Acarbose - Details On Another Top Anti-Aging Drug

Acarbose1s

Acarbose; 17% Lifespan Improvement Alone, and Up to 29% When Combined with Rapamycin.

Acarbose is another leading anti-aging drug that is FDA approved, and available today. There have been three major acarbose lifespan studies that all showed significant life extension results, with up to 17% lifespan increase seen in males at the highest dose. Life extension effects were slightly lower for females (see details below).

In new research by the NIA ITP program announced in a recent interview with Richard Miller (April, 2022) Richard revealed that they’ve recently achieved the best results they’ve ever seen in lifespan extension tests, 29% increase (in males) when they fed the mice rapamycin and acarbose at the same time.

Acarbose is a low cost, widely available, medication that is typically used in treatment of diabetes because it slows the digestion of carbohydrates / starches in the body, which helps lower peak blood sugar levels. Acarbose works best (in terms of life extension) when started earlier in life (vs. middle age).

Acarbose as a potential longevity agent due to its ability to block peak glucose levels

2013 ITP Acarbose (ACA) Lifespan Study Results:

Mice were fed ACA from 4 months of age (youth), Maximum lifespan (90th percentile) increased 11% in males and 9% in females.

2016 ITP Study Acarbose (ACA) Lifespan Study Results

Beginning at 16 months of age (middle age), mice were fed chow containing ACA. Pooling the data across sites, there was a significant increase in survival for male mice treated with ACA, with a 6% increase in median lifespan and a significant 12% increase in maximal lifespan. ACA started at this late age had only a small effect on median lifespan in females (2%), but led to a significant (6%) increase in maximal lifespan.

2019 ITP Study Acarbose (ACA) Lifespan Study Results

we studied ACA at three doses: 400, 1,000 (the original dose), and 2,500 ppm, using genetically heterogeneous mice at three sites. Mice were fed ACA from 8 months of age (teen/young adult in human terms).

The two higher doses produced 16% or 17% increases in median longevity of males, but only 4% or 5% increases in females. Age at the 90th percentile was increased significantly (8%–11%) in males at each dose, but was significantly increased (3%) in females only at 1,000 ppm.

Acarbose also seems to increase mTORC2 which is also associated with increased longevity. See: Acarbose, An mTORC2 Promoter We Should All Take?

Where to Buy Acarbose

You can purchase acarbose, and/or get a prescription for the medication, from most of the same resources you would use for rapamycin. See the links below for details:

Acarbose Side Effects

The key issues with acarbose are related to its’ high rate of unfortunate side effects:

  • abdominal pain (19%)
  • diarrhea (31%)
  • flatulence (74%)

There are reports (both in the scientific literature, and from users and doctors) that the side-effects may be highly diet related - specifically “Wheat” seems to cause a lot of the GI issues - people who largely avoid wheat are apparently spared the worst side effects. Rich Miller discussed this in the recent LiveLonger World Podcast.

Other strategies to minimize Acarbose Side Effects:

Though, on the positive side, the flatulance/gas you create while on acarbose doesn’t smell very bad it seems:

What is acarbose?

Acarbose belongs to a class of drugs called alpha-glucosidase inhibitors. It works by slowing the action of certain enzymes that break food down into sugars. This slows down digestion of carbohydrates to keep your blood sugar from rising very high after you eat

Why did the National Institute on Aging ITP program do these studies?

The following information is sourced from the Peter Attia / Richard Miller podcast. The rationale for testing acarbose on impact on lifespan was that “Caloric restriction is good for you” and acarbose is sort of like caloric restriction (CR) in that it blocks the digestion of starches to sugars. Peter Attia has pointed out that there are really two different hypotheses that you could be testing:

  • One is that you will functionally consume or absorb fewer calories, and therefore it’s like CR
  • Another could be that the animal will continue to eat the same calories, but they will have lower glucose (which is a good thing for long-term health)

The three studies showed results from using various doses and starting at 4, 8 and 16 months. Both sexes has significant improvement in lifespan but the improvement was higher in the males; From the abstract:

The acarbose results confirm and extend our original report, prompt further attention to the effects of transient periods of high blood glucose on aging and the diseases of aging, including cancer, and should motivate studies of acarbose and other glucose‐control drugs in humans .”

What is Rich Miller’s hypothesis on why acarbose extends lifespan?

Rich Miller’s current interpretation of the life extension benefits of acarbose is that it is blocking the very highest levels of glucose. He suggests that in humans, we often look at hemoglobin A1C, which gives you a measure of avg. blood glucose over the last few weeks, and if a person with diabetes takes acarbose, that hemoglobin A1C goes down — signifying that it’s working in a person, but in mice it turns out that HbA1c does not go down. Therefore, he suggests it’s probably not an overall change in the amount of glucose that gets in, but a change in how quickly the glucose enters the blood stream.

In summary :

Rich Miller’s guess is that acarbose was working by blocking the peak glucose. Acarbose (and canagliflozin) are working by eliminating the huge peak of glucose you get after you eat a meal with a lot of starch in it.

Was there any gastro-intestinal (GI) / stomach/bowel distress in the mice?

Richard Miller says that the mice didn’t stop eating or show obvious signs of distress, but their GI tract is very different from that of humans, so a direct one-to-one comparisons for what our GI tract can handle and theirs is difficult. Most people experience some sort of gastro-intestinal distress from acarbose, especially at the higher dosages (e.g. 100mg, typically taken with a meal).

Where there changes in weight in the mice?

Rich Miller states that acarbose led to weight loss (or a lack of weight gain) in the original ITP paper. That is seen in some populations, but not all. For example, in Rich Miller’s lab, he made a batch of acarbose-treated mice for another purpose and they didn’t see a dramatic change in weight — “We really don’t know why. So it’s a little bit frustrating .”

In human studies with acarbose, there is a weight loss typically seen in acarbose as this study shows:

Acarbose, especially in combination with the low calorie diet and exercise, seems to lose weight effectively in obese and overweight patients in communities that have a high carbohydrate intake (like Persian diet).

Acarbose as a candidate for human trials
Since acarbose is FDA-approved and has a long safety history—hundreds of thousands of people take it, particularly in Asia and in some parts of Europe—it’s an obvious candidate for human clinical trial in terms of anti-aging. Therefore, Rich Miller suggests, if one was thinking about what drug that works pretty well in mice would be safe for human clinical trial, acarbose has to be on that list. Rich has said that he is urging Matt Kaeberlein—who is studying rapamycin in dogs—to study acarbose in dogs as well. We have heard that Matt Kaeberlein has said his concerns with Acarbose are that it can cause diarrhea and gas, and if in a clinical trial with companion dogs the animals make a mess in the house, the trial might not go well - so it is not high on his priority list of anti-aging medications.

Personal Observations from Acarbose Use:
I have found that using acarbose (while taking rapamycin) for anti-aging is very effective in moderating glucose spikes. I use a continuous glucose monitor and while I was using acarbose my blood sugar levels seem to be well-moderated and mostly kept within the range of 80 to 110 mg/dL (approx. 3.9 and 6.0 mmol/L). However, the high level of gas / flatulence makes the drug for me far from the ideal drug for daily use. Because of this problem I investigated using canagliflozin - which I’ve reported on here:
Canagliflozin for Anti-aging - One Month and 4 Month Updates

Acarbose in Anti-Aging (mice);

acel.12898.pdf (893.2 KB)

Some Additional Acarbose Information to be Aware of:

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This study claims that α-amylase and α-glucosidase inhibition by (OTC) scutellaria baicalensis extract is stronger in vitro than acarbose. Now I’m eager to give it a try.

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Great find - thanks for posting. Let us know if you find a good source and pricing please! Hope it doesn’t cause the gas that acarbose does… its pretty horrific :wink:

So - what do you think of something like this - there are very few name brand companies selling it:

Swanson is one name brand that is carried on Amazon, but I don’t know enough to recommend one brand over another. I’ve used Swanson, then Horbaach, for a couple of years, but mostly for sleep and anti-inflammation as it relates to the balance of Th17 and Treg function (for autoimmunity issues). I’ve never tried it with meals (but will now), and I hope it doesn’t make me sleepy.

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I use “chinese scullcap” which is a SB extract for sleep, occasionally. I’m going to start taking it before I start my evening eating period (I am a daily periodic faster) and see if I see any differences. After some quick reading, it seems that any body composition effects occur after a long-ish period of regular use. Very safe supplement and can’t hurt. Very interesting find. Thanks.

I’ve been using this brand…

Can acarbose work if you take it during a meal, or do you have to take it 30 minutes before a meal?

Adult dosage (ages 18 years and older)

  • Typical starting dosage: 25 mg taken three times per day with the first bite of each main meal.
  • Dosage increases: This dosage may be increased up to 100 mg taken three times per day with the first bite of each main meal.

From:

Well I just took 100mg with a bunch of oatmeal (like 500 calories of it).

So - you likely won’t see much of an increase in your blood glucose levels if you check. But - I suffer from major gas when I use acarbose. I hope it works better for you…

I don’t get any side effects when I use acarbose. But then I wonder if it’s doing anything to me…

I got one of these to track my post prandial blood glucose levels - works well. I also got a CGM to track but only use it periodically when I have a new medication I want to track effects from.

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Does this slow down transit of food through the gut? Esp beans?

The Contour Next brand is considered one of the most accurate blood glucose monitors. Such monitors are allowed to have +/- 15% accuracy by the regulatory rules, but Contour Next is closer to +/-5%.

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Does the gas expand the size of your intestines/stomach? (cause a giant bulge) This may not be a bad thing (it seems to make me eat less than I normally do, by producing a feeling of “fullness”).

UBC_Research_01

Op · 5 yr. ago

That’s a great question, thanks. Yes, these side effects can be common. I am less familiar with the mechanism of action of Olestra then I am with Acarbose. Based a quick google search, the diarrhea and the dreaded “anal leakage” associated with Olestra appear to be because it leads increased fat content in the stool. A treatment like Acarbose can also often lead to diarrhea, but for a different reason. In this case diarrhea is caused because the starch is allowed to partial breakdown into smaller sub-units of starch known as maltose. (Acarbose blocks the degradation of maltose into glucose) Therefore when this high concentration of maltose reaches the intestines we get what is known as osmotic effects where water rushes in to satisfy the high solute concentration. This added water caused by the excessive maltose concentration is what leads diarrhea…I’m not sure if anal leakage is a common side effect of Acarbose. If it is, I hope that it will be recorded in the attached survey. Also, maltose is a favourite food for many of the anaerobic bacteria in our intestines, which eat it up and release gas. So Acarbose can often result in bloating and flatulence in addition to diarrhea.

Our proposed treatment differs from Acarbose by blocking the initial breakdown steps of starch, so it will remain as a fibre when it enters the intestines. Because the starch will not be partially broken down there will not be elevated solute concentration and therefore not induce the osmotic effects, which cause diarrhea. Also, intestinal bacteria do not chew up fibrous starch as readily as they do maltose, so we hope that excess flatulence and bloating can be avoided too. I should stress that we are in the early stages of testing this treatment. So I cannot say for sure this is how our proposed treatment will work but based on what we have learned about the mechanism of action, this is what we expect to see. I hope this answers your question and I encourage you to have a look at our survey.

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I’ve been taking acarbose for a year, but only with meals that include carbs–and I vary between 50mg and 100mg based on how many carbs in the meal. I only experienced very mild intestinal issues (gas) the first couple of weeks, nothing now. But I also rarely eat starches. When I do eat carbs, it’s almost always fruit or my once-per-week Friday beer. A little over six months ago I added empagliflozin (25mg) and recently started rapamycin. I’ve been adding one new pharma intervention every six months rather than all at once, so I can track changes better.

I’m a big fan of the acarbose, but am concerned by research that the microbiota develop resistance to it over time–which is why I try to save it for carby meals.

The human microbiome encodes resistance to the antidiabetic drug acarbose

https://www.nature.com/articles/s41586-021-04091-0

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I rarely feel a need to take this. Like, you probably shouldn’t be eating oatmeal/bread/corn ANYWAYS. It’s useful with beans. It won’t work for most fruit (since most fruit sugar is not of the disaccharide kind). For emergency/cheat meals when nothing else is available, sure

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“It won’t work for most fruit…”

I was worried about that based on all the references to starches, but didn’t see any studies specifically stating it doesn’t help with fructose. On the contrary, I found some stating that it does help insulin sensitivity in fructose-fed rats.

Acarbose, an alpha-glucosidase inhibitor, improves insulin resistance in fructose-fed rats

Acarbose, an alpha-glucosidase inhibitor, improves insulin resistance in fructose-fed rats - PubMed.

Would you have any links suggesting it doesn’t help with fruit? Thanks!

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