What is Spironolactone?
Spironolactone is a medication primarily used as a diuretic (water pill) and an aldosterone receptor antagonist. It is commonly prescribed to manage conditions such as hypertension (High Blood Pressure), edema, hyperaldosteronism, acne, and transgender hormone therapy. Spironolactone is sometimes used to treat hirsutism, female pattern hair loss, and adult acne vulgaris off-label.
How does spironolactone works?
This medicine belongs to a group of medicines called “aldosterone blockers” or “potassium-sparing diuretics.” Imagine a group of medicines as a team that works in a similar way. These medicines are often used to treat similar problems.
This medicine does its job by stopping aldosterone from causing trouble. Aldosterone is like a chemical made by the body that can lead to holding onto too much water. This can make certain heart, kidney, and liver problems worse. But when this medicine steps in, your body doesn’t hold onto extra fluid. This also means your body keeps more of a mineral called potassium. This medicine might also help lower your blood pressure by putting a stop to what aldosterone does to your blood vessels.
Spironolactone slows down how much of the hormones called androgens your body makes, including testosterone. These hormones can make your skin produce too much oil, which then blocks your pores and leads to acne.
Even though androgen hormones are usually linked with male traits, everyone, including women, needs some of these hormones for normal body functions. However, reducing these hormones when there’s too much can be helpful for managing acne.
I Gained Weight On Spironolactone
Spironolactone is a medicine that some people say can help them lose weight, but others have reported gaining weight while taking it. In this article, we’ve collected stories from different people who gained weight while using Spironolactone.
Jillian shared her experience: “I used Spiro for about 2.5 years to treat hormonal acne and hair loss. During that time, I gained around 20 pounds in places like my stomach, breasts, hips, and thighs. I saw more cellulite on my legs than ever before. After stopping Spiro for about a month, I started losing weight rapidly. While it does clear your skin, dealing with cellulite, stretch marks, and changes in my breasts wasn’t worth it. If you have hormonal acne, try finding a topical treatment instead.”
Another person named SP had this to say: “I only took spironolactone for 10 weeks. Before that, I had a strong, athletic body. But I gained a lot of fat in my thighs, hips, stomach, and breasts that never went away, even though I kept being active. I’m frustrated, but it seems like I might have to accept this unless I go to extreme levels of diet and exercise. On the bright side, it did clear up my skin.”
Dupuis added their experience: “I took spironolactone for two months about four years ago to treat my cystic acne. I didn’t know it could harm my thyroid or cause estrogen problems. I was fit, ate well, and worked out regularly. But after two weeks on the medicine, my clothes got tight, and I gained 15-20 pounds. I stopped taking it and saw a doctor, but it was hard to fix. I lost some weight after months of taking zinc supplements, but my skin also got sensitive, and I got melasma on my face.”
Another person wrote: “I was given spiro for hair loss in July. I took it for about 25 days and gained 10 pounds. I had heart palpitations, hair loss, and my acne returned. Even though I had clear skin and no weight gain on birth control for five years. My dermatologist didn’t think spiro caused all this, but I stopped it anyway. My hormones were normal before the medicine, so it seemed like spiro was the reason. A month off the medicine, my heart was better, my hair improved, and my face cleared up. I’m still working on losing the extra weight. Intermittent fasting has helped in the last few months.”
Lastly, Jennifer IP shared her story: “I started spironolactone in May 2021 for my skin. Over time, I noticed stretch marks on my thighs and changes in my body shape. I’ve always been skinny and had a fast metabolism, so this was unexpected. I’ve been around 58 KGs and didn’t expect stretch marks at my age. I’ve taken 50mg twice a day. My acne wasn’t severe, but this medication didn’t do much in the long run. I want to stop taking it due to the weight gain and skin changes. My dermatologist didn’t warn me about this possibility. If you’re dealing with acne, it might be better to look for safer options.”
Potential Side Effect
1. May Cause High Potassium Levels
Spironolactone can make your blood have too much potassium. Your doctor will check this with blood tests to keep it safe. If it gets too high, they might change or stop the medicine. High potassium can be a problem, causing heart rhythm issues. Sometimes, you might not even feel symptoms, so tests are important.
People with conditions like Addison’s disease should avoid this medicine because they’re at risk for serious high potassium. If you have kidney problems or take specific meds, high potassium risk goes up. Check with your pharmacist and doctor to be safe.
2. May Cause Sore Breasts (Both Genders)
Breast tenderness can happen, but it’s usually not too bad. If it bothers you, talk to your doctor. They might lower the dose or stop the medicine to help.
3. May Cause More Female Traits in Males
For guys, spironolactone can make you develop female traits like breast growth or hair loss due to lower testosterone. If you’re using it for gender transition, this is okay. But if not, it might not be what you want. Lowering the dose might help or there could be other treatments. Tell your doctor if you don’t like these effects.
4. May Reduced Sex Drive in Males
This might happen because of the medicine’s effect on testosterone. Some men might also have trouble getting or keeping an erection. These things might improve if you take less or stop the medicine. Your doctor might suggest treatments for erection problems.
5. May Cause Changes in Periods
If you take spironolactone for acne, your periods might get irregular. You could have more or less bleeding. This happens more with higher doses. Birth control pills or changing how you take spironolactone might help. Talk to your doctor to figure out what’s best for you.
6. May Cause Dehydration
Spironolactone makes your body lose water, which can lead to dehydration. Drinking enough water is key. But if you have heart issues, ask your doctor how much water is safe for you.
7. May Lower Sodium Levels
This medicine can make your body lose sodium, which is important for your heart. Just like high potassium, low sodium is common but serious. Your doctor will test your sodium levels. They might suggest changes to your diet. If it’s too low, you might have to stop the medicine.
8. May Cause Stomach Issues (Nausea, Vomiting, Diarrhea)
Taking spironolactone on an empty stomach might upset it. Having it with food could help. If tummy troubles bug you, let your doctor know.
9. May Affect Brain and Nervous System
Some side effects might affect your brain and nerves. You could get headaches, feel sleepy, confused, or have trouble balancing. These things can be a bit scary and risky. Tell your doctor if any of these happen.
10. May Cause Skin Rash
You might get a skin rash from spironolactone. It could be minor, but in rare cases, it might be severe. If you see a rash, contact your doctor right away. Really serious rashes need immediate medical attention.
Are there any alternatives?
There are different medicines that can help with your condition. Some might be better for you than others. Here are some examples of other options for the issues that spironolactone treats. Remember, there are more choices available. You should talk to your doctor to figure out what’s best for you.
For High Blood Pressure
Here are a couple of examples of medicines other than spironolactone that doctors use to treat high blood pressure:
- eplerenone (Inspra)
For Swelling due to Liver Disease and Nephrotic Syndrome
If you have swelling because of liver disease or a kidney problem called nephrotic syndrome, here are some medicines other than spironolactone that might be used:
- amiloride (Midamor)
- eplerenone (Inspra)
For Heart Failure
When it comes to treating heart failure, there are a few alternatives to spironolactone:
- torsemide (Soaanz)
- bumetanide (Bumex)
For Excessive Aldosterone Secretion
If your body makes too much aldosterone (hyperaldosteronism), here’s another medicine that could be used instead of spironolactone:
- eplerenone (Inspra)
Always remember, there might be other options too, so have a talk with your doctor to find out what suits you best.
If you’re noticing that spironolactone is making you gain weight, it’s a good idea to talk to your doctor or healthcare provider about it. Depending on your situation, they might suggest a different medicine. Some medicines can lead to weight gain, especially for conditions that are made worse by being overweight. A recent study using information from a survey found that 1 in 5 adults in the U.S. takes a medicine that can cause weight gain.
Losing the weight you gained can be really helpful for your health. It can lower your chances of getting chronic health problems like diabetes and high blood pressure. According to the CDC, even losing a little bit of weight, like 5 to 10 percent of your whole body weight, can bring you health benefits. This can improve things like your blood pressure, cholesterol, and blood sugar levels. For example, if you weigh 200 pounds, losing 10 pounds (which is 5 percent of 200) would make you weigh 190 pounds.