Here's my screed about HRT meds being used improperly and without caution, and as I mention, I was guilty of being dismissive of the strong and pervasive side-effects and jarring effects of using AA's improvidently or in the case of MtFs, without cause. This applies as written only to HRT when done intentionally to feminize. If it serves as a warning to cis-males to avoid AA's then people often say that we on this thread might be reckless and each has to make their own decision. Cis-males have different goals and estrogen in the amounts needed by MtFs for hair growth appears to be a no-go for essentially all of them.
HUGE T increase on spironolactone
This started as a comment on a great post asking for advice about Bica vs. spironolactone, which I want to hear about, but I'm a little bit freaked out and have seen a ton of great knowledge shared here, so here I go.
I started my medical transition 11months ago on 100mg of spironolactone. I only started on t-blockers because I was worried about mental health changes and a trans friend suggested it. I was also a little unsure to some degree. My T was still hovering at the same place it started around 700 after a couple months, so we upped my dose to 200mg.
By this summer it became clear I needed Estrogen. I started on 1mg two months ago with the intention to titrate up, which I am currently doing at 2mg, soon 3mg. I made this decision with my NP just the other day based off my Metabolic panel and my Estradiol levels, which was 43. There was an issue with the labs coming in late, so we didn't have the Testosterone to reference. however
when it came back later today, it was 1053 and my
free testosterone was 92.3.
Since starting spironolactone, I have no motivation. Not to cook, not to clean, barely to work, not to socialize, and I'm always angry. I thought this was because I was so low on sex hormones. Here's what I think I understand and some questions:
My testosterone could be getting blocked from binding with my receptors, but still being produced. The lack of Estradiol might have even exacerbated that, so my dosage change could help. However, is this in any way normal?
spironolactone v. Bica - Tell me everything. It seems like women who started on spironolactone but changed to bica have had success. Please advise. I'm in the US so cypro is not really an option and doesn't sound right to me.
Again, my motivation is sh*t and my generally manageable mental health goes from seemingly impossible and suicidal to so angry I have to close myself in my room and literally get in a fighting match with my bed and pillows so I don't scare my dog. When I read about testosterone issues happening in men due to anabolic steroids, I felt like that really described my experience. What do people think or have to say?
Thank you everyone and anyone who answers this post.
Comment as
JaneyElizabeth
JaneyElizabeth
1 point ·
23 minutes ago
I find what you recount disturbing not only in terms of advice from someone who, I mean, I am sort of doing the same thing, as I am no doctor but I try to only synthesize what we don't know mostly since we know so little but I never recommend anyone not use estrogen, even non-binary folks.
Again and again and again when I read complaints both here and on a hair loss thread related to HRT, AA's are involved. I think that for the most part for most people, AA's are yesterday's trash. They have been incorporated due to stasis in medication procedures and the failure by many to realize that the only point of AA's is when someone can't hit targets and you don't need to hit targets for up to years. Things like the Powers program even though he touts bicalutamide, are only more of the same stacking of potent medications without having a full handle on what or why except, "hmm, maybe adding this and switching ingestion methods of estrogen three times using different metabolites would work...." But we are the ones being experimented on on and suffering the consequences and at the very least, I want to see some data compiled instead of Tony Robbins-type hoopla. Where are the pictures? I digress a bit because I am infuriated about all of this over-medication when none of us are sick!
In the olden days, many gals never could get to targets because the meds, largely swallowed synthetic and non-human estrogens could cause significant liver artifacts the longer they were used. Due to this fear, physicians refused to prescribe enough estrogen in these forms and of course, MtF's didn't fully feminize in the long run and specifically in terms of what might be called hair and above the neck results. Breast growth can come right at the beginning or not; we are all different.
AA's in my experience impact sharply on strength and fatigue and cause much more weakness than using estrogen alone without any payback. Bica is said to be great for this and that, particularly hair but where's the evidence that it is better than just estradiol? I don't think that there is any. There could be triggering mechanisms related to hair growth and other aspects but we don't know and the risks and sides are often life-crippling. For spironolactone, people mention weakness, fatigue, brain fog (which I think is the same as the first too, largely, i.e., too tired to think). spironolactone is a potassium-sparing diuretic and causes excessive urination and the need to increase NaCl uptake. I had a shaker on my nightstand because I often awoke wanting table salt. In certain situations these potassium-raising aspects can be quite serious.
I am not saying that spironolactone doesn't work in certain circumstances but usually there are indeed reasons why targets can't be hit otherwise or there should be. If it is merely a question of speed, then I wouldn't touch the stuff. I went completely bald and I was sweating uncontrollably last summer and felt as weak as a kitten. None of that hurt results but who wants to lose all of her hair in her quest to regrow it? Higher T is a widely known and common, if not likely occurrence from using spironolactone and bica.
These are strong, jarring meds that derive from prostate cancer research which doesn't mean that they don't work but estrogen seems to work for almost all of us in a non-jarring way. The goal probably should be to be on the fewest different types of medications possible and not stacking med after med in the search of better "physical" results.
Less is more; simpler is often better especially when unlike in prostate cancer, we aren't receiving real-time or semi-real time readings to evaluate and adjust to. I think HRT has gotten out of control in the search for a la carte "results" and I become less and less sanguine about the lack of reasonable expectations and even what appears to be anger by some MtFs when they don't see happen what they though was a certainty, at least something positive results-wise. Maybe this is too bleak but these are powerful meds and not to be used without caution and respect for what they can do, and I was no different leaping to 200mg of spironolactone well ahead of what my doctor recommended and she never even recommended any spironolactone until I basically told her I would buy it offshore otherwise. She had me on tiny amounts of estrogen and she was right and I was wrong and I owe her great thanks for my "results" and I recently emailed and told her so.
I know that you can get this resolved and I hope that you will report back with your improvement.
Goddess bless.
www.ncbi.nlm.nih.gov
