What enzymes do you use?
Wholesome Wellness Digestive Enzymes 1000MG Plus Prebiotics & Probiotics Supplement, 180 Capsules, Organic Plant-Based Vegan Formula for Digestion & Lactose with Amylase & Bromelain,
I’m sure there is better and cheaper but I got tired of looking and they work.
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Thanks. I have use Doctors Best Digestive Enzymes off and on. I couldn’t say if it helped. I’ll try yours.
I take 2 before each meal. I’m 101 lbs. You might need 3 or 4. Try that with yours before switching.
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Good idea. I’m definitely taking less than that when I do take it.
Also just learned yesterday that glucose spikes are quite bad for your mitochondria as they fragment mitochondrial chains.
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Taking 2-3X the bottle dose made a big difference. Thanks.
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On Acarbose, didn’t the study say longevity benefit only on male?
No - 17% lifespan improvement in males, a little lower in females but still good. Acarbose - Details On Another Top Anti-Aging Drug
You’re thinking of canagliflozin, which worked in males, not in females.
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Very interesting. @AnUser @L_Hayes do you have any thoughts on this? Might fit with your goals.
Acarbose: safe and effective for lowering postprandial hyperglycaemia and improving cardiovascular outcomes
James J DiNicolantonio,1 Jaikrit Bhutani,2 and James H O’Keefe1
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This is great to hear. Can you share a bit more Chris?
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I saw it in a video when I made the post. Unfortunately, it was so long ago, I forgot which one. Sorry.
ok, thx, I’ll look a bit when I have more time and see what I can find.
They had diabetes. But I could try it.
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Do you think it was based on this study:
Using a geroscience approach to mitochondrial disease, we expose a connection between neurological mitochondrial disorders and the intestinal microbiome
Acarbose suppresses symptoms of mitochondrial disease in a mouse model of Leigh syndrome
Nature Metabolism
Published: 26 June 2023
https://www.nature.com/articles/s42255-023-00815-w
Discussed on twitter and then here on this thread: Acarbose suppresses symptoms of mitochondrial disease in a mouse model of Leigh syndrome
Adding @adssx given interest in neuro/mitochondria health.
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The findings of this study suggest that acarbose can reduce serum levels of TG and TC. However, no significant effects were observed on LDL or HDL levels.
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Thanks for the ping. Mitochondrial health seems indeed essential to neurological health. See from yesterday: Mitochondrial Transport Key to Neurological Health
I’m still taking acarbose from time to time whenever I have a big meal (most likely on social occasions). However, I’m unsure about its potential for neurodegenerative diseases, and I was (positively) surprised to see the Leigh article when it was published. I’m unsure because, contrary to GLP1RAs and SGLT2is that seem to be associated in longitudinal studies and RCTs with lower risks of depression (a pre-symptom of many NDDs), AD, and PD, acarbose (and other α-glucosidase inhibitors) seems to be “neutral” for these conditions:
- Diabetes, antidiabetic medications and risk of dementia: A systematic umbrella review and meta-analysis 2023: "DPP-4is, α-glucosidase inhibitors and insulin had a neutral effect on risk of dementia, while meglitinides and sulphonylureas were associated with increased risk.”
- Thiazolidinedione use and risk of Parkinson’s disease in patients with type 2 diabetes mellitus 2022
- The Effectiveness of Antidiabetic Drugs in Treating Dementia: A Peek into Pharmacological and Pharmacokinetic Properties 2022: “A nested case–control study by Wium-Andersen et al. found that acarbose was not associated with a lower OR for dementia [18]. A population-based cohort study, using Korean National Health Insurance claims data of new-onset type 2 diabetes patients between 2002 and 2013, found that acarbose monotherapy did not reduce the risk of dementia [48]. Moreover, a retrospective cohort study using the longitudinal reimbursement database of Taiwan’s National Health Insurance (NHI) found that α-glucosidase inhibitor use did not reduce the risk of dementia. The cohort included 15,524 matched pairs of ever- and never-users of acarbose from patients with new-onset type 2 diabetes patients between 1999 and 2006 [49]. These findings suggest that the glucose-lowering effect of antidiabetic drugs is insufficient to exert a beneficial effect on dementia.”
- Evaluation of Metformin on Cognitive Improvement in Patients With Non-dementia Vascular Cognitive Impairment and Abnormal Glucose Metabolism 2018: ”However, there was no obvious improvement in cognitive function in the acarbose-donepezil group.”
Also, most people with NDD have impaired olfactory neurons and acarbose does not seem to help with this whereas GLP1RAs do: Enhancement of Impaired Olfactory Neural Activation and Cognitive Capacity by Liraglutide, but Not Dapagliflozin or Acarbose, in Patients With Type 2 Diabetes: A 16-Week Randomized Parallel Comparative Study 2022
It worked in autonomic failure though so it could help to manage some symptoms of NDDs: Acarbose, an α-Glucosidase Inhibitor, Attenuates Postprandial Hypotension in Autonomic Failure 2007
One caveat to the above: acarbose is mostly used in Asia, so maybe the studies don’t have enough acarbose users in the West or maybe acarbose is more beneficial to Westerners than Asians. I don’t know.
Also, there are two exceptions that found potential neuro benefits:
- Association of cardiovascular disease management drugs with Lewy body dementia: a case–control study 2024: recent paper, great journal and authors but even there exenatide does better than acarbose for DLB, with a way better p-value. SGLTis were not included (too recent?), but I would hope empagliflozin would do even better than exenatide.
- Dementia Risk in Type 2 Diabetes Patients: Acarbose Use and Its Joint Effects with Metformin and Pioglitazone 2020: “In conclusion, reduced risk of dementia associated with acarbose is observed in the female sex and in non-users of metformin.” => It’s a good journal but a single author. I would discount it. (and I’m a male so less relevant for me anyway…)
Let’s see if the Leigh study triggers a renewed interest in acarbose for NDDs, but for now, I would rank it way lower than GLP1RA and SGLT2 for long-term neuroprotection (meaning, in practice, AD and PD).
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Have read the paper but it seems like the bold part is saying something like “reduced risk in women AND people on acarbose that are not on metformin”?
Btw, a big issue with any clinical trial is that they generally only last for a few years… while neurodegeneration and aging occur over decades - so I think they are ONE great way to help inform decisions, but you have to triangulate with other things too in a “Medicine 3.0” way when making decisions for aging (and probably neurodegeneration).
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Sorry, read too quickly, but again, I don’t attach much weight to that particular paper by one person when other people looking at the same database did not reproduce it. I also find it weird that:
Subgroup analyses showed that the reduced risk associated with acarbose was only observed in women (adjusted hazard ratio, 0.783; 95% confidence interval, 0.618-0.992) and in non-users of metformin (adjusted hazard ratio, 0.635; 95% confidence interval, 0.481-0.837). A model comparing different combinations of acarbose, metformin, and pioglitazone suggested that users of all three drugs had the lowest risk of dementia (hazard ratio, 0.406; 95% confidence interval, 0.178-0.925).
So acarbose protects from dementia when taken alone BUT does NOT protect when taken with metformin BUT protects A LOT when taken WITH metformin AND pioglitazone. 
I would expect acarbose + pioglitazone (without metformin) to work better than the combination of the 3.
And yes, RCTs are not enough for NDDs; that’s why I look at longitudinal data and animal studies (ofc, animal models suck for NDDs) to have some signals. And so far, the signal for acarbose for AD & PD is very weak at best. Whereas the same studies all show a very strong signal for GLP1RAs and SGLTis.
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In 2011, France and Germany banned pioglitazone due to a concomitant risk for bladder cancer.
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