International Journal of Movement Education and Sports Sciences (IJMESS) Annual Refereed & Peer Reviewed Journal Vol. I No. 1 January-December 2013 Online ISSN 2321-7200 Diuretics the Masking Agent: Adverse effect,
Therapeutic Use and Misuse in Sports
* Phy. Edu. Teacher, Jawahar Navodaya Vidyalaya-Butana, Sonipat, Haryana (India) (Received 01 June 2013 – Accepted 07 June 2013) Abstracts
Background: Diuretics are also called water pill because these drugs increased the rate of urine
flow and sodium excretion to adjust the volume and composition of body fluids. There are many
categories of this drug class and the compounds vary greatly in structure, physicochemical
properties, effects on urinary composition and renal hemodynamics, and site and mechanism of
action. These drugs are mostly abused by athletes to loose the body weight rapidly and mask to
mask the presence of other prohibited performance enhancing substances. Because of their abuse
by sportsman, diuretics have been included on.
Methods: Analytical methods was used for this article by reviewing relevant publications,
primarily based on the online sports medicine journals available on Internet, Wikipedia, Elsevier,
Pub Med and National Anti Doping Agency literature.
Conclusion: The World Anti-Doping Agency's (WADA) list of prohibited substances; the use of
diuretics is banned both in competition and out of competition and diuretics are usually tested by
authorized anti-doping laboratories of WADA. This review provides an overview of the
therapeutics use and misuse of diuretics in sports and discusses their adverse effect on health.
Keywords: Diuretics, Adverse Effect, World Anti Doping Agency

Diuretics are commonly defined as drugs that increase the amount of urine produced by the kidneys. A precise definition is that diuretics are agents which augment the renal excretion of sodium and either chloride or bicarbonate primarily, and water excretion secondarily. Masking agents are substances that have the potential to impair the excretion of prohibited substances to conceal their presence in urine or other doping control samples or to increase hematological parameters. In those sport activities in which body weight is crucial the use of diuretics may have a long tradition. In 1998 four members of the Chinese swimming team were tested positive during the world championships in Perth. They used the diuretic substance triamterene in order to reduce their body weight and by this to gain an advantage for the competition or to mask use of other doping substances. Not only in swimming but also in other kinds of sport where body Weight classes are used for classifying athletes and producing fair competitions, diuretics are frequently used as well. Many sporting organizations test athletes for diuretic use. Some athletes use diuretics to lose weight or cover up steroid use. In 2003 Australian cricket player Shane Warne received a one-year suspension after testing positive for a banned diuretic. Sports such as weightlifting, wrestling, and boxing require regular weigh-ins. Diuretics are sometimes used by athletes to lose weight quickly in order to compete in lower-weight classes. The pressure to keep their weight down may extend beyond the use of diuretics, leading to starvation diets and attempts to sweat off pounds in rubber suits or saunas. These and other unsafe practices can put athletes at risk for severe dehydration, seizures, and even death. Because diuretics can not only reduce weight but also enhance muscle profile it is used in body-building as well. Dehydration and electrolyte imbalances are well known health risks Copyright 2013 Dabas Educational Welfare Society (DEWS) International Journal of Movement Education and Sports Sciences (IJMESS) Annual Refereed & Peer Reviewed Journal Vol. I No. 1 January-December 2013 Online ISSN 2321-7200 accompanied by others (Wagner 1991). Clinically diuretics are the mainstay of treatment of hypertension and edematous states like congestive heart failure, cirrhosis with ascites, nephritic edema, and edema or pregnancy. METHODOLOGY
This survey is an analysis of literature on of up to now research conducted on Diuretics in sports medicine. The analysis involves a dozen scientific databases, examined in order to find out the health hazard approach in sports. The gathered data are supplemented and verified from the web source of WADA, NADA and NDTL. Therapeutic Uses of Diuretics
Congestive Heart Failure (CHF). Digitalis is used in adequate doses to increase the cardiac output, and improve renal hemodynamic, with results in diuresis. Dietary sodium intake is restricted. Essential hypertension. The thiazides usually serve as primary antihypertensive agents. Hepatic cirrhosis with ascites. Potassium-sparing diuretics like spironolactone may be employed. If spironolactone alone fails, then a thiazide diuretic can be added cautiously. Nephrotic syndrome. Dietary sodium restriction may be combined with a thiazide diuretic, adding spironolactone to control secondary hyperaldosteronism. Chronic renal failure. Careful attention to salt and water balance is required. A loop diuretic like frusemide may be useful in controlling both edema and hypertension.
Misuse of Diuretics in Sports

To flush out the symptoms of previously taken prohibited substances with forced diuresis. This effect was examined by Delbeke and Debackere (1991) who showed that stimulants are washed out. But these substances nevertheless have been tested also after forced diuresis but in a smaller amount. This indicates that the desired effect does not always occur. Another desired effect is to lose weight for starting in a lower weight-class in For these reasons urine samples out-of-competition and in competition are tested on It is therefore remarkable that in bodybuilding it is a desired effect of the use of diuretics that all subcutaneous tissue water will be washed out for a better definition of the muscles. Biomedical side effects of Diuretics
The most common and adverse effects of use of diuretics are as follow: Frequent urination
This may occur last for several hours after a dose. By the excess urination the body salt are also depleted which lead to mineral imbalance in the body of athletes.
The most common side effect associated with diuretics is an increased elimination of potassium, resulting in a dangerously low level of potassium in the body. With the exception of potassium-sparing versions, all diuretics may cause a loss of potassium, which, if left untreated, increases the risk for heart rhythm disturbances that can be serious. Abnormal heart rhythm may Copyright 2013 Dabas Educational Welfare Society (DEWS) International Journal of Movement Education and Sports Sciences (IJMESS) Annual Refereed & Peer Reviewed Journal Vol. I No. 1 January-December 2013 Online ISSN 2321-7200
be due to the abnormal potassium and sodium which is the regulator of cardiac rhythm. So by the
use of diuretics the arrhythmia can be adverse effect on athlete’s health.
Extreme Tiredness or Weakness
These effects can be increase if any athlete uses this substance. Body feel extreme tiredness or weakness due to not adjusts to the medication. So this is also an adverse effect of
this substance.
Muscle Cramps or Weakness
By the use of this substance the excess body fluid through the urination. Due to not take the correct dose of potassium supplements, so the salt and mineral are depleted which lead the
muscle cramp.
Dizziness and Light Headedness
The dizziness and lightheadedness can be experienced by the athletes or its user. Which resultant to adverse effect of diuretics when getting up from a lying or sitting position.
Adverse effect of this substance includes extreme thirst, and excessive dryness of the mouth, decreased urine output, dark-colored urine, or constipation is found in many study and sources due to dehydration. Rapid and Excessive Weight Loss
By the using of this drug the excess flow of fluid from the body so excessive or rapid weight loss could be take place in athletes. Skin Rash
The skin rashes developed by the use of diuretics and other masking agents and stop taking the medication and contact your doctor right away. Digestive System
Loss of appetite, nausea and vomiting are more common adverse effects on the digestive tract by the use of this substance on the health of sportsman, athletes and the other users.
Diuretics in the world of sports have another documented use. Called "masking," it is when diuretics are used to speed the elimination of banned performance-enhancing substances
from the body. The use of diuretics is banned both in competition and out of competition by the
World Anti-Doping Agency; diuretics are in the list of prohibited substances and usually tested
by authorized anti-doping laboratories of WADA. The therapeutics uses of this substance are
exempted only on prescription of authorized Doctor in case of renal disorder of Athletes. The
adverse effect on health are muscle cramp, dehydration, tiredness, excessive weight loss, skin
rash, loss of appetites, nausea and vomiting are more common adverse effects. The use of this
drug is illegal and it is very harmful to health.
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Chobanian AV, et al. (2003). The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. New England Journal of Medicine. 2003;289:2560. Copyright 2013 Dabas Educational Welfare Society (DEWS) International Journal of Movement Education and Sports Sciences (IJMESS) Annual Refereed & Peer Reviewed Journal Vol. I No. 1 January-December 2013 Online ISSN 2321-7200 Flynn JT. (2010). Treatment of high blood pressure: Drug therapy. In: Kaplan NM, et al. Kaplan's Clinical Hypertension. 10th ed. Philadelphia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2010:192. High blood pressure: Medicines to help you. U.S. Food and Drug Administration. for consumers/by audience/for women/ucm118594.htm. Accessed Apr. 3. Ivan Waddington and Andy Smith (2009) An Introduction to Drugs in Sport, Routledge 270, Kaplan NM, et al. (2013). Indications and contraindications to the use of specific antihypertensive drugs. Accessed. Malik, A. (2013). Making the 'Invisible' 'Visible: Struggle of Wada. Horizon Palaestra: International Journal of Health, Sports and Physical Education, 1 (2), 147 - 149. Available from: NADA (2011). Play Fair: Doping Controll Handbook, A publication of National Anti Doping Prof. Keun-Youl, (2005, October). Side Effects of Doping drugs. From WADA Web site: document/MACAU_Effects of_Doping.pdf. S.K.Gaur (2012). Doping In Sports and Its Effects, Indian Journal of Movement Education and Exercises Sciences (IJMEES), Bi-annual Refereed Journal, Vol. II No. 1. Types of blood pressure medications. American Heart Association. HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Types-of-Blood-Pressure-Medications_UCM_303247_Article.jsp. Accessed March. 30, 2013. http:// http://www.doping-prevention.sp.tum.d Copyright 2013 Dabas Educational Welfare Society (DEWS)


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