One of the most common complaints of a bodybuilder on the day of a show is “holding water.” This term describes the blurring of muscular definition caused by a relative excess of extra-cellular water. Athletes in other sports, particularly those with weight classes or limits, will also complain of “holding water,” referring to the extra pounds that might be shed through dehydration, rubberized sweat suits or nonstop spitting.
It is a common practice among these athletes to use a class of drugs called diuretics to shed the excess water. While diuretic use is most obvious in bodybuilding, its abuse is more prevalent in the sports of wrestling and horseracing (both the horses and jockeys), as well as the profession of modeling.
Diuretics drugs increase the amount of water lost through urinating. Most commonly used in the treatment of hypertension (high blood pressure), they may also be used to treat other medical conditions, providing lifesaving therapy in critical situations.1,2 Despite the benefits offered by diuretics, there are also definite risks, including sudden death. The choice to use diuretics should never be approached lightly. In fact, the wisest decision regarding diuretics would be never to use them at all. Bodybuilding has experienced tragedies, with athletes dying on and offstage. The single drug implicated in most bodybuilder deaths is a potent diuretic known as Lasix.
Take Lasix, Pee Like a Racehorse
Lasix is the brand name for the drug furosemide, which is marketed as a generic and may be manufactured under a varietyof trade names.3 Contrary to common belief, the generic drugs, including those of foreign manufacture, have proven to be bioequivalent (containing the claimed amount of drug, with the same effect on the body).4-6 This makes Lasix, or an equivalent generic, a very inexpensive drug, particularly if purchased in Mexico. The low price of Lasix and the obvious effect of the drug (literally peeing like a racehorse) seem to have kept counterfeit products from infiltrating the black market.3
Diuretics act on the kidney through different mechanisms; some are milder and relatively safe, while others are extremely potent and carry greater risk. Lasix, as a member of the class called “loop diuretics,” is one of the most powerful and dangerous diuretics used in the United States. Understanding how Lasix works requires a fairly extensive knowledge of kidney anatomy and physiology,1 but it can be explained in general terms sufficiently to appreciate the effect and risks inherent in this drug.
The kidney filters a number of waste products from the blood and clears out excess ions (or electrolytes). This is a critical function of the kidney, as it maintains blood pressure in a healthy, normal range when functioning properly. The ions may be excreted into the urine after being filtered, or they may be returned to the blood, depending upon the blood pressure. If it is high, more ions are excreted (peed away). This reduces blood pressure by pulling more water into the urine, so the body dehydrates to a degree in order to reduce the blood pressure.1 The extracellular water comes from the plasma (the watery part of blood) and interstitial fluid. Interstitial fluid is the water that lies between cells, and accounts for the smooth look that blurs muscular definition. So, the advantage to bodybuilders of using diuretics is clear; it increases muscular definition by removing interstitial water.
The Price You May Pay
This does not come without cost. In the pool of urine created by the diuretic effect of Lasix, too many electrolytes can be lost, as the effect of the drug overpowers the natural balance maintained by an unadulterated kidney. In a very short time, a matter of hours, a person can enter into an electrolyte imbalance that can affect the function of the brain, muscles and heart.1,7-10 If the electrolyte imbalance is severe enough, the heart’s rhythm becomes irregular and may stop. When the heart stops, the body dies… quickly.
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