Alternative to Spironlactone in USA?

[JennJenn]

Is there a safe alternative to spironlactone, that is effective and available in the USA?  (Perhaps one that might even work better?)

I am getting way too much dehydration as I am taking a larger dose.  Especially problem since it is causing rising uric acid levels and I'm starting to develop gout.

I am on estradiol as well.  No micronized progesterone at the moment, but thinking about getting back on it after years.

I wonder if it is possible to have normal T and free testosterone levels with estrogen alone since testes have shrunk so much over the past 10 years of HRT.

EDIT: I'm working on getting orchiectomy asap.  Eventually SRS when I can afford it.

[Anela]

Is there a safe alternative to spironlactone, that is effective and available in the USA?  (Perhaps one that might even work better?)

I am getting way too much dehydration as I am taking a larger dose.  Especially problem since it is causing rising uric acid levels and I'm starting to develop gout.

I am on estradiol as well.  No micronized progesterone at the moment, but thinking about getting back on it after years.

I wonder if it is possible to have normal T and free testosterone levels with estrogen alone since testes have shrunk so much over the past 10 years of HRT.

EDIT: I'm working on getting orchiectomy asap.  Eventually SRS when I can afford it.

Sweetie, I did notice by keeping water on me , two tablespoons of chia seeds in morning with one pint pure tablespoon of chia did wonders on keeping the dehydration down.
We all have different bodies and nobody is to give e you advise what to do but I simply advised you on a super food additive to your morning and it might make things mellow out for ya and you can stay on what you are doing.
  Remember, no matter what you do, you will have to sacrifice and treat your body as a baby or you WILL in fact have problems....

Sent from my XT1635-01 using Tapatalk

[Chloe]

Is there a safe alternative to spironlactone . . .

I would take Casodex (bicalutamide) before getting/instead of an orchi.

Took for 7+ years with no downsides and some pluses that, as of now, are more-or-less permanent and don't feel need to take anymore. Plan to see endo soon, will let know results.

Since bicalutamide will block ('mimic' is better word) the (binding) effect of testosterone (and DHT) on all tissues, there will be no response by the body to the increased androgen levels, but the rising sex hormone production will increase the estrogen levels in the man to be much higher than they would be in a person who has not been taking bicalutamide

And there is no adverse action on the brain at all.

[stephaniec]

I cant take spiro because my potassium levels go off the wall so I take Finasteride

[kelly_aus]

There's no real need for spiro or other antiandrogens. A sufficient estradiol level will suppress T production without the need for additional drugs.

[JoanneB]

Is there a safe alternative to spironlactone, that is effective and available in the USA?  (Perhaps one that might even work better?)

I am getting way too much dehydration as I am taking a larger dose.  Especially problem since it is causing rising uric acid levels and I'm starting to develop gout.

I am on estradiol as well.  No micronized progesterone at the moment, but thinking about getting back on it after years.

I wonder if it is possible to have normal T and free testosterone levels with estrogen alone since testes have shrunk so much over the past 10 years of HRT.

EDIT: I'm working on getting orchiectomy asap.  Eventually SRS when I can afford it.

I was on E as well as a kick ass AA unavailable in the US for about 4 years. My T was in the sub-sub-basement. Since I hate having to take pills "Every Day" (I do shots for E) I figured at this point I can probably slack off on the AA.

Surprise!  After about 6-9 months I was getting a lot more depressed again. When I went legit and got and got my blood tests back. Surprise, My T was low normal... MALE 

As far as an AA goes, our choices are limited. Orchi or spiro

[Harley Quinn]

Progesterone is a mild AA add it to Estradiol and you may be good. Suggest it to your doctor and see what they say. Or heavily adjust your diet if. You're worried about potassium.

[tgirlamg]

Hi Jenn!!!

My first month on HRT, I end d up in the emergency room due to An allergic reaction to Spironolactone!!! I was switched to Finasteride as my blocker and T was well suppresed up to GRS... After which it was no longer needed!!!

Onward we go!!!

Ashley 😀

[Lucy Ross]

There's no real need for spiro or other antiandrogens. A sufficient estradiol level will suppress T production without the need for additional drugs.

I've read about a FB group dedicated to that cause, with an extra over-zealous membership, the TG equivalent of P90 or the Master Cleanse, from the sound of things. In fact I think I read about it from your posts.  Know the group I'm describing?

My big bag of spearmint tea arrived today, would that do the trick? You'd have to constantly explain why you're drinking toothpaste... not much of a downside!

[staciM]

I've read about a FB group dedicated to that cause, with an extra over-zealous membership, the TG equivalent of P90 or the Master Cleanse, from the sound of things. In fact I think I read about it from your posts.  Know the group I'm describing?

My big bag of spearmint tea arrived today, would that do the trick? You'd have to constantly explain why you're drinking toothpaste... not much of a downside!

That's being polite.  I've been a part of that group and it's closer to a cult.  They are belligerent toward anyone that doesn't practice their method.  It didn't take me long to realize it was a place I didn't want to be.

[kelly_aus]

As cult-like as that group may be, the fact is, a sufficient E level will suppress T, it's not a new idea and is medically sound. Why take a drug you don't need to? Especially when they are often unfriendly to our bodies.

[Chloe]

As far as an AA goes, our choices are limited. Orchi or spiro

Huh?? My endo approves what I decide to take . . .

As cult-like as that group may be, the fact is, a sufficient E level will suppress T,

The more 'E' taken the greater the risk. Thought the whole point of AA's was to reduce that risk?? Spiro is not FDA approved for "T" intolerance don't understand why people are hung up on it so.

Christine Jorgensen died of cancer. My father died of "prostrate cancer". Not gonna be me!!

[Dena]

Christine Jorgensen died of cancer. My father died of "prostrate cancer". Not gonna be me!!

Most likely won't be. She died of bladder and lung cancer. This was most likely caused by smoking, something which about 50% of the population did in the 1950's and 1960's. Prostate cancer can also be cause by smoking as my father was treated for it. In the end, smoking caused my father's death with lung cancer.

[kelly_aus]

Huh?? My endo approves what I decide to take . . .

The more 'E' taken the greater the risk. Thought the whole point of AA's was to reduce that risk?? Spiro is not FDA approved for "T" intolerance don't understand why people are hung up on it so.

Christine Jorgensen died of cancer. My father died of "prostrate cancer". Not gonna be me!!

OK, if you say so. That study of non bio identical estrogens is damn persistent, even when it doesn't apply. Looking back, AA's were added to the HRT mix because trans people complained E didn't lower the T level fast enough.

Levels of 250 pg/mL are sufficient in some - this is not a high level, in fact it's not at all uncommon.

[Mariah]

The Endo I used to have would have said no to this question and the reason is because he doesn't feel any are as affective as Spiro which is I have no doubt true. Is there something that in combination with estradiol that can help yes. I would recommend asking your endo for assistance in regards to that though. Hugs
Mariah

Is there a safe alternative to spironlactone, that is effective and available in the USA?  (Perhaps one that might even work better?)

I am getting way too much dehydration as I am taking a larger dose.  Especially problem since it is causing rising uric acid levels and I'm starting to develop gout.

I am on estradiol as well.  No micronized progesterone at the moment, but thinking about getting back on it after years.

I wonder if it is possible to have normal T and free testosterone levels with estrogen alone since testes have shrunk so much over the past 10 years of HRT.

EDIT: I'm working on getting orchiectomy asap.  Eventually SRS when I can afford it.

[Mariah]

Almost had to go that route which I was fine with. Hugs
Mariah

As cult-like as that group may be, the fact is, a sufficient E level will suppress T, it's not a new idea and is medically sound. Why take a drug you don't need to? Especially when they are often unfriendly to our bodies.

[JennJenn]

How quickly do testosterone and free testosterone levels rise after stopping spironlactone?  Do they rise after 1 day? Or is the drug built up in your system over month before they have much effect -- like many other drugs.

I have been having a problem with dehydration and have stopped taking them for 16 hours now, I'd like to stop my spiro for a week and see if I feel better with respect to dehydration.   Then I want to go get a blood test of both testosterone and free testosterone to see where they are at.  How much will they have risen? I been on HRT for 10 years (spiro/estrodial) and gonads shrunk to size of tiny grape.

I won't start losing my hairline or spur body hair growth will I, after just one week off the drug?

[josie76]

My understanding of the action of spironolactone is that it does nothing to shut down The production. It does bind to cellular androgen receptors with an extremely low activation rate thus locking up those receptors so neither T or DHT can get to them. Estrogen HRT is what eventually shuts off the activation hormone at the pituitary so the testes quit production if T. So the point of Spiro is to stop the effects of The on the body while the added HRT slowly turns off the T production.

This is from what I've read as well as the way my endo (professor at Wash U) explained it. His goal was to have enough E to put The into female range. He doesn't even ask for E levels on blood tests.

Since the OP has been on HRT for years it's likely that her current HRT will maintain her surpressed T levels and that the Spiro is no longer needed.

I'm only 6 months on HRT and my T is in the female range but I do want an Orchi so I never have to think about those Things producers again. Also my urologist will do all the notarized papers for me so I can legally change everything.

[JennJenn]

My understanding of the action of spironolactone is that it does nothing to shut down The production. It does bind to cellular androgen receptors with an extremely low activation rate thus locking up those receptors so neither T or DHT can get to them. Estrogen HRT is what eventually shuts off the activation hormone at the pituitary so the testes quit production if T. So the point of Spiro is to stop the effects of The on the body while the added HRT slowly turns off the T production.

This is from what I've read as well as the way my endo (professor at Wash U) explained it. His goal was to have enough E to put The into female range. He doesn't even ask for E levels on blood tests.

Since the OP has been on HRT for years it's likely that her current HRT will maintain her surpressed T levels and that the Spiro is no longer needed.

I'm only 6 months on HRT and my T is in the female range but I do want an Orchi so I never have to think about those Things producers again. Also my urologist will do all the notarized papers for me so I can legally change everything.

Thanks I didn't realize this.

My last blood test (a couple weeks ago)

Estradiol 132 pg/mL
Testosterone 24 ng/dL   (0-50 is normal female range)
Testosterone, Free, Direct 1.3 pg/mL.  (0-0-4.2 is normal range for female)

So since I am producing such little T now (due to the estrogen I guess), I don't really need Spironolactone at all do I?--I mean there isn't really anything to block that is significant. I am going to talk to my endocrinologist about this -- she's taking over my HRT (famiy doctor took care of me for 10 years but he closed down).

Wow I've had T in the 25 range along with Free Testosterone under 1 pg/mL for past 7 years.  To think I've been taking this spiro for 10 years for nothing.. geeez!  Also I read it interferes with some estrogen receptors?  e.g. for breasts?  Maybe if I quit this spiro my breast development will improve?

EDIT: I just read in Spiro wikipedia, that Spiro also acts as an androgen production inhibitor.  If that is the case maybe I might need it.  I could talk to the doc about cutting dose in half for a while and monitor estradiol, T and free T levels.   Then keep cutting it down perhaps.  I dunno.

[Antonia J]

I can't take Spiro, and my endo has me using Lupron as an alternative (in the USA, btw). It works very differently from Spiro, but essentially has the same outcome. Lupron halts the testes from making T. It's very expensive, which is why Spiro is the first choice. Lupron is most often used in pre-adolescent trans children to delay puberty. As a 46 yr old trans-woman, I am using it effectvely.

Also, I use finasteride. This does not do the same as either Spiro or Lupron. It blocks DHT, not T. The upside is that you will not lose the hair on your head on finasteride, but the downside is that your body hair will not thin and you may not get fat redistribution at a more moderate pace (and other changes that a T blocker will cause), until your E sufficiently inhibits your T production. My endo explained that E alone, without Spriro or Lupron, would probably stretch the changes I would see from a T blocker from 1-2 years to 3-5 years. However, he also put in a big qualifier that everyone's bodies respond differently, which is why we have our blood levels checked.

Good luck! I would suggest talking to your endo about Lupron as a Spriro alternative. Be safe 🙂