Dr. Attia takes PCSK9 inhibitor along with bempedoic acid + ezetimibe.
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PDM
#43
Agree with all except acarbose. What this drug is doing is protecting against the noxious effects of glucose (carbs), so eating few to no carbs, or low enough to avoid spikes in blood sugar, ought to be as good or better than acarbose, but without side effects.
AnUser
#44
This video by Lustgarten from 2020 brings forth an argument that acarbose could work via altering the gut microbiome, and not from carb reduction. But Canagliflozin might.
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I have decided to try acarbose to see if feeding my gut microbiome more food is a good thing, and maybe Iāll get a blood sugar benefit as well. I already eat 30 different plants every week, so I am feeding my gut a lot of fiber and phytonutrients but there are complex carbs in those plants as well. Itās a worthy experiment, I think. If I ate low carb, then I wouldnāt bother, as you say.
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If low carb worked as well as Acarbose works in mice I think there would be a lot more obvious human data showing it, and low carb health influencers would live longer - rather than shorter, which seems to be the case. Of course itās possible Acarbose also wonāt work as well in humans as it does in mice, either.
In general it would be great if ITP had a ācaloric restrictionā control and intervention group - to help see what interventions are making up for overeating, and what helps in addition to good lifestyle. For all we know some things āworkā by making the food taste bad so they eat less. I would certainly eat less if there was NAC in my food!
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LaraPo
#47
Iām mostly on a carb diet with plant and some fish protein and occasionally an egg or two per month. To watch possible glucose spikes I started testing for glucose a few times a day - early in the morning, after morning coffee, after lunch, after dinner and before going to bed. I was surprised to find out that I donāt have glucose spikes. After a meal my glucose is 115-130. Fasting is 90-92. After coffee itās 104. Once measured it in mid night - was 83. Itās nice to understand a pattern. The only inconvenience is poking finger too often.
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I understand that one of the ways acarbose works to help people lose weight is to encourage people to stop eating starchy foods because it causes gas. Whatever worksā¦
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My issue is my hba1c is 5.5 with every intervention I can stand. No added sugars, no starch, metformin (low dose), berberine, SGLT2 inhibitor. This might be a symptom of stress (hello coffee) but I am fighting it as much as I can. My fasting glucose is in the 80s and my insulin is normal. So why is my hba1c 5.8 or higher with no interventions? My family has a lot of diabetes. I will have diabetes unless I fight. One of these days Iāll get a CGM again (I hate finger pokes).
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JDK
#50
I would add the astaxanthin in as well, ITP showed 12% 
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However I saw on the thread that the human equivalent dose of astaxanthin is very large and costs several thousand a month. And no effect in females.
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JDK
#52
Yes they used high dosage, but i dont think the antioxidant is what makes this effect, its that astaxanthin activates all those longevity and healthy functions in the body, so big dosage in itself might not be neded, but i am curious to se their follow ups with lower dosage
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SNK
#53
Btw, someone on these boards suggested mucuna as a precursor to dopamine. Iāve been taking it last 5 days or so 1000mg in the morning and boy does that really work in more ways than one. HUGE energy boost, improved mood in general, less inflammation and holy moly. I have literally been walking around with a bulge (1/2 aroused) last 5 days. My testosterone should be in the 10 thousand range LOL. Never witnessed anything like this. Donāt take it in the afternoon though. Took 500/one pill couple days ago (cause I love how it makes me feel in the morning) and couldnāt sleep till 3:AM.
So far no side effects but it is unreal how much difference it has made in my overall wellbeing. Hope it doesnāt screw something up if continued long term because this is my ABSOLUTELY number one supplement for me.
Guys if you want your women to love you make sure you take some of this stuff 


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JuanDaw
#54
Mucuna pruriens.
Aptly named. It helps the prurient interest.
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Neo
#55
There are some people for which HbA1c is not a good estimate of average glucose for. (Peter Attia is such a person and has discussed the issue).
It might be worth figuring that out as the high values you keep having might be an issue or it might just be a genetic artifact.
One when to figure it out to use a CGM for an extended period and look at the average glucose from that and compare to what the HbA1c implies for the average and see if similar or discordant.
(Then you can also see spikes and variance and other valuable info too).
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Neo
#56
I want to do this too, but decided to do it after my Pendulum experiment to not confound which intervention is impacting what.
(I also decided to get some data on my gut health so did Genova Diagnostics stool and breath tests (and viome, but that is a bit more black box).
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Yes. If my red blood cells live longer than normal they will accumulate more glycation. But. I have family history of diabetes. I have to act as though itās real and progressive. The CGM is a good idea. I will do it someday.
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Itās smart to make one change at a time. My acarbose is on a slow boat from India so I wonāt be starting any time soon (I bet).
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Jacob_F
#59
For whatever itās worth, you described my current stack with one omission which is Semaglutide. I personally think they should be putting that stuff in the water. Also worth mentioning is some kind of fiber supplement like psyllium husk, green banana flour, etc.
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Jacob_F
#60
I get my Acarbose from Amazon pharmacy. It arrives in a few days. Without insurance a 30 day supply (assuming 3 x 25mg per day) is only about $16.75. You would need a doctor to prescribe it. I would be surprised if a general practitioner would be willing to write the script. It is a very innocuous medicine. . . except, of course, for the explosive flatulence.
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LukeMV
#61
I donāt agree. I think most of the benefits are because of what Acarbose does for the microbiome. If it was the glucose lowering, then we would have seen the same results with Metformin but we havenāt seen that at all.