Angry doctor claims HCTZ is safe!

Hydrochlorothiazide (HCTZ) is one of the most commonly prescribed drugs in the USA. It is a diuretic that helps lower blood pressure. Finally, done 10 million people swallow this pill every day. But HCTZ is also combined with blood pressure (BP) medications such as lisinopril, losartan, valsartan, olmesartan, bisoprolol, and triamterene. That adds another one 7 million people. Many people believe that HCTZ is safe, yet there are side effects. A doctor asked us about the connection between hydrochlorothiazide and high blood sugar.

MD is crazy as hell! He says that HCTZ is safe:

Q. I am a retired doctor who was also a pharmacist. I believe your answer about hydrochlorothiazide (HCTZ) and diabetes is wrong and can potentially scare patients away from a beneficial drug.

HCTZ can raise blood sugar by a few percent, but it does not cause a person to become diabetic. According to several studies, the benefits of lowering blood pressure outweigh the slight increase in blood sugar levels. Please do not make the doctor’s job difficult.

AND. Thanks for pointing out the important role that diuretics like HCTZ play in the treatment of high blood pressure. Let’s go back to our previous questions and answers:

Q. I took hydrochlorothiazide for ten years to treat my blood pressure. Because of this, I got diabetes, for which the doctor prescribed me some pills that I don’t like.

When I visited my new doctor last spring, I provided a list of vitamins and foods I eat instead of pills to control my diabetes, blood pressure, and high cholesterol. He read the list, then looked at me and said, “If that’s what you’re doing, keep it up! All your numbers are low!”

Mostly it was just common everyday foods like garlic, turmeric, cinnamon and vinegar water. I’m just done with diabetes. I think people should know about these possibilities.

Previous answer:

AND. Hydrochlorothiazide and similar blood pressure diuretics can raise blood sugar, as you have learned from experience. Generally, doctors prescribe medication to control diabetes, although diet and exercise can be very helpful.

We are impressed that you are doing so well and it makes sense for your doctor to monitor your progress. There are many ways to control blood sugar without drugs, and you use several of them. Both turmeric and cinnamon have research supporting their effectiveness.

HCTZ is safe…but it has side effects

Meta-analyses show that, on average, the increase in blood glucose associated with HCTZ is small (Journal of Clinical HypertensionApril 2016; Journal of general internal medicineJune 2020).

Most people probably have no difficulty with this effect. However, for a few individuals, this could become a concern. Some people are more sensitive to drug side effects than others.

It is always important to warn people about potential side effects so they can be on the lookout for complications. It would be unfortunate if someone developed diabetes due to a drug reaction and did not realize that it could be corrected simply by changing the drug.

We urge all readers to work with their physicians to appropriately balance the benefits and risks. The person who contacted us about HCTZ raising blood sugar was able to control both their blood pressure and diabetes with drug-free approaches.

Other complications of HCTZ:

Because doctors prescribe hydrochlorothiazide so often, they may take it for granted. We agree with this doctor that HCTZ is safe, but here are some potential side effects that patients may not be warned about:

Hydrochlorothiazide and gout:

When uric acid levels become too high, a person may experience gout. Joint pain can be excruciating. People should always be warned that diuretics like HCTZ can raise uric acid levels. Here is the link about such a reaction:

Hydrochlorothiazide (HCTZ) Side effects, complications and gout!

This article also mentions that HCTZ and similar diuretics can lead to electrolyte imbalances:

• Low potassium levels (hypokalaemia)
• Low sodium levels (hyponatremia)
• Low levels of magnesium (hypomagnesemia)
• High calcium levels (hypercalcemia)
• Low chloride levels (hypochloremia)
• Low zinc levels

It’s worth a minute of your time to check out some others common HCTZ side effects at this link.

HCTZ is safe…But what about skin cancer?

We suspect that most doctors have never heard of the link between hydrochlorothiazide and skin cancer. It’s controversial. Here is a link to an article on HCTZ and squamous cell carcinoma. A diuretic can make the skin more sensitive to the sun’s ultraviolet radiation.

Here is the magazine article Evidence-based dentistry (March 2022).

The authors conclude:

“The risk of NMSC [non-melanoma skin cancer] and lip cancer in the UK population increased with cumulative exposure to high doses of HCTZ. Therefore, it is important for dentists to be aware that this may increase the suspicion of lesions in patients taking these medications.”

The association was confirmed in European Journal of Clinical Pharmacology (June 2022).

“Purpose: The aim of this study is to investigate the association between the use of hydrochlorothiazide (HCTZ) and the risk of skin [skin] and the development of squamous cell carcinoma of the lip.

“the results: A total of 2181 published studies related to the topic were identified, of which six were included in this systematic review… This meta-analysis showed the possibility of developing squamous cell carcinoma of the skin and lips in any part of the body in hydrochlorothiazide users of 1 .76 times higher than in non-users. In addition, a risk factor of 1.80 higher for squamous cell carcinoma of the skin in the head and neck area was observed in HCTZ users.

“Findings: Our results confirm the association between the use of hydrochlorothiazide and the development of squamous cell carcinoma of the skin and lips.”

We offer information on the pros and cons of BP medications in our eGuide to Blood Pressure Solutions. This online resource can be found under Health eGuides tab. A number of over-the-counter medications to help control high blood pressure are also discussed.

Share your experience with blood pressure medication in the comments section below.