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Diuretics cause bone loss in older men The use of potent water pills called "loop diuretics," which include drugs such as furosemide and torsemide, by men over the age of 65 can cause thinning of the bones, investigators report in the Archives of Internal Medicine. "Loop diuretics are commonly prescribed to older adults, but data on the effect of loop diuretics on bone density are scarce and conflicting," said lead author Dr. Lionel S. Lim. "It is a plausible hypothesis, given that loop diuretics increase calcium excretion through the kidneys, that long-term exposure to loop diuretics could lead to bone loss." Loop diuretics have been associated with an increased risk of broken bones, according to Lim, who heads the Osteoporotic Fractures in Men Study Group at Griffin Hospital in Derby, Connecticut. Whether this might be related to effects on bone thickness, dizziness leading to falls, or other problems is not clear. The study involved 3,269 men who underwent two special x-rays, roughly 5 years apart, to determine how bone thickness, also referred to as bone mineral density, changed with loop diuretic use. Overall, 84 men were classified as continuous users of loop diuretics, 3004 as nonusers, and 181 as intermittent users. Continuous users experienced the fastest bone loss, followed by intermittent users, and lastly by nonusers. Statistical analysis confirmed that the bone loss seen in the continuous users was greater than that noted in the intermittent users or the nonusers. Doctors should be aware of the potential for bone loss, leading to osteoporosis, bone-thinning disease, in older men who are on long-term treatment with loop diuretics," Lim advised. "This is particularly true when other risk factors for osteoporosis are already present." In general, thiazides (diuretics of a different class), such as chlorothiazide or hydrochlorothiazide, are preferred over loop diuretics in treating high blood pressure, Lim noted. However, there are other conditions, such as severe heart failure, in which loop diuretics provide the most effective means of eliminating the excess fluid, which complicates the problems, he noted. His team is now setting up a similar study among older women, "to determine the rate of bone loss in women who take loop diuretics, as well as the risk for falls and fractures that may result from loop diuretic use." SOURCE: Archives of Internal Medicine, April 14, 2008 Dr. Cinque's comments: I have said before, and it's worth repeating, that the use of diuretic drugs is one of the most misguided and foolish practices in all of Medicine. No good comes from it. Oh sure, perhaps symptomatically, the patient may seem a little better for a while- superficially and temporarily. But, the improvement is an illusion, and no real physiological improvement or correction occurs from taking diuretics. Unfortunately, people have been led to believe that diuretics make their kidneys work better. It is just the opposite! Diuretics make them work worse- except that it's a different kind of bad than what they are used to. Diuretics interfere with and sabotage the normal functioning of the kidneys. How is any good supposed to come from that? Sure, the quantity of urine may go up for a while, but what about the quality? Kidney filtration is a very delicate and multi-faceted physiological process that involves removing the bad and salvaging the good and balancing everything out. Your kidneys are involved not only in eliminating waste products, but also in maintaining homeostasis, which refers to a steady state of equilibrium throughout your entire system. It is a very complex, intricate, and fragile biological process, which diuretics wantonly disrupt. You can no more fix your kidneys with a diuretic than you can fix a Rolex watch with a sledge hammer. Diuretics are given to reduce fluid buildup- which they may or may not do- but not without causing other problems. Diuretics are not a solution to anything; they are just a pharmaceutical trick, a ruse. But, taking a diuretic drove down your blood pressure, you say? So what. It doesn't mean that you are any healthier because of it. It only means that you've added drug-induced dehydration to the problems that you started with. Taking a diuretic got rid of the puffiness around your ankles, you say? Well, you are being fooled by appearances, and I am worried for you. The diuretic is only masking your symptoms, while it is creating other more grave, though perhaps less visible, abnormalities. Such pharmaceutical tinkering sets off a vast chain reaction of harm that reaches far and wide and leads, inevitably, to new and more serious woes. Just to be clear: there are no conditions under which I would ever consider taking a diuretic. None. Zero. Zilch. Nada. The most a diuretic can do is create a semblance of normality, and one that can't last. In fact, if I ever went to a doctor, and he tried to tell me that taking a diuretic was the answer to my problem, I would fire him on the spot. If his judgment is that bad, I don't care what he thinks. I will not tolerate such stupidity, and neither should you. E-mail to a friend Next Article |
