Thank you for the link!

Just copy pasting my notes from that link:

Fri Dec 4 14:11:30 2020 UTC - Hello. I started HRT this past Monday. Spiro and estradiol. Now, I didn’t do anything to change my diet at all. I eat moderately well, and drink 2L of water a day, on top of any coffee or tea I might have. That being said, I scared the absolute shit out of myself last night. I’m pretty positive it was a combination of too little sodium and too much water, and of course the spiro. I’m only on 100mg a day and hadn’t even taken my evening dose, but I got very lightheaded, dizzy and disoriented if I was walking snd turned my head at all, when turning my head my eyes felt sluggish, as if my focus was lagging slightly behind. I felt nauseous, and my heart rate elevated. Still feeling a little shitty this morning but definitely improved. I haven’t had any other changes recently other than starting HRT so I’m sure it was the spiro. I’m gonna call my nurse practitioner soon here and explain what happened, but I definitely think I want to discontinue spiro. I went through PP so I’ll have to find a different doctor if I want a different AA, but I’d like probably to use up my prescription of estradiol pills and then go on monotherapy with injections. I hate needles, but fuck, I’ll take them over what I went through last night. So of course I’ll see what the nurse says, but can I increase my estradiol dosage in lieu of taking an AA?

• chimaeraUndying 8 points - I did it for years and it worked fine.
• Check this out. I don’t know if they are using the term “oral estradiol” the way we might in oral versus sublingual though. I think they might just mean oral versus injections, patches, etc and swallowed or dissolved sublingually I’m unsure. “Hormonal Treatment of Transgender Women With Oral Estradiol” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944393/Pulled from the footnotes in the “Medications” section here https://en.m.wikipedia.org/wiki/Transgender_hormone_therapy_(male-to-female)
• pseudomugil 1 point Tbh that sounds like not enough water. On spiro (and even not in spiro tbh) your blood pressure can drop if you don't drink enough water. I tend to feel like that if I don't drink 6-8 liters of water a day currently. I say not enough because spiro is a potassium sparing diuretic and as an effect of that, will dehydrate you and deplete your body of sodium. Dehydration then leads to low blood pressure which leads to disorientation, lightheadedness, and can even lead fainting (it's happened to me before when I don't drink enough). It's possible taking some sodium pulled water into your bloodstream which would help, and sodium is a good idea generally on spiro. Still definitely talk to your NP about it, it's something they need to know about, but there's a decent to middling chance they'll say you need to drink more water. It is a ton of water a day, yeah. There's a reason you'll see memes about peeing all the time on spiro.