Is it ok to take my estradiol and spironolactone 10 mins before eating?

[Angélique LaCava]

It's a question that popped in my head after eating, but would eating 10 mins after taking estradiol and spironolactone affect them any? If so how long should I wait to eat after taking them.

[Laurie]

That information is likely on the papers that come with the medication or your doctor should be able to tell you. Didn't your doctor give you instructions on how to take your medications?

Are you really that worried about every little thing that may or may not affect your medication's effectiveness?
Or do you just ask because you are insecure and need to be reassured that you look great?

There is nothing wrong with your HRT medications, They are working fine for you.
There is nothing wrong with the way you look, you look great and very female.

  Hugs,
   Laurie

[Angélique LaCava]

That information is likely on the papers that come with the medication or your doctor should be able to tell you. Didn't your doctor give you instructions on how to take your medications?

Are you really that worried about every little thing that may or may not affect your medication's effectiveness?
Or do you just ask because you are insecure and need to be reassured that you look great?

There is nothing wrong with your HRT medications, They are working fine for you.
There is nothing wrong with the way you look, you look great and very female.

  Hugs,
   Laurie

i didn't mention anything about my looks. I just want the most out of my hormones. It dosnt say anything about food on the papers.

[Devlyn]

Absolutely not! Now gimme that sandwich and I'll eat it for you. 

Hugs, Devlyn

[Doreen]

When in doubt I look at the PDR (physicians desk reference) for the definitive answer on most things medication wise.. I also refer to abstract .pdf that usually contain very wordy but specific information on drugs.  In this particular case I'll refer you to <Link not allowed>

Oral Administration
Administer with or immediately after food to decrease nausea.

As far as efficacy, you'll have to look at the actual scholarly articles .pdf's usually.
Just at first blush I found <Link not allowed>
<Link not allowed>
  most .gov websites are fairly 'reliable'... as much as anything from the government is... but I'd trust this a lot more than some nameless .com website too.

If you're taking.. St. John's Wort
preparations (Hypericum perforatum), phenobarbital, carbamazepine, and rifampin it can reduce its effect btw.


BTW almost all medications (or at least many) have problems with grapefruit and black licorice, as well as a couple other interesting foods.  Some medications as well, so never hurts to brush up on the information provided here.

In case it helps I'm a RN, and study these things for 'fun' lol.

Hope this helps.

It's a question that popped in my head after eating, but would eating 10 mins after taking estradiol and spironolactone affect them any? If so how long should I wait to eat after taking them.

Moderator edit: Links removed due to ToS 1 Violation

[Dani]

Angelique,

How are you taking your hormones? Oral, sublingual, topical or injectable? There is no interaction with topical or injectable.

I take my estradiol by sublingual and I wait 30 minutes before eating or drinking and I try not to swallow my saliva during the same 30 minutes. This is to keep the estradiol under the tongue where it is being absorbed and not wash it down to the stomach, where what remains will be absorbed by the stomach and head straight to the liver.

[Angélique LaCava]

Angelique,

How are you taking your hormones? Oral, sublingual, topical or injectable? There is no interaction with topical or injectable.

I take my estradiol by sublingual and I wait 30 minutes before eating or drinking and I try not to swallow my saliva during the same 30 minutes. This is to keep the estradiol under the tongue where it is being absorbed and not wash it down to the stomach, where what remains will be absorbed by the stomach and head straight to the liver.

oral. I know subligual gives you more medication, but I'm only interested in doing oral, so if I eat 10 mins after taking my hormones will they be just as effective as they have been if I waited 30-40 mins to eat?

[Maybebaby56]

Hi Angelique,

The bioavailability of spironolactone is greatly enhanced when taken with food, so there is no problem with that. In fact it's preferred. As far as estradiol, I have not read anything about it making a difference whether you take it with food or not.  It's going to be metabolized by the liver in either case.

~Terri

[Laurie]

i didn't mention anything about my looks. I just want the most out of my hormones. It dosnt say anything about food on the papers.

  No, No you did not Angelique,

  I included that on my own after having followed your posts for quite some time and they pretty much fall into two categories.

  1. Does xxxx affect  your HRT effectiveness?
and
  2. Does xxx  HRT medication affect something concerning your appearance?

  I don't want to sound insensitive or rude Angelique but your questions do conjure up images of a woman that is either insecure or vain.  You are a very good looking woman Angelique. Your HRT regimen has, and is working wonders in you.  You are the envy of many of us here. Whatever you are doing is working great for you Angelique. Stop worrying about it and keep doing it.
  I know you are a sensitive , friendly, and caring woman from some other threads you are active in, Angelique. And I am sorry if I have hurt your feelings. that was not my intent here. I don't want to make you angry with me either though I know I probably have. Again I'm sorry for doing so. I'd rather we be friends.

Hugs,
   Laurie

[Dani]

oral. I know subligual gives you more medication, but I'm only interested in doing oral, so if I eat 10 mins after taking my hormones will they be just as effective as they have been if I waited 30-40 mins to eat?

There may be some benefit by taking with food if you experience any nausea when you take your hormones. 

But the blood levels will be much lower than on an empty stomach, because with food in the stomach at the same time as your hormone, the rate of absorption is much slower.

[RockiesRhea]

Personally Im very surprised at how much dr's actually dont know about how to take estradiols.

My hrt prescribing dr was certain that I need to ingest it and without food. The same for spiro.
Thankfully I had come across info about a month after starting spiro that led me to wondering this same question.
With spiro, after talking with 5, yes 5 different pharmacists i realized would be more effective taken with food.
I have an iron clad tummy and so nausea certainely was not one of my concerns.

I had by my dr not been told this. Infact he told me to take with only water. Which was dead wrong.
Spiro deffinitely ( so each pharmacist i asked says ) wprks better with food.
So personaly I take my spiro second.

Estradiol is better absorbed when taken subligually. You loose a fair amount of it when ingested. I nolonger remember the numbers but you loose a significant amount when ingested as it goes through first pass, digestive metabolism destroying a fair amount via stomach acids. This metabolism route takes the estradiol next to the liver where it partly is lost some aswell.
It also then is filtered out of your system by the liver. Now when you take anything through the liver it causing micro damage. This normally wouldnt be an issue if we were not taking into consideration that we will, as transwoman, likely be on it for the rest of our lives. For this reason IT MATTERS. This slowly over years of use damages the liver and who wants a damaged liver. Especially when you consider that here we are taking HRTs because we care about and love ourselves as much as to come out and undertake such a massive life change.

Sublingual estradiol nearly all reaches the bloodstream. Not only that but it also entirely bypasses the liver.
Now my dr who issued spiro at first was a different dr then the one i then got estradiol from and whom i now get both my scripts from. The 2nd dr was certain it would be best to take both via oral ingestion until i had presented her my online research and some info that 3 pharmacists had given me.

After looking into this for a few weeks dr #2 said, well Rhea you sure seem to know what your talking about but lets so how it reflects in your blood screens. And so for the next 3 months i had bloodwork every 2 weeks (if i remember this perfectly spot on as it was a few years back).
By the time 3 months had passed dr #2 said and i quote.... "I conceede Rhea, you deffinitely were rite, your hormone levels are spot on with the expected cis-womans range.
And yes my research deffintely agrees with yours as to the liver absorbtion factor."

She then stated to continue this method of administration of my estradiol and spiro.

She even was convinced that there was absolutely no reason to use prometrium, which she now prescribes me and prescribes me as a cycling regime. But thats another atory which i will not get into.


My point in this is that.
Spiro = take with food.
Estradiol = take sublingual before you eat (largely because..... hey your going to take it for ever so why risk damaging your health, liver wise and also go loosing a fairly large amount of it on digestive process)

[Wednesday]

i had presented her my online research and some info that 3 pharmacists had given me.

I think this is really interesting.

May I ask you via PM for any link you got at hand on the subject? Im curious about the E percentage lost by oral intake. Also interested in the reasons to prescribe prometrium.

Thanks in advance!

[RockiesRhea]

It was 2.5 years ago that I found that information about percentages lost and the reason I did not post them was because I had already gone to my old bookmark and the page is a 401 error. IOW the site / page no longer exists.
However... I do remember that there were a few places my script prescribing Dr had found identical information but she never gave me those site URLs.

I wished I could have quoted those numbers as I knew that people would want them. But, crappy as it is, i cant.

They were significant enough however that I was able to knock 1, <dosage not allowed>tablet off my daily intake after the 3 months of screening.

Now let me stress this part....
It will vary, sometimes greatly, from patient to patient. Therefore its best to undertake that journey of discovery on an individual basis in my opinion.

There were multiples of reasons for the prometrium. For one, purely on a person desire, I wanted to experience as close to a cis-womans cycle as possible and so I self advocated towards hormone cycling. I do have some solid info on that which i will share in a this post. But first.....
This will also very greatly from one person to another....
Personally Ive spoken to 3 other transwomen who cycled with the same scripts but theyre own custom levels and only one found what Im about to state.

I pretty much experience a period. Menstration??? of course not.
I do every month when i cycle prometrium get moody, crampy, bloaty, even headaches sometimes. So its not for everyone in my honest opinion but for me I am EXTREMELY happy with it and it has simply become a normal part of life for me now.

Before I share the URL that I can about the prometrium cycling I urge anyone that would look into this to extend there own research and understanding past this site as I did. It took me months of presenting my case to my HRT issueing Dr and an endocrinologist to get this and they were clear that they would try it for a short term as an "experiment" and if they were not comfortable with the outcome at any time they would pull the prometrium script and return my regimen to the previous state and I had to agree to that with absolutely no argument if that was the outcome.
Thankfully for ME I am just now starting my 6th cycle and both Dr's are completely onboard so far. This may be different for anyone else... Our bodys all respond very differently then others which is why dosage is typically a big no no to share with others as going off of someone elses dosage can SERIOUSLY harm someone else and why I refuse to share dosage. Not just due to rules on typically every site about transition but also to people I know in person.

On to the information that I can share via URL about simulating the Cis cycle.

<Link to dosage schedule not allowed>

I hope this helps you out / answers questions you have and no doubt will have as you read on.
As for PMing me.... I dont mind at all but I only get on the site from time to time so dont be taken back if im slow to respond. Im still getting familiar with the site and dont even get how to put a custom user pic on my profile


As an after thought... Im very new on susans place and am still getting familiar with the particulars of rules etc.
I truely hope that I'm correct in that Im not breaking any of those rules through this information. If so PLEASE admins adjust as according but also I would appreciate being told where I went wrong as to prevent stepping on toes later.

Moderator Edit: We do not allow dosages on this site.

[KayXo]

Personally Im very surprised at how much dr's actually dont know about how to take estradiols.

My hrt prescribing dr was certain that I need to ingest it and without food. The same for spiro.

Studies have shown that absorption is enhanced when Spiro is taken with food while no such findings have been made with oral estradiol. Grapefruit can also increase concentrations of both estradiol and spironolactone as it inhibits enzymes that metabolize these substances. Always check with your doctors and pharmacist.

Spiro deffinitely ( so each pharmacist i asked says ) wprks better with food.

Yup. Sometimes, pharmacists are better informed than doctors.

Estradiol is better absorbed when taken subligually. You loose a fair amount of it when ingested.

True and this has been confirmed by studies, time and time again BUT, personally, I found no difference in terms of effects on my feminization or mental disposition.

I nolonger remember the numbers but you loose a significant amount when ingested as it goes through first pass, digestive metabolism destroying a fair amount via stomach acids.  This metabolism route takes the estradiol next to the liver where it partly is lost some aswell.

I think it's more the enzymes in the small intestines, after the stomach, and those in the liver that destroy or rather metabolize a fair amount of estradiol into estrone, a weaker form of estrogen and other inactive substances. Like CYP1A2 and CYP3A4. The bio-availability is around 5%, on average.

Now when you take anything through the liver it causing micro damage. This normally wouldnt be an issue if we were not taking into consideration that we will, as transwoman, likely be on it for the rest of our lives. For this reason IT MATTERS. This slowly over years of use damages the liver and who wants a damaged liver. Especially when you consider that here we are taking HRTs because we care about and love ourselves as much as to come out and undertake such a massive life change.

I personally disagree. Search all the studies you want and you won't find any findings of BIO-IDENTICAL estrogen causing liver damage, even in quite high amounts. Perhaps, this was the case with non bio-identical forms but let's remember to distinguish between the different types of estrogen. Androcur is more likely to cause liver problems, more so at higher doses and alcohol, tylenol, etc. I've personally taken oral for several years, moderate to high doses with no change in liver function. Studies in trans and ciswomen confirm this.

Sublingual estradiol nearly all reaches the bloodstream. Not only that but it also entirely bypasses the liver.

I'm not so sure. I believe some is inevitably swallowed as if you take a blood test, you will often notice how high your estrone levels are relative to estradiol. A study confirmed this, showing estrone levels to be higher than estradiol after a few hours.

"I conceede Rhea, you deffinitely were rite, your hormone levels are spot on with the expected cis-womans range.

A ciswoman's range is quite wide, from as little as 20 pg/ml to up to 650 pg/ml during a menstrual cycle, and up to 75,000 pg/ml during pregnancy. This range overlaps that of males (10-60 pg/ml).

Sublingually, levels peak and drop rapidly so measuring levels is inaccurate. They would be significantly higher the first few hours, perhaps exceeding the menstrual cycle range and then, taken just before the next dose, they could be quite low, near the lower end of the range. They are all over the place and test doesn't measure sensitivity to levels.

Also interested in the reasons to prescribe prometrium.

Can improve libido, hair/skin texture (less dry and brittle), can improve mood, fat distribution, breast growth/volume, shape, nipples/areola, etc. To each their own. Trial and error.

There were multiples of reasons for the prometrium. For one, purely on a person desire, I wanted to experience as close to a cis-womans cycle as possible and so I self advocated towards hormone cycling. I do have some solid info on that which i will share in a this post.

Having so many cycles in a lifetime is not natural and is a result of modernization and of the advent of birth control pills. Traditionally, women spent much more time being pregnant and breastfeeding, this is more natural and this has been confirmed in observations of traditional societies. An increased number of cycles has also been associated with an increased risk of breast cancer (i.e. nuns, modern vs traditional societies although associations do not imply cause and effect). Cycles also result in PMS.

I do every month when i cycle prometrium get moody, crampy, bloaty, even headaches sometimes.

I also get headaches from it, sometimes. More likely if my estrogen is not particularly high or dropping. Progesterone is somewhat anti-estrogenic. Progesterone can lead to bloating due to conversion to neurosteroids that have sedative properties so the intestines move slower and food remains there longer. But, progesterone is anti-mineralocorticoid, meaning like Spiro, it reduces water retention. Those neurosteroids derived from progesterone also usually make someone sleepy, feel calm and relaxed, "zen"-like. Withdrawal can lead to mood deterioration and levels can drop quite rapidly.

[Wednesday]

Gotcha @KayXo.

In my case the most I noticed from P cycles where just unwanted effects: bloating an awful lot, more constipation than usual, hungry all the time, I think I got less libido and less energy. Also skin gets a bit more oily (which I dont like). The only good thing I got was a temporary filling of my boobs that vanished one or two days after the last P intake and the volume increase was not such a big deal given I have E cup implants.

Furthermore, cycling P and doing the 2-3 days break at the end of the month (just as some meds are intended to take, mimicking the natural cycle) messes a bit with my mood and I don't like at all the whole "cycle" thing.

[Angélique LaCava]

Gotcha @KayXo.

In my case the most I noticed from P cycles where just unwanted effects: bloating an awful lot, more constipation than usual, hungry all the time, I think I got less libido and less energy. Also skin gets a bit more oily (which I dont like). The only good thing I got is a temporary filling of my boobs that vanishes one or two days after the last P intake and the volume increase its not big deal given I have E cup implants.

Furthermore, cycling P and doing the 2-3 days break at the end of the month (just as some meds are intended to take, mimicking the natural cycle) messes a bit with my mood and I don't like at all the whole "cycle" thing.

why would you want E cup implants? If I ever get implants I mean not going higher than a C cup, but I have a tiny frame, anything bigger would look weird on me.

[Wednesday]

why would you want E cup implants? If I ever get implants I mean not going higher than a C cup, but I have a tiny frame, anything bigger would look weird on me.

Im this kind of person who once in a while enjoys dramatical changes lol.

Given that the most common regret when it comes to BA is not going big enough... I just went straight for big DD's/small E's. I would regret much more going too small than going too big.

Also once you start checking BA outcomes while planning your surgery... You realize E's are not that big. I mean they are big for sure, but it takes at least G cups to make things look weird.

Furthermore they work like a charm when it comes to catch guys attention lol (got to admit this played a major role in my decision).

On the downside they may be a little uncomfortable sometimes (messing with your posture, etc) but for me they are totally worth it.

[TheLittlestSlam]

should be fine I do it regularly.