Technische Universität München

The Entrepreneurial University

Diuretics are justifiably considered as the major category of banned drugs in sports, which is mostly linked to disturbed electrolyte metabolism.

Unlike medical patients, athletes do not retain excess water, thus the use of diuretics results in an abnormal and dangerous loss of water and electrolytes. Athletes with diuretic-induced dehydration, performing in heat, are more susceptible to heat exhaustion. Hypotension can be particularly troublesome sometimes. Use of diuretics commonly leads to low levels of body potassium. However, severe symptomatic hypokalemia is rare, while moderate levels of hypokalemia are common.  Hypokalemia mainly causes disturbed neurological functioning and cardiac arrhythmias, even heart failure. Additionally, symptoms as muscle weakness and muscle cramps are common.

On the other hand, overuse of diuretics such as spironolactone, triamterene and amiloride may lead to extremely high potassium concentration in the blood. Hyperkalemia may lead to malignant arrhythmias such as run of sustained ventricular tachycardia. Furthermore, most diuretics disturb the metabolism of uric acid and this can precipitate a painful attack of gout.