I see the bp affects of Spiro talked about often. The salt thing comes up frequently as well. Personally, my issues with Spiro revolve around potassium. My baseline levels were near the high end of the range (5.0 not sure of units and too lazy to look). My endo put me on Spiro and E as is the usual starting point. Despite avoiding potassium rich foods it still spiked my levels (5.6 at highest, 5.1 being top of the reference range). I didn't have any symptoms of hyperkalemia and my levels slowly crept back to baseline over a year. Unfortunately, we couldn't use Spiro as an effective method to lower testosterone. Luckily, continued increases in E lowered my T levels. Just putting it out there so others can read that it can happen. I did discuss other options for anti-androgens, but my doc is very conservative it seems. Not sure what I would have done had E not been sufficient since I can't afford orchi at this point in time. Not life threatening,but an annoying hurdle.