Water pills are natural or manufactured substances that people typically ingest to cause the kidneys to excrete more sodium and produce more urine. Better known as diuretics, they come in four major varieties that vary in mechanism and effectiveness. Doctors prescribe them as a treatment for a variety of conditions such as high blood pressure and edema. Some people use them for weight loss, as well, but this is controversial and not recommended, especially for long-term results. Manufacturers often use natural substances such as coffee as a base for diuretic formulations, so in some cases, a person can fall back on these natural ingredients to get the same effects the pills offer.
Doctors have four major types of water pills they typically prescribe, and they may prescribe more than one kind at a time, depending on a person’s needs. The first two types, loop and thiazide, work very similarly. They interfere with the amount of sodium the kidneys reabsorb. The body has to pull water from the blood to flush this excess sodium away, so the volume of urine the kidneys make usually goes up.
An important distinction between these two kinds of diuretics is that loops act on the thick ascending limb of the loop of Henle in the kidney, which is responsible for as much as 25 percent of sodium reabsorption. Thiazides, by contrast, act on the distal tubule. This part of the kidney handles only about 5 percent of sodium reabsorption, so thiazides are not as effective in producing significantly more urine.
The third class is potassium-sparing. Loop and thiazide diuretics cause the body to lose potassium because of how they interact with sodium. This is potentially dangerous because a proper amount of potassium plays a role in causing the heart to beat properly. Potassium also relates to nerve and muscle function. Potassium-sparing versions compete with aldosterone or block sodium channels, so they have a slightly different mechanism, but the end result is still a small increase in urine output.
Carbonic anhydrase inhibitors are the last type of water pill. They help prevent sodium reabsorption by effecting the movement of bicarbonate. These versions act on the proximal convoluted tubule of the kidneys and aren’t very strong.
One common use of diuretics is as a blood pressure treatment. These medications take some water from the blood in order to flush extra sodium from the body, so they lower overall blood volume. The result is a decrease in blood pressure. This can lessen strain on the heart and lower the risk of damaged arteries and aneurysm. It also may reduce the odds of developing kidney disease.
The reduction of blood volume that occurs with use means that capillary hydrostatic pressure goes down. Subsequently, the amount of fluid that moves out of the capillaries and into the surrounding tissues decreases. Physicians therefore give people water pills if edema, or retention of water in the body tissues, is a problem.
Diuretics act on differing parts of the kidneys, which are primary filtration organs for the body. Medical professionals therefore may give water pills to patients as a means of flushing toxins from the body. Toxins are highly varied, however, so the way the body handles them is not always the same. The effectiveness varies depending on what toxins are involved.
Weight loss is a highly controversial use of water pills. Water is heavy and can contribute to a puffy or overweight appearance, so removing excess water is one way to shed pounds and look a little trimmer. Celebrities often use techniques to shed water weight before photo shoots and other events for this reason.
Using diuretics in this way is problematic for multiple reasons. They can create electrolyte imbalances because of how they affect sodium and potassium levels, which can cause problems such as muscle cramps and irregular heartbeat. Problems such as dizziness and fainting can happen if dehydration and a drop in blood pressure are too extreme. Lastly, the body naturally will try to replenish its supply of water once diuretic use ends, so weight loss under this method is not sustainable.
Psychologists and psychiatrists are especially concerned about the use of both water pills and laxatives in cases of anorexia nervosa and bulimia nervosa. Even though these medications are not meant to be taken for an extremely long time even in cases of medical necessity, individuals suffering from these conditions use them over extended periods to keep weight as low as possible. Stopping the use often means working through intense mental and behavioral issues such as distorted body image.
Natural Versus Manufactured Diuretics
Most prescription diuretics are formulated drugs people ingest. Manufacturing ensures that patients get better dosing and sometimes offers improved control of side effects. Many natural substances have a diuretic effect, however, and some manufacturers use them as a base for their formulations. Coffee, for example, is a well-known diuretic. Parsley, juniper, goldenrod and bearberry are additional alternatives.
The fact that natural substances can remove water from the body means that a person sometimes can control issues like high blood pressure, edema, kidney disease, electrolyte imbalances and dehydration through dietary changes, at least to a small degree. Some people find this to be more palatable and less cumbersome than taking medication, and they like that the dietary alternatives can eliminate potentially harmful additives. Regardless of what the source of the diuretic is, safety still requires a doctor’s supervision.