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How much sodium should people on spironolactone intake a day?

Started by Angélique LaCava, May 03, 2017, 03:21:04 PM

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Angélique LaCava

Just curious since spironolactone makes you excrete more sodium and water than a person who isn't taking it.
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stephaniec

I stopped taking spiro because my sodium was always too high. Whenever I ended up in the hospital I had dangerously high sodium levels to where they told me to syop taking Spiro . I take the stuff that starts with an F ,  sorry I don't know the name off hand.
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SophieD

Quote from: stephaniec on May 03, 2017, 03:40:20 PM
I take the stuff that starts with an F ,  sorry I don't know the name off hand.

Finasteride, maybe?
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staciM

^ sodium or potassium?  If anything your potassium levels are much more likely to be too high because it's a potassium sparring water pill.  Sodium would be excreted.
- Staci -
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stephaniec

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Dena

When the body is low on sodium, you will crave it. It makes food taste so much better and even salt by it's self has a different taste to it. I discovered this by working in the Arizona sun where sweat drew enough salt out of my body to make me start craving it. Under normal conditions, I can take or leave salt and I only need a minimal amount on food so if you find your taste for salt has changed, you may require more in your diet.
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
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laurenb

I agree with Dena. I've noticed that since I've been taking Spiro I now crave salt when I'm low on it. Hence the salt thread here somewhere else and my now public 5pm pickle indulgence. Really, though, your body should just migrate toward those potato chips or whatever your thing is. I was working outside in the garden for a couple hours. I came in and had some water (don't forget the water!). Like instantly I had a craving for salt. I also can tell by the fit of my rings. If they're tight then I'm retaining water - like first thing in the morning before I take my pills. If they're loose I'm low on salt. If you exercise or work outside be doubly conscious of it. I was always careful about salt because my blood pressure although not high was pre-hypertensive (like 135/89). Now, if I don't get enough salt, my BP can be low (112/75).
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Deborah

I eat about 7 g (+) of sodium each day to keep my sodium levels normal.  However, in addition to the spiro I work out a lot and living in a humid place sweat a lot.  I've also had to increase my liquid over 25 glasses a day to stay hydrated.  Even with that much drinking I don't have to pee much more than normally and before spiro I needed at least a gallon of water each day.

Even with this much salt my BP is consistently now lower than 120/80.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote
Love is not obedience, conformity, or submission. It is a counterfeit love that is contingent upon authority, punishment, or reward. True love is respect and admiration, compassion and kindness, freely given by a healthy, unafraid human being....  - Dan Barker

U.S. Army Retired
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Tori

Over the years, I developed high anxiety. It was so long after I started HRT that I didn't think any part of my regemin was to blame.

So I learned to deal with and cope with a life of anxiety.

Then one day I stumbled upon a post in FB, someone talking about how they had developed anxiety and they were told to stop taking Spiro, and their anxiety went away.

So, being me, I did a lot of research. Turns out, Spiro was never intended to be used long term. It's anti androgenic properties were stumbled upon by accident. Very little research has been done on long term Spiro use.

But after looking into it further, I discovered anxiety, growing belly fat when it should be migrating elsewhere, and a slew of other weird things keep being reported by trans women who have been on healthy doses of Spiro for several years, and the symptoms stopped if they dropped Spiro.

So, what should I take instead?

Whelp, turns out, all you need is more estrogen to suppress your T. Nature has a way of preventing 'roid rage. Excess testosterone in the body turns into estrogen. And in people with testicles, excess estrogen tells the testes to stop producing T.

So, I found myself a doctor who was willing to work with me and see if I couldn't suppress my T with E alone. I dropped the Spiro. And now, a month later, I feel GREAT. Like, better than I have felt since my first few months of HRT. And my T, just like it should be, has been suppressed with E alone.

Here's the thing. At first I was scared sh*tless about this whole thing because I like that Spiro nukes my testosterone. Who wouldn't?

But you know what feels even better? Nuking your T with excess E. you are literally killing your production of guy juice with girl juice. There is little I have experienced that has felt both as empowering and as feminine/femininizing.

Lots of gals on this forum do some variation of this hormone regimen I am now on. I was a bit late to the game. But now I get why they seem a little smug when they talk about their treatments. You don't feel like you need to worry about changing your diet to get the most out of every microgram of E in your system. You feel as relentlessly at the mercy of E as you once felt at the mercy of T... but this feels good instead of terrible.

You asked about salt. I'm not talking about salt. WTF?!? You're thinking. I'll get to it. I promise.

Recently you asked about peanuts and how they effect HRT. Now you are asking about salt.

So, I figure you have diet on the mind and are really trying to get the most out of your HRT with the right foods. That is sound logic.

But...

What I hear is this: You are unsatisfied with the results of HRT so far, you are also on Spiro, and by God with your raw material (I mean, you have been passing since before you even started HRT) you expect some damn results. Right?

Whelp, hormonal transition is puberty. Female puberty. For best results, wouldn't you want your puberty to happen like cis girls, if possible? You know what they don't make or need? Spiro! Anti androgens!

Doctors give us Spiro so they can give us less E because back in the 90's there was a big hormone scare (all synthetics) and labels for ALL pharmaceutical female hormones suddenly had to state that they may cause heart problems. So doctors worry about giving us more E, even though we don't even take the kind of E that was known to have these issues and there is NO evidence bioidentical hormones have these same risks. This is true. Doctors adjusted by giving lower doses of E and experimentally adding Spiro, developed to be an emergency high blood pressure drug, to suppress T instead.

So docs try to transition us on less E than a healthy, fertile, adult female gets for her puberty. And they give us an anti androgen to make up for the fact they are often giving us menopausal, maintenance  levels of E... because synthetics are bad for you... even though we don't take synthetics.

We don't take Spiro to suppress our T because E can't. We take Spiro to suppress T because doctors are often too cautious to prescribe enough E to do the work instead. All because of a risk that doesn't really exist in the way it once did.

Meanwhile, Spiro is risky as all get out. It makes you crave salt like a vampire craves blood. Makes you piss like a racehorse (a risk if you don't pass, especially in this day and age). Makes you store unnatural amounts of potassium which can damage and enlarge glands on the border of your brain. And it might be causing some of us to lose our minds the longer we are on it.

I told you before, medicine, not food.

Get the best medicine you can. Study hormones like you are currently studying your diet. Get your HRT to adult, fertile female levels. Drop the stupid pill that makes some foods poison and makes you crave salt...

And then you can focus on having a NORMAL HUMAN FEMALE DIET.

Good hormones. Good diet.

Do BOTH, just don't bend your diet to get the most of your hormones. Bend your hormones so you can just have a normal female diet and get the most out of BOTH.

Wow. This may be the world's longest post. I hope some of it helps. You deserve the best transition available. Good luck.


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staciM

^ my Dr. and I use a Spiro/E approach but I have always been curious about only using higher  E.  However, the FB group that I read that pushed the E only regiment was (and is) run more like a cult so I've been turned off of it. 
- Staci -
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Tori

Yeah, I know that group, I think. They can work a good bit on their bedside manner. They pointed me towards some solid research as I went down this rabbit hole. I hear you about that cult vibe, but I just wrote the world longest post about HRT in a thread about salt so... I am starting to think good HRT makes them a bit emphatic and passionate. Like, "OMG!!! YOU MUST TRY THIS KOOL AID!!!"

Learned a lot from our members here who are on pellet implants and no AAs. They always seemed the most satisfied with their HRT. I asked a lot of questions.

I thought I could get to the bottom of all this... and...

It is REALLY amazing to learn how LITTLE actual research there is on transitional HRT, and how almost every doctor seems to have a completely different approach to it. I mean, there is a lot of research out there but there are still a bunch of GLARING holes.

At this point, I'm like, eff it. It can't be too hard to learn more about HRT than most doctors. And it isn't. HRT compared to some medicine is fairly elementary stuff. And the lifting of my crippling anxiety that came from out of nowhere is a godsend, byeee Spiro. I'm finally being social again. Hugely liberating.

Knowing Angélique, I figure she'd dig this.


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Janes Groove

Quote from: Tori on May 03, 2017, 10:10:38 PM
So, I found myself a doctor who was willing to work with me and see if I couldn't suppress my T with E alone. I dropped the Spiro.

Great post.  I dropped Spiro after I was on it for 8 months because it was causing my hair to fall out.  My provider at Planned Parenthood was adamant that I stay on it filling me with horror stories about how I was going to go back to being all masculine and stuff.  I fired them.  When I told my new doc that having hair on my head was a very important secondary sex characteristic for me she just said, "I agree."  And she put me on Proscar instead.  A couple of days after I quit Spiro, the shedding stopped.  I've been off Spiro for 2 months now with little noticeable difference.  In a few weeks I think I'll ask my doc to up my estrogen dosage.  What surprises me tho is that docs don't routinely offer orchiectomy as an alternative to AA's. It's a simple, safe procedure. 100% natural. And eleminates all the horrible AA side effects right away.

Transgender medicine as a specialty has a long way to go IMO.
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Tori

Enough estrogen avoids the need for an anti androgen or an orchie. Let's you keep your bits till surgery if you have it, and gives the doc more raw material to work with.

I wouldn't mind having my bits gone anyway... seems to finally end the physical masculinization machine.

In summation, God I hate Spiro.


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josie76

That's great information about Spironolactone. It's not even hot out here yet, but a couple of times just working has made me feel like I was falling out. I drink plenty and have been eating a lot more salty foods.

I want to save up enough for an orchi. Insurance won't cover it.  :-\ I have found a urologist who will do it. I'd like to get off the spiro.

Oh, did someone say PICKLES ? My fridge is empty of those right now.   :(
04/26/2018 bi-lateral orchiectomy

A lifetime of depression and repressed emotions is nothing more than existence. I for one want to live now not just exist!

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Janes Groove

Quote from: Tori on May 04, 2017, 12:12:37 AM
Enough estrogen avoids the need for an anti androgen or an orchie. Let's you keep your bits till surgery if you have it, and gives the doc more raw material to work with.

100% correct.  But my issue is with the large percentage of transexuals who never get SRS.  I'm not sure what the exact number is, or if it's ever even been measured, but I suspect it's quite large.  For this group there is really very little medical justification for not offering/suggesting orchiectomy as an option early and often.  As standard medical procedure.  But most docs I think hold the archaic opinion that it is a violation of the Hippocratic Oath, first do no harm, never remove health organs, still feel that it is elective surgery, etc.  It is, I think, an indication of just how misunderstood we are by the medical establishment. Rant over.


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Tori

Ahhhhh,

I see where you are coming from. Sorry I didn't quite get it from your first post.


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laurenb

Tori, hold on a sec. I seem to remember reading that back in the 70's/early 80's they did prescribe massive amounts of E to transwomen without AA's. There was a problem with that, right? Stroke risk and blot clots and DVT. I'm certainly not biased toward Spiro - the fewer meds the better for me. If you're right then I'm all for it, but my understanding is that this current paradigm of E+Spiro has got to be the most prescribed regimen and therefore has the best statistical track record. I looked around at protocols across the country and Canada and they all seem to be variations on this theme. I also know some folks with congestive heart failure that have been on Spiro for literally over a decade. Now I'm curious.

BTW; I don't mean to hijack this thread - sorry. We can take this elsewhere but it does relate to the salt craving as it is a side effect.
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Dena

We were prescribed similar dosages to what is provided today however estradiol wasn't yet available as they hadn't figured out how to produce it. Instead we received synthetics with harmful side effects or Premarin which is about half estrone the the remainder horse estrogens which aren't exactly comparable with the human body. The track record with estradiol as a medication is relatively short however CIS woman have had generations of experience with it suggesting estradiol is relatively safe compared to early HRT. 
Rebirth Date 1982 - PMs are welcome - Use [email]dena@susans.org[/email] or Discord if your unable to PM - Skype is available - My Transition
If you are helped by this site, consider leaving a tip in the jar at the bottom of the page or become a subscriber
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DawnOday

Quote from: stephaniec on May 03, 2017, 03:40:20 PM
I stopped taking spiro because my sodium was always too high. Whenever I ended up in the hospital I had dangerously high sodium levels to where they told me to syop taking Spiro . I take the stuff that starts with an F ,  sorry I don't know the name off hand.
Spironolactone (generic)  Brand name Aldactone  Is primarily used as a diuretic for congestive heart failure, Besides pee, I sweat and the sweat generally leaches salt from the body. It used to be thought that it was good to take a lick of salt after sweating to replace the salt in the sweat. It has since been learned that excessive salt leads to high blood pressure. I did not find a generic with an F in the name but I do know there is another diuretic by the name of furosemide which is generic Lasix.   
Dawn Oday

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First indication I was different- 1956 kindergarten
First crossdress - Asked mother to dress me in sisters costumes  Age 7
First revelation - 1982 to my present wife
First time telling the truth in therapy June 15, 2016
Start HRT Aug 2016
First public appearance 5/15/17



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Artesia

I am still trying to figure out my sodium intake.  I have this HORRIBLE habit of drinking too much water.  When I was in the service, I was actually hospitalized because of it.  Last month I almost did the same thing, as my legs were cramping just walking across the kitchen at work.  Luckily, I was able to down 3 bottles of Gatorade, an 8oz glass of Apple juice, and a 24oz glass of Orange Juice with 3 Tbsp of salt added in.  Fixed my cramping in an hour, good thing working with a bunch of nurses.

I always go over the suggested value of sodium intake for a given day, even while trying to eat healthy, and eating healthcare planned meals.  I remain thirsty all day long, but am afraid to drink more than 3 bottles of water in a day, and never more than 5.
All the worlds a joke, and the people, merely punchlines

September 13, 2016 HRT start date
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