Does spironolactone help with insulin resistance?

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Last updated: February 20, 2025View editorial policy

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From the Research

Spironolactone can help with insulin resistance in certain cases, particularly in individuals with high aldosterone levels or those with conditions like polycystic ovary syndrome (PCOS), as evidenced by the most recent and highest quality study 1. The medication works by blocking aldosterone, a hormone that can contribute to insulin resistance, and its anti-androgenic properties can be beneficial for those with PCOS. To implement this treatment:

  • Consult with a healthcare provider for proper diagnosis and dosing.
  • Start with a lower dose (e.g., 25 mg) and increase as directed.
  • Monitor potassium levels regularly, as spironolactone can increase potassium retention.
  • Combine with lifestyle modifications like diet and exercise for optimal results. Some studies have shown that spironolactone can improve insulin sensitivity, particularly in individuals with chronic heart failure 1 or nonalcoholic fatty liver disease 2. Additionally, spironolactone has been shown to prevent chlorthalidone-induced sympathetic activation and insulin resistance in hypertensive patients 3. It is also worth noting that spironolactone may have a novel role in increasing glucose uptake into adipose cells and attenuating adipose tissue inflammation, with implications for management of metabolic syndrome 4. However, the most recent and highest quality study 1 suggests that spironolactone can improve insulin resistance in patients with chronic heart failure, making it a potential treatment option for this population. Overall, the evidence suggests that spironolactone can be a useful treatment for insulin resistance in certain cases, and its use should be considered in consultation with a healthcare provider.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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