From the Research
Diuretics are not effective in treating lymphedema and are generally not recommended for this condition. Lymphedema is caused by a blockage or damage to the lymphatic system, resulting in fluid accumulation in tissues, while diuretics work by increasing kidney excretion of salt and water from the bloodstream. These medications do not address the underlying problem of impaired lymphatic drainage. In fact, diuretics may worsen the situation by potentially causing dehydration, electrolyte imbalances, and further concentration of protein-rich lymphatic fluid in tissues, which can exacerbate inflammation and fibrosis.
The standard treatment for lymphedema includes complete decongestive therapy (CDT), which combines manual lymphatic drainage, compression therapy, exercise, and skin care, as recommended by recent guidelines 1. Some patients may benefit from surgical interventions in specific cases. If you have lymphedema, it's essential to work with healthcare providers who specialize in lymphedema management rather than attempting to manage the condition with diuretics, which could potentially cause harm without addressing the fundamental issue.
Key components of CDT, as outlined in a recent expert consensus document 2, include examination, compression, manual techniques, exercise, skin care, education, and self-management. Adjunctive interventions and alternatives may complement CDT, but diuretics are not a recommended treatment option. The use of diuretics for pure lymphedema is physiologically unsound, as noted in earlier studies 3, and may be of use only in edema of mixed origin or in palliative circumstances.
In contrast, manual lymphatic drainage has been shown to be strongly decongestive when applied intensively, as demonstrated in a recent retrospective analysis 4. Therefore, the most effective approach to managing lymphedema is through CDT and other evidence-based treatments, rather than relying on diuretics. It's crucial to prioritize treatments that address the underlying causes of lymphedema and promote optimal patient outcomes in terms of morbidity, mortality, and quality of life.