casperz
Experienced Member
- Reaction score
- 25
I called up an old friend that I went to college with and
he is now a physician. I asked him if I could pick his brain about
hair loss and we talked for quite a while. He is a NW5 and does not
do anything as far as treatment. Say he just does not have time but
would jump at some of the new treatments that will be available.
I asked him about spironolactone and he had a lot to say about it and he
really cleared up some things for me. After talking with him
I'm pretty sure I would never take it. Here are my questions and
his comments:
spironolactone does not reduce testosterone directly but it certainly will reduce
testosterone through modifying the feedback loop and the dosage can be very small if taken correctly.
What happens is spironolactone binds to the T receptors leaving an excess of T
floating around un-bound. The pituitary glad which regulates the T production
senses the excess T and tells the testes to produce less T. Over time the
pituitary will continue to down-regulate the T that is produced until the free T
is normal again. If you continue to take spironolactone the cells in the testes that
produce the T will atrophy from non-use and over time (about six months to a
year) will never recover. You will have permanent reduction of T even if you
stop taking spironolactone. By then your testicles will be the size of small grapes
due to the tissue loss.
The reason that the dosage can vary is that spironolactone can only block a fixed
number of T receptors at one time and it has a very short life. So unless you
took the exact dosage your system needs (which is different for everybody
because everyone has a different number of receptors) to bind to all the
receptors and split it up evenly throughout the day and night some T receptors
are going to be un-bound and allow the free T to bind to them. That in turn
causes the pituitary gland to produce more and your T goes up. So if you
want to reduce T the trick is to find the correct dosage and then spit it up so
that it is not all used up. That being very difficult so instead you take one
large dose per day and overwhelm the system with much more than is needed.
Some patients could take as little as 1mg every hour and totally shutdown the
testes production of T. Others might take as much as 16mg per hour. Ideally
a time release capsule of sprio would be perfect, but no such deliver method
exists.
Studies are often looking at one focused problem and people tend to
read into them many, many things and come up with totally off-base
conclusions. I'm completely up to date on the effects of spironolactone and prescribe it
to male patients for very specific reasons and I know first hand that and
have no doubt that spironolactone will reduce testosterone at some dosage level. For
some males a very small amount is needed to achieve the desired reduction.
If someone tells you it does not reduce T at any dosage they are
mis-informed.
There is most definitely permanent damage being done to the testes in the
form of atrophy and after a period of taking spironolactone the testes may not recover
to 100% and if it's been long enough not at all. That period is going to vary
from person to person.
The ONLY reason that people see results from oral spironolactone is not magic, they
just reduce there T levels and at the same time DHT. Less DHT to attack
the follicles means less hair loss. spironolactone does not add anything other
than a complete shutdown of T at higher dosages.
Transsexual also take Estrogen and E actually binds to the same receptors
as the T and has the same effect as the spironolactone. Remember, the pituitary
glad cannot tell a the difference between T and E and E competes with
the T in your body for the same receptors. Everyone is born with a
fixed number of receptors and that number varies.
A transsexual taking E set's up the same feedback sequence of events that
lowers T. T could be reduced with E alone but the E dosage has to be much
higher and there are risks to taking large doses of E. So spironolactone is used to
allow a lower dosage of E to be taken.
The breast swelling when taking spironolactone is due to the free T that is not allowed
to bind to the receptors. The body converts the excess T into E to be
stored in fat. The breast tissue in males is a prime area that this occurs
because it is E sensitive. The same thing happens to body builders that take
large doses of T or steroids to build muscle, the excess T is converted to E
and that is why all the body builders wonder why they develop breasts.
The same thing happens to a degree with finasteride which blocks DHT only from
the receptors. The excess DHT is converted into estrogen and depending on
the sensitivity of the mans breast tissue may experience gyno. Over time the
pituitary will down regulate the T so that excess will go away. And the breast
tissue will re-absorb over time. I hear a lot of guys that stop propecia and
after a panic in seeing the start of gyno. If they just ride it out the system will
regulate itself and the gyno will go away. It also goes away if they stop finasteride
but of course they don't gain the benefits of finasteride. At normal dosages a
small percentage of finasteride users get gyno and it will go away even if they
stay on the drug, however the same is not true of spironolactone. Due to total
blockage of T more aggressive breast tissue is developed and will not be
re-absorbed if you stop in many cases. This is also true if taking higher
dosages of finasteride.
I would not recommend spironolactone for any male, the benefits are not any
greater than finasteride and there is no reason to even consider it in any dosage.
So there you have it. Take it for what it is, free advise.
We also talked about some of the new things that are coming and he
seemed very informed on them, I'll post more about that in another thread.
he is now a physician. I asked him if I could pick his brain about
hair loss and we talked for quite a while. He is a NW5 and does not
do anything as far as treatment. Say he just does not have time but
would jump at some of the new treatments that will be available.
I asked him about spironolactone and he had a lot to say about it and he
really cleared up some things for me. After talking with him
I'm pretty sure I would never take it. Here are my questions and
his comments:
spironolactone does not reduce testosterone directly but it certainly will reduce
testosterone through modifying the feedback loop and the dosage can be very small if taken correctly.
What happens is spironolactone binds to the T receptors leaving an excess of T
floating around un-bound. The pituitary glad which regulates the T production
senses the excess T and tells the testes to produce less T. Over time the
pituitary will continue to down-regulate the T that is produced until the free T
is normal again. If you continue to take spironolactone the cells in the testes that
produce the T will atrophy from non-use and over time (about six months to a
year) will never recover. You will have permanent reduction of T even if you
stop taking spironolactone. By then your testicles will be the size of small grapes
due to the tissue loss.
The reason that the dosage can vary is that spironolactone can only block a fixed
number of T receptors at one time and it has a very short life. So unless you
took the exact dosage your system needs (which is different for everybody
because everyone has a different number of receptors) to bind to all the
receptors and split it up evenly throughout the day and night some T receptors
are going to be un-bound and allow the free T to bind to them. That in turn
causes the pituitary gland to produce more and your T goes up. So if you
want to reduce T the trick is to find the correct dosage and then spit it up so
that it is not all used up. That being very difficult so instead you take one
large dose per day and overwhelm the system with much more than is needed.
Some patients could take as little as 1mg every hour and totally shutdown the
testes production of T. Others might take as much as 16mg per hour. Ideally
a time release capsule of sprio would be perfect, but no such deliver method
exists.
Studies are often looking at one focused problem and people tend to
read into them many, many things and come up with totally off-base
conclusions. I'm completely up to date on the effects of spironolactone and prescribe it
to male patients for very specific reasons and I know first hand that and
have no doubt that spironolactone will reduce testosterone at some dosage level. For
some males a very small amount is needed to achieve the desired reduction.
If someone tells you it does not reduce T at any dosage they are
mis-informed.
There is most definitely permanent damage being done to the testes in the
form of atrophy and after a period of taking spironolactone the testes may not recover
to 100% and if it's been long enough not at all. That period is going to vary
from person to person.
The ONLY reason that people see results from oral spironolactone is not magic, they
just reduce there T levels and at the same time DHT. Less DHT to attack
the follicles means less hair loss. spironolactone does not add anything other
than a complete shutdown of T at higher dosages.
Transsexual also take Estrogen and E actually binds to the same receptors
as the T and has the same effect as the spironolactone. Remember, the pituitary
glad cannot tell a the difference between T and E and E competes with
the T in your body for the same receptors. Everyone is born with a
fixed number of receptors and that number varies.
A transsexual taking E set's up the same feedback sequence of events that
lowers T. T could be reduced with E alone but the E dosage has to be much
higher and there are risks to taking large doses of E. So spironolactone is used to
allow a lower dosage of E to be taken.
The breast swelling when taking spironolactone is due to the free T that is not allowed
to bind to the receptors. The body converts the excess T into E to be
stored in fat. The breast tissue in males is a prime area that this occurs
because it is E sensitive. The same thing happens to body builders that take
large doses of T or steroids to build muscle, the excess T is converted to E
and that is why all the body builders wonder why they develop breasts.
The same thing happens to a degree with finasteride which blocks DHT only from
the receptors. The excess DHT is converted into estrogen and depending on
the sensitivity of the mans breast tissue may experience gyno. Over time the
pituitary will down regulate the T so that excess will go away. And the breast
tissue will re-absorb over time. I hear a lot of guys that stop propecia and
after a panic in seeing the start of gyno. If they just ride it out the system will
regulate itself and the gyno will go away. It also goes away if they stop finasteride
but of course they don't gain the benefits of finasteride. At normal dosages a
small percentage of finasteride users get gyno and it will go away even if they
stay on the drug, however the same is not true of spironolactone. Due to total
blockage of T more aggressive breast tissue is developed and will not be
re-absorbed if you stop in many cases. This is also true if taking higher
dosages of finasteride.
I would not recommend spironolactone for any male, the benefits are not any
greater than finasteride and there is no reason to even consider it in any dosage.
So there you have it. Take it for what it is, free advise.
We also talked about some of the new things that are coming and he
seemed very informed on them, I'll post more about that in another thread.
