertension) because they lower blood pressure by helping your body eliminate sodium and water through your urine. However, some diuretics can also cause you to eliminate more potassium in your urine. This can lead to low potassium levels in your blood (hypokalemia).”

If you’re experiencing low potassium levels, you may feel tired or weak. You could experience muscle cramping or constipation. Eventually, if potassium drops low enough, it can affect heart function. 

The Science on Potassium and Diuretics

Non-potassium sparing diuretics, including natural diuretics, can cause a loss in potassium. Researchers suggest adopting a special diet to combat the loss and reduce the chances of negative side effects. 

Hypokalemia induced by the use of diuretics is common. Those at risk include the elderly, women, patients with edematous states, and patients in whom higher doses and/or the more potent agents are used. Prevention should include a low-salt diet rich in potassium, magnesium, and chloride (either through foods enriched with these elements or through potassium chloride supplements)…”

There’s also evidence that diuretic overuse, leading to unhealthy rises or falls in electrolyte levels, can lead to life-threatening heart arrhythmias.

Diuretic Foods and Drinks

Not all diuretics come in pill or tea form. There are natural diuretic properties found in many foods and drinks. Some of the most common foods and drinks include:

  • “Watermelon
  • Grapes
  • Berries
  • Celery
  • Asparagus
  • Onion
  • Garlic
  • Bell Peppers”
  • Green Tea and Black Tea 
  • Caffeine

How Do Foods and Drinks Work as Diuretics?

Certain foods are high in potassium and water. These foods increase urine output by helping balance sodium levels in the blood. The potassium helps relieve blood vessel constriction, and fluid is moved around and out, more quickly and efficiently.

How Are Diuretics Used? 

After looking at what diuretics are, how they work in the body, and some possible risks and side effects, we can turn to the effects diuretics have on health and wellness in a medical setting. Studies in medicine are typically completed using prescription diuretics, so the below-mentioned information is not relevant to natural, herbal diuretics, foods, or drinks. 

Health/Medical

Over the years, diuretics have grown in popularity as treatments for a variety of health conditions associated with water retention. Let’s take a look at what health and medical conditions diuretics are used to treat.

Combat high blood pressure

A common use of diuretics is for the treatment of high blood pressure. Often, these medications are the first line of treatment. Diuretics can be combined, if needed, for added effect in particularly difficult cases. Other prescription drugs can be combined with diuretics, under the care of your healthcare provider, to maximize benefit. 

“The European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines recommend that thiazide diuretics should be considered as suitable as β-blockers, calcium antagonists, ACE inhibitors, and angiotensin receptor blockers for the initiation and maintenance of antihypertensive treatment.”

Research also shows that “diuretics have long been cherished as drugs of choice for uncomplicated primary hypertension. Robust mortality and morbidity data are available for diuretics to back this strategy.”

Edema

Edema is an unnatural collection of fluid under the skin. Edema can occur throughout the body, but it is most common in extremities. The causes of edema may include side effects from medications, side effects from supplements, and disease (heart disease, kidney disease).

Research into the effects of diuretics on edema spans back more than 40 years. Much of the research repeats the same thing over and over again. Thus, leading to the simple statement, “treatment of edema with diuretics is often straightforward.”

Glaucoma

“Glaucoma is a disease that damages your eye’s optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve. Glaucoma is a leading cause of blindness for people over 60 years old. But blindness from glaucoma can often be prevented with early treatment.”

Because diuretics help reduce water retention and build-up, they can be used to reduce pressure on the eye caused by glaucoma. According to research in Current Medical Research and Opinion, the use of adjunct therapies, like diuretics, in the treatment of glaucoma shows promise. 

There’s no indication, based on science, that diuretics are an effective or safe way to lose weight.

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Osteoporosis in postmenopausal women

Osteoporosis, which literally means porous bone, is a disease in which the density and quality of bone are reduced. As bones become more porous and fragile, the risk of fracture is greatly increased. The loss of bone occurs silently and progressively. Often there are no symptoms until the first fracture occurs,” according to the International Osteoporosis Foundation.

There have been several medical studies into the effect of diuretics on osteoporosis. In one published in Osteoporosis International, after four years of taking hydrochlorothiazide, patients showed significant improvements in bone health and a reduction in bone loss. 

Additional research, this time in the American Journal of Medicine, showed, again, that hydrochlorothiazide, a prescription diuretic, “slows cortical bone loss in normal postmenopausal women. It may act directly on bone as well as on the renal tubule.” 

Diabetes insipidus

Diabetes insipidus is a rare disorder that occurs when a person’s kidneys pass an abnormally large volume of urine that is insipid—dilute and odorless. In most people, the kidneys pass about 1 to 2 quarts of urine a day. In people with diabetes insipidus, the kidneys can pass 3 to 20 quarts of urine a day.”

As for diuretic use in cases of diabetes insipidus, which can be a chronic or temporary condition, surprisingly, despite the excessive urine output, certain diuretics have been shown to help treat the disease, especially when caused by certain medications, according to the Journal of the American Society of Nephrology

Heart failure

“Heart failure is a condition in which the heart can’t pump enough blood to meet the body’s needs. In some cases, the heart can’t fill with enough blood. In other cases, the heart can’t pump blood to the rest of the body with enough force. Some people have both problems.

The term “heart failure” doesn’t mean that your heart has stopped or is about to stop working. However, heart failure is a serious condition that requires medical care,” according to the National Heart, Lung, and Blood Institute

As for research into how diuretics work to combat heart failure, Medicina Clinica published research in 2014 that shared the fact that diuretics are “prescribed to the majority of HF [heart failure] patients.” This is because removing excess fluid from the body is a critical factor in controlling the disease. 

Additional research, this time in European Cardiology Review, shares that “Research of new physiology-based approaches designed to offset the primary determinants of water retention could improve the management of patients affected by CHF [congestive heart failure]. Until then, diuretic therapy will remain the cornerstone in CHF.”

Liver failure

There are multiple causes of liver failure, including the use of certain medications, medical conditions, and addiction, such as is the case with alcoholism. 

According to the International Journal of Nephrology, “Effective and adequate diuresis can be achieved in patients with cardiac failure, cirrhosis, and nephrotic syndrome with ideal therapeutic approach of diuretics therapy.”

Recreational

There are times when diuretics are used for purposes other than medical conditions. These uses include weight loss, fasting, detox, sports, and bodybuilding, among others. Recreational use of diuretics is not typically monitored by a healthcare provider. Some would say the same risk of side effects, like an unhealthy drop in potassium levels, is a risk that comes with both prescription and natural diuretics. 

Let’s take a look at how diuretics are used and the risks that come with the use.

Weight loss

Most of the research into diuretics and weight loss pertains to patients with underlying medical conditions. For instance, 2017 research published in Zhonghua Xin Xue Guan Bing Za Zhi showed that in patients with chronic congestive heart failure, the use of diuretics did result in weight loss. This could be because the body is holding on to excess fluid as a symptom of heart failure.

Risks of Using Diuretics for Weight Loss

Using a water pill to lose weight is not an effective strategy. The water you lose is being held by the body for a reason. That could be an underlying medical condition or the body’s natural balance mechanism. Either way, once you stop taking the diuretic, you will regain any weight loss because the underlying cause hasn’t been addressed. 

There’s also the potential issue of electrolyte imbalance. Extreme electrolyte imbalance has been known to cause serious heart-related side effects and death in some extreme athletes.

Fasting

Because diuretics are often used to treat heart-related conditions, as the symptoms of heart failure, there is information out there about how best to follow a fast without increasing the risk of effects to your health. 

We did find research using rats that showed that when fasting, diuretics don’t work as they should. That means if someone with a health condition that causes fluid retention decides to fast, it could negate the effectiveness of diuretic supplements or medications. 

Risks of Diuretic Use in Fasting

The main risk of using diuretics while fasting is that they don’t work as well as they would when taking with a diet that includes food sources. The exact reason for the effectiveness of diuretics is not well understood, but it could have something to do with the fact that fasting already has a diuretic effect. 

Detox

Detoxes typically include diuretics of some sort to flush the “toxins” out of the body. We know based on research and how the body naturally works, that there are no toxins to flush out. The body takes care of all toxins naturally, but that doesn’t stop the supplement market from claiming a detox once in a while is good for health and wellness. 

There is no relevant or reliable research into the effects of detoxing on diuretic effects or the effects of taking a diuretic on toxin levels in the body.

Risks of Diuretic Use in Detox

The biggest problem with using a diuretic, like those found in detox supplements, is that they are often partnered with colon cleansers or natural laxatives. This poses a problem with dehydration. The laxative forces fluid out of the body, as does the diuretic. Dehydration and electrolyte imbalance could result. 

If you’ve chosen to detox, you may want to keep track of what you’ve consumed to make sure you stay on track.

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Water Loss – Sports

Diuretics are commonly used in sports as a means of quickly reducing weight. In sports like boxing and wrestling, water weight can mean the difference between weighing in for a specific class and breaking the weight limit, which could cause the athlete to forgo competition. However, there are other reasons why athletes use diuretics. 

Research from 2010 published in the British Journal of Pharmacology shows that athletes sometimes use diuretics to flush illegal drugs, often performance-enhancing drugs, out of the body before a drug test. This anti-doping technique is rarely effective, but the World Anti-Doping Agency has listed diuretics on the banned substance list, nonetheless. 

There’s also the problem with dehydration in athletes. Published research in Medical Science in Sports and Medicine showed that runners who used diuretics suffered from dehydration, especially those competing in longer distances. Dehydration affects performance and recovery. 

Risks of Diuretic Use in Sports

The same risks of using diuretics in medicine exist across all sports. When using diuretics, especially in conjunction with exercise and training, dehydration is a common side effect. Typically, however, in sports that require weigh-ins, the athlete rehydrates soon after the weigh-in, sometimes gaining as much as 10 or 15 pounds or more.

Water Loss – Bodybuilding

Bodybuilding is another sport that uses diuretics for competition. Still, unlike other sports, the use is concentrated for a few weeks before a competition. In professional competition, there have been cases where athletes have used one or more diuretics to the point that overall health was affected. 

Research published in Sports in 2018 talks about how diuretics are used by bodybuilders. “Bodybuilders attempted to remove superfluous water by exploiting the diuretic/polyuria effect associated with water loading/restriction.” Among the natural bodybuilders followed in the study, “Carbohydrate and water manipulation were the most frequently employed strategies in the present investigation.” 

Risks of Diuretic Use in Bodybuilding

The main risk of using diuretics during bodybuilding is extreme fluid loss. When an extreme fluid loss occurs, it can cause an imbalance in electrolytes. In some cases, the intense effect of using one or more diuretics can cause death. 

During our research, we also found a disproportionate number of bodybuilders who have suffered from kidney disease and/or required a kidney transplant. In some cases, the bodybuilders died before the age of 50. While there’s no definitive clinical proof that diuretics were to blame, diuretics do cause kidneys to work harder, thus potentially leading to kidney disease and failure. 

General Risks of Using Diuretics

Diuretic use is common across many health conditions, including high blood pressure and heart disease, but what are the risks associated with the use and do the risks outweigh the benefits? 

Electrolyte loss

Electrolytes are minerals that are found in the human body. These minerals have an electric charge, which makes them quite unique. In terms of health, electrolytes work to help:

  • “Balance the amount of water in your body
  • Balance your body’s acid/base (pH) level
  • Move nutrients into your cells
  • Move wastes out of your cells
  • Make sure that your nerves, muscles, the heart, and the brain work the way they should

According to NCBI StatPearls, “Electrolytes are essential for basic life functioning such as maintaining electrical neutrality in the cells, generation, and conduction of action potentials in the nerves and muscles. Sodium, potassium, and chloride are the significant electrolytes along with magnesium, calcium, phosphate, and bicarbonates. Electrolytes come from our food and fluids. 

These electrolytes can have an imbalance, leading to either high or low levels. A high or a low level of electrolytes disrupts the normal bodily functions. It can lead to even life-threatening complications.” 

What to do: According to Harvard Health, “People with high blood pressure or heart failure are often advised to limit how much salt or sodium they consume. One way to do that is to use salt substitutes, but these products are high in potassium—a quarter teaspoon of one brand contains about 800 mg of potassium.”

Drinking water isn’t enough to replenish electrolytes.

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Elevated blood potassium levels

In patients taking a potassium-sparing diuretic, potassium supplements, and salt replacements that contain potassium can cause an excessive build-up of potassium. This condition is called hyperkalemia, according to the American Kidney Fund.

What to do: Few symptoms are leading up to complications of hyperkalemia. When in advanced stages, the condition can affect heart health, increasing the risk of heart attack, and, over time, cause death. If you are taking a potassium-sparing diuretic, talk with your doctor about having potassium levels tested regularly. This is especially important if you’re following a low-salt diet for high blood pressure or other conditions as some low-salt foods replace the salt with potassium. 

Gout

There is some indication, based on information from the Mayo Clinic, that taking diuretics increases the risk of gout. Gout is a form of arthritis. When uric acid crystals buildup in joints, it causes the condition. 

According to research, weight and higher body fat increase the risk of gout, but the research also showed that diuretic use independently increased risk as well. That means that the effect was not localized to the participants with higher weights or body fat measurements.

What to do: There are some tips for fighting gout, including to eat lots of vegetables and plant proteins, skip the alcohol, and lose those extra pounds. The idea is to improve overall health, so the diuretic is no longer needed, thus reducing the increased risk of gout associated with it. 

Increased blood glucose

Increased blood glucose is also called hyperglycemia. The condition is a symptom in people with type 1 and type 2 diabetes. But, there’s also a connection between using diuretics and an increased risk of high blood sugar. 

According to DiabetesSpectrum from the American Diabetes Association, “Thiazide antihypertensive drugs (e.g., hydrochlorothiazide) and thiazide-like drugs (e.g., metolazone) are often prescribed to control blood pressure in people with diabetes. Thiazide diuretics are known to promote hyperglycemia and, in some cases, contribute to the new onset of diabetes.” So, diuretics may cause an increase in blood glucose in patients that would otherwise not have developed diabetes. 

What to do: There are many types and varieties of blood pressure medications. If your blood glucose levels have increased since starting on a diuretic, talk with your healthcare provider immediately as there may be a connection. People with diabetes should never take an over-the-counter or natural diuretic unless specified by their healthcare provider who’s aware of the diabetes diagnosis. 

Death

Unfortunately, much research has been published into the relationship between diuretic use and death. Some results of completed research show a positive correlation. 

Clinical and Experimental Hypertension – 1996

As far back as 1996, research has shown death can be a side effect of taking diuretics. 

“We conclude that the available evidence strongly suggests that hypertensive patients on non-potassium-sparing diuretic therapy are at an increased risk of sudden death.”

Circulation – 1999

Jumping forward to 1999 and we find the same results. 

“These data suggest that diuretic-induced electrolyte disturbances may result in fatal arrhythmias in patients with systolic left ventricular dysfunction.”

Journal of the American College of Cardiology – 2003

Now things change a little with research published in 2003. 

“The use of PSDs [potassium-sparing diuretics] in HF [progressive heart failure] patients is associated with a reduced risk of death from, or hospitalization for [HF].” 

Journal of Cardiac Failure – 2006

As of 2006, research is back on track with results showing an increased risk of death with diuretic use in some patients. 

“NPSDs [non-potassium sparing diuretics] are associated with increased risk of death, CVD [cardiovascular disease], progressive HF [heart failure] death, SCD [sudden cardiac death], and HF hospitalization.”

European Heart Journal – 2008

When we take a look at 2008 research, this time results from a study of more than 75000 people, we find that “Chronic diuretic use was associated with increased long-term mortality and hospitalizations in a wide spectrum of ambulatory chronic systolic and diastolic HF [heart failure] patients.”

ESC Heart Failure – 2018

Now we jump forward a decade with results from a review of all available, qualifying research. The research results concurred with nearly all previous research in that diuretic use causes an increased risk of death in patients with heart failure.

Medication Interactions

It’s important to share all current medications with all healthcare providers you visit. There is the potential for medication interactions with taking a prescription diuretic, and possibly, other natural or over-the-counter varieties. 

Possible interactions exist between diuretics and:

Glucocorticoids → increased hypokalemia

Carbamazepine → increased hyponatremia

ACE inhibitors → hypotension (especially first-dose hypotension)

Propranolol → increased hyperlipidemia and hyperglycemia

NSAIDs → ↓ diuretic effect, ↑ Effects of digitalis, methotrexate, and lithium

The possible interactions between medications and diuretics are something that’s been studied for decades. As far back as 1984, researchers knew of many possible interactions. 

Interactions between diuretics and other substances may have beneficial or adverse consequences. Co-prescription of diuretics with antihypertensive agents, potassium, magnesium or acid salts, probenecid, quinidine, anticoagulants, lithium, cardiac glycosides, or other diuretics can result in both beneficial and adverse interactions. Laxatives, oral antidiabetic agents, non-steroidal anti-inflammatory drugs, adenylate cyclase activators, mineralocorticoids, hypolipidaemic agents, neuromuscular blockers, chloral hydrate, carbenoxolone, drugs likely to produce the syndrome of inappropriate secretion of antidiuretic hormone and some antibiotics may be involved in adverse interactions with diuretics.”

After another look through research, we found research dating back to 1978 discussing medication interactions of diuretic use.

There’s no need to risk medication interactions by taking diuretics if you’re looking to lose weight.

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Side Effects of Using Diuretics

Diuretic use is associated with life-saving medical outcomes, but there are risks and side effects to consider. In many cases, healthcare providers first treat the condition and then the patient. This means some potential side effects are considered “worth it” if the medication is working to help control a medical condition. 

However, even if this is the case with your healthcare provider, it is important to report any events of side effects as they could be a sign of a more serious condition

“Dizziness or headache

Thirstiness

Rash or itching

Higher blood glucose or cholesterol level

Changes in your sexual function or menstrual period

Muscle cramps (loop diuretics)

Ringing in the ears (loop diuretics)

Low sodium, potassium, and/or magnesium levels in the blood (loop diuretics)

High potassium levels in the blood (potassium-sparing diuretics)

Enlarged breasts in men (Aldactone and Inspra),” according to EverydayHealth.com.

Other side effects may include dehydration, joint disorders, breast enlargement in men, and impotence.

Diuretics and Exercise

Diuretics aren’t always used for medical conditions, or use for medical conditions affects how the body reacts to exercise. Here’s a take from the experts on how diuretics and exercise are related. 

According to the American Council on Exercise (ACE), diuretics can cause excessively low blood pressure after exercise. If blood pressure is well within the normal range, especially in the lower normal range, you may experience some symptoms of hypotension or low blood pressure. Post-exercise blood pressure numbers drop. If you’re already at the lower end of normal, the extra drop could cause issues. ACE Fitness suggests gradually cooling down to ensure blood pressure doesn’t drastically drop. 

There’s also evidence that, in patients with stable angina, diuretic use decreases anginal effects.

Exercise Response to Cardiac Medications 

According to the Health Education Assessment Rehabilitation Toolkit, taking diuretics while exercising requires you to “Monitor for symptoms of hypotension and unexpected rapid weight changes. Over diuresis or fluid loss through vomiting or diarrhoea in the presence of diuretics, may exacerbate hypotension.” 

Diuretics and Weight Loss

As was the case with sports and bodybuilding, diuretics are often used for issues other than medical problems. One such use is as a weight-loss aid. 

There is no scientific evidence that shows taking diuretics, whether prescription or over-the-counter, is a treatment for weight loss. When patients have a condition that causes fluid retention, weight gain is common. The diuretic simply removes excess fluid, so the patient’s new weight is their actual weight. 

In one study from 1988, the amount of weight loss was directly linked to how much medication was required to reduce water weight.

The Final Take on Diuretics

Diuretics play a critical part in healthcare. Providers prescribe diuretics for patients with high blood pressure, heart failure, and other life-threatening conditions. No doubt, using these water pills is of benefit to millions, but there’s a darker side. 

Diuretics are often used for recreational purposes like water loss before an athletic competition, weight loss, and as part of a home detox or cleansing program. In all cases, the risk of hypokalemia, or low potassium levels, increases. Potassium, which is an electrolyte, is required for various functions, including heart function. 

Diuretics must be used with caution and under the care of a healthcare provider. Using diuretics for recreational purposes may put the user at increased risk of life-threatening side effects.  

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Diuretics Questions and Answers

 What are the three types of diuretics?

 The three most well-known types of diuretics are loop acting diuretics, potassium sparing diuretics, and thiazide diuretics.

 How do diuretics work?

 Diuretics work by “increasing the amount of salt and water that comes out through your urine. Too much salt can cause extra fluid to build up in your blood vessels, raising your blood pressure. Diuretics lower your blood pressure by flushing salt out of your body, taking this unwanted extra fluid with it.” This is also how diuretics work to decrease water retention, as per Blood Pressure UK.

 What drinks are diuretics?

 Some diuretic drinks include coffee, dandelion tea, green tea, and black tea. Caffeine sources of all kinds also have a diuretic effect.

 Why are diuretics banned?

 Diuretics are banned in sports because they can increase weight loss and facilitate the removal of drugs from the system through increased urination.

 Are diuretics dangerous?

 Diuretics are not considered dangerous when used as prescribed. All ages, from children to aging adults, are prescribed diuretics for various health concerns. Natural or supplemental diuretics have not been tested on anyone under the age of 18.

 Are coffee, tea, or caffeine a diuretic?

 Yes. Coffee, tea, and all caffeinated drinks have a diuretic effect.

 What is a natural diuretic?

 A natural diuretic is one that occurs in nature and was not developed in a laboratory. Typically over-the-counter supplements and diuretics include natural ingredients, whereas prescription medications don’t tend to be natural.

 What does a diuretic do?

 A diuretic forces extra salt and water out of the body through urination. The extra fluid is naturally flushed out.

 What are diuretics used for?

 Diuretics are used for various health conditions, including high blood pressure, congestive heart failure, kidney disease, and edema.

 Is water a diuretic?

 Yes. Water is a natural diuretic.