#1666

I’ve considered it and may do it. My brother did and he lost all his excess weight. However I think he may have lost a lot of muscle as well. He was a professional body builder at one point.

#1667

Well it’s the body fat in the pancreas causing the prediabetes probably, so whether you lose muscle mass by not doing resistance training at the same time and eating adequate protein won’t keep you from your objective.

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#1668

Yes, I’d like to try resistance training first to lose weight. I’m not obese. However, I could lose a few pounds though.

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#1669

I never said you were obese. I said your fat threshold for prediabetes might be lower than what you have now, which is why I asked if you have six pack abs.

People have differing levels of fat threshold, when the pancreas stop working and they develop prediabetes, based on how much body fat they’re carrying.

Resistance training doesn’t work to lose weight. It’s diet that works, whether with Wegovy or not. It’s combined with resistance training and diet.

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#1670

I take 25 mg and experience no side effects at all

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#1671

Tirzepatide is even better. The GIP component helps directly burn visceral fat.

I wasn’t obese before, but I had excess visceral fat. I’ve got a 6 pack now and my muscles are a lot more visible.

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#1672

I doubt that. They’re miraculous drugs for many people but let’s not get ahead of ourselves when there’s the confounder of reduced calorie intake.

It’s specifically fat in the pancreas causing type 2 diabetes in most people as far as I understand.

#1673

“In this exploratory analysis, treatment with tirzepatide in people with T2D resulted in a significant reduction of z-VAT and z-LF, while z-aSAT was increased from an initially negative value, suggesting a possible treatment-related shift towards a more balanced fat distribution pattern with prominent VAT and LF loss.”

“Change in visceral fat mass was −40.1% with tirzepatide and −7.3% with placebo”

https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.16275

Whether this is superior to reduced calorie intake it’s hard to say. It’s easier. It does the job. The evidence does point towards significant visceral fat loss.

2 Likes
#1674

Tirzepatide works via a reduction of calorie intake.

You’d need a study that controlled for calorie intake or weight loss to find any independent effects.

#1675

That’s where wegovy (semaglutide) comes into the picture, only way reduce stigma of such things is to smash right through the stigma, or maybe not. Why don’t you take it?

Not sure about @DeStrider’s reasoning but GLP1’s have some commonly occurring nasty side-effects including severe nausea and GI issues. As someone who already has a naturally low appetite and a very sensitive stomach, GLP1’s aren’t very appealing.

3 Likes
#1676

Dose and compound has to be weighed against having prediabetes (and soon diabetes), though, if that’s the case, so it’s an individual risk-reward benefit. The good thing is they can just stop the GLP-1 agonist, change, lower the dose.

1 Like
#1677

Potential side effects are highly variable. I’m prone to nausea but I get no nausea from tirzepatide, for instance, just some constipation which is easy to deal with. My wife, mother and brother also have no nausea issues from tirz. Point is, I wouldn’t automatically write off an entire class of meds that you haven’t tried that could be life-changing just because some people have side effects. The beauty of compounded tirz is that you can start as low and slow as you want.

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#1678

Got my most recent blood test back and decided it was time to take the SGLT2i plunge. Took my first 10mg empagliflozin this morning. I think outside of maybe rapamycin, empagliflozin is the drug I’m most excited about.

My current Rx stack is now: 10mg ezetimibe, 20mg telmisartan (have been taking 40-80mg for almost 8 months now, but I just got an Rx for it and they wanted me to start at a lower dose), 0.5mg dutasteride, 10mg empagliflozin, 150mg buproprion, and 180mg test cyp.

Supplementing 200mg caffeine, 500mg tributyrin, 5mg lithium orotate qod, 3g taurine, 3g glycine, 1.5g mag-L-threonate, 5g creatine, 1,000IU Vitamin D qod, 100mg epicatechin, 10mg famotidine, 10mg melatonin, and 60-80mg 7-OH-mitragynine. Was taking 12mg astaxanthin for a bit but ran out.

I tried to start acarbose again recently but I think it just doesn’t agree with me. Haven’t really been taking rapa consistently either—I’m at 5 doses total this year. Probably later in the year I’ll hop back on it more consistently.

3 Likes
#1679

I had a friend who ended up in the hospital with esophageal bleeding from a GLP1. It also gave them horrible acid reflux and stomach pain, so due to my past struggles with gastritis those things turned me off from experimenting. I also am trying to gain weight if anything, so it just doesn’t make much sense for me.

I tried to help them find one that would be less prone to nausea, so I definitely agree on the general sentiment.

1 Like
#1680

I’m curious how you came to choose empagliflozin over the other flozins.

For clarity, I’m in no way saying this is not the best one for you and am only curious what informs these decisions for anyone.

My doc put my on dapagliflozin, but I have no idea why :slight_smile:

2 Likes
#1681

Price may have something to do with it. That’s where I would start anyway.

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#1682

@qBx123Yk caused me to take a closer look at this.

I can no longer tolerate metformin. It gives me diarrhea, even the slow-release form.
Under “Be careful what you wish for.”: I asked my doctor to prescribe Jardiance
(empagliflozin) because of the advertising hype.

It turns out that Jardiance is not currently available as a generic medication in the U.S. or anywhere else that I can find. Jardiance in the US is expensive, even with insurance.
I bought it from India, even though it is still pricey, because it costs less than my insurance copay.

The good news is that a generic version of dapagliflozin, the active ingredient in Farxiga, is available in the United States. And, additionally, “there was no significant difference in efficacy between dapagliflozin and empagliflozin, even with the administration of different doses of these agents.”

“If your primary goal is fasting blood sugar control, either agent is a valid and effective choice. There’s no compelling evidence that empagliflozin delivers meaningfully better fasting glucose reduction across the board. Clinical context—such as cardiovascular or renal comorbidities.”

The next time I see my doctor, I will ask for a prescription for dapagliflozin.

**Comparative Assessment of the Long-Term Effectiveness and Safety of Dapagliflozin and Empagliflozin as Add-on Therapy to Hypoglycemic Drugs in Patients with Type 2 Diabetes
https://onlinelibrary.wiley.com/doi/10.1155/2022/2420857

Head-to-Head Comparison of Dapagliflozin vs. Empagliflozin—Cardiovascular and Safety Events

https://diabetesjournals.org/diabetes/article/73/Supplement_1/915-P/156680/915-P-Head-to-Head-Comparison-of-Dapagliflozin-vs

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#1683

That was great, thank you.

FWIW, I’ve been getting forxiga from India. $6.50 for a sheet of 14 pills.

When I checked goodrx for an option here, it was still over $200 per month. You most likely have better insurance than I do!

Also, just incase anyone is interested, I was curious and asked Healthspan what kind of sglt2 they use, and their answer was Brenzavvy. It’s still more expensive than buying through India, but it was cheaper than getting it from a US pharmacy, at least for me.

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#1684

? Is Brenzavvy (bexagliflozin) available from India? I didn’t see it there (I was looking for it, as one option for my cat). At least I didn’t see it on IndiaMart, but didn’t ask any of India based pharmacist.

#1685

It turns out that Jardiance is not currently available as a generic medication in the U.S. or anywhere else that I can find. Jardiance in the US is expensive, even with insurance.

The cost of Jardiance (empagliflozin) varies significantly based on insurance coverage and whether you qualify for manufacturer discounts or patient assistance programs. Without insurance, a 30-day supply can cost around $763, but with insurance and potential savings programs, the cost can be as low as $10-$20 per month, according to GoodRx.

I am hoping my insurance will cover it. Just started using pharm samples from my physician. Only side effect is I pee a lot more. Must be getting that sugar and salt out of the body - I guess.

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