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Hormone replacement (Oestrogen)

Hi I'm #######, I have hypoPP. So far I have tried a variety of medications, and currently I am on Aldactone (Spironolactone) 200mg daily and Metoprolol (beta blocker). This combination is the one that worked best for me, although I still have attacks every month at least. My doctor suggested I try Dichlorphenamide (Daranide). I also have to start Cyclo-progynova (Oestrogen) treatment. However, I have read in various articles that hormones, especially oestrogen, lower potassium therefore are potential trigger for attacks. Has anyone with hypoPP taken hormone replacement therapy? I am apprehensive to start two new medications simultaneously.

My neurologist told me to introduce one drug at a time so I would know if I had a problem with it.

Spironolactone has some hormone properties in it. "Preg" and "ene" in the chemical compound relate to hormone(s).

I was going to publish the following observation in another area later; but, will share now because of your question about hormones. I have been on this site for several years and have observed a pattern. It appears that in order to stop paralyzing completely, at least for some (even genetically identified), both the neuro system and the endocrine system have to be treated at the same time. The problem lies within identifying which endocrine gland is malfunctioning. I don't believe our lab tests are sensitive enough, or we don't have some tests we need. For example, I tested out as "euthyroid" meaning the tests showed that I had a "good thyroid" and there was nothing wrong with it. At that time, my thyroid was swollen 2-1/2 times its normal size and had cysts/nodules on it. Maybe a test for iodine levels when you have a goiter.

One member can give himself testosterone (endocrine) shots and he comes out of a paralysis immediately; but, still continues to periodically paralyze. I believe it's because the other system (neuro) is not treated as of yet. Another member being treated for hypoPP was on Diamox (acetazolamide) for its diuretic effect while at the same time was on potassium (both treat the neuro system) and did not stop paralyzing completely until Inspra (eplerenone) was added for its diuretic effect. Inspra is like Aldactone; it has hormone properties, "preg" and "ene" (endocrine system).

Until I took a drug that is both a hormone (in the adrenal medulla over the kidney - endocrine system) and a neurotransmitter (neuro system), simultaneously, I did not stop paralyzing. From the very first pill in February, 2013, I have not paralyzed but once. And, that was when I was given an iodine contrast (Gastrofin) in the ER to do a CT scan last March. Although, all the research of iodine contrast I could find links it to MG muscle weakness only, not PP. Because I was in an almost full body for 2 hours within 10-15 mins of 3 swallows of that drink, I believe it falls under PP. I believe it somehow affected my thyroid (endocrine). My opinion at this time is unless we overdo one system, I think some of us can have success with eliminating all, or at least most, paralyses. Please keep us updated.

Old thread, but just in the terribly off-chance it helps anyone: I also have hypoPP (SCN4a), and I'm transitioning MtF as well, so I take spironolactone 200mg in addition to estradiol shots. It's a nice coincidence that the spiro works for both treatments. I have not noticed any difference in my symptoms from before and after the estradiol, though I took the spironolactone before transitioning as well, and it certainly does help. For whatever it's worth, I have not tried Dichlorphenamide, but Acetazolamide did not help me.