Hmm…… Sadly does not appear as efficacious for women. “Ultimately, the resolution of these sex differences comes down to experimentation. “
“A promising and novel approach for identifying anti-aging therapeutics has been the repurposing of clinically approved and readily available drugs in mice. Canagliflozin, a clinically approved safe, and effective drug for type 2 diabetic patients, was recently shown to robustly retard age-related lesions in male mice but less so in female mice. While this type of sex disparity is often seen in the field of aging, it does represent a dilemma of not knowing the cause or how translationally relevant the sex differences would be in older humans treated with Canagliflozin.
Thoughtful and mechanistic investigations are needed to understand why these differences are present and whether they can be eliminated by new drugs.”
So my understanding is you do not take Acarbose and Jardiance at the same time due to the risk of low blood sugar. The only reason you use them both is so you can take breaks from Jardiance or from Acarbose.
What is the logic of taking breaks from either one? Which one is it you use most of the time? How long are your breaks?
My thinking has changed a little on this over the past year. I need to do more testing with my CGM and acarbose and SGLT2 inhibitor, to see how my blood sugar levels fluctuate with just one or both of them. Acarbose may have benefits outside of the blood glucose lowering, as might the SGLT2 inhibitors… that is what the current research seems to suggest now.
The logic of breaks (only from SGLT2 inhibitors) is that you are peeing out a lot of sugar with them, and with the increase in sugar (my pharmacist friend tells me) … bacteria love sugar, and so the more sugar in your urine, the more risk of UTIs. I’ve never had a UTI, and as male I think we get fewer anyway, but taking periodic breaks are going to help lower bacteria levels in your Urinary tract, at least thats part of my thinking. The other part of my rationale is that as a healthy person taking these drugs it seems reasonable to take breaks periodically just to help minimize risks associated with poly pharmacy (numerous drugs at the same time).
But its all a SWAG (scientific, wild ass guess). I have no data to back any of this up yet. I will continue to do blood glucose and blood testing to track my results over time. Nothing major to report yet.
@RapAdmin Dont forget about methylene blue. It accumulates in the bladder and is an antimicrobial. And it has nootropic benefits (helping brain and other mitochondria to function better).
Stem talk podcast with Dr. Francisco Gonzalez-Lima, a behavioral neuroscientist at The University of Texas at Austin.
I think I’m just going to take 25mg per day along with my acarbose and see how I go. I’m having trouble getting my lipids in order and as an APOE 4/4 carrier my heart is more at risk. My dad had a heart attack at 50 and I’m 42.
Unfortunately meds and diet are two of my main tools as I’m mostly sedentary due to a chronic pain issue (Trigeminal Neuralgia). My Lipids were very high due to two years of keto. I’ve been on a high fibre, low saturated fat, medi diet for the last two years and lipids have improved but still high end of normal.
At the moment, meds wise, I’m taking 6mg of Rapamycin a week and daily Acarbose, Finasteride, and Brillo EZ. Then I’m adding in small dose Rosuvastatin and Jardiance next month one by one in an effort to get my lipids down and other benefits I’ve read about. Hopefully I’ll see some improvement.
Some people have expressed concern about UTI risk with sglt2 inhibitors. I’ve had no issues, but if you are concerned about the risk, you may want to look into this new development:
The UTI vaccine, known as Uromune, was developed by Spain-based pharmaceutical company Immunotek, and contains whole bacteria of the four most common bugs that cause UTIs in men and women – Escherichia coli, Klebsiella pneumoniae, Proteus vulgaris and Enterococcus Faecalis.
It is licensed in Spain and although it is currently only available off-licence in Britain, experts are hoping it will soon be passed for use on the NHS. New results are expected to be passed to the Medicines and Healthcare Products Regulatory Agency (MHRA).
Another option for people who are concerned about UTIs with SGLT2 inhibitors:
D-mannose reduces age-triggered changes in urinary tract that increase susceptibility to UTIs | BCM
The researchers show in the journal Developmental Cell that, compared to the younger counterpart, the aging urinary tract in animal models changes how it functions at the cellular level in ways that seem to favor the establishment and recurrence of UTIs. Furthermore, the researchers also found that the sugar D-mannose reduces the severity of aging-associated decline in urinary tract functionality, suggesting that this common, over-the-counter supplement could improve this age-associated dysfunction and help reduce UTIs.
“We began this study by comparing the functions of naturally aging cells in mouse bladders with those of younger animals, in the absence of a bacterial infection. Specifically, we studied urothelial cells, the cells that line the inside of the bladder where urine is stored,” said corresponding author Dr. Indira Mysorekar, professor of medicine – infectious diseases and E.L. Wagner, M.D., Chair of Internal Medicine at Baylor.
Hi any information on whether this vaccine is coming to the US or can get it somehow? Seems like an excellent strategy to reduce the UTI risk of these sglt2 inhibitors.
From the wikipedia entry (all that I’ve seen on this so far):
Uromune first became available for clinical use in 2010[2] and was first described in the literature by 2012.[9] It was developed and marketed in Spain by Immunotek S.L.[1][10][9] Uromune has also been approved in Mexico and the Dominican Republic and is currently pending approval in Canada.[2][11][1]The vaccine is under development for use and is available via special-access programs in numerous other countries, including in many European countries, Australia, New Zealand, and Chile, among others.[1][2][11] Development and approval in the United States is expected to take longer than other countries.[6][11] Uromune is also under investigation for other uses besides prevention of uncomplicated recurrent UTIs in adults, as well as readministration following potential waning effectiveness.[2]
Until then, low dose methylene blue is know to deal with UTI as MB accumulates in the bladder. MB has many other benefits worth exploring. Check out Dr Gonzalez on The Drive and STEMtalk podcasts.
Methylene blue is pretty safe at any dose a person would normally do.
I only use 20 to 40 mg daily and that is enough to turn my urine to a distinctive aqua blue.
When I finish my toilet looks much like some of the toilet tank additives
"Overview
Methylene blue is generally considered safe when used at appropriate therapeutic doses. The typical prophylactic oral dose is around 200-300 mg per day, though higher doses up to 1000 mg/day have been used for short durations. Proper dosing, administration, and monitoring are important to minimize potential side effects.
Dosing
The standard oral dose for prophylaxis is 200-300 mg per day, taken in divided doses.
Doses up to 1000 mg/day have been used for 7-23 days for malaria prophylaxis.
The recommended intravenous dose is 0.5-2 mg/kg given slowly over several minutes.
Safety and Precautions Methylene blue is considered safe at doses less than 2 mg/kg. Higher doses may increase the risk of adverse effects.
It can cause a blue-green discoloration of the skin and urine at typical doses. This is harmless.
Rarely, it may cause serious side effects like serotonin syndrome, especially when combined with serotonergic drugs.
Use caution in patients with G6PD deficiency as it can precipitate hemolysis.
Monitoring
Monitor for side effects like chest pain, confusion, headache, dizziness, sweating, and gastrointestinal upset.
Check methemoglobin levels and clinical signs of methemoglobinemia if using for that
indication.
Kidney and liver function should also be periodically assessed.
Contraindications
Methylene blue is contraindicated in:
G6PD deficiency
Severe renal impairment
Hypersensitivity to methylene blue or thiazine dyes"
Gonzalez-lima answers dr Mercola that taking mb with ascorbic acid does not reduce its ability to be an elecron recycler, and facilitates the recycling
I’ve been taking MB with ascorbic acid. I cant say where I got the impression that this was increasing the absorption by a factor of 4.
Dr Sherr said he worried the vit c lowered the benefit. My pee has been blue with and without vit c but I stopped using vit c. I just use the dropper down the back of my throat.
I don’t see how taking acarbose with jardiance would at all increase the risk of hypoglycemia. Acarbose works exclusively in the gut, ie during digestion. It does not lower circulating blood glucose other than to blunt its increase if you ate carbs.
Acarbose would only impair recovery from jardiance-mediated hypoglycemia if you ate more complex carbs to counter it. But even then, you can take glucose pills which acarbose wouldn’t block.
I think neither Jardiance (or other flozins) nor Acarbose will cause hypoglycemia at the levels we are taking them at. I only experienced hypoglycemia by taking large doses of Metformin (1.5-2 g daily) and not eating between lunch and dinner. If I had a late afternoon snack, it wouldn’t be a problem either.
Interesting. I was waking up exhausted and light headed when I was taking Metformin and Acarbose together. Then the same thing happened when I tried 25mg of Jardiance and Acarbose. I don’t know what else to put that down to really. Therefore I only take Acarbose alone because it suits my diet well. I was thinking of trying a lower dose of Jardiance as I know it may have other heart benefits.
