Thank you for your responses. What I really wanted to ask was whether the long-term use of metformin and acarbose to control blood sugar and blood lipids could cause damage and negative effects on the body. For example, if the fact that rapa causes false blood sugar elevation is true, would it be better not to intervene? If we use metformin to intervene, could it have a counterproductive effect? Although some studies have shown that using both drugs together can synergize, these studies are based on experiments in mice. As humans have a longer lifespan, we are more prone to cardiovascular and cerebrovascular problems. Therefore, how do you view the issue of long-term use?
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All great questions which few here are truly facing into. If CHD is the leading cause of death; and ApoB is the best marker for CHD risk… then why would we take a drug that increases ApoB?! Perhaps we should only take it in conjunction with a statin?
RE: Metformin
There are several threads that debate the pros and cons. I don’t believe the current research supports its use in non diabetics. I think acarbose has much more potential as a longevity agent and now take it rather than rapamycin.
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I agree. We need more focus on the main killer of mankind. Cardiovascular diseases/metabolic dysfunctions.
I take rapamune and my question is also. How to do more than lifestyle interventions like, exercise and sleep and diet, to reduce risk for death due to CVD?
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There is some good evidence that rapamycin protects against ASCVD, there are several studies that confirm that in animal models and dyslipidemia does not produce the same result as without rapamycin. I understand that is really counterintuitive to take something that raises causative agent as we understand it now. I think ASCVD is complex disease that is not yet fully understood especially the inflammation factor.
You can always add statins, but I would prefer to add something like ezetimibe that is similar to acarbose in the fact that it is not a systemic and has minimal absorption and yet a really good effect on lowering apoBs.
IR and “benevolent” diabetes caused by rapamycin as I understand is easily controlled with diet, some moderate caloric restriction and avoidance of refined carbohydrates, but you can always add acarbose to reduce glucose spikes and at the same time feed your microbiome which is favorable on its own.
Metformin and rapamycin seem to work well together. They counter each others negative points. I think that is why the combination to worked better in the ITP study given that Metformin failed on its own.
I was taking Metformin before I started rapamycin. My point is that rapamycin did not make my blood sugar worse. I have added acarbose but given my sourcing issues I use it very sporadically.
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Why avocado oil? Thanks.
When you take rapamyin with higher fat (meal or oil) it increases the bioavailability by about 30%. Details here: Improve Bioavailability of Rapamycin (2)
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Rapamycin pseudo-diabetes is not benevolent and should be addressed. There is a mouse study where diabetic mice taking Rapamycin had their diabetes worsened and they ended up dying earlier than the control. Rapamycin aggravates diabetes and can shorten your life if your diabetes is not under control. The mice taking Rapamycin with diabetes died from inflammation caused by the Rapamycin making their diabetes worse. Do not take Rapamycin if your blood sugar is not under control. You may die earlier. Metformin or acarbose can help get your blood sugar under control. I am getting my prescription for acarbose as I write this.
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Thank you,De Strider,My current blood sugar levels are normal. If I start taking rapa and my blood sugar rises to prediabetic levels, how should I manage it? Should I stop taking the medication and observe, or add acarbose to my treatment plan?"
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HIF is the key to problems with hyperglycemia
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I would add Acarbose to manage it.
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Thank you,What do you think of the Canagliflozin? Would you use it as a replacement for acarbose if your blood sugar levels increased after taking rapamycin?
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Canagliflozin, acarbose and Metformin are all potential treatments for high blood sugar. It’s up to you which you would prefer. I personally will be using acarbose and Metformin. I may use canagliflozin at a later time but it may be overkill at this point.
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Regarding Acarbose vs. Canagliflozin, please see this earlier discussion thread: (IMPORTANT) SGLT inhibitors are not a substitute for Acarbose
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SGLT2 inhibitors can be used in low dose intermittently (e.g. every other day, three times a week…) with good results in diabetics so this can be an option. I picked up some empaglifozin some two weeks ago, but still contemplating using it. From what I read it is a better option than metformin, as SGLT2 inhibitors are CVD and kidney protective and there is some evidence on improving/protecting against cognitive impairment.
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I believe I had some symptoms of high blood sugar after raising my Biocon dosage to 8mg with fats. An urgency to urinate that had me plotting how to arrange my day so I was never 60 minutes from an bath room. I didn’t have strips to measure blood sugar but the symptoms were new and strong. I stopped Biocon and the symptoms disappeared after a few weeks and travel to the tropics (got loads of sunshine vit d).
I have my strips now and found that 2mg of Biocon (with grape fruit) had the following morning blood levels about 10mg/dl higher than normal.
So I am using Myo-Inositol - 1500 mg twice a day (total 3000 mg) and 500 mg IP6 once a day to control blood sugar. I took 2 weeks off from Biocon to free my system of rapamycin. Took the Myo-Inositol and IP6 and found it lowered my morning blood sugar 10 mg/dl below by normal reading. After 5mg Biocon, I found a small rise above my normal blood sugar levels the morning after, but the following mornings back to below normal levels.
My main goal with rapamycin use in the near future is to help with training for a sprint triathlon in August. Some have reported here about having better recovery and time goals in their athletic training and I have experienced that too I believe. I think a weekly medium dose of 6mg (with fats) and then stopping 4 weeks before the event will be a good strategy and one that seemed to work last summer (though with rapamycin from a compounding pharmacy).
If my morning blood sugar rises over time, I will drop dosage and extend time between taking. I am also more mindful of what I am eating on dosage days - fast most of the day with low carbs and low protein.
N=1, but am very happy with these results, albeit limited usage so far. I think the research literature is very robust on the efficacy of using Myo-Inositol for lowering blood sugar and blood lipids also. I can’t see why one would not choose it over acarbose, at least to start. Do a search on this site for myo-inositol. The following review article is a good synopsis also. Omoruyi FO, Stennett D, Foster S, Dilworth L. New Frontiers for the Use of IP6 and Inositol Combination in Treating Diabetes Mellitus: A Review. Molecules . 2020 Molecules | Free Full-Text | New Frontiers for the Use of IP6 and Inositol Combination in Treating Diabetes Mellitus: A Review
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You could also lose body fat to become more insulin sensitive, eat less carbs, and do more high-intensity exercises, such as weight training, to use up the excess glucose. High-intensity exercises use more glucose whereas low-intensity exercises use more fat. Having lots of muscles and using them regularly provide the best protection against diabetes.
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I’ve been on Rapamycin for 8 days, yesterday I took 3mg dose (1mg last week). I also received my continuous glucose monitor yesterday so I put it on. My glucose has been between 110-120 all day both days during the daytime and 100 or so at night. I’ve never had a fasting glucose over 90 before so I think the rapamycin is bumping it up. I’m going to keep watching this week to see if it tapers back down as the rapamycin level does down in my bloodstream.
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There are ways to avoid the glucose bump of Rapamycin such as by taking metformin, acarbose or an SGLT2I. Studies have shown that these combinations extend mouse life expectancy much more than Rapamycin by itself. (Except SGLT2I hasn’t been tested)
For increased lipids from Rapamycin, you can take Bempedoic Acid, Ezetemibe or a statin to counteract the increase.
I personally take 500 mg of Metformin, Bempedoic Acid, Ezetemibe and Acarbose during carb heavy meals. I’ll be adding an SGLT2I.
My HBA1C jumped from 4.9 to 5.7 on Rapamycin. After adding Metformin, Acarbose and Akkermansia probiotics, I brought it back down to 4.9. My LDL jumped from 65 to 120 after Rapamycin and then came back down to 66 on Bempedoic Acid and Ezetemibe.
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This is interesting because I experienced similar elevation of HbA1C and reduction of insulin on Repatha – even though I was concurrently taking 1000 Metformin. I am thin and fit with no risk factors for elevated glucose. Decided to take a break from Repatha (and Ezitimibe) and do a washout for a couple of months. Since I have elevated Lp(a) I was so happy to have been on the Repatha (which dropped it from 40 to 29). Just received a shipment of Rapamycin and shelving it for the time being, trying to decide what to do.
Anyone here on both Repatha and Rapamycin? Any thoughts about all this impact on glucose?