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  • You have lupus.

  • You have kidney or liver problems.

  • You have diabetes.

  • You have urinary tract problems such as an enlarged prostate that interferes with urination. Diuretics can make you even more uncomfortable by increasing the number of times you have to urinate.

  What Are the Interactions with Food? The absorption of the drug may be reduced if you take it with food. Also, if you consume too many electrolytes, such as in sports drinks, you may reduce the effectiveness of the drug.

  Signs of a Mineral Imbalance

  Dizziness

  Dry mouth

  Low blood pressure

  Muscle pains or cramps

  Nausea and vomiting

  Rapid heartbeat

  Sleepiness and confusion

  Weakness

  It’s good to eat plenty of high-potassium foods when taking diuretics that don’t “spare” potassium. Some common high-potassium foods include bananas, citrus fruits, melons, almonds, green leafy vegetables, potatoes, carrots, avocados, and soybeans.

  Licorice (not the candy made with anise, but the herb or root) can be an antidiuretic and reduce the actions of these drugs.

  Eating a lot of meat can increase uric acid even more, increasing the possibility of gout.

  If you are sensitive to MSG, its negative effects can be exaggerated when you’re taking diuretics.

  What Nutrients Do They Deplete or Throw out of Balance? Minerals, especially sodium, potassium, calcium, and magnesium. Zinc is another important mineral that can be lost. Zinc is crucial to proper immune system functioning, wound healing, and thyroid function.

  Taken long-term, loop diuretics cause a depletion of the vitamin thiamine (B1), which plays a key role in the functioning of the nervous system. A deficiency of thiamine can aggravate CHF or other heart problems. Chronic thiamine deficiency can also block enzymes involved in glucose metabolism, which may be why these drugs can cause hypoglycemia.

  Diuretics can cause a depletion of vitamin A, which many Americans are already deficient in.

  What Else to Take While Taking These Drugs. A good mineral formula that includes zinc, copper, boron, iodine, cobalt, manganese, molybdenum, vanadium, chromium, selenium, and if you’re a premenopausal woman, iron. Eat plenty of fresh fruits and vegetables.

  An extra B-complex vitamin supplement that includes at least 50 mg of thiamine. (It’s best to take the B vitamins together.)

  Be sure you’re getting both beta-carotene and vitamin A in your multivitamin formula.

  Other Tips on These Drugs. They can skew the results of many blood and urine tests. Take them with food, or they may upset your stomach.

  Examples of Potassium-Sparing Diuretics

  Amiloride (Midamor)

  Spironolactone (Aldactone)

  Triamterene (Dyrenium)

  Combinations (Dyazide, Moduretic, Aldactazide, Maxzide)

  The potassium-sparing diuretics are usually combined with one of the other diuretics to reduce excessive potassium depletion. However, the potassium-sparing diuretics in turn may cause excess potassium, called hyperkalemia, which can also be dangerous. Symptoms of too much potassium include muscular weakness, fatigue, numbness and tingling, and irregular heartbeat.

  What Do They Do in the Body? Reduce fluid and water retention in such a way that the body retains potassium.

  What Are They Prescribed For? In conjunction with loop and thiazide diuretics prescribed for high blood pressure and CHF, to reduce the loss of potassium, to treat aldosteronism (an excess of the adrenal hormone aldosterone, which causes the body to hold on to salt and excrete potassium), and to treat a variety of conditions involving potassium loss.

  Spironolactone reduces the level of aldosterone, an androgen (male hormone), so it has been used to treat excess hair growth, acne, and other symptoms of excess androgens. Considering that this drug promotes tumor growth in rats and can cause unexplained uterine bleeding in women at high doses, it seems frivolous to use it other than short-term in life-threatening situations.

  Triamterene is mainly used to treat edema, or water retention, especially when it is caused by aldosteronism.

  What Are the Possible Side Effects? Excess potassium (hyperkalemia), dizziness, nausea, vomiting, and appetite loss. Liver and kidney problems may get worse. The peripheral neuropathy (numbness in the extremities) caused by diabetes may get worse.

  Spironolactone affects sex hormones by reducing aldosterone levels. Aldosterone is an androgen, or male hormone. Taking spironolac-tone can cause a reduction in male hormones, and as a consequence, causes breast enlargement and other feminizing effects in men. It also promotes the growth of a variety of malignant tumors in rats. Spironolactone can cause lethargy, mental confusion, headaches, stomachaches, irregular menstruation, and thirst.

  Triamterene may promote the formation of kidney stones and can raise blood sugar levels. It can also induce kidney failure.

  CAUTION!

  Think Twice About Taking These Drugs If . . .

  • You have kidney or liver problems.

  • You have diabetes.

  • You have urinary tract problems such as an enlarged prostate that interferes with urination. Diuretics can make you even more uncomfortable by increasing the number of times you have to urinate.

  What Are the Interactions with Food? If you consume too many electrolytes, such as in sports drinks, you may get too much potassium. Eating a lot of high-potassium foods in combination with taking the drugs can also raise potassium levels too high. Some common high-potassium foods include bananas, citrus fruits, melons, almonds, green leafy vegetables, potatoes, carrots, avocados, and soybeans.

  Licorice (the root or herb used medicinally, or the candy with real licorice flavoring) can be an antidiuretic and may reduce the effect of these drugs. Licorice also contains a component called glycyrrhizin, which is similar to aldosterone, the very hormone that spironolactone is prescribed to reduce, so taking a lot of (real) licorice could negate those effects.

  Eating a lot of meat can increase uric acid even more, increasing the possibility of gout.

  Spironolactone levels may be increased by eating a lot of protein or fat at one sitting. Levels may be decreased by a high-fiber diet. If you’re eating fiber-rich cereals or taking a fiber supplement such as psyllium, take it a few hours apart from taking this drug.

  If you are sensitive to MSG, its negative effects may be exaggerated when you’re taking diuretics.

  What Nutrients Do They Deplete or Throw out of Balance? Minerals, especially sodium, potassium, calcium, magnesium, and zinc. Zinc is crucial to proper immune system functioning, wound healing, and thyroid function. Diuretics can cause a depletion of vitamin A, which many Americans are already deficient in.

  What Else to Take While Taking These Drugs. A good mineral formula that includes zinc, copper, boron, iodine, cobalt, manganese, molybdenum, vanadium, chromium, selenium, and if you’re a premenopausal woman, iron.

  Be sure you’re getting both beta-carotene and vitamin A in your multivitamin formula. Eat plenty of fresh fruits and vegetables.

  Examples of Beta-Blockers

  Beta-adrenergic-blocking agents: acebutolol (Sectral); atenolol (Tenormin); betaxolol (Kerlone); bisoprolol fumarate (Zebeta); esmolol (Brevibloc) used for abnormal heartbeat; Levobunolol; metoprolol (Lopressor, Toprol XL); nadolol (Corgard); Oxyprenolol; Penbutolol sulfate (Levatol); pindolol (Betapindol, Calvisken, Decreten, Durapindol Visken); propranolol (Betachron E-R, Inderal, Inderal LA, Avlocardyl, Deralin, Dociton, Inderalici, InnoPran XL, Sumial); sotalol HCl (Betapace, Sotalex, Sotacor) used for irregular heartbeat; timolol maleate (Blocadren)

  Alpha/beta-adrenergic blockers: arotinolol (Almarl), carvedilol (Coreg, Dilatrend, Eucardic, Carloc), celiprolol (Cardem, Celectol, Celipres, Celipro, Celol, Cordiax, Dilanorm, Selectol), labetalol (Normodyne, Trandate)

  Beta-blockers, or beta-adrenergic-blocking drugs, are somewhat outdated, but some physicians st
ill use them to treat high blood pressure. The downside of these drugs is that they can actually cause CHF, heart attacks, strokes, and asthma. Beta-blockers can cause serious arrhythmias (irregular heartbeats) and may worsen blood vessel problems that reduce circulation to the extremities, such as in diabetes. Asthmatics should never take a beta-blocker as it may trigger life-threatening airway spasms.

  According to an article published in a 2007 issue of the Journal of the American College of Cardiology that reviewed 10 studies on using beta-blockers to control high blood pressure, diuretics and other blood pressure drugs work better to control blood pressure and have fewer side effects. The article points out that beta-blockers may be useful for treating patients who have had a heart attack or who have heart failure, but they shouldn’t be routinely used to treat high blood pressure.

  For years beta-blockers have been routinely given to patients who might be or are at risk of heart disease, before they have surgery. The practice is said to reduce the risk of heart attack and abnormal heart rhythms after surgery. The POISE (perioperative ischemic evaluation) study, a large, double-blind study out of Canada and published in the journal The Lancet, found that compared to a placebo, patients who were given beta-blockers before surgery were one-third more likely to die within a month, had doubled the risk of stroke, and were more likely to have clinically low blood pressure or low heart rate. The specific beta-blocker used in this study was metoprolol (Toprol).

  Beta-blockers can cause serious new arrhythmias, dangerously low blood pressure, abnormally slow heart rates, CHF, heart attacks, gastrointestinal bleeding, liver and kidney damage, and reduced white blood cell count, and they interact dangerously with many other drugs.

  What Do They Do in the Body? Beta-blockers reduce blood pressure by slowing the heart rate, reducing the force of contractions of the heart muscle, and relaxing the arteries.

  What Are They Prescribed For? High blood pressure, especially in combination with a thiazide diuretic, and many other heart disease symptoms such as angina, irregular heartbeat, and recovery from some types of heart attacks, migraines, tremors, and anxiety.

  What Are the Possible Side Effects? Dozens of “adverse effects” have been reported by people taking beta-blockers, which are listed on the drug information insert. If you have any type of new symptoms while on this drug, even if you have been on it for a long time, check with your physician and read the drug information insert. If you don’t have the insert, either ask your pharmacist for one or look it up online. See the “Resources and Recommended Reading” section at the back of this book for online sources of drug information.

  Dizziness and fatigue are two of the most common complaints of people on these drugs. That may mean they’re taking too much. These side effects are considered “mild” by drug companies and physicians, but they can cause depression and reduce the activities you can participate in—yet another good reason to lower your blood pressure naturally!

  A large, double-blind, multicenter randomized trial (the National Heart, Lung and Blood Institute’s Cardiac Arrhythmia Suppression Trial) found that in certain types of heart attack patients, some beta-blockers caused a significantly higher death rate and risk of a second heart attack compared to patients who did nothing.

  Beta-blockers can cause serious arrhythmias and may worsen blood vessel problems that reduce circulation to the extremities, such as in diabetes. They can also lead to cardiac failure by overdepressing the ability of the heart to contract.

  Like all drugs that are prescribed to lower blood pressure, beta-blockers can easily send blood pressure too far in the other direction, causing hypotension, or low blood pressure. Symptoms of hypotension include dizziness when standing, sweating, and fatigue.

  Other side effects can include muscle weakness, dizziness, hypo- and hyperglycemia, impotence, eye problems, worsening of lung problems, depression, joint pain, and rarely, anaphylaxis, a severe allergic reaction.

  Kidney and liver damage may be made worse by beta-blockers and can cause unpredictable increases in drug levels.

  Some beta-blockers can send your cholesterol levels in the opposite direction that you want them to go: increased LDL, VLDL, VH, and triglycerides, and decreased HDL.

  Sudden withdrawal from beta-blockers can be dangerous.

  The beta-blockers propranolol and atenolol reduce the nighttime production of melatonin, a brain hormone essential for good sleep. Melatonin deficiency has been implicated in breast cancer.

  Beta-blockers can deplete CoQ10, which can cause fatigue and muscle pain.

  CAUTION!

  Think Twice About Taking These Drugs If . . .

  • You have CHF or irregular heartbeat.

  • You have asthma or other lung diseases such as chronic bronchitis and emphysema.

  Most beta-blockers can suppress symptoms of diabetes and an overactive thyroid (hyperthyroidism). Since beta-blockers can cause or prolong hypoglycemia, use caution if you are diabetic.

  What Are the Interactions with Food? Taking atenolol (Tenormin) and sotalol (Betapace) with food may reduce or slow their action. Taking labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), and propanolol (Inderal) with food may increase drug levels. Taking propanolol with a high-protein meal or with alcohol may increase drug levels even more.

  Other Tips on These Drugs. They may interfere with glucose tolerance tests, insulin tests, glaucoma tests, and a variety of other blood and urine tests.

  Examples of ACE inhibitors

  Inhibitors of angiotensin-converting enzyme): benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec, Renitec), fosinopril (Monopril), lisinopril (Lisodur, Lopril, Novatec, Prinivil, Zestril), moexipril (Univasc), perindopril (Coversyl, Aceon), quinapril (Accupril), ramipril (Altace, Tritace, Ramace, Ramiwin), trandolapril (Mavik), zofenopril

  Angiotensin antagonists: losartan potassium (Cozaar), candesartan cilexetil (Atacand), eprosartan mesylate (Teveten), irbesartan (Avapro), telmisartan (Micardis), valsartan (Diovan)

  What Do They Do in the Body? ACE inhibitors lower blood pressure by blocking the production of a series of chemicals, especially one called angiotensin, that the body releases to raise blood pressure. When blood pressure drops, the kidneys release a hormone called renin, which in turn stimulates the production of angiotensin, which has its own potent actions, including constricting the arteries to raise blood pressure. Angiotensin also stimulates the release of the adrenal hormone aldosterone, which gives cells signals to hold on to sodium and release potassium, thus allowing fluid buildup, another way of raising blood pressure.

  Thus taking an ACE inhibitor has a very powerful effect on an important blood-pressure control mechanism, which is good news when your blood pressure needs lowering in the moment. But this can be bad news when it needs to rise, because the mechanism that allows it to do so is suppressed.

  ACE inhibitors are a classic example of suppressing a symptom to treat a disease. The danger, of course, is that the disease progresses underneath, and a whole new set of symptoms and risks are created by the drug.

  What Are They Prescribed For? High blood pressure, especially in combination with thiazide diuretics. Some of the ACE inhibitors are prescribed for CHF and for heart attack patients after a myocardial infarction, and sometimes for diabetic nephropathy (kidney disease).

  What Are the Possible Side Effects? The most common side effect of ACE inhibitors is an annoying, persistent, nagging cough. While this isn’t directly life threatening, it’s a big energy drain and it’s enough to create a loss of sleep. ACE inhibitors have probably gotten more people stuck on the drug treadmill than any other single drug. Why? They take an ACE inhibitor, get a cough, and then complain to their physician. Instead of taking them off the ACE inhibitor, the physician prescribes a cough suppressant, which causes insomnia, so the physician prescribes a sleeping pill, which is addictive, and so on.

  The ACE inhibitor captopril (Capoten) can cause a large reduction of white blood cells (neutrope
nia), seriously compromising the immune system. This seems like an unacceptably severe side effect when there are so many alternatives. The risk of neutropenia is especially high for people with some kinds of kidney problems. There is some evidence that other ACE inhibitors could also cause neutropenia, although not as frequently. Captopril may also cause kidney damage.

  ACE inhibitors can cause a serious allergy-type reaction (anaphylactic) that causes swelling, especially around the head and neck, which can be fatal when it obstructs airways.

  Because ACE inhibitors block the release of the adrenal hormone aldosterone, which is an androgen, or male hormone, they have been known to cause symptoms of feminization in men such as breast enlargement. This same mechanism also blocks signals telling the body to release potassium, which can result in excessively high levels of potassium.

  As with all drugs that lower blood pressure, there is always the risk that the blood pressure is lowered too much or that some other factor such as food, another drug, diarrhea, dehydration, exercise, or overheating will combine with the drug to lower blood pressure too far.

  The ACE inhibitors ramipril (Altace) and fosinopril (Monopril) can aggravate existing liver disease. There have been cases where people taking ACE inhibitors suffered liver damage and liver failure (death), as well as kidney damage and kidney failure.

  Other side effects of ACE inhibitors are dizziness (common with all drugs that lower blood pressure), headaches, irregular heartbeat, chest pain, diarrhea, nausea, fatigue, shortness of breath, rash, sexual dysfunction, vision disturbances, taste disturbances, and weakness.

  There have been dozens of “adverse effects” reported by people taking ACE inhibitors, so don’t rule out a symptom as a side effect of this drug just because it’s not on this list. The latest to make the (unofficial) ACE inhibitor side effects list is sleep disturbances and nightmares, which apparently go away rapidly when the drug is stopped.