What do fluid tablets do for you? Should you rely on them?
Diuretics (or water tablets) are used to rid the body of extra fluid or salt. People with high blood pressure, heart failure, swollen tissues, and kidney disease often use diuretics to treat these conditions. … Prescription diuretics are commonly called water pills, and their first effect is to increase urination.
The buildup of excess fluid in your body can take a variety of forms from belly bloating and swollen ankles to nausea, persistent coughing and fatigue. You may be tempted initially to dismiss this hodgepodge of problems as having little to do with your heart. However, they all signal water retention, which can mean trouble for people with a history of heart failure. Fluid build up can quickly escalate and become life threatening.
Heart failure may start with injury from a heart attack or develop as a result of damaged valves, infection or disease of the heart muscle cells. Many times, it is the product of years of toil against high blood pressure and clogged arteries. Regardless of what triggers the decline, heart failure culminates in a progressive weakening of your heart’s power to pump.
Consequently, blood circulates through your heart and body more slowly; your cells thirst for fresh oxygen and nutrients. To compensate for its weakened state, the heart undergoes a series of structural transformations. Other physical processes also come into play. When the kidneys detect the diminished blood flow, they activate hormones that prompt the body to retain fluid and sodium in an effort to boost the volume of blood in circulation.
Fluid regularly leaks into body tissues from the blood. The lymphatic system is a network of tubes throughout the body that drains this fluid (called lymph) from tissues and empties it back into the bloodstream. Fluid retention (oedema) occurs when the fluid isn’t removed from the tissues.
The two broad categories of fluid retention include generalised oedema, when swelling occurs throughout the body, and localised oedema, when particular parts of the body are affected.
The wide range of causes includes the body’s reaction to hot weather, a high salt intake, and the hormones associated with the menstrual cycle. However, it’s recommended that you see your doctor rather than self-treat, because oedema can be symptomatic of serious medical conditions such as heart, kidney or liver disease.
Symptoms of fluid retention
Symptoms of fluid retention can include:
- swelling of affected body parts (feet, ankles and hands are commonly affected)
- aching of affected body parts
- stiff joints
- rapid weight gain over a few days or weeks
- unexplained weight fluctuations
- when pressed, the skin may hold the indent for a few seconds (pitting oedema)
- in other cases, the skin may not hold an indent when pressed (non-pitting oedema).
Causes of fluid retention
Some of the many common causes of fluid retention include:
- gravity – standing up for long periods of time allows fluid to ‘pool’ in the tissues of the lower leg
- hot weather – the body tends to be less efficient at removing fluid from tissues during the summer months
- burns – including sunburn. The skin retains fluid and swells in response to burn injuries
- menstrual cycle – some women experience oedema in the two weeks prior to menstruation
- pregnancy – hormones encourage the body to hold onto excess fluid
- the pill – oral contraceptives that include oestrogen can trigger fluid retention
- dietary deficiency – such as insufficient protein or vitamin B1 (thiamine) in the diet
- medications – certain drugs, including high blood pressure medication (antihypertensives), corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) are known to cause fluid retention
- chronic venous insufficiency – weakened valves in the veins of the legs fail to efficiently return blood to the heart. The pooling of blood can result in varicose veins.
Medical conditions that may cause fluid retention
Fluid retention may be a symptom of serious underlying conditions, including:
- kidney disease – such as nephrotic syndrome and acute glomerulonephritis
- heart failure – if the heart does not pump effectively, the body compensates in various ways. it starts to retain fluid and increase the volume of blood. This results in congestion of the veins, enlargement of the liver, and the accumulation of fluid in body cavities like the abdominal cavity (ascites) and in subcutaneous tissues, causing swelling (oedema) of the legs
- chronic lung diseases – such as severe emphysema, which put excessive pressure on the heart’s right ventricle, leading to its failure
- liver disease – such as severe cirrhosis that triggers liver failure
- malignant lymphoedema – cancerous tumours that block structures of the lymphatic system, such as the lymph nodes
- thyroid disease – such as hypothyroidism
- arthritis – joints affected by some types of arthritis tend to swell with fluid
- allergic reaction – in susceptible people, the body tends to swell in response to particular allergens, such as an insect bite. In some cases, the reaction is severe (anaphylaxis) and requires urgent medical attention. this swelling is short-lived rather than ongoing
- autoimmune diseases such as lupus.
Diagnosis of fluid retention
The underlying cause of the oedema must be found before treatment can begin. Diagnostic tests may include:
- physical examination
- medical history
- detailed questioning about the fluid retention, such as when it started, any factors that worsen the swelling and whether it is constant or intermittent
- blood tests
- urine tests
- liver function tests
- kidney function tests
- chest x-ray
- heart function tests, such as electrocardiogram (ECG).
Treatment for fluid retention
Depending on the cause, treatment may include:
- a low-salt diet
- diuretics (water pills)
- treatment for the underlying medical condition: for example, hormone replacement (thyroxine) in the case of hypothyroidism
- lifestyle changes in response to the underlying medical condition: for example, avoidance of alcohol if liver disease is the cause
- changes to medication or dosage, if drugs are the cause
- dietary adjustments, if malnutrition is the cause
- ongoing medical supervision
- aids such as support stockings.
- Regular Manual lymphatic drainage treatments.
Types of Diuretics (fluid tablets)
Thiazides are the most commonly prescribed diuretics. They’re most often used to treat high blood pressure. These drugs not only decrease fluids, they also cause your blood vessels to relax.
Loop diuretics are often used to treat heart failure.
Potassium-sparing diuretics reduce fluid levels in your body without causing you to lose potassium, an important nutrient.
The other types of diuretics cause you to lose potassium, which can lead to health problems such as arrhythmia. Potassium-sparing diuretics may be prescribed for people at risk of low potassium levels, such as those who take other medications that deplete potassium.
Potassium-sparing diuretics don’t reduce blood pressure as well as the other types of diuretics do. Therefore, your doctor may prescribe a potassium-sparing diuretic with another medication that also lowers blood pressure.
Self-care options for fluid retention
Mild fluid retention can be helped in the following ways:
- Reduce the amount of salt in your diet; for instance, don’t add salt during the cooking process and stop salting your meals at the table. Avoid foods like potato chips and salted peanuts. Be wary of processed foods such as manufactured meats, which tend to contain ‘hidden’ salt.
- Vitamin B6 (pyridoxine) is thought to help in cases of mild fluid retention. Good sources of vitamin B6 include brown rice and red meat.
- Vitamin B5 (pantothenic acid), calcium and vitamin D help the body to excrete excess fluids. Include fresh fruits and low-fat dairy foods in your daily diet.
- Supplements may help in the case of fluid retention caused by the menstrual cycle: for example calcium, magnesium, manganese, evening primrose oil and chaste tree.
- Herbal diuretics include dandelion leaf, corn silk and horsetail.
- Make sure to discuss the use of supplements with your doctor or health care professional, particularly if you are on any type of medication.
- Drink plenty of water. It may sound contradictory, but a well-hydrated body is less likely to retain fluid.
- Cut back on dehydrating drinks such as tea, coffee and alcohol.
- Cranberry juice has a mild diuretic action.
- Lie down with your legs higher than your head, when possible.
- Exercise regularly.
- Wear support stockings
More common side effects
The more common side effects of diuretics include:
- too little potassium in the blood
- too much potassium in the blood (for potassium-sparing diuretics)
- low sodium levels
- increased blood sugar
- muscle cramps
- increased cholesterol
- skin rash
Herb and plant diuretics
Some herbs and plants are considered “natural diuretics,” including:
- green and black tea
Manual lymphatic drainage can help to supplement any medical treatments you are receiving, and in some cases might even reduce the need to rely as much on medication.
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Or, contact us if you want to discuss your particular case to see if we can help.