Spironolactone and Electrolyte Balance: All Good

The nice professional lady who manages my health issues specific to hormone replacement therapy called today to discuss the findings of my latest blood test, now that I’ve been on spironolactone (“spiro”) for two months, at a mild dosage of 100mg per day.

NOV26_2The main risk of spiro is that … well, let me see if I can explain it in a way that does justice to what my (late) dad explained to me, plus having read up about it on Wikipedia.

The body uses potassium and sodium for muscle function. When a muscle contracts, it’s due to the sodium and potassium interacting in a particular way.  So, the body needs both sodium and potassium for the muscles to function. An imbalance would be bad. Muscles can start to fail. That includes the heart muscle. An extreme imbalance can cause heart failure.  In fact, officially administered lethal injections (as in, capital punishment in the US) kill by inducing an extreme imbalance. Bottom line: maintaining a good potassium-sodium balance is vital.

One of the chemicals in the human body is Aldosterone.  It help the body manage its potassium-sodium balance by causing sodium to be retained while causing potassium to be excreted. A side effect it that: it helps the body retain water too.

Spiro interferes with Aldosterone thus making it less effective.  So, the body excretes more sodium and retains more potassium, basically a double whammy likely to cause a potassium-sodium imbalance.

NOV26_3Being aware of this risk, I modified my eating habits so that I ate fewer bananas, tomatoes and potatoes. I also avoided manufactured items high in potassium. For example, low-sodium V8 vegetable juice is very high in potassium, so I avoid that and I drink the regular V8 vegetable juice.

As to the water that my body now doesn’t retain as well as it normally does, I drink much more water to try to compensate. This doesn’t counteract the effects of spiro but my reasoning is: whatever amount of water the body is willing to retain, I want to ensure that such water is available, i.e., that a lack of water is never a contributing factor as to my body retaining less water than it should.

NOV26_1As it turns out, whatever I’ve been doing is working beautifully. My blood test results show my potassium-sodium balance as being spot-on. So, I seem to have navigated this particular mine-field well. Yay!

When taking hormones or hormone-affecting chemicals, it’s wise to start modestly and to have the results monitored regularly and professionally — and to increase the intensity only when things are safe. So, now that this particular test has shown such good results, I have the official green light to increase my daily intake to 200mg instead of 100mg. I’m excited!

spiroWith the stakes now higher, this means I have to drink water more diligently yet, and take in more sodium yet, and eat yet fewer potassium-rich foods.  Probably my occasional glass of V-8 vegetable juice will become a daily event instead, and I’ll eat fewer potatoes yet.

The pictures of me, shown here, are all from today.


2 thoughts on “Spironolactone and Electrolyte Balance: All Good

  1. My doctor prescribed that I take a glass of V-8 for what reason I’m not sure. I was aware tha potassium is a problem so I stay away from potatoes (except for fries, I love fries,lol), but I’m on a regime of Finesteride and Estradiol. If I drink 1 glass of V-8 every couple of days is that OK ???


    • Hi Catherine! The short answer, much as I wish you well and am cheering you on, is … I don’t know. I’m on a mix of Spironolactone and Estradiol so my agenda is to use sparing amounts of potassium as in potatoes / fries and in tomato juice including V8. V8 has a lot of sodium too, which I’m supposed to focus on ingesting in vast volumes, so V8 is a good-and-bad-both thing for me. For you, being on Finesteride and Estradiol I doubt that the same rules apply because you not being on Spironolactone makes a big difference relative to my situation, since Spironolactone is notorious for how it changes the sodium/potassium retention/excretion dynamic and I’m not aware of such an effect with Finesteride. Kudos on using an MD and really that’s who should be answering your (very reasonable) question. I wish you much success! 🙂

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