#423

I take 50 mg right before my berries-apple-yoghurt sallad.

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#424

I take 50mg with every meal when I remember. At least once per day and usually twice.

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#425

I take 100 mg at a time. Usually before a big meal. Not sure how much an effect it would have for my breakfast oatmeal or lunch salad.

#426

I take 100mg before every meal. 200mg for a (simpler)carb heavy meal (rice, pasta, breadā€¦).

#427

The 25 mg that Iā€™m taking is nothing in comparison to your dose. Should I bump it up if my BG prior and post meal is normal? Any thoughts?

#428

I donā€™t have a good experience with acarbose and not just the gas thing. It is something i donā€™t intend to be doing for long time. Plus, someone posted a study earlier that showed acarbose started at old/older age in mice had zero or a negative effect on mice longevity. Control subject on RAPA lived longer on that study then the ones on RAPA plus acarbose. My two cents. I am however a believer on metformin at low doses.

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#429

Iā€™m on a 500 mg Metformin dose on my Rapa days only. May be I donā€™t need Acarbose bc my BG is normal at post meals (114 mg/dL).

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#430

Honestly, myself I would not use it regularly, maybe Iā€™ll keep the rest of the pills I have for heavy carb meals. But I may start on 200mg of metformin regularly. For people that their BG after meal is normal i would rather do a very low dose like 2-4mg statin. I think that would accumulate more benefits for heart health than acarbose. But again, we tend to be all different and that is my opinion which is mainly based on few people that had CVD and were on statins for a long time, and they lived healthy long lives.

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#431

Do have a reference to this study ?

Everything Iā€™ve seen on the internet so far seems to say age doesnā€™t matter.

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#432

No, but it was posted not long ago, which said that acarbose started later in life may not be of any help. Iā€™ll try to search but if the person that posted sees this message, then please repost.

#433

I believe the ITP results stated that effects were diminished with age, but not reduced to 0. Off the top of my head, I think it was like 60-70% of the benefit when started young. Which is still impressive.

#434

@RapAdmin Can we call you Dr. House? Fountain of all the good stuff.

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#435

I actually thought the study said that rapa plus acarbose started at later years had less of a lifespan thanRAPA alone, which i took it to mean acarbose has no effect if started in late life

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#436

Probably it it this:

https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13724

But it doesnā€™t look that bad as you are making it sound. iTP did 9 and 16 months combination of acarbose and rapamycin and there was substantially larger benefit at 9 months there was a clear benefit at 16 months as well. 9 months would probably be what? Around 40-50 in human years? And 16 months around 70 years?

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#437

No it is not this one. The study I was referring to was one that said ā€œrapa plus acarbose in old mice, had a bit less lifespan than rapa only in the same age category miceā€. Again, Iā€™m not saying it may not be helpful but even in this study it tends to show that if started at late years there little if any benefit. For some reason it does not sit well with me, but that could be because i do not have a glucose problem.
When i take metformin i usually feel less bloated, and lighter on my feet. With ACA i seem to feel opposite for some reason.

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#438

I upped my acarbose dose the past week to 50mg whenever I take it, which has been 2-3x/day. The first few weeks I was only taking 25mg at once, and only 1-2x/day.

Iā€™ve also noticed that the past week has been the best my GI tract has felt in a long time. I got a really bad case of gastritis in Fall 2019 and the worst part lasted until Fall 2022. Over the past year I was able to mostly recover, which I attribute to supplementing butyrate, as well as strictly managing my diet. Still, I thought Iā€™d never be able to drink coffee again, and some minor but annoying symptoms remained.

About a week ago I bought low-acid coffee (first time trying it, so itā€™s possible I couldā€™ve tolerated it before) and Iā€™ve been able to handle 2 espresso shots made with it per day. I also ate an entire dark chocolate bar a couple days ago and it didnā€™t bother me a bit. Coffee is probably the single worst thing you can do for gastritis, and chocolate is up there as well, and I really think that a month ago these two wouldā€™ve bothered me pretty badly.

Oh and also this super uncomfortable gassy pain in my left lower abdominal quadrant has totally disappeared as well. It was one of the symptoms that didnā€™t completely go away once I got past the worst of my gastritis.

One other thing that might be contributing is being more consistent with taurine the past week (1g 3-4x/day). The whole reason I bought taurine in the first place was to see if itā€™d help my gastritis, but it never seemed to help much in the past. Perhaps I wasnā€™t far enough along in the healing process for it to help, or perhaps itā€™s more effective for gastritis in combination with acarbose.

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#439

Arenā€™t SGLT2 inhibitors infinitely better than metformin for CKD?

(I donā€™t get why in 2024 some still swear by metformin although it failed the ITP and human studies whereas alternatives like acarbose and SGLT2 succeededā€¦)

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#440

My reading is that SGLT2 inhibitors can be detrimental in CKD but the mechanism seems vague. From what I see it is related to dehydration that occurs by diuresis. Chronic NSAID use and SGLT2 inhibitors can cause problems as well.

#441

People still like Metformin because when paired with Rapamycin it synergistically extends lifespan in the ITP trials. The same holds for Acarbose. If the ITP tests an SGLT2 inhibitor with Rapamycin and the results blow past the Rapa + Metformin effects, thatā€™ll probably be the final nail in the coffin for Metformin.

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#442

SGLT2 inhibitors are specifically approved in the US and the EU (among other countries) for CKD. How could they be detrimental?

See for instance: Forxiga approved in the EU for the treatment of chronic kidney disease in patients with and without type-2 diabetes

The DAPA-CKD Phase III trial demonstrated that Forxiga, on top of standard-of-care (SoC) treatment with an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker, reduced the relative risk of worsening of renal function, onset of end-stage kidney disease (ESKD), or risk of cardiovascular (CV) or renal death by 39% (the primary composite endpoint), compared to placebo (absolute risk reduction [ARR]=5.3%, p<0.0001) in patients with CKD Stages 2-4 and elevated urinary albumin excretion.

And also: Europe Approves Empagliflozin for Chronic Kidney Disease

During a median follow-up of 2.0 years, the relative risk of the primary combined endpoint ā€” kidney disease progression or cardiovascular death ā€” was reduced by 28% with empagliflozin in comparison with placebo (hazard ratio [HR], 0.72; P < .000001). The relative risk of hospitalization for any cause was reduced 14% with empagliflozin in comparison with placebo (HR, 0.86; P = .0025).

Yes, I get that. But Acarbose + Rapamycin is still much much more potent than Metformin + Rapamycin (+37% vs +23% for median male). This should have been the final nail in Metforminā€™s coffin already. (On top of that, acarbose isnā€™t linked to any risk of Parkinsonā€™s disease contrary to Metforminā€¦) Anyway, I agree with you, I really want to see SGLT2i + rapa (ideally empagliflozin instead of canagliflozin) and GLP1 + rapa (e.g., oral semaglutide).

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