I read in another spiro-related post that you have to really be conscious of your potassium intake when on spiro or else you could end up with an electrolyte imbalance leading to a massive heart attack. Does anyone know how big a risk this is?
I had been reading such great things about spiro and had got my hopes up that my doctor would prescribe it for me (I see him tomorrow afternoon), but now I'm worried. How much do you have to restrict your intake? I eat a banana a day and usually eat other foods high in potassium (cantalope, sweet potatoes, tomatoes, beans, etc.) several times a week...
-soogie_k
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I would ask your doctor. It sounds (from reading other posts) that ladies on here have been given different information from their doctors. I've been on 200mg Spiro since I started it ... about 6 years ago. When I started my doctor mentioned that it had potassium sparing effects but that the effects... or amount of potassium 'spared' was so minimal that it was absolutely nothing to worry about. And I've never watched my potassium intake, or had a problem. I enjoy bananas as well! I don't have one every day ... but I still enjoy them.
so like I said ask your doc... but according to (the doc I was seeing at the time) it's nothing to worry about.
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Truthfully I don't watch my intake either. I've been on it for about 6 years now. I read an article in the paper a few years ago about people who take spiro having an increased risk of heart attacks. Excess potassium in the body can be harmful, but I think it's case specific. Excess potassium can throw off electrolyte balances in the body which can be harmful. Everyone makes a big deal about the whole potassium thing (in articles I mean), but my doctor has never said anything about checking my levels. If you're curious just ask, or do some reasearch. Just Google "spironolactone potassium." Here's some stuff I came up with:
If you are concerned, maybe you can talk to your doctor and have him test you a few months after you start Spiro for potassium levels. Continue with your normal diet during that time, and if your levels come back high, you know you have to adjust. My doctor had me do that, and I had no problems with my potassium level when I started on spiro.
Our bodies must be pretty good at regulating electrolyte balance, since so many people eat massive amounts of sodium and very little potassium but still have serum sodium and potassium in the normal range. For whatever that's worth.
I've recently been thinking that spiro and licorice might be a great combination for PCOS. Licorice (by inhibiting the breakdown in the kidneys of cortisol, which can activate mineralocorticoid receptors) can do the opposite of spiro electrolyte-wise, that is, promote potassium loss and sodium retention. (This is why people with high blood pressure shouldn't take/eat real licorice.) So licorice and spiro might cancel out the other's effects on electrolyte balance. Here's a study on carbenoxolone (a UK drug derived from licorice) that also administered amiloride (another potassium-sparing diuretic) in order to counter carbenoxolone's effects on electrolyte balance: http://www.pnas.org/cgi/content/full/101/17/6734
"There were no adverse events, and blood pressure and plasma sodium, potassium, and cortisol did not differ between study phases." I expect the coadministration of licorice (with a standardized content of glycyrrhizic acid) and spironolactone would work similarly.
(The testosterone-lowering study above used 3.5 g/day in divided doses of pure licorice tablets that were 7.6% W.W. of glycyrrhizic acid, so 266mg/day of glycyrrhizic acid.) Oh, and licorice candy in the U.S. doesn't typically contain any licorice; it's flavored with anise instead.
Potassium-rich foods dangerous when on spiro? 
