Lymphovenous Canada: Diuretics - How effective are they in the treatment of lymphedema?

Reputable health authorities advise against using diuretics in the treatment of lymphedema pointing out that the therapy is generally not effective and can be damaging when used over a long period of time:

• The Canadian Medical Association Journal, Clinical practice guidelines for the care and treatment of breast cancer: 11. Lymphedema (CMAJ 2001;164(2):191-9) released in January of 2001 by Susan R. Harris, Maria R. Hugi, Ivo A. Olivotto, Mark Levine, for the Steering Committee for Clinical Practice Guidelines for the Care and Treatment of Breast Cancer notes:

  Diuretics, which have been recommended in the past, may temporarily mobilize water, but the increased interstitial oncotic pressure exerted by the high protein concentration of lymph fluid will cause rapid recurrence of edema. The diuretic effect in the rest of the body may cause adverse side effects, such as hypotension, dehydration and electrolyte imbalance.

• The National Cancer Institute (NCI) points out that, " Diuretics encourage vascular fluid depletion, but do nothing for excess protein deposits and could hasten connective tissue fibrosis. Therefore, diuretics should be used with caution and only for treatment of excess vascular fluid due to other causes (1998)".
• The 1995 consensus document of the International Society of Lymphology Executive Committee reports that although diuretics may be occasionally be useful during the initial phase of physiotherapy or in certain unique medical situations, their use on a long term basis is not generally effective. "Long-term administration of diuretics is discouraged as being of marginal benefit and potentially complicated by fluid and electolyte disturbances.".