Doctors sometimes prescribe medications called diuretics to increase urine production, often for patients experiencing high blood pressure or fluid retention. Different types of diuretics work best for specific conditions. Although these pharmaceuticals can effectively reduce the amount of fluid in the body, there are possible side effects, as well.

What a Diuretic Does

Diuretics cause the kidneys to remove larger amounts of sodium and water from the body. Some also cause a loss of potassium in the urine. This decrease in fluid and salts also decreases blood volume within the arteries. As a result, there is less pressure exerted on artery walls. The heart pumps fewer beats, lowering blood pressure.

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Why Doctors Prescribe Them

Diuretics are a common, effective, and inexpensive way to treat hypertension, or high blood pressure, along with many other chronic illnesses. Doctors recommend them for people who are experiencing water retention and specific types of kidney or liver disease. Physicians also prescribe diuretics for individuals with congestive heart failure because it reduces vascular congestion caused by fluid overload in the lungs.

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Potassium-Sparing Diuretics

Of the three types of diuretics, doctors most often prescribe potassium-sparing diuretics to reduce the amount of water in the body while maintaining potassium levels. This type is weaker than the others, but they can still lead to hyperkalemia, or excessive amounts of potassium in the body, in some cases.

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Loop-Acting Diuretics

When a person has edema or fluid retention, a physician will most likely prescribe a loop-acting diuretic. This fast-acting version increases urine flow from the kidneys, leading to large amounts of fluid loss. The result is reduced water and fluid in the body as lower blood pressure.

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Thiazide Diuretics

Physicians usually prescribe thiazide diuretics in low doses and in cases where they are seeking to avoid excessive potassium loss, although potassium loss is a known side effect of these medications.  Thiazide diuretics are effective against high blood pressure and heart failure. They usually act within one to two hours of consumption. Many people experience less dramatic water loss with thiazide diuretics than with loop-acting diuretics.

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Potassium and Diuretics

Thiazide diuretics can cause potassium levels to drop severely, leading to possible life-threatening issues, including cardiac arrest. Symptoms of this condition, hypokalemia, include arrhythmias, muscle cramps, weakness, constipation, and fatigue. People who take potassium-sparing diuretics could experience higher potassium levels or hyperkalemia. Nausea, numbness, tingling, arrhythmias, and muscle weakness are signs of excessive potassium levels in the body.

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Side Effects

Generally, the medical community deems diuretics safe. However, they can cause other side effects in addition to changes in potassium levels. Because loop diuretics cause extensive fluid loss, some people experience postural hypotension — dizziness when standing, due to a drop in blood pressure. Some people taking thiazide diuretics may develop increased blood sugar levels. Those who take thiazide or loop diuretics could experience gout due to the uric acid in the bloodstream moving into the joints. Some men experience erectile dysfunction.

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Herbal Diuretics

Some people turn to natural plant diuretics or supplements instead of pharmaceuticals. However, there is little scientific evidence to support the effectiveness of these over-the-counter or homegrown solutions as diuretics. For people experiencing fluid retention, medical professionals advise consultation with a physician before turning to these treatments.

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Diuretic Abuse

Diuretics are one of the most common types of drugs taken without medical supervision. Athletes and people with eating disorders take diuretics to lose weight quickly. Unfortunately, because diuretic medications cause a rapid loss of body fluid, they can also lead to severe dehydration, electrolyte deficiencies, cardiac arrhythmias, and muscle weakness. If not treated, these conditions could cause severe illness and even death.

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People Who Should Not Take Diuretics

Before prescribing a diuretic, the physician should be aware of any other medications the patient is taking, including antidepressants, other diuretics, and those for high blood pressure, heart conditions, or to prevent transplant rejection. People with diabetes and those pregnant or considering pregnancy should let their physician know. Physicians also avoid prescribing diuretics to individuals who are prone to dehydration.

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