Diuretics, which are essentially designed to reduce fluid levels by making you urinate more, are one of the most common blood pressure medicines prescribed and, relatively speaking, the safest. One of the biggest problems with diuretics is the depletion of minerals. In addition to losing sodium, you lose most of the other minerals too, including potassium, magnesium, and calcium, which are essential to proper heart function, not to mention healthy bones. There’s no sense in lowering your blood pressure to prevent heart disease if your method of lowering it is going to cause it anyway. Numerous studies have shown that people with high blood pressure tend to be deficient in magnesium, so the last thing they need is to lose more.
Diuretics also tend to deplete the B vitamins. If you’re on a diuretic, be sure you’re taking plenty of B vitamins and a good multimineral supplement. One of the most devastating side effects of diuretics for women is their tendency to promote the excretion of calcium in the urine, resulting in bone loss and osteoporosis.
Another side effect of diuretics is a higher susceptibility to heatstroke or heat stress, caused by the body’s inability to cool off by sweating. This is particularly important for older people who live in a warm or hot climate. When it’s hot and you’re taking a diuretic, it’s important to drink plenty of fluids.
Since diuretics tend to make you urinate more than usual, this can create an added discomfort for men with an enlarged prostate who often are already inconvenienced by having to urinate frequently. This side effect can also create more waking at night to urinate, which causes sleep loss, and in the elderly it increases the risk for a fall.
Although the side effects of the diuretics are not pleasant, they are minor compared to the potential side effects of the other antihypertensive drugs.
Examples of Thiazide Diuretics
Chlorthalidone (Thalitone, Hygroton)
Chlorothiazide (Diuril, Hygroton)
Hydrochlorothiazide (Aquazide, Esidrix, HydroDIURIL, Microzide, Hydro-Par, Oretic, Ezide)
Hydroflumethiazide (Diucardin, Saluron)
Indapamide (Lozol, Lozide)
Methyclothiazide (Aquatensen, Enduron)
Metolazone (Zaroxolyn, Mykrox)
Trichlormethiazide (Metahydrin, Naqua, Diurese)
What Do They Do in the Body? Increase urination, reduce fluid and water retention.
What Are They Prescribed For? High blood pressure, edema (swelling, water retention, puff-iness), and CHF.
What Are the Possible Side Effects? The most common and dangerous side effect of diuretics is excessive loss of minerals or an imbalance of minerals, called an electrolyte imbalance. Signs of a mineral imbalance can include dizziness, dry mouth, weakness, muscle pains or cramps, low blood pressure, rapid heartbeat, sleepiness, and confusion.
These drugs commonly cause dizziness, usually a signal that blood pressure is too low. Dizziness can lead to falls, dangerous driving, and mental fogginess—symptoms often attributed to aging, but which may be simply treated by reducing the dose of a blood pressure medication.
High uric acid levels can lead to gout, a painful inflammation usually in the big toe. Other possible side effects include kidney damage, hyperglycemia (may increase fasting blood glucose) or precipitation of underlying diabetes, raised LDL “bad” cholesterol and triglyceride levels, anemia, and sun sensitivity.
These drugs can also cause a wide variety of digestive problems, loss of appetite, vision problems, headaches, skin problems, restlessness, and impotence.
Even taking the preceding cautions into account, for most people diuretics are the safest prescription drugs for lowering blood pressure.
Think Twice About Taking These Drugs If . . .
• You have lupus.
• You have kidney or liver problems.
• You have diabetes.
• You have urinary tract problems such as an enlarged prostate that interferes with urination. Diuretics can make you even more uncomfortable by increasing the number of times you have to urinate.
What Are the Interactions with Food? If you take too many electrolytes, such as in sports drinks, you may reduce the effectiveness of the drug.
It’s good to eat plenty of high-potassium foods when taking diuretics that don’t “spare” potassium. Some common high-potassium foods include bananas, citrus fruits, melons, almonds, green leafy vegetables, potatoes, carrots, avocados, and soybeans.
Licorice (not the candy made with anise, but the herb or root) can be an antidiuretic and reduce the actions of these drugs. It can also cause you to excrete higher-than-normal levels of potassium, the last thing you want on a diuretic that doesn’t spare potassium.
Eating a lot of meat can increase uric acid even more, increasing the possibility of gout. If you are sensitive to monosodium glutamate (MSG), its negative effects can be exaggerated when you’re taking diuretics.
Since the secondary purpose of taking diuretics is to reduce your levels of sodium, it’s obviously wise to follow a low-sodium diet to reduce your need for the diuretics. One of the best ways to do this is to eliminate processed and packaged foods from your diet and concentrate on whole foods such as whole grains and fresh fruits and vegetables. When you do buy processed foods, read labels carefully. Many low-fat or sugar-free foods add lots of salt or MSG to improve taste.
What Nutrients Do They Deplete or Throw out of Balance? Minerals, especially sodium, potassium, calcium, and magnesium. Zinc is another important mineral that can be lost. Zinc is crucial to proper immune system functioning, wound healing, and thyroid function.
Diuretics can cause a depletion of vitamin A, which many Americans are already deficient in.
What Else to Take If You Take These Drugs. A good mineral formula that includes zinc, copper, boron, iodine, cobalt, manganese, molybdenum, vanadium, chromium, selenium, plenty of calcium and magnesium, and if you’re a premenopausal woman, iron.
Be sure you’re getting both beta-carotene and vitamin A in your multivitamin formula. Eat plenty of fresh fruits and vegetables.
Other Tips on These Drugs. They can skew the results of many blood and urine tests.