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spironolactone and licorice = synergistic combination?

#1

I wasn't entirely sure where to put this since it involves both an herb and a synthetic drug, finally decided to put it here.

I came across this study earlier today when I became curious about the possibility of combining these two substances. The idea came to me that both spironolactone and the main active constituent of licorice have their primary actions on the same endocrine pathways. Both are powerful inhibitors of 17-beta-HSD and 17,20 lyase. However, whereas spironolactone is a upregulator of the 11-beta-HSD pathway, it is well known that licorice does the exact opposite and severely inhibits that same pathway... So I thought, hey, what happens if you combine them? The answer:

https://www.ncbi.nlm.nih.gov/pubmed/17113210

They cancel each other on their mineralocorticoid activities whilst maintaining their effect on crippling androgens!

Too bad we won't likely be seeing endo's prescribing licorice together with spiro for MtF's any time soon... This study is an amazing discovery if you ask me.

For people who are math challenged, this comes to being that the study participants who had the combination took a combined dose of 100mg spiro and 266mg glycyrrhetinic acid. Assuming an average weight of 68kg for the participants, they took approximately 1.5mg/kg spiro and 4mg/kg glycyrrhetinic acid and had synergy. We don't know if this precise balance is required, just optimal, or even optimal at all... There haven't been any further studies using different doses of spiro and licorice.
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#2

Nice find Abi:



Commentary: It’s very useful to find a second study on licorice and it’s role in PCOS. Glycyrrhetinic acid has been shown to reduce serum testosterone and induce regular ovulation. (Yaginuma T, Izumi R, Yasui H, et al. Effect of traditional herbal medicine on serum testosterone levels and its inductions of regular ovulation in hyperandrogenic and oligomenorrheic women. Nippon Sanka Fujinka Gakkai Zasshi 1982;34:939-944) ( Takahashi K, Yoshino K, Shirai T, et al. Effect of a traditional herbal medicine on testosterone secretion in patients with polycystic ovary syndrome detected by ultrasound. Nippon Sanka Fujinka Gakkai Zasshi 1988;789-92.)
Spironolactone is often used as part of a treatment plan in PCOS women with bothersome hirsutism. While Spironolactone can be helpful, fatigue and polyuria are a frequent side effect. It may be that licorice and glycyrrhetinic acid have a potential synergistic effect on the androgen receptors, reduce the side effects associated with Spironolactone, as well as reducing serum testosterone and inducing regular ovulation. Licorice extract along with a lower carbohydrate/higher protein diet, therapies that increase SHBG such as nettles root, green tea, flax seeds and soy and insulin sensitizing strategies such as daily aerobic exercise, fenugreek powder, cinnamon extract, d-pinitol, chromium (and possibly glucophage) offer a comprehensive approach for women with PCOS.
http://drtorihudson.com/botanicals/licor...-syndrome/

One other side effect from spiro is spasms. A few of us who use spiro have experienced these spasms. I get them on my sides, from what I've been able to find is its related to an electrolyte imbalance.

Quote:The mineralocorticoid antagonist, spironolactone, and its major circulating metabolite, canrenone, also competitively interact with adrenal steroid hydroxylases. In addition, spironolactone is converted by adrenal microsomes to an unknown metabolite which promotes the destruction of cytochromes P-450, decreasing the activities of steroid hydroxylases.
https://www.ncbi.nlm.nih.gov/m/pubmed/6786868/

Spiro inhibits DHT (by blocking androgen receptors)
@ 50%
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