No - I had no urinary tract issues at all - even at 300mg / day for 3 months. But I did have some fatigue issues with canagliflozin which led me to abandon it. Now I’m taking 10mg empagliflozin and it seems to be going well, but I’m taking it slowly (not ramping up to higher doses yet - I’ve been taking it for almost a month now).
Okay, thanks! It’d be nice to some day see cgm based comparisons between the two. Good to hear that you aren’t experiencing fatigue with empagliflozin. Also I wonder if a smaller dose of acarbose along with a smaller dose of sglt-2 inhibitors would be the way to go, to reduce side effects from either.
Ah - good idea. I will post some CGM results from my empagliflozin experience. I use the CGM intermittently. I use acarbose as a periodic assistant in situations where I’m having a more carb/starch heavy meal later in the day. But the side effects of acarbose are - at least for me - pretty bad, so I don’t use it that much. Ultimately - these drugs may have different results with different people - so the best thing to do is to try things out for a while and see how your body responds, and work with your doctor and get blood work/cgm/blood glucose readings - to see how its working.
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Odd no mention or comparison with 500 mg x 2x of Metformin? comparison of side effects?
Does cana act as a intestinal gut flora antibiotic, Metformins original experimental intent. I’ve stopped metformin due to gut flora effects, and its blocking of nutrient absorbtion including the B’s / b-12.
Another re purposed drug would be useful for the similar anti aging effects.
Dr Kaufmann’s protocol includes metformin; Dosage — kaufmannprotocol.com
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Curt,
I took metformin for about 6 or 8 months, two years ago. No side effects. But I saw the research coming out on its impact on metformin impairing training / exercise - related improvements, so I phased off it.
I’ve not seen any research to suggest Cana acts as an antibiotic.
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Does Canagliflozin reduce glucose more at higher levels of glucose or at lower levels of glucose (aka fasting levels)?
It doesn’t reduce glucose levels. It blocks absorption of the sugars you are eating. If you are on a low carb diet/ keto diet or fasting, it won’t lower your blood glucose levels further (which is good - you don’t need to worry about hypoglycemia). But why bother even taking if if you aren’t eating carbs?
INVOKANA® works with your kidneys to stop some excess sugar from being absorbed back into your body, and to help you lose approximately 100 grams of sugar a day through the process of urination.
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Hm, so does it only work when your glucose is above a certain threshold, like 170? (170 is when glucose starts spilling into the urine).
No - it prevents the rise / absorption of the glucose in your blood. When I’m on it my blood glucose levels stay under 110 all day typically…
You do pee a lot more than normal.
Ugh, I need this. Fuck indiamart for scamming me, fuck it.
So just to be clear, the way these drugs work is that you still fully absorb the glucose you eat/drink, but then it gets excreted through the kidneys (and out via the urine) before it can be deposited as fat or do too much damage to the blood vessels/tissues/organs. If it prevented sugar absorption from the intestine, it would cause diarrhea like acarbose. The fact that the glucose is excreted through the urine also explains why you have to urinate more often – the glucose binds water and drags out water with it (osmotic diuresis), so these drugs are often called “smart diuretics” because they help eliminate excess water from the body without a dramatic disruption in electrolytes.
As RapAdmin said, if you’re truly on a low carb diet and always stick w/it and if you aren’t insulin resistant (how many overweight/obese people do we know who say they’re doing “low carb?” A lot, in my experience), then an SGLT2 inhibitor may not be doing much unless the health benefits go above and beyond glucose disposal/diuresis, which is possible.
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So it’s kind of like acarbose, except acarbose blunts the increase (and doesn’t work for many foods, like a lot of fruit) - in that it can work like an emergency glucose-lowering pill.
I’m mostly keto but take 25mg daily of empagliflozin. There’s evidence it has benefits beyond glucose, including mitochondrial biogenesis.
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So, have you ever had an UTI for to empagliflozin? Perhaps it’s not an issue of one’s on keto.
I’ve taken canagliflozin and empagliflozin for most of the past year with no UTI issues. I think it may only be an increased risk for women, not men.
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No UTI despite taking it for a year now. About 6 months at 10mg and now 6 months at 25mg.
I drink a lot of water and my only source of sugar is fruit. My last labs I did have borderline glucosuria–which makes sense given that I’m peeing out the sugars that I do take in. But my urine glucose was just a hair over normal. I can imagine if you’re eating lots of carbs, that would be significantly higher, which in turn would increase your risk of UTI.
I also take acarbose any time I eat fruit (though I’m never quite sure how effective it is against fruit–I think it helps vs sucrose but not fructose, and fruits are a combo) as well as mullberry extract.
Despite being “keto plus fruit” I was pushing into prediabetes pretty hard before I started this, and it has dramatically reduced my fasting blood glucose (from around 5.8 to 4.7) and my HBA1C (to a less dramatic extent).
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I have been using luteolin (a fructokinase inhibitor) before when I take fructose. You may want to look at this. However I have no idea about the optimal dosage or desired timing before consumption of fruit.
I just do 100-200 mg and hope it provides some benefits.
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Rick Johnson and David Perlmutter’s views on Fructose and Uric acid make me wary of fruits. When I consume fruits, it’s usually lower GI (like berries) and also comes with a lot of polyphenols (like berries).
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