Depletions

Taking loop diuretics may deplete calcium, magnesium, phosphorus, potassium, and vitamin B1.

Calcium

Calcium, along with vitamin D, keeps your bones strong and healthy.

Low levels of calcium may cause:

• Muscle cramps
• Numbness or tingling in toes and feet
• Irregular heartbeat
• Depression
• Bone pain
• Spinal problems
• Seizures

Magnesium

Magnesium deficiency affects calcium and vitamin D levels in the body. This may cause:

• Muscle cramps
• Muscle weakness
• Irregular heartbeat
• Numbness and tingling in feet and toes
• Seizures
• Insomnia
• High blood pressure

Phosphorus

Phosphorus deficiency is rare, but low levels can cause:

• Muscle pain and weakness
• Bone pain
• Confusion
• Numbness and tingling in feet and toes
• Loss of appetite
• Increased risk of infections
• Trouble breathing
• Seizures
• Irregular heartbeat

Potassium

Symptoms of potassium deficiency include:

• Nausea and vomiting
• Tiredness
• Drowsiness
• Feeling of apprehension
• Weakness
• Muscle pain and weakness (mostly in the legs)
• Muscle cramps
• Strong, rapid or irregular heartbeat

Vitamin B1 (Thiamine)

Low levels of vitamin B1 may cause:

• Fatigue
• Nausea
• Loss of appetite
• Constipation
• Short-term memory loss
• Confusion
• Depression

Severe deficiency of vitamin B1 causes beriberi.

Symptoms may include:

• Tingling or burning sensation in toes and feet
• Fluid buildup in the body (edema)
• Increased heart rate
• Heart failure

Editorial Note

The information presented here covers some of the nutrients that may be affected when you take certain medicines. If you have any of these signs and symptoms, it does not always mean you have low levels of these nutrients.

Factors that affect the level of nutrients are:

• Your medical history
• Diet
• Lifestyle
• How long you have been taking the medicine

Please talk to your health care provider. They can best address your health care needs and see if you are at risk for low levels of any nutrients.

Supporting Research

Asiedu DK. Vitamin deficiency (Hypovitaminosis). In: Ferri FF, ed. Ferri's Clinical Advisor 2017. Philadelphia, PA: Elsevier; 2017:1359-1360.

Dominiczak MH, Broom JI. Vitamins and minerals. In: Baynes JW, Dominiczak MH, eds. Medical Biochemistry. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 11.

First Consult: Hypomagnesemia. February 20, 2013. www.clinicalkey.com/#!/content/medical_topic/21-s2.0-2001655. Accessed July 7, 2016

Gold Standard Drug Database. Drug Monograph: Bumetanide, 2014. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-74. Accessed July 1, 2016.

Gold Standard Drug Database. Drug Monograph: Ethacrynic Acid, 2014. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-231. Accessed July 1, 2016.

Gold Standard Drug Database. Drug Monograph: Furosemide, 2012. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-270. Accessed July 1, 2016.

Gold Standard Drug Database. Drug Monograph: Torsemide, 2012. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-620. Accessed July 1, 2016.

Hoorn EJ, Wilcox CS, Ellison DH. Diuretics. In: Skorecki K, Chertow GM, Marsden PA, Yu ASL, Taal MW, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 51.

Leone KA. Calcium, magnesium, and phosphorus. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 166.

Osborn MB. Potassium. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 165.

Shenkin A, Roberts NB. Vitamins and trace elements. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 5th ed. St. Louis, MO: Elsevier Saunders; 2012:chap 31.

Smogorzewski MJ, Stubbs JR, Yu ASL. Disorders of calcium, magnesium, and phosphate balance. In: Skorecki K, Chertow GM, Marsden PA, Yu ASL, Taal MW, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 19.

Yu ASL. Disorders of magnesium and phosphorus. In: Lee G, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier; 2016:chap 119.