Diuretics And Weiight Gain

[gumboot]

I'm currently taking 5mg Metolozone, 5mg Bumetaide and 100mg Spironolactone daily for congestive heart failure as well as a load of other medication.

I weigh myself daily but I try not to take the diuretics daily as they aggravate my gout and make my tinnitus worse. I can gain about 1200 grams daily if I sit at home and do much of nothing like this but if I go out and exercise by walking as far as I am able, my weight increases by around 2000 to 2500 grams.

I know it's all fluid loss but what I don't understand is why I gain more weight on exercising than I do when I'm sedentary. I really want to try and walk as much as I can but I find this situation maddening and illogical given that walking/exercise is meant to reduce weight. There's no variation in my diet to account for this.

Thank you.

[Sqad]

No, sorry, I am as confused as you.
The only explanation and it is a weak one , is that on the days that you exercise, you do not take your diuretics and the weight gain is due to water retention.
Sorry......best i can do.

[gumboot]

Thanks Sqad. I'm very grateful for your reply all the same.

I've tried all ways of figuring this to no avail. If I sit at home and don't take the diuretics, the following morning my weight will have increased by about 1200 grams. If i sit at home and take the tablets, I obviously pee profusely throughout the day and my weight will have gone down by about 3 to 3.5kg the following morning. However, if I don't take the diuretics on a day I need to go out and just walk around a few shops for an hour or so, my weight will have increased by up to the 2.5kg or so by the following morning.

It's this difference between the 1200 gram I gain sitting at home on non-diuretic days and the 2500 gram gain on walking on non-diuretic days that I can't get my head around!

[Sqad]

I understand gumboot......but I cannot, unfortunately be of any help.

[gumboot]

I understand. Thank you again.

[woofgang]

This is probably a VERY silly question but do you measure input as well as output? and do you count high liquid solids like fruit, jelly, soup?

[woofgang]

..also is there any variation in bowel movement, frequency, amount and texture?

[gumboot]

woofgang, input as you call it is indeed measured for people with heart failure when the patient is in hospital. Most of the time, the ward staff try to restrict fluid intake to about 1500ml per day. Personally, I've had it reduced to 1000ml a day when I was seriously ill. This recording of intake does give them a better idea of what's going on. Liquids such as fruit juice etc are measured but I've never known jelly or fruit to be measured as they are semi-solid or solid.

Yes, diuretics have an effect on bowel movements as they dry up and can cause some constipation. Diuretics remove water from anywhere and everywhere in the body and by the end of the day, I feel worse than when I started!

[woofgang]

my experience is in monitoring someone with chronic kidney disease and “liquid solids” are (or used to be) taken into account, also juicy soft fruit......If there is no change in your input (solid or liquid) on your active days, then there MUST be less output.

[gumboot]

Of course woofgang. As I said, on my active days, I don't take diuretics. This leads to my body accumulating my normal daily intake of fluids and bunging it everywhere in preference to sending it off to my bladder. My urine output is diminished on those days and I'm told that the dark colour is indicative of it being concentrated.

I can't quite see the point you're trying to make here.

[bednobs]

have you been advised to weigh every day?

[woofgang]

If you gain more weight on non medication (diuretic) days then I am not sure what the mystery is?

[gumboot]

bednobs, yes I do weigh myself daily - this is what provides the figures I gave in the original post.

Let me try to clarify this. When I exercise on non-diuretic day, I put weight on The weight that I put on is about double the weight I put on during days that I sit at home on non-diuretic days. The conclusion is that the exercise is directly or indirectly causing my weight to increase by 100% over the norm. Logically, it's obviously the exercise that is causing the doubling of the fluid retained. The puzzle is why does it happen. All other factors in my lifestyle remain the same.

[Sqad]

gumboat....LOL.

Seems a logical question, wish i could think of a logical answer.

[gingejbee]

Weighing oneself daily seems as pointless as measuring blood pressure daily.....it's the upward or downward trend over a decent period that's important - not the small daily variations, that only serve to puzzle/annoy/concern.

[gumboot]

gingejbee, I'm afraid it's not as simple as that in heart failure. Trends are indeed important but Cardiologists need alerting to weight figures too for many reasons including the fact that weight gain can tell the the degree to which fluid is being retained. In my case, when my weight rises excessively and the diuretics are not considered to be working properly, I'm taken into hospital for IV diuretic treatment.

The last time this happened, three days IV Furosemide (a diuretic) took my weight from 145kg to 85kg. Trends would not have alerted the Cardiologists them to the seriousness of the problem.

As for these issues annoying or concerning me, I'm long past that. The prognosis in advanced HF is extremely poor but I've learned to come to terms with it

[gumboot]

Cardiologists require all Heart Failure patients to keep a daily written log of their weight as part of the treatment regime. The couple of dozen or so Cardiologists I've seen in my own hospital and the nearby tertiary centre all emphasis the need to do this.

[Sqad]

gumboot.......I have been thinking.
By the medication that you have been taking it is clear that you have a very advanced stage of congestive cardiac failure and in such situations the metabolism (muscle and heart response) acts differently.
Now....two situations a) the work of the heart at rest b) work of the heart during exercise...both situations whilst taking diuretics.
At rest...the heart, although in a weak state is capable of coping in the resting condition, even with swollen ankles, legs etc.
However during exercise, the heart is unable to meet the demands of the muscles which are excising and the metabolism acts differently (anaerobic) and extra fluid is formed to add to the fluid already present...hence weight gain during exercise...FLUID.
I have no idea of the biochemistry of this, but i am sure that it is the answer to your problem.

You are correct to point out the importance of daily weighing in advanced congestive cardiac failure.

[gumboot]

That's brilliant! Thank you very much Sqad. I think you may well be right and I'm very grateful for your suggestion.

It'll give me something to discuss with the cardiologists in the New Year and I hope that they are as clever as you are! Thank you again.