Spironolactone and potassium

[louise000]

After several months on spiro when I didn't pay much attention to its potassium-sparing properties, I have become concerned about maintaining a healthy diet whilst avoiding potassium rich foods. It seems as if so many foods which one would assume to healthy, such as bananas, apricots, dried fruit, baked potatoes, etc., etc. are high in potassium and therefore not good to eat if you are taking spiro as an anti-androgen.
I'd be so interested to hear what sort of meals other girls on spiro eat whilst avoiding potassium rich items. Or do you do what I did for several months and carry on as normal?

[Kendall]

I try to stick to protein and vegetable diet. Whole grains, chicken, salads (though be careful which vegetables I use), nuts (without potassium). Also one must monitor one's liquids. Also I have to keep salt use low. The hard part is that Potassium is uses as a preservative and salt substitute. Even sweating like doing exercise can effect the whole equation of salt/potassium.

Here is some potassium amounts for vegetables
http://www.wholefoodsmarket.com/products/produce/list_veg.html

Or an awesome search tool for almost any kind of food and amount
http://www.nutritiondata.com/tools/nutrient-search

[lisagurl]

You do not need to avoid potassium only excessive amounts. A healthy diet is recommended that includes salt and foods that have potassium eaten in moderate amounts.

[Hypatia]

I had been fine with potassium levels for my first two years of HRT. But just recently my doctor warned me that my potassium has spiked upwards. He warned me of fatal cardiac arrhythmia if the K gets too high. I wondered if it was because I had recently started drinking orange juice. I took to orange juice because I had just started using whey protein powder and needed something to mix it with. So I quit the OJ. Doc sent me for more bloodwork, and the K was still too high. He told me to take half as much spironolactone, twice a day. I had just refilled my prescription and had a full bottle of a certain size of pills which now needed to be halved. So I went and bought a pill splitter.

[Steph]

The best advice if you are worried or experiencing problems is to monitor your levels with your doctor.  That way you can adjust your dosage as needed.  One of the fruits that is high in potassium is bananas, and one of the indicators that your levels are high is cramping or pain in your lower legs (but this can also indicate a problem with estrogen levels,) and cramping of your toes.

Steph

[JENNIFER]

Potassium sparing? 

Is that sparing the loss of or introducing the element?

My understanding is that the loss potassium is detrimenntal to our cause and by 'sparing' the loss we help ourselves. This is , I assume, the reason for Spironolactone, to spare the loss of Potassium. It must be important otherwise we would not be debating the matter.

I may be in serious error but I have been taking Potassium as a supplement to my regular diet to boost my reserves etc., 

[April221]

I've been on a very limited diet, low in fat and sodium largely due to concerns of weight. I've recently retired, so I'm not as physically active. Add to that HRT and my success in quitting cigarette smoking, and I can gain weight so easily that a lot of thought goes into what and how much I eat. Because of the spiro, bananas have been eliminated from my diet. Generally, I would think that excercise and a healthy diet would benefit anyone, especially people who take medication.

[Steph]

One needs to remember that spiro was not developed or intended for use in FtM HRT.  It's effects as an anti-androgen, and it's ability to block testosterone in FtM were only discovered later.

Here is a portion of the of the pharmaceutical information provided by http://www.drugs.com

Before taking spironolactone

Do not use this medication if you have:
kidney disease or are unable to urinate;
high potassium levels (hyperkalemia); or
if you are taking potassium supplements or other potassium-sparing diuretics such as Aldactazide, amiloride (Midamor, Moduretic), or triamterene (Dyrenium, Dyazide, Maxzide).
Before using spironolactone, tell your doctor if you have:
heart disease;
liver disease; or
if you are using a steroid, or another diuretic.

What should I avoid while taking spironolactone?

Avoid drinking alcohol, which can increase some of the side effects of spironolactone.
Avoid using other medicines that make you light-headed (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to the side effects of spironolactone.
Do not use salt substitutes or low-sodium milk products that contain potassium. These products could cause your potassium levels to get too high while you are taking spironolactone.
Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.
This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Spironolactone side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:
numbness or tingly feeling;
muscle pain or weakness;
slow, fast, or uneven heartbeat;
feeling drowsy, restless, or light-headed;
urinating less than usual or not at all;
shallow breathing;
tremors, confusion; or
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Continue using spironolactone and talk with your doctor if you have any of these less serious side effects:
mild nausea or vomiting;
dizziness, headache;
gas, stomach pain; or
skin rash.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

You may want to read the article in our Wiki on Spiro found here:

https://www.susans.org/wiki/Spironolactone

Steph

[Keira]

Potassium sparing means it spares the loss of potassium,
it controls blood pressure by diminishing the blood volume
through fluid loss (less water, less blood in the body,
lower blood pressure), it eliminates sodium
also. So, with fluid loss and lower sodium level, the electrolite balance
can get out of wack if you don't drink enough water or take in
sodium you can severe cramping of all muscles, including the heart (which
where lies the danger).

There is two choice here to restore electrolite balance Sodium - Potassium
cutting or taking more water and sodium. In most diet,
there's way enough sodium, so there should be no problem. So, drinking
water or taking less potassium would be solutions. But, most diets
don't have excess potassimum (there is potassium in almost everything,
so cutting it is pointless, just checking that your not eating tons of the
top potassium food like bananas is enough). But, even if you eat
an excess of potassium, drinking a lot of water solves the problem.

[Lisbeth]

The only change I made in my diet was to cut out bananas (which is sad because I love bananas).  But before HRT, I always had a high heart rate and my bloodwork always came back with low potasium, so my doctor kept wondering if I should go on a potasium suppliment.  Now with spironolactone, that little problem has been taken care of.

[Hypatia]

spiro was not developed or intended for use in FtM

Or even MTF for that matter.

[Steph]

spiro was not developed or intended for use in FtM

Or even MTF for that matter.

Oops, I meant MtF

Steph

[KarenLyn]

Potassium sparing? 

Is that sparing the loss of or introducing the element?

My understanding is that the loss potassium is detrimenntal to our cause and by 'sparing' the loss we help ourselves. This is , I assume, the reason for Spironolactone, to spare the loss of Potassium. It must be important otherwise we would not be debating the matter.

I may be in serious error but I have been taking Potassium as a supplement to my regular diet to boost my reserves etc., 

Spironolactone is a diuretic (makes you pee more) and is "potassium sparing" in that it causes your body to retain it instead of passing it in the urine. Too much potassium can be lethal so you should definitely have your levels monitored by a doctor. I've been on a high dose for a number of years and have to watch my potassium intake as I'm running near the upper end of the range.

Karen Lyn

[Hypatia]

Oops, I meant MtF

Heh, don't feel bad, honey, I once embarrassed myself by making the same error when coming out in an internet forum. Somebody caught it for me and asked "Wait, don't you mean MTF?" I made some feeble joke about possible correlation of TS and dyslexia.

[louise000]

The best advice if you are worried or experiencing problems is to monitor your levels with your doctor.  That way you can adjust your dosage as needed.  One of the fruits that is high in potassium is bananas, and one of the indicators that your levels are high is cramping or pain in your lower legs (but this can also indicate a problem with estrogen levels,) and cramping of your toes.

Steph

I do love bananas and have one most days. Although I've not experienced any cramping in my legs I have had some toe-cramping lately, possibly a symptom of K being slightly too high. I will try and avoid them on such a regular basis.
L.

[Berliegh]

After several months on spiro when I didn't pay much attention to its potassium-sparing properties, I have become concerned about maintaining a healthy diet whilst avoiding potassium rich foods. It seems as if so many foods which one would assume to healthy, such as bananas, apricots, dried fruit, baked potatoes, etc., etc. are high in potassium and therefore not good to eat if you are taking spiro as an anti-androgen.
I'd be so interested to hear what sort of meals other girls on spiro eat whilst avoiding potassium rich items. Or do you do what I did for several months and carry on as normal?

I keep hearing this on various forums like this one. I take anti - androgens (but not Spiro) and I eat Bananas and it's not a problem. Obviously it will effect individuals differently.

Posted on: April 28, 2008, 05:18:15 AM

Potassium sparing means it spares the loss of potassium,
it controls blood pressure by diminishing the blood volume
through fluid loss (less water, less blood in the body,
lower blood pressure), it eliminates sodium
also. So, with fluid loss and lower sodium level, the electrolite balance
can get out of wack if you don't drink enough water or take in
sodium you can severe cramping of all muscles, including the heart (which
where lies the danger).

There is two choice here to restore electrolite balance Sodium - Potassium
cutting or taking more water and sodium. In most diet,
there's way enough sodium, so there should be no problem. So, drinking
water or taking less potassium would be solutions. But, most diets
don't have excess potassimum (there is potassium in almost everything,
so cutting it is pointless, just checking that your not eating tons of the
top potassium food like bananas is enough). But, even if you eat
an excess of potassium, drinking a lot of water solves the problem.

Thanks Keira. I found that helpful..