Diuretics: The Nutrient Depletions You Need To Know About

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Diuretics, commonly known as water pills, are a diverse group of medications frequently prescribed to manage conditions like hypertension, heart failure, and edema. While these medications are invaluable for their ability to help regulate fluid balance within the body, they can also influence the way we absorb, utilize, and process essential nutrients. In this brief article, we discuss diuretics and their complex relationship with nutrients.

Potassium-Sparing Diuretics:

These include Spironolactone, Eplerenone, Amiloride, and Triamterene.

Potassium-sparing diuretics are a type of water pill that help your body get rid of extra water without losing potassium, a vital electrolyte that helps your heart and muscles work properly. Unlike other diuretics that can lower potassium levels, potassium-sparing diuretics medications actually help keep potassium in your body.

It’s important to keep an eye on your potassium intake. A high potassium intake might lead to high levels of potassium in the blood. This is important because it can cause irregular heartbeats. The main concerns with diet and health, when you are taking these medications, include:

  • Potassium chloride salt substitutes
  • Large amounts of orange juice or tomato juice or a combination of high-potassium foods
  • A high potassium diet with poor kidney function.

So, while you don’t usually need to worry about losing potassium with these diuretics, you do need to make sure your potassium levels don’t get too high. Your doctor should monitor your potassium levels in routine blood tests. Make sure to talk with your physician or Registered Dietitian about potassium-containing supplements. Read our article: Potassium: Understanding This Major Mineral and Its Impact on Health.

Irregular heartbeats may not always be noticeable, but if you do feel fluttering, pounding, or skipped beats, it could be a sign of hyperkalemia, a condition that requires immediate medical attention.

Thiazide Diuretics

Thiazide diuretics include as Hydrochlorothiazide, Chlorthalidone, Indapamide, Metolazone, Bendroflumethiazide.

Thiazide diuretics can lead to drug-induced nutrient depletions. This is primarily due to their mechanism of action, which promotes the excretion of water and electrolytes. Here are some nutrient depletions associated with thiazide diuretics:

  • Potassium: Thiazide diuretics can lead to potassium depletion. This is why they are sometimes classified as “potassium-wasting” diuretics. Low potassium levels can cause muscle weakness, irregular heartbeat, and other symptoms. Although your physician should monitor your potassium level, you may guess you need more potassium if you have muscle cramps. Consider keeping potassium supplements on hand for this situation. Potassium supplements are available in a 99 mg dose. Keep in mind that excessive dosages can disrupt heart rhythm.
  • Magnesium: Thiazide diuretics can also lead to magnesium depletion. Low magnesium levels can result in muscle cramps, tremors, and abnormal heart rhythms. A magnesium supplement containing 250–400 mg daily is generally recommended.  Absorption differs among the different forms of magnesium.  Consider taking 250 mg of the glycinate or taurate form of magnesium or 400 mg of magnesium citrate or other forms.
  • Calcium: Thiazide diuretics may increase calcium reabsorption in the kidneys, potentially leading to higher calcium levels in the blood. This can have both positive and negative effects, as it may reduce the risk of kidney stones but could also lead to hypercalcemia (high calcium levels).
  • Vitamin D: Thiazide diuretics can raise calcium levels in the blood, which may indirectly reduce vitamin D levels. These higher calcium levels may reduce the kidneys’ rate of conversion of inactive vitamin D2 to its active form Vitamin D3. Active vitamin D is needed for many critical metabolic processes. Vitamin D dosages should be adjusted based on your blood level with many clinicians recommending an optimal Vitamin D level of 50-80 ng/ml. Vitamin D Labs (affiliate link) can be ordered in the NutriScape Lab Shop.
  • Sodium: While thiazides promote sodium excretion, they can also lead to sodium depletion. Although this is less common, it can happen with a very low sodium diet. Sodium depletion can cause symptoms like dizziness and low blood pressure.

Loop Diuretics

Loop diuretics include Furosemide, Bumetanide, Torsemide, and Ethacrynic acid.

Drug-Nutrient Interactions

  • Zinc: Loop diuretics can potentially cause zinc loss as a side effect. Supplemental Zinc of 11 mg/day is suggested.
  • Calcium: Loop Diuretics increase calcium loss in the urine so they can lead to lower blood calcium levels. Low calcium intake can contribute to the risk for osteoporosis, especially in people who are thin with small bone structure and history of low calcium intake or steroid medications.
  • Magnesium: Loop Diuretics deplete magnesium. A magnesium supplement containing 250–400 mg daily is often recommended. 
  • PotassiumLoop diuretics deplete potassium, so ask your provider is you should be taking a supplement. You may guess you need more potassium if you have muscle cramps. Consider keeping potassium supplements on hand for this situation. Potassium supplements are available in a 99 mg dose. Follow your physician’s recommendations for dosage and always keep in mind that excessive dosages of potassium supplements have the danger of possibly disrupting heart rhythm.

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Food First!

Although this article discusses supplements in detail, don’t forget that we are absolutely committed to the “Food First” approach to nutrition. When it comes to your health, the totality of your eating habits far surpasses the impact of individual nutrients or any single supplement you consume. Even though this article doesn’t delve into the broader picture of your overall diet, it’s crucial to keep this element at the forefront of our minds. Your food needs to provide all the vitamins, minerals, fiber, and phytochemicals to nourish your body systems down to the cellular level.

Food choices, rather than supplements, are the most critical factors for a healthy gut microbiome. These trillions of tiny inhabitants in your gut affect your brain waves; they orchestrate your immune system. They possess the power to create molecules that can switch genes on or off and are even capable of synthesizing neurotransmitters. Opting for organic foods and steering clear of plastic packaging (including those labeled BPA-free) is a smart move to limit toxin exposure. The sum of all these parts leads to a powerful conclusion: the ultimate key to your health lies in the quality and balance of the food you consume. Supplements are secondary.

To Sum It Up

Diuretics serve as valuable tools in managing a range of health conditions, from hypertension to congestive heart failure, and their benefits are undeniable. Yet, it is equally vital to recognize the potential impact these medications can have on our nutrient balance. The delicate equilibrium of minerals like potassium, calcium, magnesium, and others can be disrupted, leading to unintended consequences.

This Article is Not a Substitute for Medical Advice

Dietary supplements are not designed to diagnose, treat, cure, or prevent any disease. The Supplement Sciences website seeks to provide comprehensive access to the most relevant supplement information along with convenient online ordering. We do not provide medical advice and cannot guarantee that every product suggested is completely without risk. Since each person is unique in their health history and medication use, it is important to discuss supplements with your personal physician. Specifically, pregnant women and individuals being treated for cancer or liver or kidney problems must consult their physician about every nutritional supplement they plan to take. People taking medications for the treatment of HIV or with a history of organ transplant must not take supplements without consulting with their physician.

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