The Facts About Diuretics

Diuretics, known as water pills, are pills that help rid the body of excess salt and water through urine.

Diuretics are often prescribed to reduce high blood pressure, and many patients stay on such medication for life. High blood pressure, or hypertension, is caused by narrowing arteries due to prolonged periods of stress or plaque buildup from poor diet and lack of activity.

High blood pressure risks include stroke and kidney failure, and high blood pressure can also be a sign of preeclampsia in pregnant people.

All diuretics work at the kidney level, which is where the body decides what to excrete and not excrete as urine. Diuretics help the kidneys release more sodium into the urine. Sodium helps remove water from your blood, reducing the amount of fluid flowing through your veins and arteries, which in turn reduces blood pressure.

Thiazide

Thiazide diuretics are the most common choice for treating high blood pressure. The goal of this type is to clear fluid from the kidneys, and they are not known to significantly increase urination.

Loop

Loop diuretics are used more for heart failure, nephrotic syndrome or cirrhosis in addition to high blood pressure. They work in the loop of Henle in the kidney, interfering with the reabsorption of salt and water, and reducing blood pressure in the process.

Potassium-sparing

Potassium-sparing diuretics are the weakest of the three and typically taken in conjunction with other diuretics. Potassium-sparing pills help to flush excess fluid from the body while preventing too much potassium from being flushed out at the same time.

High blood pressure is the most common illness treated with diuretics, but other heart-related issues can benefit from diuretics, too.

Diuretics are commonly prescribed to treat:

• Edema
• Heart failure
• Kidney issues, such as kidney stones
• Liver failure
• Male pattern baldness
• Osteoporosis 
• Polycystic ovary syndrome (PCOS)

Thiazide diuretics are often the first medication prescribed for high blood pressure, and all diuretics can be used with other medications to treat various ailments. Since high blood pressure during pregnancy can be very dangerous to both mother and baby, some doctors may prescribe diuretics, depending on the stage of the pregnancy and the patient's other medications.

Many medications are prescribed alongside diuretics, but some specific ones shouldn't be taken with diuretics. Consulting a doctor is crucial to ensure you're not mixing medications that could potentially cause serious side effects.

Beta blockers and thiazide diuretics are often prescribed together. But other medications, such as many cancer drugs, aspirin and even bismuth subsalicylate (brand name: Pepto-Bismol)—used to provide relief from nausea, diarrhea and upset stomach—should not be used in concert with diuretics. Additionally, some mood stabilizers and other dehydrating drugs should not be taken at the same time as diuretics.

When using diuretics, it's crucial to keep an eye on potassium levels, especially when taking other medications.

There are countless side effects to diuretics, ranging from vitamin deficiency to female sexual dysfunction.

Loop and thiazide diuretics can cause low potassium, but other side effects include low magnesium, dehydration, dizziness, muscle cramps and gout. The side effects are usually easily treatable with other supplements or medications, and they may lessen or worsen over time.

Different types of diuretics may have different side effects. Keeping regular appointments with your doctor is important to monitor your progress using diuretics.

There are many direct correlations between sexual health and high blood pressure, and of all the different medications to lower blood pressure, diuretics cause the most sexual side effects.

Since diuretics decrease blood flow to the penis, erectile dysfunction (ED) is a common sexual side effect of the blood pressure drug. High blood pressure medications can cause low libido, vaginal dryness and an inability to reach climax.

There are ways to mitigate these side effects through lifestyle changes, but there are also other over-the-counter or prescription medications available to combat some of these sexual side effects.

There are direct links between ED and diuretics, with many medical studies and reviews researching the correlation between the two.

Diuretics can decrease the blood flow to the penis, which makes getting and sustaining an erection difficult. Diuretics also impact the production of zinc in the body, which is crucial for the production of testosterone, the primary sex hormone and anabolic steroid in males that plays a key role in the development of male reproductive tissues such as the testes and prostate.

Alpha blockers, ACE inhibitors, calcium channel blockers and angiotensin receptor blockers (ARBs) are less likely to cause ED and can still be effective at treating high blood pressure.

All hope is not lost when suffering sexual health issues while taking diuretics.

If you have erectile dysfunction, for example, adjusting the dosage of the diuretic or getting a prescription for anxiety medication may take care of sexual side effects. Switching to another diuretic may do the trick as well.

Since beta blockers are often taken alongside diuretics, changing the beta blocker has the potential to lessen or eliminate sexual side effects, even increasing sexual health. For vaginal dryness or sensitivity, lubricants provide a temporary solution.

Diet and exercise working in concert is the most natural way to achieve good heart health, and the prevention of high blood pressure is key. Decreasing salt consumption, even if you haven't been diagnosed with high blood pressure, is a good way to decrease your chance of ever developing it.

Cardiovascular exercises are crucial to heart health. Walking, jogging, biking, swimming and other exercises get the heart pumping, strengthen the heart and reduce the amount of fat surrounding it.

Maintain your heart health with regular blood pressure monitoring and tweaks of diet and exercise to find the solution that works for your body.

Changing your diet after a high blood pressure diagnosis is a good way to reduce the effects and lessen the amount of time you spend on medication. Avoiding the consumption of animal products or implementing diets such as the DASH (Dietary Approaches to Stop Hypertension) or the Nordic diet are good strategies to consider. The DASH diet focuses on reducing sodium intake, while the Nordic diet encourages eating whole, unprocessed foods. Both diets emphasize an increase in fruits, vegetables and grains.

As always, consult your doctor to explore any specific dietary needs before changing your diet to treat high blood pressure.

If you're experiencing symptoms of high blood pressure such as headaches, fatigue, confusion, chest pain, vision problems, difficulty breathing and more, see a doctor to check your blood pressure.

But remember that high blood pressure is called the "silent killer" for good reason, mainly because many of the symptoms attributed to high blood pressure are often overlooked as insignificant or mistaken for something else.

Regular checkups and bloodwork can detect high blood pressure in its early stages before you start experiencing symptoms.

Who should take diuretics?

If you have high blood pressure or other fluid overload disorders, diuretics could be a viable course of action. However, people suffering from other issues, such as kidney failure, edema, PCOS, male pattern baldness, osteoporosis and liver failure, can also benefit from diuretics.

What foods interact with diuretics?

Most restaurant food and previously prepared and processed foods contain high sodium levels. Since diuretics work to flush excess sodium from the body, eating an excess of those foods could cause the diuretics to be less effective.

Eating natural foods, such as fruits, vegetables and whole grains, that contain little or no sodium not only helps your body naturally lower blood pressure, but also aids the diuretics in doing their job.

What drugs interact with diuretics?

Many drugs, such as beta blockers and antianxiety medication, are prescribed alongside diuretics. However, some medications, like lithium mood stabilizers, antidepressants, aspirin and some cancer drugs, should not be taken with diuretics. Some over-the-counter remedies, such as Pepto-Bismol, also have negative interactions with diuretics.

Always consult your doctor before taking other medication while on diuretics.