I’m slowly losing weight, but am still overweight. I guess the next thing would be to drop 20 lbs to get to my optimal weight through GLP-1s. Or hitting the gym.
Jardiance has led to a slow 0.8 lb weight loss per week since I started. However vacations undo the weight loss pretty quickly. I’ll have to bring my Jardiance on my next trip!
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I’ve also seen this protocol and it’s WAY easier. Honestly, I thought this was the standard until I saw on reddit (urgh) people talking about a week of prep, dietary restrictions etc. Kinda crazy.
For me, I’m just seeing a huge amount of “noise” here and no single cause. If it’s linked to obesity, T2D, sugar consumption, processed food etc, then it’s basically linked to anything and everything. You can’t really untangle those things to any degree of precision IMO, especially from the point of view of trying to prevent it.
I think a clearer summary is the culmination of our modern lifestyle is the cause. It’s very very unlikely IMO that we’d find a single causative agent.
IMO, in your situation, getting a colonoscopy every couple years and dealing with the polyps seems like a very viable approach. To my knowledge, they take a few years to form, and a few more years for < 20% of them to turn cancerous. So you can kinda consider this is dealt with by colonoscopies, and then choose whatever diet and lifestyle you like based on your other health goals.
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Yes, since 90+% of all CRCs develop from polyps, getting rid of polyps is a fantastic strategy.
The one confusing thing to me, is that I read very confusing claims in the literature regarding timeframes of CRC. The one big claim is that it takes 10+ years to go from polyp to CRC. That’s the justification behind the recommendation of 10 years between screenings for polyp free individuals - if you show zero polyps, and the next day a polyp starts growing, it’ll take 10 years before it turns into CRC right on time to be caught on the next colonoscopy.
But here’s what’s confusing - how is that any different from Chris’s situation? If his polyps take 10 years to turn into CRC, then why does he have to rush to cut them out at 1-3 year intervals? Unless it takes less than 10 years for a polyp to go rogue, at which point why are the rest of the folks safe waiting for 10 years?
Sure, get them out the earlier the better, but the 10 year recommendation is puzzling. FWIW, Peter Attia is gung ho about getting colonoscopies every 3-5 years regardless of whether polyps are found or not. So?
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There’s always the chance the doctor missed a polyp especially if small. So if you miss a 3 year old small polyp, you really only have 7 years.
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LaraPo
#231
IMO it’s diet. Add Psyllium husk to everything you eat. It mixes well with anything. Good luck!
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Beth
#232
.8lbs a week is outstanding!!! I think that sounds healthier than going faster, so I imagine you don’t need a glp1, especially because it sounds you are only 20 from your ideal. As you say, you just need to pack better 
I’ve had two colonoscopies, and both times I used the ‘better’ of the two options we are offered here…. You still have to fast the entire day prior and drink some awful stuff, but you have to drink significantly less of the awful stuff than the old school prep option.
And yeah, @CronosTempi, the prep is the only mental block I have about getting one.
I’ve been meaning to ask the hive mind if anyone feels the home tests are worth doing? My goal would not to replace a colonoscopy, but to check more often in a more affordable way during the times between colonoscopies. Waiting 10 years doesn’t seem like a great option to me, but maybe I do another at 5 and maybe a home test at 3?
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Bicep
#233
I’ve done both and the home is much easier, but more important it’s safer. Nothing can go wrong. Depending on who is doing the colonoscopy, you can get perforated there. My neighbor did and spent time in the hospital from it. If you have a good team with good experience, then probably ok. I know the home test is not as good.
So tough call.
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That’s my thinking — and if done frequently enough and combined with the Cologuard 2.0 (when it finally hits the market), IMO it might even be a good alternative to colonoscopy.
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Beth
#235
I just googled and saw how expensive cologuard is, so thank you for sharing about FIT! Staying healthy is too $$$$.
FIT is far cheaper than Cologuard — though either is much cheaper than an additional colonoscopy.
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sol
#237
my insurance covers it 100%. Check with yours.
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In a recent study, Allen and his colleagues found FIT cost just over $17 a year, while Cologuard cost Medicare about $350. (Private insurers are often charged far more.) A colonoscopy can easily run $10,000. Under the Affordable Care Act, all screening tests must be covered by insurers.
https://www.cancertodaymag.org/cancer-talk/comparing-costs-of-at-home-colorectal-screening-tests/
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I had a colonoscopy done at the University of Michigan Hospital a few years ago (2018?). It cost $800 with no insurance. $10,000 is way too expensive.
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How long do you intend to be getting colonoscopies? After age 75 it’s no longer recommended, but I imagine that depends on if they keep finding polyps. Colonoscopies are still the gold standard, but in your situation these other tests like FIT are not relevant? Because you still have to cut out the polyps and that happens at the time of colonoscopies, so I’d think from your point of view never stop colonoscopies?
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I need to do a colonoscopy every 3 years. I figure I want to live to at least 120, so I’ll stop getting them at 110. 
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Neo
#242
I like that it is cheap and hence can be done more often
Though I don’t think it’s correct to say that it is as good?
It requires to detect blood
While even Cologuard 1.0 offers a broader detection scope, identifying both blood and DNA markers associated with cancer and precancerous conditions
Or did I misunderstand how the two tests work?
(Makes sense that Cologuard has some advanced otherwise why would insurance and CMS agree to pay it if something else is equally good but an onset of magnitude or more cheaper?)
(Tagging @Beth @RapAdmin too just fyi)
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True, but they’re only required to offer it without charge once every ten years to people over age 45 at typical risk. Beth was asking about doing additional screening in the interval with a stool-based test.
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If you look at the numbers on the USPSTF meta-analysis, their overall performance is similar. You get somewhat higher false negatives for certain kinds of lesions with FIT and a higher rate of false positives with first-gen Cologuard.
Cologuard 2.0 has better sensitivity and specificity than first-gen Cologuard, making it a stronger choice.
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Neo
#245
Thanks @RapamycinCurious
So similar for detecting actual, full cancers, but worse on detecting pre-cancers?
Do you have a link to that meta analysis?
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I want to detect and remove polyps when they are precancerous. I don’t want to wait until they are full blown cancer. I’ll stick with Colonoscopies and remove those suckers. Also, my insurance covers the cost so I only pay a couple hundred dollars out of pocket. (They retail at $3,500 USD here).
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