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Over the Counter Diuretics for Edema

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Examining the usefulness, side effects, and safety of over the counter (OTC) diuretics for edema.

Diuretics are substances that help to get rid of water retention in the body through urination. These can be taken in the form of over-the-counter diuretics, homeopathic, and herbal remedies

Certain foods have diuretic qualities that promote urine formation. Whatever the source, diuretics help to prevent fluid retention (edema). 

In this article, we will discuss over-the-counter diuretics, and how beneficial they are for edema treatment. 

How Do Over The Counter Diuretics for Edema Work?

Diuretics work by making the kidneys expel more sodium in the urine. The body then creates a balance for this increased amount of sodium by adding more fluid to the urine from the bloodstream, during the process of urine formation. 

Over-the-counter diuretics containing caffeine (Diurex) are used to alleviate symptoms related to edema or water retention. More severe edematous conditions may require medical attention. 

Treatment of edema with prescription medications is limited to the use of diuretics, commonly referred to as “water pills.” 

Agents often used include thiazide diuretics, loop diuretics; and potassium-sparing diuretics

Over the counter diuretics like pamabrom (Aquaban) can help ease water retention caused by premenstrual syndrome (PMS). 

There are 3 main classes of diuretics used in the treatment of edema. These are loop diuretics, thiazide diuretics, and potassium-sparing diuretics.

Loop Diuretics

Loop diuretics act at the ascending limb of the loop of Henle of the kidney nephrons. There, they inhibit the sodium/potassium/chloride symporter which is a transporter responsible for reabsorbing sodium, potassium, and chloride ions back into the bloodstream.

By inhibiting this symporter, loop diuretics prevent the reabsorption of sodium ions and thus increase the electrolyte concentration of the fluid passing through the nephron. When concentrated, water cannot be moved from the nephron back to the bloodstream.

Therefore, by inhibiting sodium reabsorption, loop diuretics promote the loss of more water as urine. Loop diuretics increase urine volume and the frequency of urination.  By this mechanism, they reduce the number of fluids retained in the body by getting rid of water passing through the kidneys.

They also reduce blood volume since the amount of water reabsorbed into the blood is lessened. A lower blood volume directly translates into lower blood pressure. Therefore, diuretics are useful antihypertensive drugs too.

However, loop diuretics prevent the reabsorption of other essential minerals besides sodium. They also promote the loss of potassium, calcium, and magnesium ions from the body.

Thiazide Diuretics

Thiazide diuretics are all chemically similar. They act at the distal convoluted tubule where they inhibit a symporter like the one inhabited by loop diuretics.

Thiazides, therefore, produce effects similar to those of loop diuretics.  They inhibit the reabsorption of sodium and water. Unfortunately, they also inhibit the reabsorption of potassium. However, they spare calcium ions.

Potassium-sparing Diuretics

Potassium-sparing diuretics are known for not inhibiting the reabsorption of potassium while they flush out sodium and water. They are especially useful for those with a high risk of hypokalemia (low potassium levels).

There are two types of potassium-sparing diuretics. There are drugs such as spironolactone which inhibits aldosterone, and there are others like amiloride which simply inhibit sodium pumps.

Spironolactone and other potassium-sparing diuretics in its class act on the corticosteroid hormone produced by the renin-angiotensin system. This system is activated in the brain and, through a cascade reaction, leads to the secretion of aldosterone from the adrenal gland.

Aldosterone then enters the kidney nephrons where it promotes water retention and, therefore, edema. Spironolactone blocks the action of aldosterone, and so gets rid of edema in this way.

Amiloride and the other drugs in its class, on the other hand, selectively targets sodium pumps. In this way, amiloride does not affect the reabsorption of potassium. It only inhibits the reabsorption of sodium and, by extension, water.

Over The Counter Diuretics for Edema - Are They Safe?

Over-the-counter diuretics are considered to be quite safe. They can be homeopathic remedies, foods, pills, herbs, teas, etc. The diuretics are safe when taken in recommended doses, under the guidance of a physician. 

Overdose can lead to side effects such as skin rashes, sleeping disorders, iron deficiency, etc. Sometimes, these diuretics may interfere with routine medications and create health problems. 

Similarly, the removal of excess water may reduce the essential vitamins and minerals from the body, resulting in a nutrient shortage. 

Over-the-counter diuretics should not be administered to small children or to women who are pregnant or breastfeeding. Though they are not toxic, they may interact with some medications. 

Thus, it is always safe to consult your health care provider before opting for over the counter diuretics. 

Side Effects of Diuretics

Loop diuretics such as Lasix (Furosemide) are the most commonly used diuretics. They are especially effective for edema patients who also suffer from renal impairment, liver cirrhosis, heart failure, and nephrotic syndrome.

However, loop diuretics cause the loss of essential minerals such as potassium and calcium from the body. Potassium is needed for cardiovascular health and in the nervous system while calcium is essential for bone health.

Therefore, loop diuretics may cause symptoms related to hypokalemia and hypocalcemia. When loop diuretics are to be taken for a prolonged period of time, calcium but more urgently, potassium supplements, are recommended.

A special formulation of Lasix (Lasix K) includes a potassium salt that can supply potassium as a supplement.

Other side effects of loop diuretics include dizziness, increased deposition of uric acid, jaundice, and temporary hearing loss.

Thiazides are also very effective diuretics. However, they have a few peculiar side effects.

Thiazides interfere with glucose control and are therefore not recommended for diabetic patients who are also treating edema. Thiazide diuretics also promote the accumulation of uric acid. This can worsen gout in edema patients suffering from the disease.

Furthermore, thiazides are generally not recommended for pregnant women.

Other side effects of thiazide diuretics include blurry vision, high cholesterol levels, and allergic reactions to thiazides.

Potassium-sparing diuretics can cause hyperkalemia, numbness, lethargy, mental confusion, and breathing problems.

While each class of diuretics has its own set of side effects, some adverse effects are shared by all diuretics. These adverse effects include frequent urination, thirst, electrolyte imbalance especially hyponatremia, muscle cramps, headaches, nausea, and loss of appetite.

However, it should be noted that these side effects are not universal. Some people experience them while others do not. Some of the side effects also resolve quickly to dose adjustment or combination therapy.

Are They Useful?

Over-the-counter diuretics are taken to prevent or treat water retention or edema. They are known to increase the production of urine by releasing accumulated fluid in the body. 

Diuretics also help to get rid of body toxins, and so they play an important role in detoxification. 

Cranberries and cranberry juice, coffee, tea, and other substances which contain caffeine and apple cider vinegar are commonly available and widely used diuretics. 

If you are worried about the safety of over the counter diuretics, then be assured that the natural diuretics are quite safe if used in moderation. 

For more information regarding edema and its treatment methods, read these articles: Edema Diet: Foods to Avoid, Edema and Exercise, and Edema Products.

Next Article: Edema Diet: Foods to Avoid for Edema