Quote from: TonyaW on October 22, 2016, 04:04:50 PMAlso, off the top of my head I think that finasteride would be a better option than spironolactone. My guess is it is not used more because it can take a while for newer treatments to filter out to the mainstream (especially for a drug that's already off patent) and/or potential side effects from the finasteride.
Finasteride will reduce DHT levels while Spiro not only reduces DHT levels but testosterone levels as well AND partially blocks them at receptors, while also having the other effects mentioned above. Spiro is a stronger anti-androgen, finasteride is sometimes taken in addition to it. Finasteride was approved by the FDA back in 1992 so isn't really a new drug.
Quote from: Stephenie S on October 22, 2016, 04:09:37 PM
Okay fine your doctor prescribes twice daily and is probably following a protocol that they know are have reasons to trust.
I don't take Spiro, have never taken it. I am now post-op, since 2005. I know hundreds of transsexual women who have taken Spiro that way.
Some info on this...
Med J Aust. 1980 Feb 9;1(3):124-5."Once-a-day therapy with spironolactone has been compared with a twice-a-day regimen in an open crossover trial in patients with essential hypertension. When compared with placebo, both treatments significantly lowered blood pressure. Twice-a-day therapy provided slightly better blood pressure control than the once-a-day dosing schedule. There were only minor differences in biochemical findings between the two regimens."
QuoteI just don't like seeing people get stressed about this which possibly is more detrimental.
I agree.
QuoteAgain, the OP's concern was to do with feminization apparently at a standstill and wondered about splitting spiro which isn't the main feminization component.
I also don't think taking it once vs twice daily will make much difference but this should be discussed with the doctor. However, androgen being an important inhibitor of feminization like breast growth and causing other undesirable side-effects (masculinization), I think Spiro is an important contributor to the feminization component as it is anti-androgenic.
QuoteMost doctors will say that if your levels are in the female range then you are going to experience effects from this.
The female range is quite wide, from as low as 20 pg/ml (which is pretty similar to the levels found in males) to up to 649 pg/ml (
http://www.specialtylabs.com/clients/outreach/web/site/details.asp?tid=44312&cid=301&keyword) and up to 75,000 pg/ml during pregnancy. So, where exactly is the ideal level? And for whom? Some may need more, some less. Levels also greatly vary in time, in the same individual so measuring levels may be inaccurate.
When girls develop breasts, their growth hormones are high, as opposed to low with most of us who aren't in puberty any longer so that trying to replicate the levels they experience would also not be exact. Also, levels vary from one girl to another. I think instead, finding the right
dose for the individual in question is best but that is only my opinion, based on all I know. Some doctors agree with this approach, others prefer following the protocol of 100-200 pg/ml.
