Spironolactone - Will weight gain with aldactone usage go away once the body adjusts?

I now manage my acne very well by eating a whole-foods vegan diet rich in vegetables and using a salicylic acid solution from Paula's Choice and a retinol product.

For those of you worried about never losing the weight, I want to tell you that hope is not lost. It has been 9 months since I stopped spironolactone. A month ago I decided I would try to start losing this weight again. I am eating a 1600-1800 calorie diet and exercising about 45 minutes 3 to 5 times a week. The weight is coming off at a normal rate now. Don't give up! I think it just takes a while for the body to readjust.

Now, I don't know how much you all know about the medication so I just want to provide some basis for the people who maybe don't know: Spironolactone is a potassium-sparing diuretic with a nifty anti-androgen side effect (which is the part that helps with the acne). Given that it is a diuretic, it wants to flush water out of your system to help regulate the level of sodium and other minerals/etc. that affect high blood pressure (as that is its original purpose). However, when the body realizes it's losing water it will attempt to regulate by holding onto any water it can. So, if you're not drinking enough water, you will most likely look "soft" or "puffy" because your body does not want to let go of it, thereby creating the water weight we all dread.

For those of you who may drink plenty of water and are still having issues, the other players in this equation are hormones. Now, I am someone who typically has testosterone levels within the appropriate range but on the higher end. Therefore, this might be why I can handle it better. Additionally, I do not take birth control as my body is very poor at processing estrogen it does not make itself for some reason. While I don't know for a fact that so much estrogen in your body might be a huge reason for your weight gain, I can say that, if you're taking BC and Spironolactone, there is some potential for a major hormonal imbalance. Think about it: you're decreasing your male hormones (which are still necessary at some level in the female body) which creates a higher ratio of available estrogen in your system; on top of that, you're adding MORE estrogen by taking BC, creating an even higher ratio of estrogen to androgen/testosterone. Any imbalance one way or the other is likely to create weight gain of some sort. The main difference is where the weight gain occurs.

Now, after getting off the medication, I see that there are a lot who still cannot lose weight. As I don't have that experience personally, I can only say that I highly suggest getting blood tests done (for those of you who haven't) to see where all of your hormone levels are. In fact, check out your Thyroid and other endocrine system functions while you're at it. Even if you're technically "within range" for your hormone levels, see if your estrogen is on the low end and your testosterone/androgen on the high end and vice versa. As someone who was having issues losing weight BEFORE Spironolactone due to a higher androgen to estrogen ratio, I have finally been able to lose a couple pounds as it has decreased my male hormone levels to something more reasonable.

This isn't a fully exhaustive list of possibilities and shouldn't be used to treat your conditions, but at least maybe it can provide some of you a base of what to look for and discuss with your doctor at your next visit :)

HOWEVER, for the last month or so, I’ve been cleaning up my diet again. I’ve started to get back in the swing of working out and going to boot camp/personal training sessions. The last week, I’ve been to boot camp six times and my diet has been ridiculously clean... I haven’t lost a single pound. Now, I know it’s only been a week, but, in the past I’ve never had any trouble getting weight off if I consistently workout and eat clean. It would just fall off. It’s incredibly frustrating. The only difference in life between last year and this year is the spironolactone. Today I made the decision to go off cold turkey. Eating clean tends to help my cystic acne. My dermatologist also prescribed a retinol that helps. I suffer from anxiety and weight gain makes my anxiety 1000x worse!! Anybody experience weight loss when going off??

I started taking it when I was 35 so, initially, I just attributed it to age or natural hormone changes. But the weight kept coming. And coming. My diet didn't change - if anything, over those 7 years my diet IMPROVED as did my activity level. In fact, my activity level increased dramatically after about 4 years on it but the weight just kept climbing. That's when I knew something was crazy wrong.

It took me awhile to make a connection between the weight gain and the meds - my skin wasn't totally clear on it but it was significantly improved - but I finally did and I was horrified at all the stories I was reading.

I searched for the actions of the meds (testosterone blocking which, to be honest, I didn't even realize when I started taking it - after 20 years of acne, I was just desperate for something to work!) and I looked up the symptoms of low testosterone and I could check off EVERY item on the list. It was not just weight gain but WHERE I gained weight. I was always a pear shape such that, when I gained weight, it was always in my lower body/hips (only small amounts in my waist) and it took a lot to gain it in my torso/bust area.

Now, my entire body shape has changed. I have big, flabby upper arms that I never had before. I haven't been able to wear anything with spaghetti straps in YEARS!! My waist is proportionately MUCH wider than it was before (I used to have an 11 inch difference between my waist and hips, now I have about 8! That's a massive difference). I have gained FOUR cup sizes in my bust (which sounds like it might be ok till you try slugging around 34 G/H cups! NO!!).

My hair has totally thinned out, which means less frequent shaving of my legs... but... also... flat, thinned out, less voluminous hair!! :( I mean ALL the hair on my body is significantly diminished.

I can do a vigorous workout every day and the weight barely moves. Only things like smoothie diets and radical eating plans have caused any weight gain... but it comes back soon. Nearly every food recommended for low-t is something i already eat.

Needless to say, as soon as I identified the problem, I got OFF the meds!! At first, my skin went nuts but then it leveled out. It is still not great on my periods but at least I'm not still gaining weight (I'm just not losing it either - more than two years after getting off the meds).

Last time I had my testosterone levels checked, I had the levels of a post-menopausal woman, even though I am NOT!

And, on top of all that, my acne isn't as controlled and my chest/upper back acne that was completely controlled, has come back. It doesn't seem right, nor does it make sense, that I can have both the negative effects of taking the medicine concurrent with the negative effects of NOT taking the medicine.

At this point, I've just had to learn to get used to myself as a much larger, fuller person. It makes me mad that a medicine could do THIS much harm and nobody felt inclined to mention it to me.

So, my advice it to stick it out with the acne. It is still preferable to massive and irreversible body overhaul.

If I could do it again, I would decline taking it. I would find another way in order to have my body back... to have it back to normal. And to be able to buy bras at a non-specialty store. LOL

I've thought about taking something to boost my testosterone but I fear that that will worsen my acne again. And, as I near 45, I feel like I'm so "over" having to deal with acne! At some point, the thirty year battle with acne should be done, ya know?

I have also read that it takes time, but that your body will re-adjust. I hope this is true! Has anyone seen the weight come back off? My daughter is pretty healthy and works out three times a week, all the gain has been in her thighs and abdominal area.