“It takes 50 years to get a wrong idea out of medicine, and 100 years a right one into medicine.” —John Hughlings Jackson, neurologist
Diuretics can relieve the symptom of fluid congestion by forcing you to pee more. But, diuretics:
- increase risk of heart death by 50% (Ahmed et al 2007)
- increase risk of overall death by 31% (Ahmed et al 2006).
- are predictive of worse kidney function by 575% (Breidthardt et al 2010)
Research shows that people with heart failure may actually have the failure due to diuretics (Bayliss et al 1987). Furthermore, withdrawal of diuretics cause patients to see improvements in kidney function (Galve 2005). And, if the doctor increases your dose of loop diuretics, he’s increasing your chances of death (Hasselblad et al 2007).
In simple terms, stop using diuretics if you want to live.
Loop diuretics shut down your kidneys’ ability to reabsorb sodium, a primary function of kidneys. Diuretics tell kidneys “you can’t do what you do”.
As diuretics strip kidney function, an emergency mechanism in our body, the renin-angiotensin-aldosterone system (RAAS), is triggered. RAAS sacrifices the health of our heart and arteries to keep blood pressure at a safe level for the short-run.
Loop diuretics are essentially “low-salt diet pills”, starving your body of salt by overriding your kidneys. Unfortunately, low-salt diets are dangerous, causing a stiffening of the heart, artery plaque, heart death, and significantly higher mortality rates. Salt doesn’t “give” you high blood pressure; salt gives you the blood pressure your body needs for what cardiovascular health is left.
In a nutshell, diuretics trigger rapid destruction of your cardiovascular system to give you temporary relief of congestion. This is like giving away your pension plan for steak and potatoes.
A low-salt diet is practically the worst thing in the world for your heart. But for some reason, doctors put heart patients on low-salt diets, plus loop diuretics; a double-whammy. This is paying for “how to become an ancestor in a hurry”.
The kidneys are like the “thermostat” for the heart. Kidneys control the RAAS system, which controls heart health. Regular consumption of organic sea salt allows the thermostat to select the proper blood pressure for the thermostat to keep working correctly. Diuretics are like gambling that pills are a better thermostat. So, how many prosperous gamblers do you know?
In a classic display of doctors thinking they know more than our bodies, most heart patients are prescribed an ACE inhibitor to slow down the RAAS, plus diuretics, which ramp-up RAAS. Thus begins the familiar toxic cocktail that puts our benelles to work on opposite tasks, mindlessly working them like zombies into sickness and death. Really; what would happen to a machine told to go forward and backward at the same time?
Using chemicals to tell your benelles “you can’t do what you do” is dangerous, and it’s the calling card of our healthcare system. Diuretics are an example of why the US healthcare system is broken: the middle class pays astronomical bills to doctors and Pharma for drugs that cause additional doctors visits, but which speed-up sickness and death.
Even doctors know diuretics are dangerous, as discussed by this academic paper (Chiong 2010), emphasis mine:
An attempt to randomize ADHF patients to diuretics or placebo is also viewed as unethical, as many consider it a medical emergency sufficiently frightening to the patient and accompanying persons. Most physicians are resistant to the idea of not intervening and reluctant to obtain informed consent for a clinical trial in emergent or urgent settings. The thought of a patient dying with untreated HF regardless of the evidence for benefit or harm of a particular treatment is usually regarded as unacceptable; the pressure to act becomes irresistible.
What Chiong is saying is simple. Patients and their families are scared shitless when told “it’s heart failure”. The pressure on the doctor to “do something” is so strong, the doctor simply gives what’s harmful because he has nothing else.
Let’s take the example of someone who slowly eats pounds of artificial chemicals over some years and gets heart and artery damage. The heart compensates by pumping harder to get through arteries that are like blocked hoses. As long as the heart is allowed to pump harder, the kidneys stay healthy and the RAAS system stays quiet. The heart and kidneys work together to compensate for decades of damage from high edible chemical load. But the doctor will enter and say, “Let’s get that blood pressure down!”, and commence to wreck the healthy teamwork and chemistry of the heart and kidneys.
In this example, the patient is not 100% healthy because of eating artificial chemicals for decades. But the only power the doctor has available is to prescribe chemicals that will damage the kidneys, accelerate the heart problem, and cause early death. Essentially, heart patients everywhere are exercising their “right to die” by following doctor’s orders.
Here’s how truth in disclosure might look. A newly-diagnosed heart failure patient would receive easy-to-understand information about how her heart, lungs, kidneys are doing an outstanding job of compensating for the illness. Then it would be explained the condition may feel sudden, but was probably brought on by decades of poor habits. Lastly, the doctor might say, “We can put you on some medicine which might help you with shortness of breath, but will increase your chances of kidney death, heart death, as well as an overall early death.”
Telling the truth would help fix our bankrupt healthcare system. Nonsensical medical costs are eroding the middle class, but who wants treatment after they find out it increases chances of death? Hell, they should be paying us for organic damages.
Doctors are not bad people, but they live in a system where they have to lie and have to cause harm to earn a living. This ultimately traces back to the government. To fix healthcare, the government must allow a “less is more” benelles approach, where doctors can earn as much money by advising patients with evidence and truth as they do ordering tests and writing prescriptions. Sure, Pharma will have a hissy, but doctors won’t care because they would make the same. Our health is more than a business transaction, or a taxable sub-component of GDP; our health is our life.
Until politicians do the right thing, patients can help themselves. In a group of heart failure patients who stopped diuretics for 3 months: kidney function improved, blood sugar levels improved, and blood pressure stayed stable (Galve 2005). If we could call them up, I bet the patients would tell us they felt better too.
Ahmed A, et al “Heart failure, chronic diuretic use, and increase in mortality and hospitalization: an observational study using propensity score methods” European Heart Journal May 2006. 1431-1439 doi: http://dx.doi.org/10.1093/eurheartj/ehi890
Ahmed A, et al “A propensity-matched study of the effects of chronic diuretic therapy on mortality and hospitalization in older adults with heart failure” Int J Cardiol Apr 10, 2008; 125(2): 246–253. doi: http://dx.doi.org/10.1016/j.ijcard.2007.05.032
Bayliss J, et al “Untreated heart failure: clinical and neuroendocrine effects of introducing diuretics” Br Heart J Jan 1987. 57(1):17-22 weblink
Breidthardt T, et al “Effect and Clinical Prediction of Worsening Renal Function in Acute Decompensated Heart Failure” Am J Cardiol Mar 2011. 1;107(5):730-5. doi: 10.1016/j.amjcard.2010.10.056
Chiong J, Cheung R “Loop Diuretic Therapy in Heart Failure:The Need for Solid Evidence on a Fluid Issue” Clin Cardiol Jun 2010. 33(6):345-52. doi: 10.1002/clc.20771
Galve E, et al “Clinical and neurohumoral consequences of diuretic withdrawal in patients with chronic, stabilized heart failure and systolic dysfunction” Eur J Heart Fail Aug 2005. 7(5):892-8. doi: 10.1016/j.ejheart.2004.09.006
Hasselblad V, et al “Relation Between Dose of Loop Diuretics and Outcomes in a Heart Failure Population: Results of the ESCAPE Trial” Eur J Heart Fail Oct 2007. 9(10): 1064–1069. doi: 10.1016/j.ejheart.2007.07.011