Spironolactone at only 25mg

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Spironolactone at only 25mg

Postby nervousticdizzys » Thu Jun 28, 2012 10:32 am

Quick question:

Has anyone been on spiro at 25mg/day? And if so, did you experience any effects? I'm working with a doctor who has been discussing different strategies and paths forward, and one was beginning spiro at this dosage without an estrogen for 6 months.

It all just seemed a little low, even to just get a baseline.

Any help would be appreciated.
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Re: Spironolactone at only 25mg

Postby Tracyohus » Thu Jun 28, 2012 1:05 pm

That's not out of the ordinary. It's actually pretty common and the sensible thing to do.

I started Finasteride and Spiro quite a while before estrogen. When I started Spiro we started low and worked up. When I started Finasteride before that we started low and worked up. When I started estrogen we started low and worked up.

Your doctor can see your blood work and will be working off those numbers to transform your hormone levels to female levels.
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Re: Spironolactone at only 25mg

Postby BecomingSusan » Thu Jun 28, 2012 1:27 pm

I was also started at 25mg per day and eventually worked up to 200mg per day. I started estrogen at the same time I started spironolactone at 1mg per day and ended up at 4mg per day.
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Re: Spironolactone at only 25mg

Postby Tracyohus » Thu Jun 28, 2012 2:39 pm

My doctors made me wait until I lost enough weight to get my BMI down to the number they wanted before giving me the script for estrogen. I was on 5mg of Finasteride and 200mg of Spiro for quite a while before I was given the script for estrogen. But by that time I did not need very much estrogen to achieve normal female hormone levels. Basically, aside from Finasteride, my regimen is the pretty much the same as that of a a cis-female who is treating female pattern hair loss (FPB). I have been on that regimen for quite a long while now.
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Re: Spironolactone at only 25mg

Postby jennx » Thu Jun 28, 2012 10:12 pm

IMHO... Yes, it is on the low side. However, every doc has a different approach to HRT. Some don't even prescribe Spiro at all. So, I'd first talk to your doc and try to see the goal or big picture he is trying to accomplish and his methods of operation.

25mg of Sprio based on the "norm" is low for a MTF patient, unless there is some other health condition or concern present. I started out at 200mg Spiro and 4mg Estradiol... I'm still at 200mg Spiro and now 6mg Estradiol 2 years later. Dosages also depend greatly on how fast and to what degree your body metabolizes and/or excretes these drugs. Some people with absorb more of a lower dose, whereas others pass more of these drugs out of their system without absorbing them. So dosages to some degree are very subjective at best, without doing the proper blood work to be sure. The whole point of taking Spiro is to get you total Testosterone level down to 40 ng/dl or less. So as long as you safely accomplish that goal, thats all that matters.
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Re: Spironolactone at only 25mg

Postby tsukikomori » Fri Jun 29, 2012 12:33 am

it seems pretty low. 25mg is a more common dose for its alternative use as a diuretic (low enough that it doesn't have many antiandrogenic effects), so personally, it strikes me as a waste of six months.

i was on spironolactone 50mg qd for five months before beginning estradiol. i don't count that as being part of my hrt, and i had absolutely no changes that occurred in that time. perhaps my own frustration at its ineffectiveness is what's talking right now, though, rather than what's medically sound.
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Re: Spironolactone at only 25mg

Postby Tracyohus » Fri Jun 29, 2012 9:42 am

tsukikomori wrote:it seems pretty low. 25mg is a more common dose for its alternative use as a diuretic (low enough that it doesn't have many antiandrogenic effects), so personally, it strikes me as a waste of six months.


That is Spiro's primary use, not it's alternate use. It is very common for doctors to start low and work up. Doctors do this with many medications. Chances are better than good that her doctor started at that dose for a good reason.
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Re: Spironolactone at only 25mg

Postby FFChristie » Fri Jun 29, 2012 9:46 am

I started at 25mg twice daily, I'm up to 50mg twice daily. My T levels are well below typical male ranges, and even low for female ranges.

I thought my starting dose was low too, but the blood tests proved it was working. Everyone's different. After a few months my doctor told me that while my T levels had been lower, they still weren't in the range they wanted, so they upped my dosage. That's the standard procedure. No worries.
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Re: Spironolactone at only 25mg

Postby Jenetic » Sun Jul 01, 2012 6:52 am

FFChristie wrote: Everyone's different.


QFT!

However, if you aren't satisfied with your doctor's opinion then you are well within your right to find a different one. Shop around until you find one you are comfortable with. It took me a few to get the wonderful one I have now.
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Re: Spironolactone at only 25mg

Postby Amy Farrah Fowler » Sun Jul 01, 2012 2:28 pm

As a vegan (that almost inevitably means high-potassium diet), I'm very scared of spiro, so I'll probably ask for 25 mg. a day to start, if the doctor offers higher. Based on past experience, she'll order monthly blood tests that will include my K+ levels, and if they stay in the normal range, I'll be reassured to go up to 25 mg. 2x a day, followed by more tests, etc. Hey, I'm willing to go all the way up to 200 mg. a day, as long as I don't go into hyperkalemia.
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Re: Spironolactone at only 25mg

Postby AliciaRyanne » Mon Jul 02, 2012 10:14 am

My doctor started me on Estrogen first before any Spiro. I was put on .1mg patches for 3 months before she prescribed spiro. At the 3 month mark, I was given 100mg per day...with the option to start at 50 by cutting the pills. I opted to just go straight up with the 100mg per day at that time.

However, I was also put on 5mg of finasteride intially too. No slow ramp up. I was already on 1.25mg per day from hair surgeon, but my endo immediately upped me to 5mg finasteride when she gave me the E script.

The higher dose of finasteride may have been why she didnt prescribe spiro right away. In any event...6 months seems like an extraordinarily long time to be on such a small dose without even thought of adjusting it in the meantime. I know I wouldnt have stood for that.

But...maybe your doctor has reasons. Maybe you have some medical past or other flags where the doc is wanting to be super careful
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Re: Spironolactone at only 25mg

Postby Tracyohus » Mon Jul 02, 2012 2:31 pm

AliciaRyanne wrote:In any event...6 months seems like an extraordinarily long time to be on such a small dose without even thought of adjusting it in the meantime. I know I wouldnt have stood for that.

But...maybe your doctor has reasons. Maybe you have some medical past or other flags where the doc is wanting to be super careful


That's just it though. None of us here are doctors and even if we were none of us can see her blood work. Second opinions from other doctors are usually a good thing. Gathering opinions from those who are not doctors is usually not.
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Re: Spironolactone at only 25mg

Postby RedPie » Thu Jul 12, 2012 5:47 pm

I think I started at 50, then 100 then now 200
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Re: Spironolactone at only 25mg

Postby starlitjessi » Fri Jul 13, 2012 12:35 pm

I've had transfriends with lower spiro doses than I've got. (I started at 200/4, and now I'm at 200/6) They look great. As for 25, that seems low, but I haven't done enough research to really know what effects 25mg will have. =\
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Re: Spironolactone at only 25mg

Postby Tracyohus » Sat Jul 14, 2012 12:46 am

Can you explain what you mean by 200/4 and 200/6? If I am to understand that to mean a total of 800mg or 1,200mg per day, that is more than just high - it's dangerously high. I certainly hope you are being monitored by a competent doctor and not self medicating.

It is not at all uncommon for doctors to start very low in the beginning, even as low as only 25mg per day, then work up slowly over time. That is the safest and most sensible thing to do.
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Re: Spironolactone at only 25mg

Postby starlitjessi » Sat Jul 14, 2012 2:26 am

Sorry. When I said 200/4, I meant 200mg of Spiro and 4mg of Estradiol. 200/6 was 200mg of Spiro and 6mg of Estradiol.

I am seeing a very reputable doctor in the Nashville, TN area. Seems like every trans person in middle Tennessee goes to see him.
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Re: Spironolactone at only 25mg

Postby Madison_Dawn » Sat Jul 14, 2012 6:09 am

starlitjessi wrote:Sorry. When I said 200/4, I meant 200mg of Spiro and 4mg of Estradiol. 200/6 was 200mg of Spiro and 6mg of Estradiol.

I am seeing a very reputable doctor in the Nashville, TN area. Seems like every trans person in middle Tennessee goes to see him.

for TN that is probably true as it doesnt seem quite friendly toward tblg friendly as other states in fact its like at the bottom just below my beloved state TX. I thought Tennessee. was going to start hunting us for a while handing out tags for us to hunters.
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Re: Spironolactone at only 25mg

Postby Raven Andrews » Sun Dec 02, 2012 10:43 pm

[quote="BecomingSusan"]I was also started at 25mg per day and eventually worked up to 200mg per day. I started estrogen at the same time I started spironolactone at 1mg per day and ended up at 4mg per day.[/quote]


I'm exactly the same way, except 25mg Androcur instead of spiro : ))
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Re: Spironolactone at only 25mg

Postby Canadianharvest » Mon Dec 03, 2012 1:10 am

Hi There !

25MG seemed very low to me as well, I started on 25MG Spiro/Day, and 1MG E per day. Two weeks later went up to 50/S and 2/E and every two weeks going up like thay until I reach 100Mg/S and 4MG/E then lots more blood work to see if I need more Spiro. Not sure if this was helpful, but your not alone on a small doseage, :) good luck.
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Re: Spironolactone at only 25mg

Postby Amy Farrah Fowler » Thu Dec 20, 2012 7:28 pm

Just got bumped up today from 25 to 50 mg. I get my potassium tested in two weeks, and if it's still fine, then again after three months. This is at the point of just over four and a half months on spiro, ten and a half of estrogen, and eleven of finasteride. My clinic likes blood levels of estrogen to be 150-200, and I was last tested at 156 (pg/dL). They were satisfied with T dropping from around 700 to about 200 at the same time, but I'd rather it be lower (ng/dL). Of course, that's why we're raising my anti-androgen. The doctor says most of her patients are on 100-200 mg. a day, but we started out slow and low for me because of my concerns about potassium levels. So far, so good! Oh, before I forget--my estradiol dose is still 100 mcg. per day absorbed directly into the bloodstream, and I take 5 mg. a day of finasteride.
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Re: Spironolactone at only 25mg

Postby Victoria Jacobs » Thu Dec 20, 2012 8:45 pm

[quote="nervousticdizzys"]Quick question:

Has anyone been on spiro at 25mg/day? And if so, did you experience any effects? I'm working with a doctor who has been discussing different strategies and paths forward, and one was beginning spiro at this dosage without an estrogen for 6 months.

It all just seemed a little low, even to just get a baseline.

Any help would be appreciated.[/quote]

Depends from your age as well. I first took 4mg Estradiol Valerate daily and it worked. After two weeks I added Spironolactone 200mg daily and I started to see better results. But then suddenly after two weeks I had allergic reaction to Spironolactone and discontinued it for a while. I think it's better to start with 100mg daily but if you want to increase the dosages then don't exceed 300mg daily and always take it in divided doses. You can also refer to this link http://www.annelawrence.com/regimens.html. She knows her job well. I selfmedicate because can't afford to see the doctor. Maybe next year I'll do it under the doctor's supervision because want to switch to Estradiol Valerate injections.
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Re: Spironolactone at only 25mg

Postby Victoria Jacobs » Thu Dec 20, 2012 8:55 pm

[quote="nervousticdizzys"]Quick question:

Has anyone been on spiro at 25mg/day? And if so, did you experience any effects? I'm working with a doctor who has been discussing different strategies and paths forward, and one was beginning spiro at this dosage without an estrogen for 6 months.

It all just seemed a little low, even to just get a baseline.

Any help would be appreciated.[/quote]

Better start with Estradiol first as it also works as antiandrogen and after sometime add Spironolactone. I won't suggest you to take only Spironolactone because it will not give you female hormones and you'll have low testosterone level but not enough Estradiol level to give you feminine look. Also keep handy Benadryl or any other antihistamine medication as Spironolactone unexpectedly may cause you allergic reaction.
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Re: Spironolactone at only 25mg

Postby hthrrsln » Fri Dec 21, 2012 3:08 am

My doc told me she likes to be conservative about it and she started me at 25 mg for a month, then 50 for a couple months, but I pushed at got 100 after 1.5 months on 50, and will probably go to 200 mg in another month or so.

I just started 2 mg estradiol today, and will probably be able to increase it to 4 mg after a couple months.
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Re: Spironolactone at only 25mg

Postby jmwatson1967 » Sun Dec 22, 2013 7:56 pm

My doctor started me on 200 mg of spiro and 4 mg of Estradiol daily. She specializes in hormone therapy and replacement. From what I hear that is the average dose for most unless they have a weight problem or they are smokers which I am not.
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Re: Spironolactone at only 25mg

Postby enigma » Sun Dec 22, 2013 10:28 pm

My doctor started me on Spiro 100mg/day ( 50 mg morning and evening) and Estrogen 2mg/day (1 mg morning and another in the evening). After a month I get blood work tested to make sure I don't have the pituitary gland issue (they do this for all MtF patients.) then my dosage is doubled. She handles a lot of MtF patients ( I use Callen-Lorde health center for the LGBTQ community). The first 4 days I started off with one dose and even with that, I could feel the Spiro with a slight dull ache in my testicles at brief times and of course turning into a pee factory. I had been taking Finasteride for about 3 months and that seems to have given me a little jumpstart.
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Re: Spironolactone at only 25mg

Postby Sage » Mon Dec 23, 2013 12:07 am

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Re: Spironolactone at only 25mg

Postby Willemina » Mon Dec 23, 2013 5:59 pm

Goddamn necroposts.
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Re: Spironolactone at only 25mg

Postby mckenna93 » Mon Feb 12, 2018 8:54 am

my doctor has me on low dosage to spiro 25mg a day 5mg finasteride a day and 1 mg estradol a day for then will up the dosage each month or so i'm on my 19th day so far not much just yet but gotta be patient and know that things will be happening soon.
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