Spiro and post-op

[gothique11]

I've heard several opinions on taking spiro after SRS; from that you don't need it, to you should take it for X amount of months after.

But, really, what is the scoop? Do you still take Spiro after surgery, and if so how long?

I asked my doctor and he sees no reason to take it, but if I feel more comfortable taking a small dose for a month or two, he says go ahead.

Pre-op my T levels were 0.5, so not very high. Although I had to stop Sprio 3 weeks before SRS, I don't think that the poison factories would have started producing at the same levels pre-hormones right away -- and probably not even in a month.

I was still experiencing breast growth 2 weeks after going off HRT including spiro, although on the 3rd week I started to get some hot flashes as my estrogen levels continued to decline.

Pre-op I've taken spiro here and there because of the confusion of answers I got from people. So, like, maybe a few times in a week.

Anyway, I'm stopping now and taking a blood test in the next few days (probably on or by Monday) to see where my T levels are at post-op as well as my E levels. My doctor is interested in the results as well, but doesn't expect the levels of T to be anything significant.

I think that even if there was residual T from being off HRT for three weeks, at this point (almost two months post-op) that T would have worked it's way out of my system.

I don't know -- does anyone else have experience in this?

And yes, of course, your body will still produce small amounts of T even with the balls and chains gone; but you do need some T in your system for your body to function correctly. Your body shouldn't be able to produce pre-hormone levels of T after SRS. Although, I wonder how much is produced.... hum.

--natalie

[Kate]

I've been wondering as well. I haven't found any consensus. My doc wants me off the spiro when postop, but also said we'd check my levels a month or two postop (with no spiro) and go from there.

~Kate~

[Sandy]

The amount of testosterone produced by the adrenal glad is about ten percent of the total amount of that hormone produced by the body.  It's the same for estrogen as well.

I've gotten that same number from my PCP, gyno-urologist, and my surgeon.  Dr Christine suggested that I stop all spiro post-op as the body needs some testosterone for good health (avoiding osteoporosis, libido, and strength).

As of my last blood test, my testosterone level was completely normal, for a woman.  I believe it was at about 13.  Anywhere from 10 through 40 is normal female level.

Prior to that my testosterone level was immeasurable.  Which may not have been healthy for the long term.

That is nowhere near a level that will produce any sort of masculinizing effect, so don't worry about having to go back for electrolysis. 

-Sandy

[lisagurl]

Depending how long you have been on spiro I would not worry about  testosterone, you probably have shrink some anyway. I did have plenty of water retention that took awhile to go away. I did not need spiro after SRS very few do.

[Mnemosyne]

As per my doc: No need for spiro here once postop.

Those hot flashes are a real pain. How long did it take before your's went away? It was a month+ after being back on the E.

[Beyond]

I've been wondering as well. I haven't found any consensus.

Okay, my perspective is different.  I went to Dr Bowers and she allows her patients to stay on estrogen right up to and through surgery.  So no hot flashes, night sweats or anything.  I did stop Spiro 2 weeks before SRS, but it usually takes the body that long to get them working again.  So I never felt that T rush that others sometimes comment on.  Which is what I was expecting as when I started HRT years ago it was estrogen only at first and that ALONE shut down my T production (I have the lab work to prove it).


Anywho, I would advise not taking Spiro post-op.  And if your doctor made you stop estrogen before SRS get back on it ASAP.  When you see your endo after surgery request he does a check for T production in your labwork.  Why?  On rare occasions the adrenals can go into overdrive trying to make up for lost production from down below.  I've known 2 people this happened to and they had to go back on Spiro.  That is the only reason one should use Spiro post-op.  As you all know Spiro does dry you out; I gained about 6-8 pounds after I came off of it!  But gaining weight post-op can be a GOOD thing as it tends to go where you need it.  I know I have to shop for some new shorts as my old ones are a little snug now.  Haven't had too much change from HRT yet?  Don't give up hope!  These things take time (years) and you can get a boost post-op.  That said, don't expect miracles, have realistic expectations.


Hope this helps.

[tinkerbell]

No aldactone for this girl after SRS (per Dr. Meltzer's orders), but I still swallow my daily estradiol, not in the same massive quantities I once did, but I still do. 


tink

[Beyond]

The amount of testosterone produced by the adrenal gland is about ten percent of the total amount of that hormone produced by the body.  It's the same for estrogen as well.

I've gotten that same number from my PCP, gyno-urologist, and my surgeon.  Dr Christine suggested that I stop all spiro post-op as the body needs some testosterone for good health (avoiding osteoporosis, libido, and strength).

This didn't sound quite right when I read it and now I've figured out why.  Or at least partially.

1.  The body needs hormones to perform certain functions,  BUT I don't think the body cares which hormone it is.  That's because for many functions either T or E will do.

2.  Also, consider AIS women (who are chromosomally XY).  They are insensitive to the effects of T and yet they lead relatively normal lives on estrogen only.


The things that make you go hmmmmm. 

[Keira]

Spiro is very benign, given to 90 year old people with
liver failure,
don't get the potassium poisoning thing,
which is in fact just an electrolyte umbalance, eating
a bit saltier can fix this without even stopping eating bananas or the like.

Spiro spares the potassium and evacuates the sodium as it evacuates
fluids, which leads to a Potassium to Sodium unbalance. Two choices,
cut the potassium or increase the sodium lead to the same good
result.

Spiro has a couple of effect even post-op.

First, if you are very sensitivity to T, even a low level of it
from the adrenals will
make you keep your muscle mass and accumulate fats in
the stomach area.  We start with a lot more muscles
than the average women, so we need an extra help to get
rid of it.

Even post-op, spiro helps those who have a very high
sensitivity to DHT. Those who would be totally
bald at 30 for example. For them, they need to
take not just spiro, but also a T to DHT conversion
inhibitor like dutasteride or finesteride.

Depending on your susceptibility to DHT, you may need
to take finesteride, if that's not enough dutasteride,
and if dutasteride is not enough, augment it with
a general anti-androgen like spiro.

Many women, pre-menopause slowly lose their hair all over their scalp due to
androgen sensitivity.

Spiro coupled with a DHT inhibitor also has the effect of
enabling lower E level by forcing most free T to be converted
to E through aromatase activity in a women's body's fats
(the rest is disposed of by the liver).