All about oral spironolactone

[neis]

IBM,
Yesterday, I started drinking a glass of soy milk every day, just because Soy is an excellent source of protein and the female reproductive hormone estrogen.Testosterone is suppressed by an excess of estrogen.Soy is feminizing, and commonly leads to a decrease in the size of the penis, sexual confusion and homosexuality.
I really do like the spironolactone and soy combo unk:

Anyway, thanks dude for the reply

Good luck with everything.

 

[docj077]

Doctors... :dunno: :roll:

Spironolactone competitively inhibits DHT at its receptor sites and also inhibits steroid synthesis in the adrenals and gonads.

In women that take the drug for PCOS, the levels of LH, FSH, and Testosterone all appear to fall.

J Clin Endocrinol Metab. 2004;89:2756-2762

Women who are hypertensive and take the drug to lower blood pressure appear to have no adverse hormonal effects. Testosterone and estradiol remain the same.

Acta Endocrinol (Copenh). 1979 Apr;90(4):577-84.

When this drug was tested on a population with acne, the drug lowers free and total testosterone levels in those with high initial testosterone before treatment and raises T in those with low T before treatment in certain individuals.

Aesth. Plast. Surg. 30:1
7, 2006

But, steroidogenesis in the Leydig cells of the testes also seems to be a process where by LH and mineralocorticoids often work synergistically to regulate production even if it is through possible two different pathways. However, aldosterone alone seems to increase steroidogenesis alone.

Mol Cell Endocrinol. 2005 Nov 24;243(1-2):35-42
(we're talking about rats here, so one has to be careful)


There seems to be other studies with contradictary evidence, as well.

Really, there doesn't seem to be a general consensus regarding the true hormonal effect of oral spironolactone. Hormonal outcomes seem to be somewhat dependent upon individual hormonal and genetic status before treatment even begins.

If someone has a more interesting study, post the reference or an abstract.

 

[docj077]

IBM,
Yesterday, I started drinking a glass of soy milk every day, just because Soy is an excellent source of protein and the female reproductive hormone estrogen.Testosterone is suppressed by an excess of estrogen.Soy is feminizing, and commonly leads to a decrease in the size of the penis, sexual confusion and homosexuality.
I really do like the spironolactone and soy combo unk:

Anyway, thanks dude for the reply

Good luck with everything.

By the way, the bold and underlined part...no, just no.

 

[Nuli]

IBM,
Yesterday, I started drinking a glass of soy milk every day, just because Soy is an excellent source of protein and the female reproductive hormone estrogen.Testosterone is suppressed by an excess of estrogen.Soy is feminizing, and commonly leads to a decrease in the size of the penis, sexual confusion and homosexuality.
I really do like the spironolactone and soy combo unk:

Anyway, thanks dude for the reply

Good luck with everything.

By the way, the bold and underlined part...no, just no.

It is a girlfriend you have correct? lol :gay:

 

[Bryan]

Doctors... :dunno: :roll:

Spironolactone competitively inhibits DHT at its receptor sites and also inhibits steroid synthesis in the adrenals and gonads.

So do you find what that guy (Casperz's doctor-friend) said about spironolactone to be as odd as I do?

BTW, docj, where have you been the last several months? How are you coming along on your medical career?

When this drug was tested on a population with acne, the drug lowers free and total testosterone levels in those with high initial testosterone before treatment and raises T in those with low T before treatment in certain individuals.

Very interesting! So it had kind of a "normalizing" effect on T levels? What were the doses of spironolactone that were used in that study?

Really, there doesn't seem to be a general consensus regarding the true hormonal effect of oral spironolactone. Hormonal outcomes seem to be somewhat dependent upon individual hormonal and genetic status before treatment even begins.

What do you think about the claim that even 50 mg/day of spironolactone could reduce the testosterone levels in a normal man to "female levels"? Does that seem like a reasonable possibility to you?

 

[docj077]

Bryan,

I do find what that other physician said to be odd. As both you and I know, the feedback system isn't quite so fickle. Besides, the pituitary's response is based more upon estrogen.

As for my medical career, I have two months left until my M.D. I'm going into Internal Medicine. Believe it or not, I'm actually really interested in Infectious Disease. I took my boards, I got married, I had numerous difficult rotations, my wife graduated, I had to go through my interview season with quite a bit of travel, and now I finally have some free time.

With regards to the study, initial dose was 200 mg/day for 8 weeks with a progressive lowering by 50 mg every four weeks.

Study can be found here:

http://www.cosmetic-medicine.jp/list/spironolactone.pdf

You'll appreciate the graphs at the end and how it is pretty much impossible for me to make a conclusion either way with regards to the hormonal effects of Spironolactone. What is really fascinating is the initial increase in T in many individuals which continues as the spironolactone dose is lowered...that is strange. I wish I knew which lines were women and which were men.

The real problem with this study is the lack of internal and external validity. There is no control group and the experimental group is all Asian. It's difficult to extrapolate anything. Especially, with regards to lowering testosterone to female levels. Honestly, I doubt it, but until I see some data I really don't know.

 

[Bryan]

As for my medical career, I have two months left until my M.D. I'm going into Internal Medicine. Believe it or not, I'm actually really interested in Infectious Disease. I took my boards, I got married, I had numerous difficult rotations, my wife graduated, I had to go through my interview season with quite a bit of travel, and now I finally have some free time.

Congratulations on getting married, and congratulations on being so close to your M.D.! I can only guess at the amount of hard work and dedication that requires!

Study can be found here:

http://www.cosmetic-medicine.jp/list/spironolactone.pdf

You'll appreciate the graphs at the end and how it is pretty much impossible for me to make a conclusion either way with regards to the hormonal effects of Spironolactone. What is really fascinating is the initial increase in T in many individuals which continues as the spironolactone dose is lowered...that is strange. I wish I knew which lines were women and which were men.

I think all those lines in the graphs are women, because they discontinued giving spironolactone to men part-way through the study because of the gyno that some of them developed.

But aren't you the one who pointed me to some medical article a year or so ago which said that there's no evidence for a feedback loop in women which controls testosterone production, like there is in men? Or was that somebody else? In any event, if there's no such feedback loop in women, then I don't understand why there would be a T increase in women AT ALL from taking spironolactone. But the authors of this current study make the following statement near the end:

"The mechanism by which oral spironolactone causes menstrual irregularities is not clearly understood. After the start of administration, the serum levels of testosterone or dehidrotestosterone may be acutely elevated bacause androgen receptors are competitively blocked by the drug."

Now that makes perfect sense to me as far as MEN are concerned, but how about women? I seem to be getting conflicting information on this issue. I seriously doubt that Casperz' doctor-friend's theory about spironolactone supposedly "freeing-up" more testosterone by binding to androgen recetors has anything to do with it. What are your own current thoughts as to whether or not women have a feedback mechanism (similar in some way to what men have) that regulates the production of testosterone, and increases T in response to most antiandrogens?

Overall, though, I'm pleased that the authors of that study said anything at all about that, because I've been saying for years that it's not entirely out of the question that taking spironolactone orally (by men) could conceivably RAISE testosterone levels, not reduce them, because of that feedback mechanism. I've always said that I had little doubt that large doses would reduce it by interfering with steroidogenesis, but I was uncertain about what smaller doses would do.

Another thing that surprised me about that study is that serum levels of sodium and potassium weren't significantly affected by the spironolactone! Huh?? How can you take spironolactone for several months, and NOT have it alter potassium levels??

 

[docj077]

Bryan,

Thanks.

I don't recall ever submitting such a study, but my brain isnt' what it used to be. It's mostly mush at this point.

I don't understand the elevation in T with spironolactone, as well. You can actually use that drug in women with polycystic ovarian syndrome, which is a syndrome known to have an elevated T, and menstrual irregularities will improve and so will testosterone levels. However, in women with hirsuitism, there is an increase in free T and albumin bound T, but SHBG, serum T, beta-estradiol, and DHEA-S all remain the same when oral spironolactone is administered. As far as I know, from what I was taught in physiology the feedback mechanism in men is based upon testosterone's action on the pituitary and the subsequent decrease in GnRH production. In women, it's estrogen that performs the same function. For men with oligospermia, selective estrogen receptor modulated drugs increase gonadotropin levels, but I don't know if the drugs function as agonists or antagonists in that particular tissue.

By my logic, there should be an initial elevation in testosterone when taking the medication as the androgen receptors become inhibited and SHBG/Albumin become saturated, as well as, the 5AR enzymes, aromatase, and any other enzymes of importance. The half-life for spironolactone is 1.3-2 hours and if you're taking it once a day, then the pituitary will have no need to compensate, because I'm not sure that you'd even reach a steady state unless you do divide it into equal doses throughout the day.

This drug is very individual dependent and underlying pathological states seem to greatly influence outcomes. However, in PCOS, Spironolactone actually does a better job than metformin and that's saying a lot.

As for the lines...oops...sorry about that. I think that you're right about the discontinuation. After 13% of males developed gynecomastia, the entire treatment arm was stopped.

With regards to the study, the reality of all of this is that at least in women spironolactone normalizes hormonal imbalances of testosterone. I can't even explain it, but that really is useful if it works in men. The lack of elevation in potassium levels is another troubling aspect of the study. Spironolactone is notorious for hyperkalemia. Dosing for the drug is 25-50 mg PO qday with a starting dose of 12.5 mg/day for hypertension. Edema dosing is 25-200 mg PO qday. For hyperaldosteronism, the dose jumps up to 400 mg PO qday. So, it's fairly safe even at high doses for up to a month, but no change in potassium is really bizarre.

 

[casperz]

So do you find what that guy (Casperz's doctor-friend) said about spironolactone to be as odd as I do?

Hummm... let's see do we listen to A. Guy on the internet that has read some
studies (Bryan) or B. newly minted MD (docj77) or C. a board certified
internal med Doctor in practice for almost 20 years (my friend).

I'm going with answer C and I don't really care what you guys choose.

 

[neis]

IBM,
Yesterday, I started drinking a glass of soy milk every day, just because Soy is an excellent source of protein and the female reproductive hormone estrogen.Testosterone is suppressed by an excess of estrogen.Soy is feminizing, and commonly leads to a decrease in the size of the penis, sexual confusion and homosexuality.
I really do like the spironolactone and soy combo unk:

Anyway, thanks dude for the reply

Good luck with everything.

By the way, the bold and underlined part...no, just no.

It is a girlfriend you have correct? lol :gay:

Yeah, that's correct

If you think that oral spironolactone will affect our relationship, just have a look at her facebook photos(with her permission ofc)

 

[neis]

unk:

 

[neis]

unk:

 

[Guest]

"oh-oh-oh" mate

You make me jealous..
Your girlfriend is f*****g sexy!.....

I hope you enjoy her in bed
Let her enjoy the best sex ever, she deserves it...

 

[neis]

Hey Sonic-X,

Don't You Wish Your Girlfriend Was Hot Like mine? just kidding mate!......

Don't worry about it mate!
Everything is under control. I know that she deserves it, but I try to have sex only once a week just because sex or masturbation is related with hairloss.

You mate,
Don't you have a girlfriend?

 

[Nuli]

I know that she deserves it, but I try to have sex only once a week just because sex or masturbation is related with hairloss.

:smack: :shakehead:

Proof of these claims please.

 

[neis]

I know that she deserves it, but I try to have sex only once a week just because sex or masturbation is related with hairloss.

:smack: :shakehead:

Proof of these claims please.

Do a search here on HairLossTalk.com for masturbation and you will get an idea.It has been discussed a lot. I don't want to say that it's the reason we lose hair, but in my opinion it worsens the situation.

 

[Guest]

Hey Sonic-X,

Don't You Wish Your Girlfriend Was Hot Like mine? just kidding mate!......

Don't worry about it mate!
Everything is under control. I know that she deserves it, but I try to have sex only once a week just because sex or masturbation is related with hairloss.

You mate,
Don't you have a girlfriend?

Hey mate,
I hope you have the best relationship (with your girlfriend)!!!!!

As for me, I’m going through a rocky patch in my relationship and that’s what worries me(that's why my location on the left side of the website is: "somewhere in my broken heart").I dated a girl for just over two years and its been just over a month since we both broke up and i still think about her, and occassionally i still even cry over her and what we had. Sure we did fight a lot towards the end and i think i realize that it’ll never work between us but i don’t believe i’ll ever be able to stop loving her or wishing that it would have worked out between us. I wish i could just forget about her but at the same time i never want to forget about her. We had many good times. I’m beginning to accept the idea that maybe there is no getting over her.I am not able to move on, I try to keep my mind busy on other things, but at the same time i try not to bottle all the emotions up, I know they say time heals. Maybe i’ll always carry a little pain in my heart over her. Or maybe 1 month is just not enough time to get over a 2 year relationship. I’ll have to wait see. I know that in the meantime the only thing u can do for yourself is do ur best to meet someone else, but I still Love Her, She Drives Me crazy..

 

[Petchsky]

1st love? If so, always hard to get over

 

[neis]

Hey Sonic-X,

Don't You Wish Your Girlfriend Was Hot Like mine? just kidding mate!......

Don't worry about it mate!
Everything is under control. I know that she deserves it, but I try to have sex only once a week just because sex or masturbation is related with hairloss.

You mate,
Don't you have a girlfriend?

Hey mate,
I hope you have the best relationship (with your girlfriend)!!!!!

As for me, I’m going through a rocky patch in my relationship and that’s what worries me(that's why my location on the left side of the website is: "somewhere in my broken heart").I dated a girl for just over two years and its been just over a month since we both broke up and i still think about her, and occassionally i still even cry over her and what we had. Sure we did fight a lot towards the end and i think i realize that it’ll never work between us but i don’t believe i’ll ever be able to stop loving her or wishing that it would have worked out between us. I wish i could just forget about her but at the same time i never want to forget about her. We had many good times. I’m beginning to accept the idea that maybe there is no getting over her.I am not able to move on, I try to keep my mind busy on other things, but at the same time i try not to bottle all the emotions up, I know they say time heals. Maybe i’ll always carry a little pain in my heart over her. Or maybe 1 month is just not enough time to get over a 2 year relationship. I’ll have to wait see. I know that in the meantime the only thing u can do for yourself is do ur best to meet someone else, but I still Love Her, She Drives Me crazy..

Petchsky is right.


She Drives You crazy???

Ohh Mate... that sux, I really know how it feels.
I'm only 21 but I been with my GF 2 years too and going now. But from past experiences with my friends and their GF I'd say avoid her at all cost find a hotter chick to get you back to your old self and just date around. I'm not single now but I sometimes wish I was because I'm young first of all and I'm goin to college (temptations) and its been a while since I was with a different girl.
i understand..i think once u love someone..i mean really love someone..you always love them!! you know. Life isn’t all bad. There are so much more that just laying around thinking back. It hurts. Yes. There no use just staying there. Do something. Pick up yourself & Move on. Be determined, that you want to move on and even though you may not stop missing her you may get over her.

there are soo many women out there. Don't sweet it. Just when you think you found the "right" one. theres always a girl that manages to capture a guys heart and things change. Happens all the time. It hurts, i know, expecially if she meant a lot to you..however, i do not understand, why did you break up with her?? I would have understood if it was the other way around. Things will get easier when you fall in love again.I will pray for you my brother. Just know you are not alone. We all must be strong for one another..

what does it mean when you finish kissing your girlfriend for 5 mins straight and you know it went well you gave it all you got and right when your finished she looks at you and grabs your again and starts kissing you???? does that mean your a good kisser or that she just really likes you a lot?

 

[JLL]

It means the oral spironolactone is working?