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Diuretics and Exercise
Working out with water pills.

Dangerous Water Pills
Dangerous Water Pills

A typical bodybuilder, standing on the stage for competition, has spent years preparing for the moment. Behind those physiques are hundreds of weight training workouts, countless miles of cardio and an attention to dietary detail bordering on the absurd. Their bodies appear (for some) to be the pinnacle of physical perfection.

One of the defining characteristics of those competitions is the extreme level of definition that's apparent in the top competitors. It looks like you can see every muscle, every fiber, as clearly defined as a medical drawing. The irony is that while they appear to be at their physical peak, many of the contestants have put their lives at risk, and it's all for the sake of shedding a little water weight.

Bodybuilders, jockeys, wrestlers, models and actors who must look a certain way and weigh a specific amount, often complain about "holding water." What they're talking about is the "puffy" look where muscular definition is blurred or a couple extra pounds put on because of extra-cellular water. To drop the fluid, they resort to sauna suits, non-stop spitting and other extreme methods of dehydration.

One of the most dangerous things they do is use a class of drugs called diuretics, commonly referred to as water pills, to drop the water. Unfortunately, many people who have made that choice paid with their lives.

In 1990, Mohammed Benaziza had been winning small bodybuilding competitions until he entered The Night of Champions. That win propelled him to bodybuilding stardom and Joe Weider nicknamed him the Killer of Giants. In 1992, Benaziza entered the Mr. Olympia competition. Shortly after completing the contest, he was found dead in his hotel room. An autopsy later revealed extreme dehydration from diuretics, which led to heart failure. Benaziza was only 33 years old.

In 1996, Andreas Munzer was known for his extremely low bodyfat levels and hyper muscularity. After being admitted to the hospital for stomach pain on March 12, doctors began surgery to stop the bleeding from his stomach. Shortly afterward his liver failed, followed by his kidneys. He died two days after being admitted to the hospital. The autopsy revealed his electrolytes were seriously out of balance and his potassium was extremely high, both classic problems caused by diuretics. He was only 31 years old.

Three classes of diuretics.

Loop diuretics are the most common ones abused by bodybuilders because they're cheap, powerful and easily accessible. They include Lasix (furosemide), Bumex (bumetanide) and Demadex (torsemide). If you have high blood pressure, edema or blood poisoning, loop diuretics can be a lifesaver. They flush calcium, potassium and sodium from the body with any fluid that enters. But they also have a profound effect on the body's electrolyte balance and taking even small doses without medical supervision can create complications fast.

Osmotic diuretics (also called thiazide-like) are injectable drugs that include Esidrix (hydrochlorothiazide) and Zaroxolyn (metolazone). Just like loop diuretics, osmotic diuretics are non-discriminatory. That means they remove all the water that enters the kidneys regardless of the bodies electrolyte balance. Kidney failure is a serious risk because these drugs override the function of the kidneys.

Potassium-sparing diuretics include Aldactone (spironolactone), Inspra (eplerenone) and Midamor (amiloride). Just as their name implies, potassium-sparing diuretics help your body retain the mineral potassium, that's why they're often prescribed in combination with other diuretics. Potassium-sparing diuretics are slower acting and tend to be more tolerable. That doesn't mean they're safe. As potassium builds up it can lead to cardiac dysrhythmia (irregular heartbeats) and in extreme cases sudden death.

It all seems so simple. A couple days before a competition, pop a few "water pills" and you'll simply pee the fluid away. How risky could something like that really be?

Some of the complications brought about by diuretics include blurred vision, dehydration, dizziness, fainting, a drop in blood pressure, extreme exhaustion, extreme muscle cramping, thickening of the blood, headaches, fever, vomiting, heart arrhythmia, heart failure, kidney failure, and death. Combine diuretics with other products such as bodybuilding supplements or stimulants like caffeine, and the risk of serious side effects increases.

Here's the truly astonishing part. At many major bodybuilding events, the only drugs they test for are diuretics. They don't test for anabolic steroids. They don't test for growth hormones. They don't test for stimulants. They believe diuretics are more dangerous than any of those and they don't want competitors dying onstage.

Diuretics can be lifesaving drugs when properly prescribed by a doctor. But to take them as a shortcut to getting cut, lean or in preparation for a contest is simply gambling with your life.

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  • Are you kidding?

    There are trainers that tell their clients to go on diuretics for a week or two in order to better evaluate their muscular definition. The first time I heard that I thought it was a joke. But when one of my clients confirmed it happened to him, I was horrified.

    The idea that a personal trainer would put their clients life at risk in order to "better evaluate" muscle definition is a criminal act. There are dozens of no-risk ways to evaluate the fitness of clients and design appropriate workout programs for them. You can give a Functional Movement Screen, a bodyfat test, a resting metabolic rate test or several other options.

    If you have a trainer that recommends diuretics, you're dealing with someone who has no concerns about your life or well-being. Stop training with them immediately. If they try and sell you diuretics, contact the authorities and have them put in jail. The life you save may be your own.