The short answer: possibly favorable for metabolism, but not proven to spare muscle
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Gottfrieds framework paraphrased from her published books and clinical lectures emphasizes the upstream causes of androgen excess (stress, insulin, gut, sleep) and uses spironolactone strategically: as a bridge while upstream work is happening, or as a long-term tool when lifestyle alone doesnt close the gap
That's the whole point
But HRT is not a magic pill, there is typically more to consider
Its also FDA-approved to reduce the risk of experiencing a major cardiovascular event (e.g