When Australian cricketer Shane Warne used banned diuretics, the news made head lines. He tested positive for two banned diuretics, amiloride and hydrochlorothiazide. We take a look at these two drugs and diuretics as masking agents.
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Although a diuretic is not a performance enhancer or stimulant, but merely a "water" pill - stimulating the kidneys to produce more urine - diuretics can act as masking agents for anabolic steroids, Dr Lourens Erasmus, sports doctor at the Leipoldt Sports Clinic confirmed.
Anabolic steroids facilitate muscle build and recovery after an injury. A user of anabolic steroids will recover more quickly from an injury, with less muscle fatigue during and after weight training.
Warne dislocated his shoulder in December. He recovered completely.
Medical use of diuretics
Amiloride and hydrochlorothiazide are medically prescribed to treat hypertension, heart failure, kidney and liver diseases and pre-mentrual tension. Side-effects of high doses of diuretics may include dehydration, dizziness, muscle cramps, headaches and nausea.
Anabolic steroids and diuretics
Shane Warne's use of diuretics, classified as a "masking agent", follows barely six months after Australian winger Ben Tune tested positive for the masking agent probenecid.
The use of a diuretic can mask the use of anabolic steroids, stimulants, cannabis or other banned substances. The use of masking agents is "nothing new - it has been used for many years by sportsmen wishing to conceal their steroid use."
"It inhibits the excretion of waste material that indicates steroid use."
Thus, for a while after diuretic use, no anabolic steroid will be found in the urine of the steroid user.
Diuretics are also misused for quick weight loss, particularly in sports with weight categories like boxing.
It does have a legitimate medical use, but because of its misuse by many sportsmen and women, it has been listed as a banned substance, according to Dr Erasmus.
Prohibited diuretics
Prohibited substances in Class D (the diuretics) banned by the Olympic Movement Anti-Doping Code (OMAC) include: "amiloride, acetazolamide, bumetamide, chlortalidone, etacrynic acid, furosemide, hydrochlorothiazide, mannitol, mersalyl, spironolactone, triamterene and related substances".
Diuretics are listed under the code as a "masking agent".
Masking on the increase
"The past few years have seen a refining of chemicals that can mask the use of steroids. Many of them are sufficiently effective, that laboratory staff testing urine can easily be misled, especially if the use of a new masking agent produces confusing results.
"As a result, many drugs with legitimate uses, have been placed on the list of banned substances. It is up to sportsmen and women and their doctors to take cognisance of these before any medication is prescribed."
Summary of anabolic steroids How they work:
It builds power and strength. It elevates the natural testosterone levels, a hormone already present in the body. It increases body mass, muscle strength and definition.
Who takes these?
Athletes who need spurts of power for short, but intense contests; runners; swimmers; rowers; male gymnasts; and weight and power lifters.
How is this substance traced?
Short-acting water-soluble steroids are now available. These can be absorbed by and eliminated from the body within a matter of hours. The most popular type is a synthetic derivative of testosterone. – (Health24)
When Australian cricketer Shane Warne used banned diuretics, the news made head lines. He tested positive for two banned diuretics, amiloride and hydrochlorothiazide. We take a look at these two drugs and diuretics as masking agents. 
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