[AnnieBL]

I'm glad you posted, Annie. I, too, am prediabetic and suffer from water retention in my feet and ankles. Fortunately, I do not suffer from slow healing sores on my lower extremities yet, so healing hasn't been an issue for me. I currently have rather low blood pressure, a genetic pre-disposition, hovering around 105/65 in the morning. I took a diuretic recently to gauge its effect on my foot and ankle edema and didn't notice much of an improvement. If anything, it may have induced a further lowering of my BP, I'm not sure. Anyway, getting further off the topic of this thread, I'm thinking of trying the diuretic again to get a better handle on its effect. I know that Spironolactone is a diuretic sometimes used to treat visible water retention, and since it also works as an AA, it might be useful in that regard as well. But because it also is used to lower blood pressure, I suspect it would not be appropriate for me. I do plan to discuss this with my doctor, but I'm interested in any thoughts you might have.

Clara

Clara - I shall be getting back to you on this, but since much of it may be even more off your original topic and indeed has little to do with NBE, and I'm probably rather tied up today, I'll do so later by PM, although feel free to quote or reuse anything that is relevant - it's not actually private, at least as far as this place is concerned.

[GoneGirl]

I'm glad you posted, Annie. I, too, am prediabetic and suffer from water retention in my feet and ankles. Fortunately, I do not suffer from slow healing sores on my lower extremities yet, so healing hasn't been an issue for me. I currently have rather low blood pressure, a genetic pre-disposition, hovering around 105/65 in the morning. I took a diuretic recently to gauge its effect on my foot and ankle edema and didn't notice much of an improvement. If anything, it may have induced a further lowering of my BP, I'm not sure. Anyway, getting further off the topic of this thread, I'm thinking of trying the diuretic again to get a better handle on its effect. I know that Spironolactone is a diuretic sometimes used to treat visible water retention, and since it also works as an AA, it might be useful in that regard as well. But because it also is used to lower blood pressure, I suspect it would not be appropriate for me. I do plan to discuss this with my doctor, but I'm interested in any thoughts you might have.

Clara

Clara - I shall be getting back to you on this, but since much of it may be even more off your original topic and indeed has little to do with NBE, and I'm probably rather tied up today, I'll do so later by PM, although feel free to quote or reuse anything that is relevant - it's not actually private, at least as far as this place is concerned.

Thank you so much, Annie, for the following PM which I found very interesting and useful. Although it's not directly related to NBE, it wasn't until after I began messing with NBE did I pay any attention to the edema in my lower legs. It seems to have gotten worse, though, and I'm wondering if that has been brought on by taking NBE herbs. I suspect not, but coming to a better understand of the condition and treatment options is a goal of mine now.

Hi Clara,

Diuretics are a very diverse group of natural and synthetic products, which act in a number of different ways. Some of them can have a significant effect on certain types of elevated blood pressure and some, particularly those of natural origin, less so. Many of them affect one’s electrolyte levels in various different ways, with possible adverse effects. To take a few examples, caffeine is diuretic, but does not when taken at any moderate level do much to affect average blood pressure, although it may cause short term fluctuations. Spiro does produce usually fairly modest reduction in blood pressure except for the small percentage of people whose elevated blood pressure is due to excessive aldosterone in which case it will produce a substantial drop in blood pressure which is diagnostic of that condition . Thus in intractable cases of high blood pressure it is sometimes prescribed for diagnostic purposes. If a substantial response occurs, then there are safer (but much more expensive) drugs that can be prescribed for long term treatment of hyperaldosteronism. Spiro is of course a powerful antiandrogen and also fairly effective in reducing liquid retention by the body, but it tends to raise potassium levels in the body, possibly to dangerous levels if excessive potassium is taken in from other sources. It was prescribed to me diagnostically, but it produced only a very modest reduction in my then very high BP which was proving resistant to treatment. For I know not what reason my then doctor continued with it after the first month, possibly on the basis that any slight reduction was better than none, but she did also prescribe a calcium channel blocker which proved remarkably effective in controlling my blood pressure. Incredibly she also prescribed a potassium supplement along with the spiro, but fortunately this dangerous was caught by the dispensing pharmacist. Tragically, she died of a drug overdose the night before my next appointment, with the end result that I stayed on spiro for eighteen months. I had already been on very high doses of beta blockers for a considerable time, as a result of earlier and largely ineffective efforts to control my blood pressure Such BB doses it turns out are highly effective in suppressing testosterone production, Once my prescriptions were finally overhauled, all the heart and BP medications were gone except an ACE inhibitor, ramipril, which has some BP controlling effect and is also believed to have some protective effect against type 2 diabetes, a diuretic (HCTZ) of which more later, and a calcium channel blocker (currently diltiazem), and my BP is fairly stable at levels similar to your own (somewhat on the low side of normal). I have however been keeping extensive BP records (typically three or four times a day) over the past several years and more recently also daily weight records. This helps me assess the effects of the different things I take and cyclical variations in weight are indications of changing levels of water retention in my body. My wife accuses me of being obsessive about this record keeping, and about my efforts to manage my diet to avoid blood sugar spikes, primarily by reducing intake of rapidly assimilable carbohydrates, and organising my reduced intake so as to limit glycemic load. The nurse practitioner who is now my PHP, and who was previously a cardiac nurse, and my cardiologist seem to find the records valuable and ask for them. I also try to restrict sodium intake to below recommended limits. I find that dietary lapses definitely tend to worsen my peripheral neuropathy symptoms.

Two diuretics in particular, both of which act on the kidneys in different ways, are very widely used in treating hypertension, and indeed commonly form the first line of attack on it. In many cases nothing more is needed, and both are very inexpensive. HCTZ (hydrochlorothiazide), already mentioned, which costs here less than $10 for a three month supply, is a thiazide type diuretic, and has the problems that its half life is short, and the dosage that can be taken without excessive risk of unacceptable side effects is quite limited. It is normally taken in the morning (who wants to spend the night making trips to the bathroom), and I have seen it suggested that its apparent effectiveness is because its effect does not usually wear off until after typical times for medical appointments. Lasix (furosemide) is a loop diuretic and acts differently on the kidneys. It also has a short half life, but can be taken in larger and more frequent doses. Reputedly and illegally it is frequently taken by jockeys trying to get down to weight. What I don’t know about these two is to what extent they act more on high than normal BP. Lasix is considered very useful fr controlling edema, but for me was not enough on its own. For example I was tried out on a CCB for BP 14 years back but it caused worsening edema even while I was taking substantial doses of Lasix.

I eventually got the edema under control first by wearing pressure socks, although I found I needed quite strong ones (30 - 40 mm.hg compression) which are only available in Canada by prescription, and very expensive, so I get mine from Ames Walker (ameswalker.com) in North Carolina - far cheaper (at least for their own brand products), excellent quality, and no prescription required. The pressure socks do not apply compression to the toes (some are even open at the toe ends. The wound healing specialist said that this did not matter, but for me at least that was not so. My own research led me to horse chestnut, in which the active constituent, eschin, strengthens and reduces the porosity of veins and capillaries, thus reducing edema and helping treat CVI (chronic venous insufficiency). It is also supposed to be helpful for varicose veins and hemorrhoids. There is one study saying that it is as effective as pressure socks, but I reckon one is better off using it in conjunction with the socks (and a diuretic). I’ve not noticed that taking additional diuretics, once ones BP is reduced to low normal levels, has very much further effect on blood pressure, and I have experimented with spiro, lasix and HCTZ. I gather that there is no definite threshold for low blood pressure and that it varies from person to person , although an arbitrary figure is below 90/60. Pulse rate also becomes a factor. I reckon that for me I feel low blood pressure effects if the sum of systolic and diastolic pressures with pulse rate gets down near or below 200. This used to happen sometimes when I was first prescribed the CCB on top of everything else, but is rare now that I no longer take beta blockers, spiro and digoxin, and only half the previous dose of ramipril. Oddly, my first encounter with blood pressure issues was back in 1961 driving through northeastern Iran, where I was treated for low blood pressure problems, probably brought on by exhaustion and a rapid change in altitude, by a German doctor who I was told by a group of Poles who were working there had exercised his skills in a concentration camp during WWII, and had found it wise to leave Germany hurriedly at the end of the war!

I hope that some of this may be of use to you.

This statement was particularly of interest, and something I will be looking into:

My own research led me to horse chestnut, in which the active constituent, eschin, strengthens and reduces the porosity of veins and capillaries, thus reducing edema and helping treat CVI (chronic venous insufficiency).

Also, thanks for the link to AmesWalker.com as a source for medical grade compression stockings.

Clara