Propecia vs Spiro

[SaturdayHorror]

Hello,

I will try to explain my situation a bit to give you some context...

I am trying to work on a timeline for how I feel comfortable transitioning.
For now I'd like to finish up college and just start Propecia to help hold onto the hair that I have (I have some thinning on the crown).

I know Propecia takes a while to work but I figured that will give me time to finish school and then in 6 -12 months I'll see how much Propecia helped and then could have a hair transplant to fix the rest. During the wait I am also working on laser treatments for my beard.

And then start HRT.

My dr seemed to think this was not logical at all and instead wanted to put me on Spiro right away. They said Spiro works in a similar way to Propecia and will help with hair thinning.

They told me that the insurance will cover Spiro but not Propecia. They said they could add Propecia to the prescription later on so both will be covered but have to start with Spiro first.

From my understanding taking Spiro by itself is dangerous...it can even lead to osteoporosis. Without having testosterone or estrogen your body will fall apart. I'm not looking to damage my body.

Is it safe to take Spiro by itself for hair loss or am I right in thinking this is a wrong move?
I understand if I start HRT I will be on Spiro eventually but it'll be alongside with estrogen.

I told my dr I don't mind paying out of pocket for Propecia but once they heard "transition" they seem to want to put me on an assembly line and disregarded how I'd like to go about my transition.

Does it not make more sense to just take Propecia for now? I'm thinking about going to a different dr.



Just looking for some input, any advice or suggestions would be appreciated!

[Jessica]

Hi SaturdayHorror 🙋‍♀️ Welcome to Susan's Place!  I'm Jessica.
I myself started Spiro two months before starting hrt.  I only felt dizzy at one point and if I was well hydrated it wouldn't have happened.  It was right for me, but please listen to your doctors advice above all.
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[Devlyn]

Hi there, welcome to Susan's Place!

Spiro isn't dangerous, being without a sex hormone is. Spiro alone puts a male bodied person in that  position.

I really don't understand your plan, but I don't have to understand it. I'd go with the doctor in this case.

Good luck, and I'll be seeing you around the site.

Hugs, Devlyn

[Another Nikki]

I don't have an answer to your question, but I wanted to mention that was my approach, though I am much older (45).  Im taking propecia and minoxidil to save my thinning hair.  I wasn't sure when or if I wanted to do hrt.  Now I think I'm ready for at least low dose, so I'm working towards it.  My transition will be glacial pace, on purpose.

[Dena]

Welcome to Susan's Place. Spiro can be a problem if taken for a long time without a sex hormone. There is a way to reduce the risk by getting sufficient calcium and vitamin D in your diet. That will help prevent your body from drawing on your bones as a source of calcium. I was off estradiol for around 10 years due to a improperly informed doctor and following my diet advice prevent any bone issues. Talk your fears over with your doctor but a year on Spiro only should be a problem with a little care.

[Allison S]

I actually understand your logic and seems like your doctor is missing your point a bit? Not wanting further hair loss vs transitioning from male to female are 2 very different paths... are you assertive when communicating this? Good luck

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[josie76]

First remember all drugs have potential side effects.

Spiro acts to block androgen receptors but also cuts enzyme activity and can decrease body testosterone production. So how much it blocks androgen receptors depends on how much your doctor prescribes and also how much testosterone your body is making. My endocrinologist prescribes it when we get started on HRT as it cuts the effect of testosterone in the body while estrogen will cause the body to lower signaling for T production eventually turning it mostly off.

Screenshot Spiro by Josie H, on Flickr

Finasteride works by blocking the production of two variants of the enzyme needed for dihydrotestosterone DHT production. One of the types affected is the one that acts in the scalp hair region on those who have MPB genes causing the hairs to stop growing out.

Screenshot Finasteride by Josie H, on Flickr


Both medications have risks associated with them. For most it is minimal but not for everyone.

[AshleyP]

I told my dr I don't mind paying out of pocket for Propecia but once they heard "transition" they seem to want to put me on an assembly line and disregarded how I'd like to go about my transition.

Does it not make more sense to just take Propecia for now? I'm thinking about going to a different dr.

I agree with you. It seems to me that your doctor is conflating two very different goals: 1) You wish to prevent further hair loss now, and 2) at some point in the future, you may wish to undergo cross-sex hormone therapy.

They told me that the insurance will cover Spiro but not Propecia. They said they could add Propecia to the prescription later on so both will be covered but have to start with Spiro first.

Generic Propecia isn't expensive. I wish I'd known about it earlier. When the brand name drug was introduced, it was terribly expensive. I'm much older than you and wish that I'd started using it earlier.

From my understanding taking Spiro by itself is dangerous...it can even lead to osteoporosis. Without having testosterone or estrogen your body will fall apart. I'm not looking to damage my body.

Under doctor's supervision, I took spiro for seven years at a "moderate" dosage level as part of a CHF regimen before starting HT. I did develop some "moobage," and I think it might have helped with the MPB. I did continue to lose hair, but it's been lessened/nearly eliminated since I started taking generic Propecia about five months ago.

Is it safe to take Spiro by itself for hair loss or am I right in thinking this is a wrong move?

Based on my experience, taking spiro to reduce hair loss will be a lot less effective than taking generic Propecia. While I usually qualify my statements with "YMMV" and "I'm not a doctor," in this case, in my opinion, using Propecia is an "on-label" treatment. Using spiro for hair loss is certainly an "off-label" treatment.

All the best,
AshleyP

[SarahFehrman]

Hello,

I will try to explain my situation a bit to give you some context...

I am trying to work on a timeline for how I feel comfortable transitioning.
For now I'd like to finish up college and just start Propecia to help hold onto the hair that I have (I have some thinning on the crown).

I know Propecia takes a while to work but I figured that will give me time to finish school and then in 6 -12 months I'll see how much Propecia helped and then could have a hair transplant to fix the rest. During the wait I am also working on laser treatments for my beard.

And then start HRT.

My dr seemed to think this was not logical at all and instead wanted to put me on Spiro right away. They said Spiro works in a similar way to Propecia and will help with hair thinning.

They told me that the insurance will cover Spiro but not Propecia. They said they could add Propecia to the prescription later on so both will be covered but have to start with Spiro first.

From my understanding taking Spiro by itself is dangerous...it can even lead to osteoporosis. Without having testosterone or estrogen your body will fall apart. I'm not looking to damage my body.

Is it safe to take Spiro by itself for hair loss or am I right in thinking this is a wrong move?
I understand if I start HRT I will be on Spiro eventually but it'll be alongside with estrogen.

I told my dr I don't mind paying out of pocket for Propecia but once they heard "transition" they seem to want to put me on an assembly line and disregarded how I'd like to go about my transition.

Does it not make more sense to just take Propecia for now? I'm thinking about going to a different dr.



Just looking for some input, any advice or suggestions would be appreciated!

Is say to follow your physician's advice, especially that of an endocrinologist. Let's face it, they know a lot more than we do.
The best of luck as you take your steps to being the true you!
Hugs,
Sarah


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[Roll]

My doctors have told me that Spiro and Finasteride (Propecia) are complimentary and work to treat the source of hairloss in different ways, but that while spiro will prevent future loss (as the source of DHT is cut off), spiro does not really help with regrowth (as the DHT is still left over in the scalp). I started Finasteride a few months before Spiro, and continue to take both with excellent results. (Along with minoxidill, a ketoclonazole shampoo, biotin, and castor oil. Seems like a lot, but all can be had cheap and address different issues with hair loss and growth. For minox get generic costco brand online from Amazon, 6 month supply for 20-30 varying price, ketoclonazole has 1% over the counter brand name nizoral or more effective 2% by prescription. Biotin is just a generic vitamin, got 6 month supply for like 15 bucks on amazon. Castor Oil is my most recent addition, and is helping insanely with my eyebrows as well, again can get couple months of supply for like 10 bucks online.)

Generic Propecia isn't expensive. I wish I'd known about it earlier. When the brand name drug was introduced, it was terribly expensive. I'm much older than you and wish that I'd started using it earlier.

I personally use Proscar (which is exact same thing as propecia at a higher dose) quartered, its super cheap.

[KayXo]

My doctors have told me that Spiro and Finasteride (Propecia) are complimentary and work to treat the source of hairloss in different ways, but that while spiro will prevent future loss (as the source of DHT is cut off), spiro does not really help with regrowth (as the DHT is still left over in the scalp).

Finasteride reduces the conversion of testosterone to DHT in the body. Spironolactone blocks T and DHT everywhere in the body and *sometimes* reduces T and DHT levels but not necessarily, even at higher doses.