Hyperandrogenicity From spironolactone? Hair Loss Is Increasing

[CJ-B]

Hello, 27 y/o female with CTE (and possibly Androgenetic Alopecia?) with a quick question..I've seen other users talk about hyperandrogenicity when using finasteride, is this something that can happen with oral spironolactone too? I was taking 25mg/day for 5 months and my hair loss seemed to progress faster than it was before, I also experienced increased/darkening facial and body hair however my acne improved quite a bit so I'm confused. I recently was upped to 50mg/day and have been taking that for about a month with the same symptoms happening.

I also had adjusted my minoxidil 5% dosage up to 1ml a day from the .75 I had been using before, i get facial hair with that too but it wasnt dark like it is now :/

If I slowly go off the spironolactone will I be worse off, will my acne come back really badly and my hair loss get even worse? any advice is appreciated, thanks

here's a link to some more of my history if that helps: https://www.hairlosstalk.com/intera...c-alopecia-spironolactone-not-helping.121989/

 

[hemingway_the_mercenary]

spironolactone is a terrible drug choice for treating acne imo. Not worth it all. If you have Androgenetic Alopecia some studies have shown that women who didnt respond to spironolactone did respond to flutamide. Women's hairloss is much harder to treat tho unfortunately

 

[CJ-B]

spironolactone is a terrible drug choice for treating acne imo. Not worth it all. If you have Androgenetic Alopecia some studies have shown that women who didnt respond to spironolactone did respond to flutamide. Women's hairloss is much harder to treat tho unfortunately

Thank you for responding So if my acne did get better with spironolactone but other symptoms got worse does that mean my acne isnt hormonal? I should note I am also using nutrafol (at my derms recommendation) which has saw palmetto that supposedly blocks dht as well, maybe I'm just overloading my system? What do you think of bicalutamide for my issues? Sorry if I'm asking too many questions

 

[DHTcel]

Thank you for responding So if my acne did get better with spironolactone but other symptoms got worse does that mean my acne isnt hormonal? I should note I am also using nutrafol (at my derms recommendation) which has saw palmetto that supposedly blocks dht as well, maybe I'm just overloading my system? What do you think of bicalutamide for my issues? Sorry if I'm asking too many questions

try 50mg bicalutamide with lupron injections, that should work

 

[DHTcel]

also you claim to have facial hair, can you post a photo for legitimacy concerns?

 

[hemingway_the_mercenary]

Thank you for responding So if my acne did get better with spironolactone but other symptoms got worse does that mean my acne isnt hormonal? I should note I am also using nutrafol (at my derms recommendation) which has saw palmetto that supposedly blocks dht as well, maybe I'm just overloading my system? What do you think of bicalutamide for my issues? Sorry if I'm asking too many questions

Everyone’s acne is at least somewhat hormonal. Again it’s hard to say until I know for sure if you have Androgenetic Alopecia or not. Women don’t really have much DHT at all since estradiol has to converted to testosterone and then to DHT. So it would require two passes through 5AR which would be rare

It’s possible spironolactone is blocking the ARs in your body but you have mutant ARs in the scalp which don’t respond to spironolactone (worst case).

I think bicalutamide would be much easier on the body and most likely more effective too.

 

[CJ-B]

also you claim to have facial hair, can you post a photo for legitimacy concerns?

Here you go, it's actually a bit worse than this now although in normal lighting (i used flash here) its a little less noticeable? Although it seems to be reaching further and further up my face. It's also affected the rest of my body (arms, back , stomach) but I'm not comfortable taking pictures of those, sorry I know it looks really bad, please be kind

 

[DHTcel]

Everyone’s acne is at least somewhat hormonal. Again it’s hard to say until I know for sure if you have Androgenetic Alopecia or not. Women don’t really have much DHT at all since estradiol has to converted to testosterone and then to DHT. So it would require two passes through 5AR which would be rare

It’s possible spironolactone is blocking the ARs in your body but you have mutant ARs in the scalp which don’t respond to spironolactone (worst case).

I think bicalutamide would be much easier on the body and most likely more effective too.

mutant ARs? what is that

 

[Chemichal Castration]

spironolactone is actually effective at treating acne. I rather have spironolactone than isotretinoin.
25mg a day will do nothing for your hair, you need higher doses 100-200mg range

 

[Chemichal Castration]

do you have PCOS?

 

[CJ-B]

Everyone’s acne is at least somewhat hormonal. Again it’s hard to say until I know for sure if you have Androgenetic Alopecia or not. Women don’t really have much DHT at all since estradiol has to converted to testosterone and then to DHT. So it would require two passes through 5AR which would be rare

It’s possible spironolactone is blocking the ARs in your body but you have mutant ARs in the scalp which don’t respond to spironolactone (worst case).

I think bicalutamide would be much easier on the body and most likely more effective too.

I know that I didn't have elevated DHEA-S or testosterone before I started spironolactone, in all honesty if I can't save my hair (which may be the case) I would at least like to save my skin/reduce body/facial hair. I was thinking bicalutamide might be better for me because I had read it's more targeted to dht/testosterone? I think I also read that spironolactone can have both androgenic and anti-androgenic effects but leans more adrogenic at higher doses if you don't have elevated androgens, is that true? Have I ruined my hormones permanently?

 

[CJ-B]

do you have PCOS?

as far as I know I don't

 

[hemingway_the_mercenary]

I know that I didn't have elevated DHEA-S or testosterone before I started spironolactone, in all honesty if I can't save my hair (which may be the case) I would at least like to save my skin/reduce body/facial hair. I was thinking bicalutamide might be better for me because I had read it's more targeted to dht/testosterone? I think I also read that spironolactone can have both androgenic and anti-androgenic effects but leans more adrogenic at higher doses if you don't have elevated androgens, is that true? Have I ruined my hormones permanently?

I dont think you have ruined your hormones permanently imo. Try bica, try to keep postive

 

[CJ-B]

try 50mg bicalutamide with lupron injections, that should work

I dont think you have ruined your hormones permanently imo. Try bica, try to keep postive

Thank you for the encouragement, I really appreciate it

 

[Chemichal Castration]

"In a case study of four patients, spironolactone at the dose of 200 mg daily reduced hair loss by 50%–62.9% and also increased the total number of anagen hairs."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/

25mg is nearly enough. lower doses are required for acne

 

[CJ-B]

"In a case study of four patients, spironolactone at the dose of 200 mg daily reduced hair loss by 50%–62.9% and also increased the total number of anagen hairs."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/

25mg is nearly enough. lower doses are required for acne

it definitely did help my acne but everything else got worse I'm on 50mg right now but I don't think I can tolerate a higher dose, I get pretty dizzy as it is, maybe because I'm underweight it effects me more?

 

[Chemichal Castration]

Yes, maybe. If you cant tolerate it, you should find other treatments.

One suggestion I could give you is to fruit juice or eat watery fruits to replenish your electrolytes. Maybe you should add a multivitaminic if you are underweight as well. Sport drinks are also mineral rich. I think there are several ways you cant try to work it around

 

[CJ-B]

Yes, maybe. If you cant tolerate it, you should find other treatments.

One suggestion I could give you is to fruit juice or eat watery fruits to replenish your electrolytes. Maybe you should add a multivitaminic if you are underweight as well. Sport drinks are also mineral rich. I think there are several ways you cant try to work it around

I do take a multivitamin but I probably don't get enough water and definitely not enough fruits, thanks for the suggestions, probably could help me regardless of spironolactone

 

[Ikarus]

With the facial hair, hair loss and acne... In my opinion, I think your dose isn’t high enough. If it’s helping acne at a low dose, but not helping hirsutism and hair loss could be because your dose isn’t high enough (I looked online and it’s recomended to take 100MG - 200MG to help hirsutism and hair loss). If you’re still on minoxidil, I’d recommend that you stop that because that can cause excess facial hair which is why I would never take it either.

A few questions: What areas do you get the acne? When did you notice facial hair appearing? Would you visit an endocrinologist?

 

[CJ-B]

With the facial hair, hair loss and acne... In my opinion, I think your dose isn’t high enough. If it’s helping acne at a low dose, but not helping hirsutism and hair loss could be because your dose isn’t high enough (I looked online and it’s recomended to take 100MG - 200MG to help hirsutism and hair loss). If you’re still on minoxidil, I’d recommend that you stop that because that can cause excess facial hair which is why I would never take it either.

A few questions: What areas do you get the acne? When did you notice facial hair appearing? Would you visit an endocrinologist?

I first noticed the acne on my right cheek and the lower left side of my jaw, a tiny bit on my chin. The facial hair came about 6 months or so after topical minoxidil (i used 1ml 5% once a day at most) but it wasnt really dark like it is now. I would definitely visit an endocrinologist, I asked my derm about it but she wasn't sure that its necessary. Ive been wanting to get off minoxidil for a while but Ive been using it so long now (1.5 yrs about) Im afraid to stop :/