“Dear Pharmacist
I take a water pill (diuretic) for blood pressure. Now, I have to take Boniva for osteopenia. Is there a connection? What’s next for me? I’ve read you for years so please pick my question for the paper.” –H.J., Ocala, Florida
Answer: Oh yes, definitely connected! I don’t mean to be crass but your diuretic makes you lose water volume (the point) and with every bathroom trip, you pee out minerals! Many people are saying “Aha” now, because you started out taking a blood pressure med, then at some point, you were prescribed a bone building drug for osteoporosis. I’ll share my side effect solutions because I realize you have to, need to (or want to) take your prescription medications.
You’ve asked, “What’s next for me?” Depending on the specific diuretic you take, you may eventually need an antidepressant, something for leg cramps and tinnitus (ear ringing)… you may need a drug for heart arrhythmias, all that to counter the mineral and electrolyte deficiencies that result from the drug mugging effect of drug number 1, your blood pressure drug!
Shocked? When side effects due to the drug nutrient depletion (drug mugging) are not recognized you’re get a new ‘disease’ and a new medication for it.
This year, an estimated 163,000 people will suffer memory loss (perhaps Alzheimer’s) due to various prescription drugs that mug brain nutrients. About 61,000 people will hear the words “Parkinson’s disease,” but you won’t realize it was drug-induced by all sorts of other medications! Another 32,000 of you will suffer a hip fracture from a drug-induced fall, and almost 8,000 people will die from internal bleeding which may be caused by “non-steroidal anti-inflammatory drugs” or NSAIDs.
This gets me fired up! It’s why I wrote Drug Muggers (Rodale 2011) for you, because 75 percent of doctor’s office visits end with the physician giving you a prescription for a medication and you need me to protect you! If you need a particular medication that is fine, I’m not telling you to stop your medicine. Instead, here are several side effect solutions to ask your practitioner(s) about. Don’t make changes without your physician’s approval:
Parsley or Dandelion- These are gentler diuretics, less likely to cause the harsh depletion of minerals; also less likely to cause dehydration in low doses. Let me elaborate on parsley for a moment because it is among my favorite herbs. It supports cardiovascular and nerve health because it contains folate. Folate is a natural B vitamin (often erroneously referred to as folic acid) and folate converts inflammatory homocysteine to an otherwise harmless molecule. (For the best brand of folate, click here, this lozenge is biologically active and therefore body-ready, your cells take it up like a sponge). Parsley supports kidneys and may aid in kidney stone conditions (discuss with your doctor). Dandelion is great for the liver, and it contains a prebiotic to support intestinal health. Both dandelion and parsley, being diuretics, help reduce blood pressure. Too much of any kind of diuretic can cause dehydration of course.
Goldenseal- This is a fabulous diuretic herb that not only eliminates toxins (and fluid) from the body but it also supports the digestive tract which is sometimes harmed by medications. Goldenseal is a strong diuretic so as it reduces fluid, it takes many toxins with it, plus it naturally reduces blood pressure. (Warning not to combine with other blood pressure drugs it could reduce it too much). Goldenseal is known to help with heartburn by gently reducing stomach acid; it is calming and cleansing to the body if you get a high quality brand. Because it supports digestive health in a broad way, it may be used to help both diarrhea and constipation, depending on the condition.
Marshmallow Root- Bisphosphonate drugs for bones can irritate the esophagus in sensitive folks. Marshmallow root or slippery elm tea soothe and protect your esophageal tract. This herb is particularly useful to people who take medications like Actonel, Fosamax or Boniva because those drugs affect the delicate tissues of the esophageal tract. So the marshmallow (or slippery elm) works to coat and protect the tissue. In fact, I love marshmallow root so much, it’s always in my house as an infusion. I taped a video about how to make it on Youtube. Slippery Elm is an incredible herb that you can also use to protect your esophagus, colon and urinary tract, I taped a video on how to make a gruel here.
Green foods and supplements- Think of spinach, kale, chlorophyll supplements or wheatgrass shots. These are full of minerals to restore what the drug mugger (diuretic blood pressure pill) is mugging from you. Take me seriously, mineral deficiency leads to heart beat irregularities, faintness, dizziness and depression. Sunchlorella granules are great for smoothies and the Sunchlorella tablets are also available.
Coconut water- Unsweetened, unheated coconut water will restore electrolytes if you have to take diuretics or lisinopril, a popular blood pressure drug. There is also an electrolyte supplement that you can take that tastes really good called Skratch and it’s a delicious flavored powder that you mix with water. There’s another one that is a concentrate called E-lyte. You put about a capful of this liquid into plain, filtered water and you drink that; it tastes a little salty but that is the point.
Correct diarrhea- If you have diarrhea, you need to fix that because it means that nutrients are just pouring right out of you. You are not going to absorb the nutrients needed to strengthen bones. Among the most important nutrients for bone strength: Calcium, manganese, magnesium, phosphorous, vitamin D, vitamin K2, boron, strontium and many others. Sometimes chronic diarrhea is tied to consuming gluten or other grains, or it could be poor probiotic status, or even parasites from something you’ve touched or eaten. Whatever the cause, work towards correcting diarrhea if it applies.
Do you have enough stomach acid? You need that to breakdown food and get the nutrients from it. Many of you take acid blockers (do not stop on account of what you read here!) but you need to know that reduced stomach acid means reduced ability to breakdown food, which means reduced ability to absorb nutrients (many of which are needed for bone strength). It’s all reversible if you heal your gut. Some people (like myself) do not even take an acid blocker, and still don’t make enough acid so I supplement with betaine with each meal. This is termed “hypochlorhydria” for low acid. Put these terms in my search box to see my other articles on the topic.
Just as a side note, I want you to know what nutrients are “mugged” by hydrochlorothiazide, one of the most popular diuretics on the planet, and it’s sold by prescription. I’m going to tell you what is mugged so that you can ask your doctor about supplementing with vitamins/minerals (so you can put back what you’re losing). These are the depletions: CoQ10, thiamine, folate, melatonin, potassium, zinc, magnesium, riboflavin and vitamin C.
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Suzy Cohen, has been a licensed pharmacist for over 30 years and believes the best approach to chronic illness is a combination of natural medicine and conventional. She founded her own dietary supplement company specializing in custom-formulas, some of which have patents. With a special focus on functional medicine, thyroid health and drug nutrient depletion, Suzy is the author of several related books including Thyroid Healthy, Drug Muggers, Diabetes Without Drugs, and a nationally syndicated column.
