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Diuretics in Bodybuilding: The good, the bad, the tragic

Athletes preparing for bodybuilding competitions strive for the most muscular and hardest look they can possibly achieve. This involves several months or years of building muscle, followed by several weeks of a restricted diet and cardiovascular training in an effort to reduce body fat to the lowest possible level to bring out all of the definition of the muscle. The judges look for the biggest, hardest and driest bodybuilder with the best shape. Rarely will a bodybuilder win a contest if he/she is not the hardest and driest, even if his or her shape and size is superior to the other athletes. The less water you are carrying on stage, the better you will place. In the final week of preparation prior to a competition, bodybuilders strive to fill out their out the muscles with the addition of carbohydrates, and at the same time reduce fluids in the body to remove every last bit of subcutaneous fluid in between the muscle and the skin to create the fullest and driest look possible. While these athletes appear to be at the highest level of physical fitness and health while on stage, they are actually often on the brink of very serious health issues due to lack of hydration and electrolyte imbalances caused by the lack of bodily fluids.

Reducing water from the body in preparation for a contest can be aided in a multitude of ways. Often, most or all of these methods are employed. They include cardio training in heavy garb, elimination of sodium from the diet, excessive water intake followed by a sudden and drastic reduction of water intake, drinking mineral and electrolyte free distilled water, herbs and natural water-reduction substances and most effectively; medicinal diuretics. All can be dangerous to a degree as they strive to interfere with the body's natural homeostasis of fluid and electrolyte balance and can disrupt multiple body processes. The body, however, is a master of keeping itself in a reasonable balance. It can adjust itself in most instances to this by adjusting electrolyte balances and holding on to just enough fluids to keep functioning properly. Diuretic drugs, however, are powerful enough to override the body's defenses and create havoc in the body.

Throughout the history of bodybuilding, there have, unfortunately been several deaths and multiple hospitalizations due to contest preparation and standard bodybuilding practices. These hospitalizations and deaths are rarely due to steroids and other hormones, lifting injuries, powerful stimulant-based fat-burners or highly restrictive diets. In fact, there is no direct evidence connecting the use of anabolic steroids to the death of any athlete, only indirect or circumstantial evidence. Rather, most hospitalizations and deaths are, in fact, overwhelmingly due to the use and abuse of diuretic drugs. Some of the most famous instances include:

In 1988, pro bodybuilder Albert Beckles collapses and convulses while on stage. He is subsequently resuscitated by paramedics and found to be suffering from diuretic-induced dehydration.

In 1992, pro bodybuilder Mohammed Benaziza dies after competing in a contest in Europe. An autopsy shows that he was severely dehydrated and experienced cardiovascular failure. He was age 33. He had used a combination of diuretics for the show.

In 1994, pro bodybuilder Paul Dillett cramps onstage while posing at the Arnold Classic. He is carted off the stage. Once again, the problem was extreme dehydration and electrolyte imbalance caused by Paul’s use of Lasix. Paul survived.

There was also the 1996 case of Andreas Munzer, renowned for his freaky conditioning, who died after his liver and kidneys failed. The autopsy revealed his electrolytes were completely out of balance.

These are just the most publicized cases; numerous other deaths and hospitalizations didn't get any publicity at all.

To understand why they are so harmful, we must first briefly understand diuretics.

There are three main types of diuretics; potassium-sparing, osmotic and loop diuretics:

Osmotic diuretics - These are injectable drugs that act on the kidneys by essentially instructing the kidneys to release everything that comes in. Osmotic diuretics are non-discriminatory, meaning they remove any and all water that comes to the kidneys, regardless of proper electrolyte balance. These drugs override the function of the kidneys and can cause renal (kidney) failure. Osmotic diuretics are not overly common in bodybuilding.

Potassium-sparing diuretics - These diuretics are milder, however create problems of their own. They reduce the re-absorption of sodium and water through the kidneys and flush them out of the body. They do, however discriminate by not flushing potassium(K) from the system. While these are slower acting and more tolerable, they can cause an excess of K in the body as they do not allow it to flush and keep the balance of electrolytes intact. This can cause, in extreme cases, cardiac dysrythmia (irregular heartbeats) and even sudden death in the most extreme cases.

Loop diuretics - These are far and away the most commonly used diuretics in bodybuilding and the culprit in the vast majority of bodybuilding hospitalizations and deaths. Furosimide (brand name Lasix) is easily the most widely used loop diuretic and is cheap and readily available. Loop diuretics are used medicinally to treat high blood pressure and edema; and in cases of blood poisoning are used to flush the blood of toxins and foreign agents. Loop diuretics act directly on the kidneys and are another non-discriminatory diuretic in that they remove any and all fluids coming through the kidneys. They have a profound effect on the electrolyte balance as they literally flush potassium, sodium and calcium from the body with whatever fluid enters. Side effects include a drop in blood pressure, thickening of the blood (due to lack of fluids), fainting, renal failure, extreme cramping due to electrolyte imbalances, and death (due to muscular cramping of the heart). The drug is extremely powerful and, combined with other water reduction techniques employed by bodybuilders in contest preparation, it doesn't take much Lasix to cause extremely detrimental health effects.

The dangers of medicinal diuretics can't be understated, and, are generally unnecessary for contest preparation. Whichever method you choose in order to get ready for your next contest, please be diligent and do your research thoroughly on what you are doing and do not take your gym buddies word for it.

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