"One study showed that people taking diuretics for more than six months had dramatically lower blood levels of folic acid and higher levels of homocysteine compared with individuals not taking diuretics. Homocysteine, a toxic amino acid byproduct, has been associated with atherosclerosis. Until further information is available, people taking diuretics for longer than six months should probably supplement with folic acid.

Diuretics decrease calcium loss in the urine due to actions on the kidneys. As a result, it may be less important for some people taking thiazide diuretics to supplement calcium than it is for other people.

Potassium-depleting diuretics, including thiazide diuretics, cause the body to lose potassium; they may also cause cellular magnesium depletion, although this deficiency may not be reflected by a low blood level of magnesium. Magnesium loss induced by potassium-depleting diuretics can cause additional potassium loss. Until more is known, it has been suggested that people taking potassium-depleting diuretics, including thiazide diuretics, should supplement both potassium and magnesium.

People taking thiazide diuretics should be monitored by their prescribing doctor, who will prescribe potassium supplements if needed. Such supplementation is particularly critical before surgery in patients with a history of heart disease. In a preliminary study, people with low blood levels of potassium (in part related to diuretic use) had a higher incidence of serious problems resulting from surgery (including death) compared with those having normal potassium levels. A double-blind trial showed that thiazide diuretic use led to a reduction in blood levels of potassium in some participants. Those experiencing decreased potassium levels were also more likely to experience cardiovascular events, such as heart attacks, stroke, heart failure, aneurysm, and sudden cardiac death. Fruit is high in potassium, and increasing fruit intake (especially bananas) is another way of supplementing potassium.

Magnesium supplementation for people taking thiazide diuretics is typically 300-600 mg per day, though higher amounts (over 800 mg per day) have been reported in a controlled study to reduce side effects of thiazides. Combining supplementation of both potassium and magnesium has been reported to correct abnormally low blood levels of potassium and also to protect against excessive loss of magnesium.

The reduction in urinary calcium loss resulting from treatment with thiazide diuretics is due primarily to changes in kidney function and may also be due, in part, to changes in vitamin D metabolism. However, there is no evidence to suggest that people taking diuretics have different requirements for vitamin D.

Thiazide diuretics can increase urinary zinc loss.

Diuretics, including thiazide diuretics, cause increased loss of sodium in the urine. By removing sodium from the body, diuretics also cause water to leave the body. This reduction of body water is the purpose of taking diuretics. Therefore, there is usually no reason to replace lost sodium, although strict limitation of salt intake in combination with the actions of diuretics can sometimes cause excessive sodium depletion. On the other hand, people who restrict sodium intake, and in the process reduce blood pressure, may need to have their dose of diuretics lowered."

dangers of laxitives:

"Laxatives are used to relieve occasional constipation. There are currently numerous and various kinds of laxatives and are widely available at any local drug store or pharmacy. Sadly laxatives are frequently advertised with little or no mention of short or long term side effects laxatives can cause. Many people take them without sufficient information. Prolonged use of laxatives, especially stimulant laxatives such as cascara, senna (sennosides) and bisacodyl, intensifies and perpetuates the condition for which they are used. The bowel becomes atonic and dependency is established. Overuse may cause electrolyte disturbances with symptoms of vomiting and muscle weakness.

Electrolytes are minerals like potassium and sodium that are dissolved in the blood and other body fluids. They must be present in very specific amounts for proper functioning of nerves and muscles, including the heart muscle. If laxatives and enemas upset this balance, it can result in tremors, muscle cramps and spasms. In some cases cardiac arrest (heart attack). The heart stops and unless the person receives immediate emergency medical treatment the individual will die. Vomiting can also be a culprit in upsetting this balance.

Laxatives and enemas remove required fluids from the body resulting in mild or severe dehydration. Dehydration can lead to weakness, blurry vision, fainting spells, tremors, kidney damage and in some cases can result in death. Severe cases of dehydration will require medical treatment as simply drinking fluid may not hydrate cells and tissues quickly enough. It is important to get medical attention immediately to prevent organ damage or death.

There is a protective mucus that lines the colon. Laxatives and enemas strip away this protective mucus leaving the colon vulnerable to infections. Enemas can stretch the colon and over time it can lose muscle tone resulting in the colon not being able to generate muscle contractions necessary to move fecal matter out of the body.

Laxatives irritate intestinal nerve endings and after prolonged use of laxatives, the nerve endings may no longer respond to stimulation. The individual must now take larger amounts of laxatives to produce bowel movements. The individual has become "laxative dependent" and without them may not have any bowel movements at all.

Laxative abusers may have more problems with irritable bowel syndrome , rectal pain and gas. Users may also be at risk for bowel tumors which may be benign and cancerous.

Laxative abusers may go through episodes of constipation and diarrhea which both can be painful. People who abuse laxatives can end up in a constipation-diarrhea vicious cycle in which they are always treating symptoms.

One of the most fatal dangers of laxative abuse is the risk of death. If this risk doesn't scare you, I'm not sure what will. Laxative abuse can upset your electrolyte balance and can damage muscles and tissues surrounding the heart. The heart can stop beating and without quick medical intervention, the individual can die. The severe dehydration by the use laxatives can also lead to death. At times we think "it won't happen to me" however if you are abusing laxatives, death is a possibility and risk you are taking and the reality is - it can happen to you."