A high price to pay for fluid retention treatment

Over the last couple of weeks there have probably been more words written in Australian newspapers on the subject of diuretics than appear in all the medical libraries of the world.

By definition a diuretic is any substance which increases the flow of urine. More especially, however, the term is applied to specific medicines which are taken to achieve this effect – these medicines are commonly known as “fluid tablets”.

When the sulphur antibiotics were introduced in the 1930s, some were found to have increased urine flow as a side effect. With some modification of the chemical molecule this action was increased and the so-called thiazide diuretics became a reality.

If you read the sporting pages then, hydrochlorothiazide is now the most famous of this group of diuretics. It is one of the two active ingredients of Moduretic – said to be the drug of choice for quick-fix good looks.

In reality there is no such benefit from diuretics; but there are legitimate and effective uses for these medicines. Most often they are used alone, or in combination with other medicines, to control high blood pressure. In higher doses they increase urine flow which relieves fluid retention associated with heart, kidney, liver disease or before menstrual periods.

Generally speaking diuretics are not expensive medicines. Doctors have been encouraged to consider these products in preference to the more costly, more recently developed medicines when treating high blood pressure. But for one person, one such tablet has proved to be a very expensive option indeed.

Under International Olympic Committee Guidelines, followed by most sporting administrative bodies, diuretics are banned. They have been used in sports such as boxing or weightlifting where weight determines the category in which a competitor will participate; and they have been used to flush the body of other illegal substances such as anabolic steroids.

In any even t diuretics, along with many other “banned” medicines, can be used by athletes or sportsmen and women generally, when preapproval is given for the treatment of certain medical conditions.
Of course there are occasions when certain medications, perhaps like some sportsmen, are tarred unfairly with the same unsavoury brush.

In the case of steroids, for example, it is the anabolic variety that cause the problems and are blacklisted. Others, such as those known as cortico-steriods, and used in puffer form to prevent asthma, are permitted to be used.
On the issue of steroids and asthma, there is some good news. Recent studies have shown, contrary to earlier beliefs, that even repeated short courses of oral steroids when taken to treat asthma, have no adverse effect on bone development in children.

Nevertheless, according to Professor Colin Robertson from the National Asthma Council, the regular or continual use of high-dose inhaled steroids was of greater concern.

All this serves to emphasise the point that medication treatment should be tailor made for each person. Self medicating without the advice of a doctor or pharmacist can be fraught with danger. Using someone else’s medicine might be of no benefit or even unsafe.

And if you are a sportsperson simply wanting to look good, maybe you should visit the cosmetic counter rather than the dispensary.