Are you taking diuretics? Get the best results by following this tried and true dosing method.
In this article, we'll explore diuretics. These medications work to increase the excretion of sodium and fluid through the kidneys. They're commonly prescribed to manage conditions like hypertension (high blood pressure), heart failure, and chronic kidney disease. Several types of diuretics are available, and many patients take a combination of two diuretics. Side Note: If you want to learn more about diuretics and how they work on the body, watch this video.
Here's the twist: we will discuss a unique way of prescribing diuretics that isn't found in mainstream guidelines or studies but gets the best (proven) results. So let’s dive in and learn how this unconventional approach can help you get the best results for your health.
The problem with today's diuretic prescriptions
For starters, when a diuretic is prescribed, the physician typically decides on the dose that he/she thinks is appropriate, usually once daily. The same dose gets prescribed for every day of your life regardless of the salt intake from day to day.
So If you decide to go out to eat at a restaurant, you might consume triple the amount of salt you consume during a meal at home. That's a huge difference. There are also days when you consume more processed or saltier foods than other days. And when you travel, you likely find yourself eating 2-3 meals out every day. That’s a massive amount of salt every single day yet…
you take a single dose?
With this excessive salt intake, your blood pressure will likely increase or you might retain fluid in your legs (edema). At worst, heart failure.
Conversely, if you are sick and eating little or nothing, your salt intake is much less than usual, and if you take the diuretic, it can, and does, increase the risk of dehydration and the possible need for hospitalization.
This is a big problem and why traditional guidelines for diuretic dosing can be harmful, or even fatal.
The solution for better diuretic dosing
The strategy I’ve employed with my patients over the decades is simple.
Adjust the diuretic dose depending on the salt intake.
When you eat at home, you take your usual dose. When you eat out for 2 or 3 meals or more, take a higher dose. For example, a pill and a half.
You could call this the “morning after” dose.
Put into practice, if you take 25 mg (1 pill) of hydrochlorothiazide as a regular dose:
Take a pill and a half (37.5 mg) if you’ve loaded up on salty food for a couple of days.
If you are sick and not eating as usual, cut your normal dose in half to keep from being dehydrated.
If you’re not eating at all, skip the dose (check first with your doctor).
The caveat - studies, have not examined this diuretic dosing strategy even though it makes perfect sense.
If you are interested in trying this method, discuss it with your physician. Your physician can help you come up with a plan of action and dosing that is right for your unique scenario.
Author
Physician. Professor. Researcher. Author. Speaker.
Hypertension specialist, New York Presbyterian Hospital - Weill Cornell Medical Center
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