Spironolactone

Spironolactone is a medication that is primarily used to treat high blood pressure and fluid retention (edema) in conditions such as congestive heart failure, liver cirrhosis, and kidney disease. It is a potassium-sparing diuretic, which means that it helps the body get rid of excess fluid and sodium while retaining potassium. In addition to its diuretic properties, spironolactone is also used to treat hormonal acne in women, hirsutism (excessive hair growth), and female pattern hair loss.

Overview Why It Happens Clinical Evidence Replacement

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Spironolactone

Spironolactone & Folic Acid

Depletes Folic Acid. This medication is commonly used for Hypertension

Why Spironolactone affects Folic Acid

Studies indicate that diuretics including potassium-sparing, can act as folate antagonists, potentially leading to a deficiency. This occurs because some diuretics inhibit the enzyme responsible for utilizing folate (folic acid) in the body. Research suggests a link between long-term diuretic use (over six months) and decreased blood folate levels while also showing a significant increase in damaging homocysteine levels. Folate supplementation during potassium-sparing diuretic therapy should therefore be considered.

Clinical Evidence

Maron BA, Loscalzo J. Homocysteine. Clin Lab Med. 2006 Sep;26(3):591-609, vi. doi: 10.1016/j.cll.2006.06.008. PMID: 16938586. Morrow LE, Grimsley EW. Long-term diuretic therapy in hypertensive patients: effects on serum homocysteine, vitamin B6, vitamin B12, and red blood cell folate concentrations. South Med J. 1999 Sep;92(9):866-70

Recommended Replacement

Folate (.2mg as L-5-Methylfolate) — 0.34 DFE

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