2 part question -

1/2 - So I'm on a full dose of Spironolactone, and a full dose of Estrodiol daily. I have been experiencing some serious lightheade-ness when getting up, and it's 8/10 times I get up. Maybe I'm quick to stand, but it affects me to the point where my whole vision blurs. I have discussed this with my doctor, and she wanted me to take half my regular dosage daily for two weeks to see if it subsides, but it hasn't. I visit her this month, and will discuss it again. It doesn't bother me that much, but I'm curious if anyone else experiences the same thing and has possible solutions?

2/2 - So the very first time I had visited the Children's Hospital here in Los Angeles, my doctor had repeatedly talked about getting a therapist through their recommendation list. Personally, I don't need a therapist, but of course need to complete the 1 year of therapy to get my SRS. My question is, how did you feel about first seeing a gender therapist per your doctor, if you did? I had a very negative prior experience with a therapist years ago that left me with a slight fear/PTSD for therapists in general. I never really did transition as I was raised to be/do whatever I felt I needed to do so I am INCREDIBLY uncomfortable when it comes to typical trans questions. How shall I cope cause I need to get this done sooner than later?

Thank you! - Jordan 

I can address part one for you.  It's called postural hypotension and is most likely caused by the Spiro as that can lower your blood pressure.  Hence the suggested trial of lower dosage, though shouldn't be a need to lower the estradiol.  Best thing you can do is keep talking to your doctor.  If it's a common occurrence for you, try to remember to get up more slowly all the time.  Staying hydrated may also help.

I haven't had to deal with it so don't have any tips from personal experience.  I'd guess some  other girls here can offer up some suggestions

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Have you been doing blood tests to work out how much spiro you actually need?

I'm not aware of any requirement for one year of therapy for SRS, and I've even heard of women getting a letter in one session. Is it insurance related?

Similar with me, right when I started I was lightheaded for a week or two, then it went away. At my three month checkup, my doses were doubled and the lightheadedness and dizziness returned for another week or two. Unfortunately, the increase has me constipated and that has not abated. I'm scheduling an orchi.

Hugs, Devlyn

I still occasionally get the lightheadedness when I stand. To me it's a sign to go drink some water to get the BP back up a little. Unlike most people, I find I need salt in my diet. You and your body will get used to the spiro. No other side effects (aside from smiling more).

I chose my therapist long before I came out to my GP or asked for HRT. It's a very personal thing and the first one you meet may not be a fit. Take the time to find someone right. I've had two. I selected both because they worked with people in the queer community. The first was good, the second is amazing. So much so, my partner now see's her. You may not feel the need for a therapist, but, they are great to have in your court when inevitably life happens. To have someone who is trained, works for you, understands you and is objective is just a great resource to have.

To get rid of the lightheadedness I use a lot of salt and drink a lot of water.  My salt is normally two to three times the RDA.  My blood pressure is still in the normal range so all is good.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

The other day I had an appointment with my general practitioner. I take spiro each day but the night before, I realised I had forgotten to take it that day so I took one before I went to bed around midnight. I woke up at 7am for my 8am appointment and had another (as I usually have them in the morning) and when I saw my doctor, she took my blood pressure. It was low. It is NEVER low. Has not been low since then, and had not been low before then. (I know this because I see doctors all the time and they always take my blood pressure).So there's my anecdotal evidence on excess spiro being related to low blood pressure.

I have also heard (in support of some of the posts here) that trans women are all addicted to salted pickles. Not me, I hate the things... but apparently salt is a big deal for some trans girls.

For the therapist. I am currently seeing a psychiatrist since my previous psychologist recommended it. In my country, if I want to have any surgery, I need a psychiatrist to attest that I am not crazy and that I am really trans. [sigh]... and we haven't talked about trans issues or my transition in like, the last 8 months which would be about 4 visits. However, I do think that seeing a psych can be a really good thing. Transition is pretty full on and our minds are really complicated. Even the fact you are here asking questions, sometimes it can be helpful to have someone who knows you well and can give you professional guidance. I know many transwomen who refuse to see professionals and are always coming to me with their problems and I know from my own experience that they could find some solace in professional assistance.

<dosages removed>

I love half sours. Kosher dill is ok too.


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I can only talk about the therapy thing..at the very least it should do bo harm.

A lot of us have deep-seated emotional problems..therapy is important.
Im not sure it is helping me. I've felt so much worse since I started..it stripped away my coping mechanisms and left uncomfortable truths behind without much of an answer to move forward

Lightheadedness isn't normal  First time I felt it was about 2nd grade when I was in a class play as one of the wise men. I almost passed out and my eyes had completely blacked out so I couldn't see. Now I know what it feels like, I get low whenever I feel it coming on. My resting blood pressure is normally about 110 which doesn't seem to be quite enough to supply a brain near 6'2" above the ground. If I am moving, it's not a problem but if I have to stand, watch out.  Just for the record, the only medication I take is estradiol.

Yeah... the pickles... never cared much for them until a few weeks ago... now I have insane cravings for pickles...

Sp asking if side effects: my desire for sweet food has gone away. I do need a whole lot of salt which apparently is a side effect.

Ranch dressing is my new go-to drug replacing jars full of Nutella!

I've heard of this before too.  Exogenous estrogen has a tendency to make a biological male's blood thicker. That's why DVT is a risk with MTF HRT.   When you stand up suddenly it could be because of thicker blood than you were used to pre-HRT.   My doctor has prescribed a baby aspirin once daily as a complement to my HRT regimen in order to make my blood thinner.

Hi Jordan,

  I have fairly frequent lightheadedness when getting up quickly especially when get up from lying down. I've checked my blood pressure several times after and found it to be on the low end like around 75/50. I have discussed this a couple times with my doctor and he says there is nothing to worry about as long as I feel good otherwise and to just take it easy/slower when getting up. Low blood pressure was one of the main reasons I told my doctor I had been taking spironolactone along with estradiol. He had already had me taking a BP med and I wanted him to be able to treat me properly by knowing all the medications I was taking. He now prescribes my HRT for me and I am still taking the same dosages of spiro and the other BP meds I was taking.

  As for therapy, I was never a fan of it either after basically being blackmailed into some counseling sessions with a shrink after letting it slip I had thought of doing myself harm. It was either agree to more sessions or get locked up in a facility and more therapy. I had far more serious episodes after her "sessions"
  But as for gender therapy I did decide to try it after reading so many people here on Susan's recommending it. I have have no regrets talking to my therapist. I am honest and open with him discussing my thoughts and feelings about my transition. His questions and suggestions have been helpful for me. Just having someone I can be open and honest with is a help as I have no one else IRL that I can talk to here. This forum has been a big help for me in that aspect also and I have made several good friends here that I otherwise would not have.

  Hope my experience helps you in some way.

Hugs,
   Laurie

Quote from: AnonyMs on June 03, 2017, 06:39:12 AM
Have you been doing blood tests to work out how much spiro you actually need?

I'm not aware of any requirement for one year of therapy for SRS, and I've even heard of women getting a letter in one session. Is it insurance related?

I get blood tests every single time I go in. My dosages have not changes since first getting on HRT 6 months ago. I live in California, so there is a one year with a therapist requirement to achieve your letter of recommendation for SRS. At least that  is what i have been told from my doctor, and the board of directors from the hospital I go to.

Quote from: Ofelia on June 03, 2017, 10:39:09 AM
The other day I had an appointment with my general practitioner. I take  spiro each day but the night before, I realised I had forgotten to take it that day so I took one before I went to bed around midnight. I woke up at 7am for my 8am appointment and had another (as I usually have them in the morning) and when I saw my doctor, she took my blood pressure. It was low. It is NEVER low. Has not been low since then, and had not been low before then. (I know this because I see doctors all the time and they always take my blood pressure).So there's my anecdotal evidence on excess spiro being related to low blood pressure.

I have also heard (in support of some of the posts here) that trans women are all addicted to salted pickles. Not me, I hate the things... but apparently salt is a big deal for some trans girls.

For the therapist. I am currently seeing a psychiatrist since my previous psychologist recommended it. In my country, if I want to have any surgery, I need a psychiatrist to attest that I am not crazy and that I am really trans. [sigh]... and we haven't talked about trans issues or my transition in like, the last 8 months which would be about 4 visits. However, I do think that seeing a psych can be a really good thing. Transition is pretty full on and our minds are really complicated. Even the fact you are here asking questions, sometimes it can be helpful to have someone who knows you well and can give you professional guidance. I know many transwomen who refuse to see professionals and are always coming to me with their problems and I know from my own experience that they could find some solace in professional assistance.

I heard the same with the pickles.. make sense since my medication bottles says to not use salt substitutions. I wonder if that is my exact problem. I consume extremely little amounts of salt as it makes me incredibly bloated.

Quote from: Laurie on June 03, 2017, 03:59:46 PM
Hi Jordan,

  I have fairly frequent lightheadedness when getting up quickly especially when get up from lying down. I've checked my blood pressure several times after and found it to be on the low end like around 75/50. I have discussed this a couple times with my doctor and he says there is nothing to worry about as long as I feel good otherwise and to just take it easy/slower when getting up. Low blood pressure was one of the main reasons I told my doctor I had been taking spironolactone along with estradiol. He had already had me taking a BP med and I wanted him to be able to treat me properly by knowing all the medications I was taking. He now prescribes my HRT for me and I am still taking the same dosages of spiro and the other BP meds I was taking.

  As for therapy, I was never a fan of it either after basically being blackmailed into some counseling sessions with a shrink after letting it slip I had thought of doing myself harm. It was either agree to more sessions or get locked up in a facility and more therapy. I had far more serious episodes after her "sessions"
  But as for gender therapy I did decide to try it after reading so many people here on Susan's recommending it. I have have no regrets talking to my therapist. I am honest and open with him discussing my thoughts and feelings about my transition. His questions and suggestions have been helpful for me. Just having someone I can be open and honest with is a help as I have no one else IRL that I can talk to here. This forum has been a big help for me in that aspect also and I have made several good friends here that I otherwise would not have.

  Hope my experience helps you in some way.

Hugs,
   Laurie

The old therapist I had was awful. She was apart of the LGBT community, so I figured she would be more understanding and helpful. It was a family therapist. She turned out to be very dehumanizing, borderline sexual harassing (asking how big my unit was.. I was underage at the time), and at one point she was sexually touchy with my mother who told her off and filed complaints against her. I was just in awe of her actions, which has led me to not like therapy. I dislike the questioning, but I personally don't have any  real problems in my life to see one. However it's a must for me to get the letter for SRS. 

Quote from: Jane Emily on June 03, 2017, 01:25:49 PM
I've heard of this before too.  Exogenous estrogen has a tendency to make a biological male's blood thicker. That's why DVT is a risk with MTF HRT.   When you stand up suddenly it could be because of thicker blood than you were used to pre-HRT.   My doctor has prescribed a baby aspirin once daily as a complement to my HRT regimen in order to make my blood thinner.

Very interesting!!

Quote from: Gertrude on June 03, 2017, 11:34:12 AM
I love half sours. Kosher dill is ok too.


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Pickle chips for me! Just don't want the calories...  I'm on a strict diet plan.. hmm.

Quote from: sarah1972 on June 03, 2017, 01:00:54 PM
Yeah... the pickles... never cared much for them until a few weeks ago... now I have insane cravings for pickles...

Sp asking if side effects: my desire for sweet food has gone away. I do need a whole lot of salt which apparently is a side effect.

Ranch dressing is my new go-to drug replacing jars full of Nutella!

I love pickle chips... but never was a salty food person. I consume very little salt as it makes me very bloated. I wonder if that's my problem to begin with. I'll have to see what my doctor says in 2 weeks. hmmmm

edit: Dosage removed from quoted post

Again with the pickles and olives?

  I'm going to clobber whoever mentioned drinking the olive pickling juice. It was bad enough I was eating all the olives I bring into the house, a few at a time, several times a day, but now there is never any of the juice to throw away where the olives are gone....
  My sister has even caught me drinking it from the container. 

I tell you someone is in trouble....

  Hugs,
    Laurie

Well, Spiro has been a damn miracle drug for me.  The effects have almost all been positive in my case.

I had borderline sodium sensitive high blood pressure, regularly getting readings of 140/90.  An extreme low sodium diet, limiting myself to 700 mg/day of sodium and obsessively tracking every swallow with MyFitnessPal on my phone, reduce my blood pressure to 120/80or slightly higher. (Mom died from a stroke related to high blood pressure.  Her dad had a heart attack.  My dad would have likely had a heart attack or stroke if his liver had survived the drinking.)

I was put on Spiro.  I reduced my potassium intake to 2,800 mg/day, mostly by cutting out tomato concentrates, soups, pasta sauce, that sort of thing, bananas, and root veggies.I raised my sodium intake to 1,500 then to 2,300 mg/day, effectively unrestricted.  My blood pressure runs 95/60!  The doctor is happy with that as long as it doesn't cause any problems, as am I.   I don't have to restrict my diet nearly as much, and I even feel better from another side effect of Spiro, being an antiandrogen.   That stopped the mental 'noise' I got from testosterone, with some calm periods showing up about 3 weeks in, and the full effect hitting about tow months in.

I very much looked forward to switching to a gender therapist from the initial psych therapist I was seeing, who had very little trans experience or knowledge.  He mentioned that gender therapists were available on my first visit when I spilled the story.   He mostly made sure I had the tools to deal with the severe depression and anxiety that had first put me on his couch.  The gender therapist has been great at guiding me along, and helping me past the obstacles I generated for myself.

Quote from: Jane Emily on June 03, 2017, 01:25:49 PM
I've heard of this before too.  Exogenous estrogen has a tendency to make a biological male's blood thicker. That's why DVT is a risk with MTF HRT.   When you stand up suddenly it could be because of thicker blood than you were used to pre-HRT.   My doctor has prescribed a baby aspirin once daily as a complement to my HRT regimen in order to make my blood thinner.

It does the same for cis women too, being a side effect of BC. Testosterone therapy does this as well. I took  baby aspirin when I was on it as I had a DVT incident in 1993. I suspect I will do the same with estrogen.


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Quote from: Michelle_P on June 03, 2017, 05:29:38 PM
Well, Spiro has been a damn miracle drug for me.  The effects have almost all been positive in my case.

I had borderline sodium sensitive high blood pressure, regularly getting readings of 140/90.  An extreme low sodium diet, limiting myself to 700 mg/day of sodium and obsessively tracking every swallow with MyFitnessPal on my phone, reduce my blood pressure to 120/80or slightly higher. (Mom died from a stroke related to high blood pressure.  Her dad had a heart attack.  My dad would have likely had a heart attack or stroke if his liver had survived the drinking.)

I was put on Spiro.  I reduced my potassium intake to 2,800 mg/day, mostly by cutting out tomato concentrates, soups, pasta sauce, that sort of thing, bananas, and root veggies.I raised my sodium intake to 1,500 then to 2,300 mg/day, effectively unrestricted.  My blood pressure runs 95/60!  The doctor is happy with that as long as it doesn't cause any problems, as am I.   I don't have to restrict my diet nearly as much, and I even feel better from another side effect of Spiro, being an antiandrogen.   That stopped the mental 'noise' I got from testosterone, with some calm periods showing up about 3 weeks in, and the full effect hitting about tow months in.

I very much looked forward to switching to a gender therapist from the initial psych therapist I was seeing, who had very little trans experience or knowledge.  He mentioned that gender therapists were available on my first visit when I spilled the story.   He mostly made sure I had the tools to deal with the severe depression and anxiety that had first put me on his couch.  The gender therapist has been great at guiding me along, and helping me past the obstacles I generated for myself.

I wonder if it's ok to be on bp meds while on spiro? I'm on lisinopril and metoprolol.


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Quote from: Gertrude on June 03, 2017, 05:53:08 PM
I wonder if it's ok to be on bp meds while on spiro? I'm on lisinopril and metoprolol.


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Spiro is a BP med.  Depending on your condition, your Dr might be able to reduce or eliminate the other meds.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

Quote from: Gertrude on June 03, 2017, 05:53:08 PM
I wonder if it's ok to be on bp meds while on spiro? I'm on lisinopril and metoprolol.


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Hi Trudy,

  Those are the same two BP meds I take and my Doctor left me on the spiro I was taking when I told him I was doing HRT meds. For 6 months now I've taken all 3 BP meds with his blessing. Since then my BP has been running in the 90s/60s generally.

Hugs,
   Laurie