Spironolacone

Hair Removal Methods Prescription oral medications
#41

I see this post went on to page 5. I have two other posts describing my experience/observations about Spiro on page 4. Read those first, then come back here!

Disclaimers: I am not being tested by any doctors, and that will not go over well here. If I could, I’d just as soon get a prescription and get the Spiro for $4 at Wal-Mart. But, since I can’t afford to go to New York or somewhere to get a prescript, this is what I’m doing. It’s working and I feel great. If you follow my example, it’s at your own risk. For the record, I got all my info from the transgendered community who have been getting this exact same stuff for years without a prescript or testing (I am not transgendered). As I said, I think it’s best to try to get a prescript. Especially if you take other meds.

Also, many will tell you to watch your diet. There is some truth to that. If you have a big problem with androgen excess, lay off refined carbs, limit caffeine, and drink your water (don’t drown yourself). That said, I am a slim, very healthy, very feminine (coffee-loving) female who happened to have androgen excess. You need to make sure you don’t have PCOS or some other underlying medical problem, if possible, before self-prescribing (if you go that route). I do notice a bit of a craving for salt at times now. I am supposing that it has to do with the fact that Spiro is a diuretic that excretes sodium (sparing the potassium). I eat more pickles and popcorn than I used to.

Whatever you do, don’t wax or pluck. If you have androgen excess, that androgen-loaded blood will be the first thing that rushes up to the just-plucked follicle, and that’s the LAST thing you need. After about a year it should be okay to pluck a hair here and there. Microflash electrolysis will work if you have a good technician AND you’ve got your hormones under control.

MOST IMPORTANT: Doctors usually prescribe Spiro with an oral contraceptive for a reason. This drug will cause a male fetus to not develop as a complete male child. And it is very bad for fetuses in general as it totally screws up development. I am not on OC because my husband has been “fixed”–so it’s not an issue with me. Generally, Yasmin is a great companion to Spiro if you have to take OC’s.

I don’t “check in” too often at these boards, but feel free to IM me. I’ll try to remember to check that much.

#42

I see it’s too late to edit my last post. Real quick: I said if you have androgen excess, the last thing you want to do is pluck–but that includes if you have androgen sensitivity, excess or no excess.

Also, I don’t have IM-- I meant PM. Send a private message if you wish (or post here; if there ends up being a lot of interest in this subject, I’ll check this thread more often).

#43

CoffeeGal, why can’t I pluck?

#44

Update: I ordered Spiro from the site you guys recommended - I should. I decided to start taking it on my own - I am just worried about he potassium thing - if my potassium levels are too high while on spiro what might happen??

Also, my doc called me AFTER i ordered the spiro and said I should get another blood test because after looking closely at it she said she is not sure-- so I will be getting another blood test- we’ll see what this one says but I doubt it.

#45

Potassium is (in most cases) not a problem (depending on the dose) unless you overdo it - avoid salt substitutes.

I am taking 150mg a day (this would be a high dose for a natal female), and I ate half a large watermelon and big bowl of strawberries the other night (both are moderate in potassium) and I got some tingling and cramping the next day. I will not do that again (too much and you could get a heart attack).

#46

Please do make sure to balance your hydration and electrlyte levels when using this medication. I highly recommend getting an electronic scale that measures hydration so you may monitor your levels. If my clients are any indication of the general population, most people are anywhere from 40% dehydrated, to in desperate need of an IV drip! This would be bad for one on Spiro.

#47

What are they called and where can I get one?

#48

Hi Evee:

Here are some effect of too high a potassium level.

Avoid taking vitamins that are too high in potassium, or potassium in vitamin form.

You may not have any symptoms, unless your blood potassium levels are significantly elevated.
Muscle weakness.
Diarrhea (with very high potassium levels).
Chest pain, or heart palpitations.

Alicia

#49

Evee420 – Don’t pluck, because the little trauma you cause to your hair follicle from plucking will cause some blood to rush to that spot (just as it does with any injury, large or small), and the free testosterone in your blood gets a free ride right to the follicle, where the sensitive receptors are. I am told that after 6 months to a year on spiro, it’s okay to pluck because the receptors have been sufficiently blocked and the free testosterone has been lowered significantly. I still prefer electrology.

I have no health issues with this drug, or side effects. I eat bananas and potatoes and such, but not in any mass quantities. I take NO vitamin or mineral supplements whatsoever. I am cautious of the potassium thing, but not paranoid over it.

I have no scales that measure hydration, as I’ve never heard of such an animal – but wouldn’t hurt if you can find one. I drink plenty of water and not much else, aside from a cup or two of coffee a day, and white tea. No pop, beer, wine, Kool-aid, or even fruit juices (I just eat the fruit).

I take 200mg/day; I was taking 250mg/day and had no side effects to speak of at that dose either (except good ones). If you can get a doctor to order lab work done, great. I can’t get one at this point. A pity they don’t take us seriously.

#50

Well so far it has been 1 week of taking 50mg of Spiro with breakfast each day. I switched to a new multivitamin with a lower potassium count (only 2% of daily value) and I drink lots of water throughout the day. I usually wake up around 7 and take the spiro with breakfast around 8 followed by my vitamins. I get to work around 9:30 and around 10am, I get a little dizzy feeling sometimes accompanied by very slight stomach cramps but it goes away fairly quickly- I am assuming this is due to the spiro but I dunno— is this bad?
Other than that I am doing fine…normal. I did notice that my hair is not nearly as oily and these little bumps I had on my forehead are gone–my forehead is smooth now as it was rough with bumps before. I haven’t gotten any new acne/pimples either and the ones that I have now seem to be less noticeable. I was really surprised at that because it has only been a week on a small dose. I will start 100mg tomorrow (divided into 50mg for morning and night).

#51

I read on some medical news website recently (I should have noted which one) that taking spiro with higher fat foods increases the absorption of the spiro. The explanation was that it takes your liver a lot longer to process fat than anything else, and it processes fat first, so your medication is circulating a lot longer in your body before being processed by the liver. Eating nothing with the medicine will cause the liver to rid your body of the spiro much sooner.

Weird, but I started eating some fat with my spiro. I don’t think we need to eat a slab of bacon for breakfast and supper, but I am trying to eat an avocado or cottage cheese or some healthy fats–though the other day I did splurge on bacon (sshhh).

I’ve also read in a number of places that grapefruit juice will intensify any medication… but I don’t think that’s safe. I’m not going to go there. Besides, I think grapefruit might be a high-potassium fruit.

Evee20 – You are experiencing exactly the same thing I did. The oily hair and face are the first things to disappear. Shortly after that I had no need of any deodorant, as strange as that sounds. Still sweat, of course, but no odor no matter how long I’m out in the heat. There has got to be an androgen connection, but I can’t find any info on that.

The hair will take the longest to go. Be patient… very patient.

#52

Avoid grapefruit juice if you are on spiro - I saw an article telling why this is bad just yesterday.

Edit - I just found the text (yes, it does have a lot of info regarding MtF trans people, but the main point is spiro + grapefruit = bad).

Grapefruit juice increases estrogen by slowing down its metabolic breakdown. Some doctors will advise people on estrogen therapy to avoid eating grapefruits or drinking grapefruit juice. This is a good idea. Curiously, however, avoiding grapefruit for MTF TSs is important not so much in managing estrogen but in lowering water retention that might be induced from spironolactone (which normally lowers water retention).

Consider (1). It mentions that the glycyrrhetic acid in licorice inhibits 11 beta-hydroxysteroid dehydrogenase in the kidney. This blocks the diuretic effects of spironolactone leading to water retention. Without going into detail this water retention will be much worse in a MTF TS on spironolactone than in someone else not on spironolactone due to non-genomic effects of aldosterone.

(2, 3, 4) show that the grapefruit juice can do the same thing as glycyrrhetic acid. Specifically, (3) mentions the naringenin in grapefruit juice as the substance that blocks spironolactone in the kidney.

(5) shows that increasing 11 beta-hydroxysteroid dehydrogenase in our fat cells increases fat subcutaneously but not in retroperitoneal fat. So the enzyme puts fat just where we need it to feminize ourselves. The deep, dangerous fat in our abdominal cavity (i.e. the retroperitoneal fat) is not affected
and the feminizing subcutaneous fat is increased. Obviously one has to control calorie intake to prevent going overboard on the fat gain even subcutaneously.

My recommendation is MTF TSs taking spironolactone consume no grapefruit juice and be very cautious about eating grapefruit.

Big warning - the effects of grapefruit on the kidney includes a tendency to LOWER potassium. Spironolactone has a tendency to INCREASE potassium. So, if you’ve been consuming a lot of grapefruit juice and your potassium has been just fine the two effects may have balanced out. If you stop consuming grapefruit your potassium is likely to elevate which can kill you. Be sure to have regular blood work to evaluate your potassium level and to eat a low potassium diet if on spironolactone.

Bonus information - if your cortisol has been chronically elevated by grapefruit juice once you lower cortisol by avoiding grapefruit juice you may find a considerable increase in your sex drive. That is if you’re taking progesterone or, I assume, related substances like Provera. (6) indicates that cortisol
blocks progesterone. Lowering cortisol allows progesterone to exert an effect that elevates libido. For most people in a direction heavily in the into men direction.

http://home.caregroup.org/clinical/altmed/interactions/Drugs/Spironolactone.htm
mechanism: Licorice can offset the pharmacological effect of spironolactone. 11 beta-hydroxysteroid dehydrogenase (11 beta-DH) is the enzyme that oxidizes cortisol to inactive cortisone and prevents cortisol from acting like a mineralocorticoid at the
aldosterone receptor site in the kidney. Some kinds of licorice contain glycyrrhetic acid which inhibits the action of 11 beta-DH (e.g. in the kidney) and causes cortisol to behave like aldosterone. [Nerissa note - it also allows the aldosterone which spironolactone has elevated but blocked to again become active in retaining water.]

  1. Clin Pharmacol Ther. 1996 Jan;59(1):62-71 Grapefruit juice and its flavonoids inhibit 11 beta-hydroxysteroid dehydrogenase.
    INTRODUCTION: The enzyme 11 beta-hydroxysteroid dehydrogenase (11 beta-OHSD) oxidizes cortisol to inactive cortisone.
    PMID: 8549035

  2. Zhongguo Yao Li Xue Bao. 1997 May;18(3):240-4
    Inhibition of 11 beta-hydroxysteroid dehydrogenase obtained from guinea pig kidney by some bioflavonoids and triterpenoids.
    AIM: To study the inhibitory effect of some bioflavonoids and triterpenoids on 11 beta-hydroxysteroid dehydrogenase (11 beta-OHSD) from guinea pig kidney. METHOD: The 11 beta-OHSD of kidney
    cortex microsomes in addition of cortisol was incubated in the presence of NADP, Triton DF-18, and the test compounds at 37 degrees C for 1 h. The enzyme activity was assayed by measuring the rate of conversion of cortisol to cortisone eluted with HPLC
    gradient analysis. RESULTS: The IC50 (95% confidence limits) values of glycyrrhizic acid, naringenin, fisetin, emodin were 254 (202-320), 336 (270-418), 470 (392-564), and 527 (425-653) mumol.L-1, respectively.

The inhibitory effect of oleanolic acid was 2-fold stronger than that of astramembranin I. The mode of action of naringenin was competitive inhibition.

CONCLUSION: The test compounds inhibited the 11 beta-OHSD in kidney cortex with different potencies as glycyrrhizic acid did.
PMID: 10072942
Glycyrrhizic acid is in licorice, naringenin is in grapefruit and to a lesser extent OJ, fisetin is in strawberries and emodin is in rhubarb.

  1. Eur J Endocrinol. 2005 Aug;153(2):291-9
    Expression of renal 11beta-hydroxysteroid dehydrogenase type 2 is decreased in patients with impaired renal function.
    glucocorticoids such as cortisol and may contribute to the increased sodium retention seen in patients with impaired renal function.
    PMID: 16061836

  2. J Steroid Biochem Mol Biol. 2007 Apr;104(1-2):81-4
    11-Beta hydroxysteroid dehydrogenase type 2 expression in white adipose tissue is strongly correlated with adiposity.
    High-fat fed animals overexpressed 11betaHSD2 in subcutaneous but not in retroperitoneal fat. Interestingly, mRNA levels strongly correlated in both tissues with different parameters related to obesity, such as body weight, adiposity and insulin resistance, suggesting that this gene is a reliable marker of
    adiposity in this rat model of obesity. Thus, 11betaHSD2 is expressed in adipose tissue by both adipocytes and stromal-vascular cells, which suggests that this enzyme may play an important role in preventing fat accumulation in adipose tissue.
    PMID: 17208436

http://menopause.zaadz.com/blog/2006/10/low_libido_id_rather_read_a_book
Another major component of healthy libido is stress reduction. Stress causes cortisol levels to rise above normal, and cortisol then can occupy the progesterone receptor, the lock in a cell into which progesterone fits, and block the action of this important hormone. Many women then experience an imbalance between their estrogen and progesterone. Subtle changes in progesterone action can cause low libido. Often a small amount of progesterone can improve desire along with working to minimize the impact of stress.

#53

Woooow NikkiSTL, That was much more informative than the site I read from. Licorice – I assume we are talking about the herb here, and not the candy? No matter, I don’t eat either.

I love grapefruits but have avoided them. Thank goodness.

I was a little corn-fused about this sentence:

“For most people in a direction heavily in the into men direction.”

My wild guess is that grapefruit is worse for men, which seems to be what the article implied?

If anyone knows what else we shouldn’t consume – something that would cause the spiro to not work – I’d sure like to know.

Fascinating stuff.

#54

No, it was talking about sexual preference. Ie, heavily in the into men direction means a physical attraction towards men. There have been some studies recently (I am withholding judgement until I see more data) postulating that as women go towards middle age and let themselves go (gain a lot of weight) and their cortisol levels climb, there is a tendency to gain interest in members of the same sex.

#55

Oh, I see what you mean. Never heard of that before!

Thought I’d pass this on, for what it’s worth:

Before I got on spiro, I had insomnia, and I’m not talking about the kind of insomnia where you are tired but can’t sleep. I’m talking about the kind where you stay up for two whole days and still don’t get tired at all. Well, when I got on spiro, that went away. Spiro never made me tired or drowsy, it just seemed to rid me of insomnia.

Recently I went on a vacation. I was off spiro for a few days, and I was awake all-the-time. I’d be up all day, all night, go to bed at 8:00 a.m. the next morning and only sleep a few hours, then get up and do the same thing over again. I suspect if I’d been off it any longer, I would have been permanenty awake.

As soon as I went back on them at home, I was back to normal in four days. I cannot see a connection between an androgen medication and insomnia, and have never found any info on it. I’d love to know if anyone else knows. I mean, I was totally unable to turn my brain off the whole time I wasn’t on it. It literally wouldn’t shut up! Now I’m relaxed again.

#56

might that insomnia have to do with your caffeine habits considering your name? :slight_smile: and do you by any chance take anything else, like diet pills or ADD medication that has uppers in it?

#57

Actually, nope! I drink a cup of coffee in the morning – and I do love the stuff – but I drink it whether I’m on spiro or not. I don’t drink that much coffee, and never drink soda or any other caffeinated beverage. If I do happen to want coffee at night (like if company is over) I’ll drink decaf. I love the stuff, but I don’t indulge. I don’t think any caffeine drink could keep one awake for 2 days. I was never jittery…just…wide awake!

But, good guess!
:wink:

#58

No, I take absolutely nothing else. I am 5’5 and 110 pounds, so I am not on diet pills.

That’s why I’m puzzled.

#59

Well, never did find out why spiro helped with insomnia. I did read that women on HTR have less insomnia, so there’s probably a connection between insomnia and hormones.

What I did find is that some of our body parts have both apocrine sweat glands (ruled by hormones) and eccrine sweat glands (ruled by heat). Most of our body just has eccrine glands. But that explains why I’ve never had to use deodorant since going on spiro.

I know a grocery clerk in a nearby store who I wish would get on spiro instead of Accutane. Both drugs may work for the acne, but Accutane does nothing for the (WHEW!). Judging by the acne and “scent”, I really think it’s hormone overload in that person.

Guess that’s one way to tell.

#60

CoffeeGal- how many mg of spironolactone do you take a day? I’m going to the doc on Tuesday and want to know how much to ask for to start off. (I haven’t taken it in 4 years). Did you start off taking less and then added? I don’t want to start with too little.

I didn’t understand fully why grapefruit would be bad for females taking spiro b/c it says it elevates estrogen…don’t we want more estrogen to counteract excess hairgrowth? Just wondering!
Alli