.
I'm on a high Spiro and low E right now (hopefully more E by end of month).
As far as I can tell the following have happened:
Sensitivity and development of breasts (I already had these; now they hurt a lot more)
Smooth skin, I think (never compared to aught)
Increase of hair growth in male-hairline areas
Decreased, less spontaneous libido
Change to, umm... Output...
So, unless I'm responding really well to low-dose E, those are a good number of demonstrable effects.
It's a case by case basis, though. Pretty sure my T levels have always been abnormally low (my endo doesn't test 'cause it's Wisconsin and nobody covers it, but there you go), so the Spiro probably had a better than average effect.
Spiro doesn't effect T production directly. What it does is attach to T receptors, forcing regular testosterone into the bloodstream as Free T and when the pituitary gland sees this it sends a message to the testes to stop producing T as it believes that too much T is being produced when in fact there has been no change. This lowers T levels by ceasing the production of T. It's what's called a negative feedback loop. But, yeah, E is quite good at suppressing T as well. It's also responsible for feminization. You can not feminize without E.
Thanks girl friends for posts & actual results.
I'm on medium spiro & low E/estrofem as advised. I'm too early to report anything of value
Sprio binds to androgen receptors and the causes an increased amount of testosterone in the blood and the body believes there's enough T, begins producing less.
It's all really confusing. But it doesn't seem to do much other then make me have to pee five times an hour lol E is def more important. Some people just take E and progesterone and have ample feminization. So, there are alternatives.
EDIT: The one thing I forgot to mention is I had my spiro does increased quite significantly and there has to be more T in my system because my skin does not look as smooth and pale as it did two weeks ago though it still feels soft and my libido has increased. But this could be for any number of reasons and it might be all in my head. I think it is starting to drop back down today as my libido seems to be going down again. I read on a hairloss forum that some bodybuilders use spiro for one week before a competition because in the short-term it increases T. I don't know how or why. This medication confuses me to no end. The simplest answer I read last night said that it inhibits T production and may have some weak estrogenic effects.
P.S. I'm glad the HRT is finally starting to work for you! ;-)
It is a competitive inhibitor of T. Doesn't stop it's production directly. It has a higher affinity for the same receptors that T normally would bind to.
Quote from: peky on April 23, 2013, 07:52:04 PM
It partially (dose-dependent) blocks testosterone synthesis, and blocks the testosterone receptors..in a nut shell
If the dosage is high enough and you stay on it long enough... The negative feedback loop will cause T production to be greatly reduced by causing the hypothalamus and pituitary to stop releasing hormones (LH/FSH/GnRh) which cause T production in the leydig cells of the testes. No hormones sent to testes, no T production. It's an indirect mechanism of action, but effective.
I just hope they work, funny little peach pills, taste kinda yucky on your tongue. I'm taking a moderate level.
Quote from: peky on April 23, 2013, 09:15:07 PM
Actually spiro blocks desmolase and 5 alpha reductase directly, and thus has a direct effect on the biosythesis of DHT and T
From the papers I've read, it has to be at higher dosages (near max) over a period of time to inhibit 17,20 desmolase production and then it's only a weak inhibitor. And as far as 5α-reductase, that would only be a concern to those with hair issues (balding), as Sprio will directly inhibit that enzyme, so that less T will be converted to DHT.
I Know it's my imagination however my nipples are real sensitive & hurt some. Under spiro & estrofem. Of all the changes I'm hopeful for growing some nice breasts is my most anticipated result. That would just be great!!!!! My mother had nice breasts & I'm trying my best to make her proud.
Quote from: FrancisAnn on April 24, 2013, 07:24:52 AM
I Know it's my imagination however my nipples are real sensitive & hurt some. Under spiro & estrofem. Of all the changes I'm hopeful for growing some nice breasts is my most anticipated result. That would just be great!!!!! My mother had nice breasts & I'm trying my best to make her proud.
Not necessarily, there doesn't need to be much physical change in order for them to be tender. Mines became very tender and sensitive in the first 2 months of HRT, and then after that it was significantly more sporadic AND effective.
Rita, they are definetly more sensitive. It feels great. Good luck with your girls & everything else.
Quote from: Julie53 on April 24, 2013, 04:01:56 PM
I recently had an interesting discovery when I joined this site and began to follow some of the discussions. I'm non-op (for the time being anyway) but I have been taking Spironolactone as a diuretic (water elimination) due to some edema in my left leg. My dosage is low, but I can count on needing a bathroom half an hour after I take it. As part of effective water elimination, I also have been told to limit my water intake as much as possible.
I was a little shocked to discover that Spiro is often a part of HRT, although at higher dosages than what I take for diuretic needs. As part of researching Spiro, I found that it is also popular with body builders. The water elimination helps them to achieve a sculpted, "ripped" look. I'm unsure what dosages body builders may use.
I'd be curious to know if taking Spiro at HRT levels causes water elimination as it does at my low dosage. Has anyone experienced the race horse effect (need to pee) while on HRT levels of Spiro?
Yes. It's a well known effect. You will be going to the bathroom quite often.
I never was big on pills and try to limit my intake of chemicals as much as possible. Spironolactone had me up several times during the night to pee and disrupted sleep makes this person grumpy. They do inhibit testosterone activity and it is a necessary evil while you still have your gonads. One thing to be aware of is that unlike a lot of things that flush potassium out of your system, Spironolactone builds up your potassium levels, so you want to stay away from potassium salt, bananas and other things that are rich in potassium so that you don't become poisoned by excess potassium. Though drinking a lot of water makes for excessive peeing, it's best to remain hydrated and your organs flushed. Go with the flow! :icon_peace:
Because spironolactone is commonly used in heart failure treatment, its effects on your kidneys are really important. It turns out that spironolactone causes the kidney to retain or hang on to potassium. And it can increase the blood potassium level, and in some patients actually quite significantly, and even in a few to dangerous levels. So with a new addition of spironolactone to your medical regimen, the blood potassium level should be monitored. Initially the first few days after starting it, and then every couple of weeks for probably a month or two to make sure that your blood potassium levels are okay and are not too elevated. Spironolactone can also sometimes be used to replace potassium supplements, so if you're taking potassium supplements with your loop diuretic -- Lasix or what -- and spironolactone is added, then the potassium level should be checked because the spironolactone may well reduce the need for potassium supplementation.
pee, pee, pee. This stuff is wearing me out, panties down, P up, P down, P up.
Quote from: FrancisAnn on April 25, 2013, 06:24:53 PM
pee, pee, pee. This stuff is wearing me out, panties down, P up, P down, P up.
So, um... would you say you're... pissed?
For those of us with hypertension and resulting high blood pressure, Spironolactone keeps our water levels down, (hence the frequent pee trips) without kicking our postassium levels down to the basement and thus lowers our blood pressure. I was put on Spiro for the blood pressure by my internist, with the wise crack that I would not object to the side effects of it the way some other people would. The joys of being old!!
Shantel, Thank you so much, it's lots of water for me. I'm just peeing away.
Quote from: FrancisAnn on April 25, 2013, 07:15:10 PM
Shantel, Thank you so much, it's lots of water for me.
I hated the getting up at night to pee part the most. I have trouble going back to sleep after getting up. One benefit of SRS for me is no more Spiro. I can sleep thru the night and not have to get up or at the worst, only once to pee.
I am getting used to my Spiro now. Can almost sleep the whole night.
But still wake up around 5 6 in the morning and have to Run to
Pee ...4 months its taken to get used to it
I want all T gone, breasts, all other nice pleasant changes with HRT however this pee, pee, pee every 10 minutes is going to take a while to get used to. Do natural women have to pee so often?
Quote from: FrancisAnn on April 26, 2013, 09:38:18 PM
I want all T gone, breasts, all other nice pleasant changes with HRT however this pee, pee, pee every 10 minutes is going to take a while to get used to. Do natural women have to pee so often?
Some T is actually required..
on a somewhat related note, I've been given to understand, since I started looking into HRT, that once you take Spiro in high dosage for a certain period of time (9 months? 12? 18? Not sure which) that the effects are permanent and it can be discontinued.
anything to that?
Quote from: girl you look fierce on April 27, 2013, 08:17:34 AM
Well maybe HRT can do that but like I said spiro didn't even make any difference for me so what would there be to reverse?
More and more I think E is the only thing actually useful in an HRT regimen... it lowers the T and it feminizes and yeah unless I am a special case, I don't know if spiro actually does either.
But yes they do say once you stop producing T long enough it becomes permanent...
Guess that's what people mean when they say chemical castration.
Quote from: girl you look fierce on April 28, 2013, 02:51:56 PM
They use androcur for that :P
Androcur is a type of anti androgen right? Is it really different from what spiro does?
Thanks all for the great discussion, detailed pharmacology and personal experience. Now on Spio and Estradiol for almost two months the pee and pee diuretic effect is too real while my happy little breasts feel thrilling if constantly achy. Spiro is tough on our livers while the patches are kind of annoying for placement and adhesives. Gives me reasons to consider an orchi over the long term. This is transition and along with our name we get to tailor our journey---what a ride!
Significant hepatic (liver) damage and problems associated with spironolactone are "rare" but alcohol may be a concern relative to the metabolic demands on the liver from the combination. No personal judgement, I drink too;-)
The things that make me really nervous about Spiro at this point (I already have it on hand, but waiting to start my HRT until better weather so I can be active and avoid problems from lack of exercise):
1. The potential potassium and resultant kidney problems
2. The long list of drug interactions and the fact that I NEED to take certain drugs that Spiro interacts with, or could need them in an emergency. I don't need emergency personnel between a rock and a hard place if I have a medical emergency because of Spiro.
3. I know the racehorse effect well, having once taken Lithium and the Lithium had me running to the bathroom. I also have a metabolism that has a history of sudden changes, and that could really be a problem with Spiro.
The more research I do on this drug, the more I start asking myself if Spiro is necessary or even worth the potential problems. E seems to be THE drug that does most of the work according to most people and according to the posts here. As someone else said above my post, there are alternatives.
Quote from: girl you look fierce on April 26, 2013, 09:44:48 PM
I am surprised everyone sees such a diff. on spiro, I did not think anything of it or notice I had to go to the bathroom more (but yeah again... long used to having to pee all the time lol)
There's one factor I think a bunch of us are overlooking in your "chart"... You're young, as in puberty age, correct? If so, this may explain why Spiro alone does nothing for you. Completely theoretical: but if I had to guess, since biologically you are suppose to be going through male puberty, I'd be willing to bet your brain doesn't CARE that there is tons of free T in the blood. It only wants your testes to produce more T because you're at the age where "that's what they're suppose to do".
If I remember correctly from reading your past posts, you claim that you have no trouble passing despite the high T levels. Since T isn't binding to the AR, then this would explain why you have only minimally masculinized instead of masculinizing at a rate most teenage males would. However you are correct, I believe, in your comments claiming that E is a better inhibitor of T. But only if the T doesn't block the E from doing its job.
Spiro DEFINITELY inhibits the effects of testosterone, and over time nukes it. Go on any hair loss forum or body builder forum and you will see men talk about how Spiro is almost like a death sentence to your masculinity. That's all the anecdotal evidence you'll need IMO.
I think Spiro may be useless after some time of fully suppressing T, but I'm not sure. I've been in for tests where my E was as low as 72 and my T was as low as 7, which either means Spiro IS suppressing T (as these were total T levels from serum), or that being on HRT for 18 months has completely castrated me. I think for many of us, Spiro is needed. But my question I guess is for how long? Lifetime? 2 years? 1 year?
Honestly I think it'd be smarter and would produce better results to start on a full dose of both E and T blocks. When you see levels, adjust accordingly. If T stays suppressed after a year, ween off of Spiro. I understand that doctors don't want to start you out on a full dose to protect themselves, but I really think the first 6 months or so that HRT levels are so critical to feminizing. I think they should be highly elevated so the cells in your body can create estrogen based fat before it learns to metabolize the excess chemical more effectively.
I'd love to see a study done on this, where 100 MtFs are put on a HRT regimen where 40 are given a full dose at start, 40 are given a "careful dose" of some kind, and 20 are given a placebo of some kind. Then, over a 3-5 year period, record things like HRT levels, breast growth, epidermal layer thickness, thigh hip and butt fat, emotional stability, and the patients overall impression of feminization effects after the given time is over. I'm willing to bet the ones who start out full blow full dose everything get better results with easier suppression of hormones.
Quote from: girl you look fierce on May 07, 2013, 08:44:02 AM
When you talk about the body getting used to metabolizing the E, you don't mean it like slowly gets less effective over time right??? :-X
Long post incoming (I'm usually short and sweet)
Keep in mind what I'm saying is almost completely theoretical on my part as far as the body learning to get rid of E quicker. I think the body simply learns how to get rid of the E in a faster, more effective way over time. However, I think in the first few months, it is very crucial to make sure the cells have enough estrogen so they can learn how to utilize the E before it gets flushed out by your system. From what I've read, when you start taking E, it goes into your cells and the amount of estrogen receptors in each individual cell determine your progress. I've also read that when you start, your body starts developing NEW cells that are more responsive to estrogen (perhaps in the breast tissue, hips, thighs, buttocks, subcutaneous fat?). I think the amount of initial flooding determines the amount of new cell growth with more affinity to estrogen. However, maybe if you don't initially flood, the body learns to flush it quickly enough to not build these cells, or even supply all the current cells it has with the amount of E they need for maximum feminization.
Again, purely theoretical... the only evidence I have is anecdotal...
I've met a bunch of trans people. The most passable ones that have started between their 20s and 40s are usually the ones who started out on a pretty high dose from what I've seen. For me, I started out high, 5 months in my E was ridiculously high. My E dose alone was cut by 33%, and my E levels plummeted. I have since went back to my starting dose and they rebounded, but nowhere NEAR my 5 month mark. However, staying on a high dose has turned me from a no-way-are-you-anything-but-a-guy to not even being clocked by some at trans support groups.
This leads me to believe, at least, that the body either learns to get rid of the E more effectively, or that the body has used that high E level to build many new cells and it takes more E to "feed" them. The only thing is... post ops and cis women don't need to take a high dose like me to get the levels up... so something doesn't fit? What's weird is my T has been suppressed the entire time (never tested above 25) even when my E was low (once at 112, with T of 7 and another E= 72 T = 9). Which leads me to believe that the E is attaching very well to something and I have just enough free E to have "Elevated" E for men in the serum.
Others, however... Well a friend of mine for example. She started on a low dose and she's having trouble suppressing her T 7 months in even when she ups her dose. She doesn't do tests (can't afford them) but she smells like a male. Her first few months, she was developing wonderfully. Her face was rounding QUICKLY and her skin was clearing up and softening too. However, the past 3 months she has been starting to revert. She upped her dose a month ago, and while the smell is getting less manly, she's not really developing much at all anymore.
Another one of my friends, she was on a fairly low dose at first. 3 months in, her E was in the 300s, her T was in the 40s or so. 6 months, E was in the low 200s, T was still suppressed (don't remember the number). She was developing really well at first. Her breasts were on the slow side to develop but her skin was REALLY clearing up and her face was softening, with her body fat distributing fairly quickly. After about the 8 month mark, she just hit a dead end and stopped any development.
There's also a documentary about trans women in prison called "Cruel and Unusual" that's been posted on YouTube. In it, a girl that is CLEARLY unpassable (poor gal) claims that before going to prison, she was more feminine looking. However, after coming out of prison, she never really developed back. Which leads me to believe the body DOES get used to the E and learns to flush it. Almost as if the E is a pathogen in a way, and the body develops an immunity of sorts if you go off. Or maybe it's because the body rids itself of the E cells and they do NOT grow back... who knows?
The women over 50 however get a different result. I've found almost all of them have really good results when they start late. I think this is because the T is easier to suppress since their body makes less of it as you age (1% less every year over 35 if I'm not mistaken). Starter dose or no... didn't matter. They almost always develop very well.
This leads me to believe that T suppression is ABSOLUTELY CRITICAL in the entire scheme. And the earlier into HRT you get it down and keep it down, the better results you will get.
Obviously every bodies biochemistry is different, so maybe you just don't react to Spiro that well. Also, maybe 2 pills isn't enough for you. Maybe you need 3 or 4. If you've been swallowing the pills, I'd suggest going sublingual until you can get another form (injection, topical, etc). Swallowing the pill outright IS going to go through the digestive system before reaching the blood. Perhaps your liver is breaking down the E way too much to be effective by swallowing the pill. With sublingual administration, it reaches the blood first. As far as non-oral Spiro, from what I understand it is not as potent. However, who knows... idk if any analysis has been done when topical Spiro has been used in conjunction with estradiol administration.
Either way, your E is way too low to initially suppress the T IMO. IDK why your doctor is satisfied with the levels being <100. Most literature I've seen calls for our levels to be constantly above 150. Honestly, I'd look for a new doctor or take things into my own hands.
A girl sent me a message on here today, actually, saying she had satisfactory results in breast growth using a cyclical method, using progesterone every so many days in combination with the patch. In this method, the E has a natural rise and fall like that of a cis womans. If this is something that interests you, maybe you can do some research into it...
Hm. My E was up at 165 pg/ml after 6 weeks (the first 3 of which were on a lower starting dose), and that was without any sort of T blocker. My endo added low dose andro at that point, as my T levels were still too high. Breast growth, rather than just a tingling feeling with my gynecomastia simply getting more "fleshy", has since started. It also sped up the process of my skin becoming a lot smoother. According to instructions, I simply swallow all my pills in the morning.
I guess that, at least for me, it is really the combination of a decent E level combined with my T being clobbered down that does the trick; which seems very much in line with what Alaina is saying.