Spironolactone, hyperkalemia and potassium from food?
I recently visited my doc, after pretty much ignoring my pcos for a couple of years and getting fatter, hairier and more acne-covered as a result. She prescribed metformin, Provera, and spironolactone. I've been on metformin and spironolactone before, but the spiro. was at a much lower dose before, 25 mg twice a day. It didn't help matters at all at that low dose. I told my doctor that and she said, "Of course! You need at least 100 - 200 mg a day to see any results." So she prescribed 100 mg twice a day. I'm ramping up to that amount by taking 50 mg a day for a week, then 100 mg a day for a week and so on.
So here is my concern. I wish I'd thought of it when I was in the Dr.'s office. I will call her Monday. But I'd like to get some input from others who may have taken high-doses of spironolactone. Spironolactone is a potassium sparing diuretic and you must avoid potassium supplements when taking it. Well, the amount of potassium in a supplement pales in comparison with the amount in a single orange, banana, serving of spinach, beans or almost any other fruit or vegetable you can imagine. Oh, and dairy, too. And meat's no slacker in the potassium department, either, although as a vegetarian, that's not an issue for me.
I've recently made some changes to my diet to include more fresh fruits and vegetables and I've felt much better than I have for some time. I know I need to give up some of the higher potassium fruits and veggies, but how much can I get away with eating before I get hyperkalemia (too much potassium in the blood) ?
Does anyone know anything about this? Has anyone's doctor warned them not to eat too many fresh fruits and veggies or dairy products? Is it even something I need to worry about, since my kidneys are functioning normally? Has anyone experienced a problem with too much circulating potassium caused by spironolactone?
Thanks. Well, the patient insert says to avoid a high-potassium diet in the same paragraph where it says to avoid potassium supplements. Here's some online patient info for spironolactone: http://www.rxlist.com/cgi/generic/spiron_pi.htm (Slightly different wording than the insert that came with my pills, but the same general idea.)
The insert is what got me thinking about how high in potassium my fairly recent fruit/veggie intense diet is. Most potassium supplements provide 3% of your daily value, whereas, a cup of boiled spinach provides 24%, a banana provides 14%, and a large baked potato provides a whopping 46%!
From what I've been able to research online, it's not usually a problem for those with normal kidney function, but it still concerns me a bit.
I'm just wondering if anyone here has had any issues with spiro. and high potassium levels or if anyone's doctor has discussed with them the effects of a high-potassium diet combined with spiro.
My guess is that you had your blood work done prior to being Rx'd spiro. Did your doctor express concern about high potassium levels?
Also, keep in mind that exercising regularly increases your need for postassium.
That said, just to be on the safe side, I would call your doctor, or at the very least, talk to your pharmacist. I would not self-diagnose, or assume that just because you eat a diet rich in produce, that you have high blood potassium levels (that warrant lowering your dietary consumption.)
__________________
Hey, SoulCysters! Need to eat more veggies, but can't find recipes??
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
I take Spiro and when I first started taking it I was also concerned about too much potassium. When I went back to my doctor she said not to take a potassium supplement, but other than that I should be fine. I went to the doctor about 2 months after I started taking the Spiro and she didn't do a blood test because I wasn't exhibiting any signs of a potassium overdose. I haven't had any problems since taking spiro. I agree with Kat, if you have concerns see a dr. before you self diagnose.
__________________
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts. SARAH To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
~If stress burnt calories, I would be a size 5.~
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Confirm this with a medical professional, but I think the postassium supplement warning is on spiro Rx's because many 'other' diuretics can deplete potassium, and frequently require supplementation.
Because spiro does not typically deplete postassium, the warning is there to tell people not to run out and buy a supplement...
__________________
Hey, SoulCysters! Need to eat more veggies, but can't find recipes??
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
also, sodium(salt) is the balancer of potassium so maybe consider sprinkling a little salt on some of your food if you are eating higher amounts of potassium containing foods. When you throw in a little of the sodium, it should help your body to balance the potassium by itself.
Actually, it's more than just keeping people from running out and buying a supplement. Spironolactone prevents the kidneys from excreting as much potassium as normal. There is always a risk of hyperkalemia (excess potassium) with spironolactone. They even use to to treat hypokalemia (too little potassium) when the administration of potassium alone is not enough. Not to be alarmist, but it is always good to be aware of the dangers involved with medications.
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Please click my dragon babies and eggs! Muchos Gracias!
"Just because you are blind, and unable to see my beauty doesn't mean it does not exist."
- Margaret Cho
Thanks for your replies. Deb34--Thanks for that bit of advice. I've never been one to add salt to my food, but I've found that I have a little more energy since I've been doing that. I was feeling a little low on energy. I think it was just my body adjusting to so many new meds. (Perhaps readjusting is a better word, since I've been on them in the past at lower doses, but have had a long hiatus since I last took them. )
Oh, and my doctor said to try to limit my intake of super-high potassium foods (Ya know, like no more days when I eat two bananas, an orange, a V-8, and a glass of orange juice in one day. What can I say? I love fruit.), but other than that not to change things. She also said not to worry unless my blood tests start showing too much potassium.
__________________
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
Please click my dragon babies and eggs! Muchos Gracias!
"Just because you are blind, and unable to see my beauty doesn't mean it does not exist."
- Margaret Cho
Actually, it's more than just keeping people from running out and buying a supplement. Spironolactone prevents the kidneys from excreting as much potassium as normal. There is always a risk of hyperkalemia (excess potassium) with spironolactone. They even use to to treat hypokalemia (too little potassium) when the administration of potassium alone is not enough. Not to be alarmist, but it is always good to be aware of the dangers involved with medications.
No offense, but I do think you're being an alarmist, in this instance...
BCP's increase the risk of depression in some women, but it doesn't mean that all women on BCP's should be taking counter measures for depression.
That said, agree that everyone should be very aware of the possible risks involved when taking any medication. IMO, they should consult with their doctor, or at least a pharmacist to find out how (and if) those risks relate to the person taking the drug, rather than interpreting the risks on their own (and self-diagnosing/treating).
If your doctor told you to limit your intake of bananas, certainly follow that instruction, but to everyone else reading this, it would not necessarily wise to apply someone else's restrictions to our own situation.
Quote:
Most adults need about 2000 milligrams of potassium from their diet each day. ( One small banana (467mg) )Your caregiver will tell you how much potassium you should have each day.
It's important to get this information from your personal physician since your individual potassium needs may vary based on any number of things: personal history, other meds you're taking, and level of physical activity...
"High Potassium" foods are defined as those that have more than 200 mg's of potassium per serving...
There are certainly more 'common' foods with levels higher than (or on par with) bananas:
One cup of tomato juice (535) or chopped or sliced tomato (400).
One baked sweet potato, with skin (508).
One-half of a medium avocado (450).
One-half of a medium potato, with skin (422).
One-half cup of cooked pinto beans (400), lentils (365), or dried peas (355).
One cup of soy milk (345).
Three ounces of baked or broiled salmon (319).
Six ounces of yogurt (398).
One cup of 2 percent white milk (377).
One papaya (781).
One cup of prune juice (707).
One cup of cubed cantaloupe (494) or diced honeydew melon (461).
__________________
Hey, SoulCysters! Need to eat more veggies, but can't find recipes??
To view links or images in signatures your post count must be 0 or greater. You currently have 0 posts.
im on 100mg spiro and dont avoid potassium dense foods (except potatoes/bannas etc because of the carbs). anyway i just had my bloodwork done and it was fine. i think its more a problem if you supplement or say, eat bannas all day long and nothing else.
I was on 100MG of Spironolactone for several years and then I started getting heart arrythmias about six months ago so I had to drop to 50MG and they have subsided thankfully.
I also took Metformin for six months and it was far from successful for me - I put on 3 stone in 6 months despite following a low fat low GI diet and exercising in the gym 5 days a week.
Metformin also depleted my B12 levels to the point that I now have to have bi-monthly B12 injections as my stomach now doesn't absorb it.
They did put me on a high dose that I took three times a day and it did suppress my appetite but to be honest my appetite has never been a huge problem anyway. I also developed IBS as a result.
My condition has further complicated as I have been diagnosed with an MPD - a blood disorder called Essential Thrombcytosis - which puts me at a higher risk of stroke.
What I find frustrating in the UK is the lack of understanding as regards the condition - if they cant put you on the contraceptive pill they tend to give up on you. I've been told to go on the Atkins Diet, which everyone knows is unhealthy and unsustainable, even though a dietician confirmed that there was nothing wrong with my daily diet anywa
I was worried about the potassium levels as well with my Spironolactone but so far I have not had any issues. I found the 100 mg twice a day was too much and zapped my energy level so I reduced it to only 100 mg per day and have had great results (my hair grew back - and keeps growing...no more bald spot for me!). I also added supplements of B-12 (with folic acid) and some vitamin D which, from my understanding, helps in the processing of calciums, potassiums, etc. What my doctor found was that my hair loss was not just from the testosterone levels but also from my deficiency in vitamin D! Besides checking with your doctor or pharmacist, you may consider adding some vitamin D to your diet. Good Luck!
my doctor tested my potassium after a few weeks of being on spiro. the first test showed a slightly elevated potassium level. about a month later it was fine. maybe the body compensates over time?
i don't limit my dietary potassium at all...my diet is loaded with fruit, veggies, nuts. i would recommend getting tested, at least once or twice in the beginning. it would also be a good idea to watch for the symptoms of high potassium, because it can be dangerous. if you feel a strange heart rhythms, extreme fatigue, or muscle weakness these could be signs of hyperkalemia. just get tested for your own peace of mind.
by the way spiro does a pretty good job on my acne and oily skin/hair.
Spironolactone, hyperkalemia and potassium from food? 
Good Luck!
