So, I was having a conversation with another transgendered woman today, and they were making such claims that spiro damages the mind and body, and that estrogen is enough on it's own to block T and successfully transition. Is any of this really true or is she just of full of hot air.

Edit: I am putting this up here so people don't have to scroll. Basically this person is stating their opinion to a bunch of people saying it is fact, and is going off of shady research they have done that was based off of only one study done on the subject and it was using a high dosage of T-blockers that would not be used on humans. She is stating dangerous information that could potentially harm any incoming people about to start their transition.

Edit: If anyone is curious, it is a closed group on facebook called, GENDER RESEARCH for ALL GENDERS

In some people, and with some forms of administration, estrogen can block T and blockers are not required. Only blood test will verify if it's true for you. Every medication has some issues including aspirin which most everybody has taken at one time or another. Spiro requires careful fluid and salt control or you can have serious side effects. It has been use for years as a blood pressure medication so if serious side effects were a regular occurrence, it would have been pulled from the market. Under a doctors supervision, for most of the population it is a safe drug.

Indeed...and spiro is one of the World Health Organizations "Essential Medications", and has been in use for about 50 yrs.

Quote from: Dena on July 06, 2016, 07:44:54 PM
In some people, and with some forms of administration, estrogen can block T and blockers are not required. Only blood test will verify if it's true for you. Every medication has some issues including aspirin which most everybody has taken at one time or another. Spiro requires careful fluid and salt control or you can have serious side effects. It has been use for years as a blood pressure medication so if serious side effects were a regular occurrence, it would have been pulled from the market. Under a doctors supervision, for most of the population it is a safe drug.

That's what I was thinking. This person for example took a before and after picture I posted on facebook and said this: "What happens to many of those on Spiro...we see that in their photos on their pages...when we look..is that, aside from weight gain around the middle, they tend to show this rounder/larger face development....Unfortunately they often take that to be a more feminine face (more flesh on the face) but the pattern and the size are similar to what happens in those suffering from adrenal issues (Cushing syndrome) due to the disruption of cortisol by the Spiro. Clearly you were not thin and anorexic when you started..but the pattern of development towards that rounder 'moon face', as its called seems to be there... that's where a lot of weight seems to appearing on your face... The next time someone tells you they've been juicing on high doses of spiro and love it...see if they show that facial pattern and a lot weight around the middle too" 

It doesn't make a whole lot of sense to me, but from my understanding they are saying the only way to go is estrogen and nothing else.

You are describing something else as well. We all know that blocking T will allow the natural estrogen to be more effective but it will also slow the metabolism and without a reduction in intake, you will put weight on in the face and possibly the mid section.

While Spirolactone has been used safely for a long time, from my understanding, it's indication is a blood pressure medication, ie a diuretic. It's use there is in substantially lower doses than what's required to block testosterone, which is an off label use. From what I read it can cause in some cases quite profound symptoms of low blood pressure before the body develops tolerance.

Quote from: Dena on July 06, 2016, 08:10:01 PM
You are describing something else as well. We all know that blocking T will allow the natural estrogen to be more effective but it will also slow the metabolism and without a reduction in intake, you will put weight on in the face and possibly the mid section.

I know that! But they think that Spirolactone is the only thing that causes fat redistribution and estrogen doesn't. They think anyone on Spiro is delusional and that the doctors that prescribe T blockers are just as delusional as well.

This is something I've read about in various places. I am starting to work with an endocrinologist and I plan to ask for his opinion on it at my next appointment. Up until now, I have been taking only estrogen in an herbal form. The results have been quite good, even better than expected since I have not taken any anti-androgens. I tried saw palmetto as a T-blocker, but had bad dry skin from it so I stopped after a short while.

I did get my blood work done and the herbal was not affecting my estradiol level (expected since phyto-estrogen is not the same as estradiol), and my serum testosterone was in the male range, but my bioavailable testosterone was below detectable levels. I expect that's because of the high estrogen (they checked my TSH at the same time so I know it's not due to thyroid problems).

I think there are too many people who just repeat the same recipe of estradiol + spiro just because it's what everyone else says. For me, I am starting to work with an endo so I can use his experience to hopefully explore other options to ensure the one he puts me on will be the best for my particular body and situation. Discussing whether spiro is necessary will definitely be part of that conversation.

I suggest talking with your endo about it and your situation if it's something you want to consider changing.

Quote from: kellykh on July 07, 2016, 06:42:40 AM
This is something I've read about in various places. I am starting to work with an endocrinologist and I plan to ask for his opinion on it at my next appointment. Up until now, I have been taking only estrogen in an herbal form. The results have been quite good, even better than expected since I have not taken any anti-androgens. I tried saw palmetto as a T-blocker, but had bad dry skin from it so I stopped after a short while.

I did get my blood work done and the herbal was not affecting my estradiol level (expected since phyto-estrogen is not the same as estradiol), and my serum testosterone was in the male range, but my bioavailable testosterone was below detectable levels. I expect that's because of the high estrogen (they checked my TSH at the same time so I know it's not due to thyroid problems).

I think there are too many people who just repeat the same recipe of estradiol + spiro just because it's what everyone else says. For me, I am starting to work with an endo so I can use his experience to hopefully explore other options to ensure the one he puts me on will be the best for my particular body and situation. Discussing whether spiro is necessary will definitely be part of that conversation.

I suggest talking with your endo about it and your situation if it's something you want to consider changing.

I would agree with that. and always talk to an actual doctor! The person unfortunately blocked me in the group,

I don't really know, but some people feel it does. Personally for me my doctor has had me on a high dosage of Spiro because my Ovary along with my Testes produce Androgens. I get dehydrated quite often I end up drinking at least a gal of water a day to combat that. Although, that would explain why my HRT in pill form hasn't been the best results as well until I got unto IM Injections. I'm still learning about the way these absorption techniques go, but the doc has been upfront with me. He hasn't mentioned anything about PCOS. And as far as I know I only heard that happens to FTM's + some Cis-Gender Women, but again we're still learning about my own body and the effects of being prescribed a high dosage of Spiro. So far my E, P, + T Levels are great and balanced so that's a plus.

Quote from: Raye on July 07, 2016, 07:30:47 AM
I don't really know, but some people feel it does. Personally for me my doctor has had me on a high dosage of Spiro because my Ovary along with my Testes produce Androgens. I get dehydrated quite often I end up drinking at least a gal of water a day to combat that. Although, that would explain why my HRT in pill form hasn't been the best results as well until I got unto IM Injections. I'm still learning about the way these absorption techniques go, but the doc has been upfront with me. He hasn't mentioned anything about PCOS. And as far as I know I only heard that happens to FTM's + some Cis-Gender Women, but again we're still learning about my own body and the effects of being prescribed a high dosage of Spiro. So far my E, P, + T Levels are great and balanced so that's a plus.

I'm on an average dose of spiro and a full dose of estradiol. Personally I drink about a gallon of water a day just as a precaution so I don't get dehydrated. And if some people don't want to take spiro that's fine, but they really should go around saying that it's the only way and if you take it you're wrong kind of thing. The pill has been pretty effective for me so far, but I guess we will see at my 6 month check up. I'm supposed to start Progesterone at 6 months too, but yeah!

Although I've never taken it myself, spiro is a synthetic hormone, and all synthetic hormones seem to become toxic if you take them continuously over a long period of time. I think there's likely to be a particularly high risk of adverse side effects with spiro, because its main action is on mineralocorticoid receptors, and the antiandrogen effect is just a secondary effect. So you're mucking around with your mineralocorticoid receptors for no reason at all, other than because trans healthcare workers were looking for an antiandrogen, and here was this relatively inexpensive and readily available blood pressure drug which happens to have an antiandrogen effect in addition to its main effect of lowering blood pressure.

Estradiol on its own does block T production, and apparently high enough blood E levels can achieve T suppression in most people without the need for any additional antiandrogen. From what I've heard, the only reason antiandrogens are needed is because the current standards of care aim for too low an E level to reliably suppress T, purely because of several past disasters in which doctors killed large numbers of women with synthetic estrogens. This has led to estrogens gaining an undeserved reputation for being dangerous, when actually it's synthetic hormones that are dangerous!

In my particular case, with sodium-sensitive hypertension, enlarged prostate showing regrow after a TURP procedure removed most of it, as well as MtF "testosterone poisoning", spironolactone is a sort of miracle drug.  The endocrinologist, urologist, therapist, and GP are all happy with the result.  And I get to run my sodium intake from 700 mg/day (very hard to maintain) up to 2000 mg/day!  I can eat a bagel!

Everyone is different. That's why we work with doctors on medication and dosage, rather than rely on strangers on the Internet.

Quote from: JMJW on July 06, 2016, 08:22:55 PM
While Spirolactone has been used safely for a long time, from my understanding, it's indication is a blood pressure medication, ie a diuretic. It's use there is in substantially lower doses than what's required to block testosterone, which is an off label use. From what I read it can cause in some cases quite profound symptoms of low blood pressure before the body develops tolerance.

I believe the higher end of the dosages for hypertension and some other issues are consistent with that which is prescribed for anti-androgens. 

Quote from: HughE on July 07, 2016, 12:41:29 PM
Although I've never taken it myself, spiro is a synthetic hormone, and all synthetic hormones seem to become toxic if you take them continuously over a long period of time. I think there's likely to be a particularly high risk of adverse side effects with spiro, because its main action is on mineralocorticoid receptors, and the antiandrogen effect is just a secondary effect. So you're mucking around with your mineralocorticoid receptors for no reason at all, other than because trans healthcare workers were looking for an antiandrogen, and here was this relatively inexpensive and readily available blood pressure drug which happens to have an antiandrogen effect in addition to its main effect of lowering blood pressure.

Estradiol on its own does block T production, and apparently high enough blood E levels can achieve T suppression in most people without the need for any additional antiandrogen. From what I've heard, the only reason antiandrogens are needed is because the current standards of care aim for too low an E level to reliably suppress T, purely because of several past disasters in which doctors killed large numbers of women with synthetic estrogens. This has led to estrogens gaining an undeserved reputation for being dangerous, when actually it's synthetic hormones that are dangerous!

That's why those people just get prescribed E + P and not AA's. But doctors barely wish to prescribe P until some time has passed. So they just get the E + AA's.

Quote from: Raye on July 07, 2016, 02:06:56 PM
That's why those people just get prescribed E + P and not AA's. But doctors barely wish to prescribe P until some time has passed. So they just get the E + AA's.

How long is some time before being prescribed P? For me, my doctor wants to start me on progesterone at 6 months.

Quote from: link5019 on July 07, 2016, 04:01:46 PM
How long is some time before being prescribed P? For me, my doctor wants to start me on progesterone at 6 months.

I think that varies a lot as well. My doc put me on P at about 14 months.

Quote from: RobynD on July 07, 2016, 04:03:16 PM
I think that varies a lot as well. My doc put me on P at about 14 months.

I would agree with you on that. It does seem a bit early to start P for me personally at 6 months, though, being at 4 months in and having what is essentially a b cup bra size, probably wouldn't hurt to have them round out a bit as they continue to grow.