Thank you. Good to know.
You’re with Tactogen right?
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I agree with @desertshores I would change doctors (also NOT medical advice). There are plenty out there who will work with you to get you to your goals…you just need to find them. There was a period where I would set an appt., show up, and if I wasn’t happy with our conversation I switched. Radical, I know, but it got me to the docs I’m with today who are willing to work with me. BTW, buy-pharma.md takes credit cards. I am not telling you who you should go to, I’m just saying they take MC and Visa. They are far too expensive for Rapa, however, so I go to India for that. Also, an alternative to Wise which you may want to look into is Revolut. That’s who I use and they are always reliable.
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I started taking Acarbose this past Monday and after about 1.5 days of taking 25mg with my meals, I don’t think I can continue it. Way too much gastric distress and discomfort for me at that dose.
I may try again at about half that dose just to see how that goes. Id hoped for a better result
I find it is highly dependent on the type of food you are eating. The gasto effects are much worse on wheat-based diets. And, as others here have mentioned, the gastric distress/ gas does get better after a few weeks… but your mileage may vary 
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Try taking it mid meal and slowly progress to taking it with “first bite”. I was told this in pharmacy when picking up my first prescription. It has helped a lot in the first week.
My intestines adjusted in couple of weeks, now I really don’t seem to be excessively gassy (or I just got used to it). For me it is not wheat that makes it worse but really fibrous vegetables (that make you gassy anyway, but it seems much worse on acarbose) and even tiny amount of (complex) sugars.
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I started taking 1000mg of Metformin + 50mg Acarbose on the days I dont exercise … feeling good and glucose post prandial looks great.
I start the meal with Acarbose and finish with Metformin since I eat OMAD and my feeding lasts for 2 hours 
On the days that I workout I only go for 50mg of Acarbose since my muscles are extra Insulin sensitive and I dont get any spike after workout meal.
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PDM
#330
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Well, they work by different mechanisms.
Metformin will reduce the hepatic glucose output mainly and reduce the blood glucose.
I am not sure it will blunt the glucose spike that well, maybe someone that uses CGM can expand on it.
And Acarbose of course slows down and blunts digestion of sugars in small intestines which will blunt the spike.
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For sure Fight or Flight mechanism releases tons of glucose in bloodstream from liver … been there, done that.
It makes sense … If you are in physical danger, your body wants to fuel you up for fast response.
Would sublingual application ( keeping it under tongue till it dissolves ) make it work better!?
scta123
#335
I did not research it really in depth, but since it is not systemic and it works in intestine it works best mixed with food. So chewing, crushing it with your first bite of food seems most logical. The pharmacist gave me same advice.
Yeee, you are right.
Its not supposed to be in the blood stream ( Acarbose ) but in intestines.
Makes sense to crush it with food.
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Will give that a go, thanks!
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zazim
#339
This will be my main ask when I get my physical. I want a prescription for this.
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popopop
#340
So I made a critical error in attempting to start using Acarbose. I decided that since 50 mg with my not remotely starchy dinner on Friday night went well, I would also have 50 mg with sushi for Saturday lunch and 50 mg with my yogurt loaded with resistant starch for Saturday dinner. Nothing smelled bad, but I was up half the night Saturday night with a non-trivial amount of gas.
Took yesterday off. Tonight I had 25 mg to go with the two low-carb wraps I used for dinner. Adjusting/titrating is going to be an adventure.
I make my own yogurt for the probiotics, so that will either end up making this much easier or much worse than it might otherwise have been.
But, since I can’t seem to learn my lesson, I’m ordering white kidney bean extract.
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The sucrase domain of sucrase-isomaltase is a type of alpha-glucosidase.
@AlexKChen why do you prefer beans?
