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I hope this is the right place for this question. Sorry if it’s not.
Has anyone had …or maybe I should ask it like this.
What are your thoughts and experiences on Spiro?
I read an article which scared me a bit.
https://moderntranshormones.com/2018/01/01/whats-wrong-with-spironolactone/
Therese
My personal experience with spiroloctone is positive. Within 2 months my testosterone levels went from 823 pre hrt level. 2 months later my testosterone is less than 12 and has stayed there for the last 3 months. My estrogen levels have been climbing since the start of hrt, but not at the levels theu should be, however my endo wants to up my dose and switch me to estriadial injectables which generally have a better success rate. Hope that helped, the only side effect is lactic acid buildup in my calves. So had to reduce my pottasium intake to avoid cramps in the calves. Good luck!
Traci
I had the same effects as Traci Lynn wrote about. My Endo said my T level was higher than most men, that most men would dream of having, around 740. But shortly after starting Spiro, it was less then 100. Then a month later, it was down to 9! Then I was started on Estradiol. The first thing I noticed with such a low T level was no more morning wood! In the months thereafter, my privates began shrinking. I also noticed, I could not get an erection as easy as it used to be. I could still orgasm, but I was ‘shooting blanks’! After a year of Spiro pills, the Endo gave me the 90-day shots in the abdomen. I had those for about 1.5 yrs. Then I was put on 180-day shots and have been on them since. What depressed me was they lowered my Estradiol dosage to .75 mg twice a week! Since I was put that low, I have not noticed any new changes. I started on 10mg/day, then down to 5, then down to 2, now .75 twice a week! I know the Endo was worried about blood clotting, but never had that happen on higher doses.
DVT (deep vein thrombosis) is also commonly called a blood clot in a deep vein and is a real problem that can have a number of risk factors, estrogen use being one of them. I have several of those risk factors, one being age and another being sedentary lifestyle. I do not have a sedentary life but with work I would stay in a driving position for 7-8 hours a day. I also had varicose veins which was a hereditary issue.
After 3 months on 8mg/day of estradiol pills I had a DVT. The danger of that in a deep vein is that it leads back to the right side of the heart and then to the lungs. In the lungs it can cause a pulmonary embolism with symptoms of shortness of breath and possibly death. My does was reduced to 4mg/day and was changed over to patches which are generally considered safer. Patches provide a continuous supply of estrogen and are considered safer since they do not have peaks like pills would.
It’s good at lowering your T quick, but has problems long term such as brain fog and anxiety both of which I experienced. It creeps up on you too.
A high enough blood level of E will suppress the T on it’s own. I switched endo’s to a doc who shadowed Dr Powers and the first thing we did was cut the spiro out because the injections I had started a few months earlier gave me good levels to do that.
It’s not necessary for all of us. I purposely took EV injections only without Spiro to see what my body did with just that, blood levels- wise. If it didn’t bring my T levels down, then I would plan toconsider Spiro. As it carried more risks, especially for someone like me that has kidney stones and dehydration issues in the past. In my case, with the standard initial dosing for EV, my T crashed out by itself to the bottom of female ranges by my first post-HRT blood test. I’ve since about halved my dose, and nearly two years later, I’ve never seen my T levels rise, and E2 has been in “ideal” ranges.
IMHO, start EV injections first, see what your blood levels do, and address with Spiro later, if you can’t get T down. I had two different doctors, both supporting this approach when I suggested it as risk avoidance.
My wife is a critical care and nephrology (kidney) nurse practitioner and she gave me some detail of it beyond what you might get in a google search.
Spiro is a diuretic that is one drug that can be used to reduce blood pressure even though it is not the preferred drug to use for that purpose. Kidney function is important to keep up with because that is where the process occurs. Reduction of the testosterone level is a side affect of Spiro and not its primary purpose.
Both biological men and women have estrogen and testosterone in their system, just at different levels, testosterone being stronger. If a biologic male has the normal amount of testosterone in their system then the estrogen that we take will have less of an effect since testosterone will be countering it, therefore the reason that testosterone is intentionally reduced. The desire is to reduce testosterone to a level of what would be normal for a biologic female. So the Endocrinologist tests for both hormones and getting the correct dosage is a matter of trial and error. The level for one person is not the same as for another since the dose is not as important as the cells ability to transfer the hormone across the cell wall, which varies for each individual.
If a MTF trans person is unable to take Spiro due to kidney function and their testosterone level is high the urologist can remove the testicles. I had a vasectomy 15 years ago and the urologist cut too much and my testosterone went to almost zero. I had no thoughts of transitioning 15 years ago and so I had to take testosterone for 12 years until I decided to start HRT.
So if you can get by without Spiro that is best but it is not like it will cause you severe issues as long as you have good kidney function.
Like some others have said the worst normal side affect of Spiro is having to go pee every hour.
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