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ZURICH, SWITZERLAND. Diuretics such as furosemide (Lasix) are universally used in the treatment of
hypertension and congestive heart failure. Medical researchers at the Zurich University Hospital now warn
that the use of diuretics may lead to a thiamin (vitamin-B1) deficiency that in turn may further impair heart
function. The researchers cite several recent studies that have clearly established an association between
diuretics and urinary thiamin loss. They also point to other studies that have found that 50 per cent of
elderly people and 80 per cent of heavy alcohol users suffer from a thiamin deficiency even without taking
diuretics. A very recent study concluded that injection of 200 mg/day of thiamin followed by six weeks of
oral supplementation with 200 mg/day improved the heart function very significantly in heart failure patients
taking diuretics (left ventricular ejection fraction increased by 22 per cent).
The use of diuretics has also been linked to an increase in homocysteine levels and a decrease in
magnesium levels. Magnesium is very important for heart health and is also necessary in order to convert
thiamin to its active form (thiamin pyrophosphate). The Swiss researchers make the interesting observation
that poor appetite is a powerful indicator of a thiamin deficiency in elderly patients with congestive heart
failure. They suggest that supplementation with 20-50 mg/day of thiamin should be tried in elderly heart
failure patients. This intervention is inexpensive, safe and usually shows results within a few days. They
also suggest that supplementation with folic acid and magnesium may be beneficial in order to counteract
the homocysteine increase and magnesium depletion often accompanying diuretic use. [52
references]
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