I forget… but yes my two previous physicians attitude was … you’re doing good for your age. Getting old is inevitable… just go with it. The slow death spiral. lol.
Why I changed to a new younger doctor 3 and half years ago.
6 Likes
Are any of you using the Hibose brand from Kachhela? I took 4 x 50mg today (first day taking it) didn’t notice much
1 Like
What my doctor prescribed.
Libertas Pharma Inc.
Contains: Magnesium stearate, silicon dioxide, microcrystalline cellulose, corn starch.
2 Likes
I’ll ask my doctor for a prescription next time I’m in but I don’t have an appointment for a few months so in the meantime working with the India Hibose
2 Likes
Has anyone here tried out using a combination of miglitol and acarbose with rapamycin? It apparently works better than acarbose since it is a monosacharide instead of a tetrasacharide like acarbose. So it can actually be absorbed into the bloodstream. Supposedly works better than acarbose for metabolic syndrome. I assume it has the same longevity benefit as acarbose combined with rapamycin. I was going to take 50mg of both miglitol and acarbose at every meal in addition to the 5mg of rapamycin I take weekly. The literature seems to be pretty conclusive that miglitol is superior with respect to body weight reduction, lowering a1c, and blood glucose. Also appears to increase glp1 which is a nice bonus. I am at a 28 bmi (6’4" 220lbs) and will drop miglitol and orlistat once I reach a bmi of 25. I would love to see if Rich miller would test miglitol in combo with rapamycin. Wonder if the effect would be more than just additive?
7 Likes
That’s interesting, among 3 alpha glucosidase inhibitors (miglitol, acarbose and voglibose), miglitol shows the most weight‐lowering effect. And patients with type 2 diabetes mellitus switching from the highest approved doses of acarbose or voglibose to a medium dose of miglitol have a more stable glucose fluctuations.
Comparing the GI side effects of Acarbose and Miglitol, it looks like Acarbose produces gas more, Miglitol causes diarrhea more, Acarbose increases unabsorbed polysaccharides which lead to flatulence and abdominal bloating, however Miglitol increases unabsorbed disaccharides which lead to osmotic diarrhea.
I don’t know if people has combined Acarbose and Miglitol, if GI symptoms of combining 2 drugs are tolerable, I may give it a try, and I would love to see if Rich miller would test miglitol in combo with rapamycin too.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023585/
https://sci-hub.se/https://pubmed.ncbi.nlm.nih.gov/20558922/
5 Likes
We don’t know whether other drugs in the same class other than acarbose could extend the lifespan in mice or whether it would translate to humans. It could “work better” or “worsen” or “null effect”.
There are known differences in miglitol in humans. If acarbose works in humans, there may be different alterations in the microbiome/absorption of bacterial products, as suggested with the possible side effect of mild elevation in hepatic enzymes despite acarbose being essentially non-systemically absorbed - this isn’t seen in miglitol and miglitol actually is systemically absorbed. But it could be beneficial to use multiple different chemical classes (I’m not betting on miglitol) to avoid “acarbose resistance”.
If acarbose resistance happens, it could be the case where the mice ITP studies may not apply at all if they even do.
3 Likes
I just quick previewed the acarbose resistance in this paper, but I am not deep into the mechanism behind it. Is acarbose resistance reversible and do you have strategies to prevent acarbose resistance?
In the ITP mice sutdies, they used much high dose acarbose, 400, 1000, 2500 mg per kg diet (ppm) from 8 months of age.Under such high dose, I wonder if the mice already had acarbose resistance?
1 Like
Some gut bacteria develop ways to disable acarbose so other competing bacteria get less food. The basic premise is to use multiple types of inhibitors, similar to using multiple antibiotics to avoid resistance, except the inhibitors from diet I use have a high safety profile.
4 Likes
Could you elaborate on “inhibitors from diet”?
2 Likes
My acarbose arrived from India today. Just started small with a 25mg dose with my first bite of a gomacro outmeal protein bar. I am going to use my CGM to see how this looks versus last time I ate one without. Will post when I have the data.
4 Likes
Excellent.
Been on Acarbose for about 3 months.
Easy on my gut compared to Metformin for me.
Keep us posted.
1 Like
Hey @Agetron how often and at what dose are you doing it?
Btw: No gas or GI, not sure when folks got that but I am 3 hours removed from taking and eating.
Interesting how my glucose spiked and insulin kicked in second graphic versus first. The big spikes were sans Acarbose. I ate the same protein bar in both from a fasted state.
1 Like
I take a 50 mg tablet with the first bite of a meal. Typically 3 meals a day morning - noon - night.
I do get a little gassy when I also take a combo of a Probiotic with Kefir (liquid yogurt).
Otherwise, no issue. Bowel movements are fine, solid - and often.
Stomach feels great with Acarbose - no heartburn - even with pasta & tomatoe sauces or spicey Mexican. Eat and then workout - no problem.
4 Likes
Think I’m going to try bumping my dose up to 200mg of Acarbose at a time based on Bryan Johnson’s protocol
1 Like
Most of my days with acarbose 50 mg at lunch and dinner were working pretty well. I had to stay at a hotel and eat bad food for three days recently, so I bumped up acarbose to TID. Big mistake for me, massive gas and discomfort problem. And it seems that the poop quality deteriorated. I assume the characteristics change as your poop has a greater sugar load. So it is hard to imagine what a 200 mg dose would feel like. I will stick to 50 mg AM and Lunch, but probably add Calcium polycarbophil to my diet, as the psyllium husks are so unpalatable that I avoid it at all costs.
3 Likes
Let us know how it goes…
2 Likes
A bit of a reference pointer in case it might be helpful - if you aren’t already doing it - I started titrating with 25 mg and very slowly increasing to 100 mg tid before the first bite of a meal is the “official” use recommendation but in addition, I do 5-10 minutes before meals and chew it thoroughly (I realize it’s marginal for the intended effect so this part may be optional). A suitable analogy may be similar to how we manage very slowly increased fiber intake. Did you have stool that was closer to a softer than normal or mushy quality? My poop quality personally has been unchanged, including the very occasional highly starchy “cheat meal” at a social event.
I’m still debating with myself whether to slowly titrate up to 200 mg bid and consider skipping it with a third near zero starch/disaccharide snack meal that doesn’t empirically spike blood sugar to avoid potentially throwing off results too much, but no particular evidence for this specific intervention - it’s for practical reasons to get enough calories and nutrients from diet for the day when considering a separate agent that causes unintended appetite suppression in my personal case. But I want to make sure I’m not trading off too much potential for hard-to-interpret outcomes.
As for soluble fiber sources, two options most people will find more palatable are steel-cut oats or beans/lentil soup in case that hasn’t already been a consideration.
2 Likes
Ruled out small amounts of lactose as the cause with lactose-free? (Or simply adding lactaid)
1 Like