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After You Stopped Taking It Has Made Me Strongly Consider Going Off Of Spiro Myself Asap - Blog Posts

11 months ago

Why don't you take Spiro anymore? (You mentioned this in a recent post)

My T is sufficiently suppressed without it. Estrogen and Testosterone inhibit each other through indirect pathways- both signal the hypothalamus and pituitary, which in turn signal the testes/ovaries to produce more or less of their hormone. Unfortunately, T is a more potent suppressor of E than vice versa, so a blocker is needed to drop T levels at first (usually), which then lets E get high. Once E is high enough, then it can suppress T production on its own. For me specifically, I've never had a problem suppressing T, especially later into HRT when my E was getting somewhat higher. Even after quitting spiro, my T has never gotten above 20 ng/dL, and is mostly around 15 ng/dL, which is on the low side of normal even for cis women. AA in general are theoretically unnecessary once E is high enough to suppress T on their own, but this varies strongly dependent on the individual hormone metabolism from person to person. Fun fact, this is also why masculinizing hormone therapy is way simpler than feminizing hormone therapy- T is potent enough to inhibit E right off the bat without extra help.

Personal consideration to add here: I'm quickly learning that I'm a rapid metabolizer, along with about 20-30% of the human population. Essentially this means that most medication has shorter effect periods on me, and I believe it also has had an effect on how effectively my T got suppressed. My T levels were low almost immediately when I started HRT, and I started with spiro. But, the price I had to pay is that its taken forever for my E to go up. With that in mind, I realized that for me specifically, I didn't have to worry about my T going back up if my E wasn't high enough yet.

The above are about why I felt spiro was unnecessary, but why not take it just in case? Simple- side effects. I was having very noticeable diuretic side effects to the point where it interfered with my usual routines, so I tried to quit as soon as I could. Once I quit, a brain fog that I didn't even notice was there, lifted. I was having a lot of issues that I now realize were due to low sodium- my energetics were fucked, my vision was getting hazy when I stood up, and my heart pounded in situations it didn't need to. When I quit spiro, these stopped almost immediately, and I realized that these were side effects that I hadn't even registered as side effects.

These were considerations I made based on my own personal situation, but hopefully it helps. I haven't been on an AA since February or so. I actually just got a levels test back (spreadsheet update pending) and it confirms that my T has been within cis female ranges since early October, and on the low side of cis female ranges since early November.

In my personal opinion, AAs should be used more conservatively than it currently is, but are still necessary for HRT. My ideal HRT based on papers I've seen, personal experience, and conversations with my provider is essentially: brief period of E monotherapy-> E+AA until T is suppressed and E levels are high -> E monotherapy -> additional considerations (like prog). This is not coming from a medical perspective, though, just an anecdotal one.


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