trinicorn [comrade/them]

It’s all good, just since you asked, thats my feeling

generally with stuff like this my line is like “you don’t have to like it but it doesn’t make sense to shit on it either”

I don’t really like most drag shows and stuff that I’ve seen, but my opinion isn’t the only one that matters, and its not really an articulable political point, just a preference I have. Your comment was making a political or strategic point though I suppose, I just disagreed with it

is it bad that I just see this as ragebait?

IMO yes.

These are trans people in a ragingly transphobic place, choosing to celebrate and protest by doing something both fun and yes, provocative rather than just hide from public view or continue on as if nothing was happening, and a big name celebrity is choosing to support their work. The backlash is predictable but it isn’t *the* point. Could this energy be better directed? idk maybe, but theater kids gonna theater kid. And frankly its as likely to do the opposite and inspire a backlash so disproportionate and deranged that it wakes some more people up to the fact that anti trans campaigners just hate trans people, none of their alleged grievances are in good faith

as protest its kinda libshit but as art I hope it is wonderful and fulfilling for those involved and the audience

Yeah honestly the mental health angle is my biggest concern. If these fluctuations are going to destabilize your mental health or otherwise interfere with your day that’s bad and not a worthwhile risk to take just for grapefruit, but I don’t thiiiink most people are that dialed into their levels hour-by-hour. I’m seemingly not, anyhow, but its worth considering

This inspired me to do some more digging on spiro! (might do other AAs later but got work to do unfortunately). What I’m finding is that spiro itself is not metabolized by CYP3A4, but one of its active metabolites is, at least in part. However, everything I can find seems to suggest if this interaction is significant at all, it isn’t dangerous. Spiro is actually listed here as a safe alternative to eplerenone, which is chemically similar but does have dangerous interactions with grapefruit/other cyp3a4 inhibiting substances.

I also found out during this that the active ingredient in one kind of dandruff shampoo is also a potent cyp3a4 blocker (but thankfully its not absorbed into the bloodstream really when used topically). Its actually crazy how many different things are affected by this metabolism pathway and/or inhibit or enhance its effect. hundreds of drugs easily

Also I have eaten two entire grapefruits since finding all this out and its very exciting for me

I finally did some reading on grapefruit medication interactions as it pertains to estrogen! the primary mechanism of interaction is at the “gut wall” (I was surprised to see scientific papers use this term), where the grapefruit can inhibit an enzyme that works to break down and metabolize many oral medications including estrogen. So with oral estrogen grapefruit will definitely screw with your levels and cause them to spike.

My main curiosity was injectable estrogen though. Many drugs taken by injection are unaffected by grapefruit, so I thought estrogen might be fine! As ever with biology though, apparently it’s not that simple. Even with purely endogenous (body-produced) estrogen, grapefruit consumption increases levels (though more modestly than the extreme/dangerous effects seen with oral medications, the study I saw cited a peak 26% increase in cis women 8hrs after consuming grapefruit). I didn’t see a ton of specific research on the mechanism of action here, but I expect it’s related to the fact that the exact same enzyme responsible for breaking down medications in the gut is also present in the liver and helps break down and eliminate various substances from the bloodstream there. The study noted that average levels remained the same with whole grapefruit consumption, it was just a temporary fluctuations.

So my conclusion for my own personal consumption (please don’t take this as gospel/medical advice, I’m pretty dumb) is that grapefruit intake doesn’t appear to be much more dangerous than it is for cis women if you’re doing injections (the reason for the study was elevated cancer risk associated with high estrogen levels so there may be some long term risks there).

It does affect levels, which is good to be aware of, and is a valid reason to be cautious, and there may be nuances I’m missing here (please tell me if you see any), but much like how preferred HRT dosage and levels vary widely by person, and even in cis women, vary drastically throughout hormonal cycles, the variance caused by grapefruit interaction is probably not harmful in any immediate way.

I guess if I was using a shorter lived ester with sharper peaks in levels and I was really worried about levels, I might be more concerned about not having grapefruit around those peak times? still probably not acutely dangerous though, IMO