Of mice and men and flatulence

    An introduction to acarbose.

    Steinbeck I am not, but please allow me to introduce you to an interesting compound called acarbose in a simple and jargon-free way. I promise the email subject line will make sense in a second.

    This compound is a prescription diabetes drug that’s pronounced “Uh - CARB - ose”. It’s commonly prescribed in a few countries, but not in the U.S.

    Now, why am I writing about this drug when Examine usually stays far away from pharmaceutical coverage?

    Well, I wanted to see if the occasional email on a prescription drug topic is interesting to you. Let me know by replying!

    We don’t have enough staff time or expertise to keep track of a ton of pharmaceutical studies like we do with supplements, but we could dip our toes into interesting pharmaceutical topics once in a rare while if our readers find the topic worthwhile.

    Acarbose has a notorious side effect

    Acarbose makes you fart because of the way it affects carb digestion.

    If you were to take acarbose with a meal, it would stop much of the starch and sucrose you eat from being digested into simple carbs.

    With fewer simple carbs (namely glucose) entering your bloodstream, your blood sugar is less likely to shoot up. And at least in the short term, you’d be very likely to fart a lot due to partially broken-down carbs migrating to your colon and being digested by gas-producing colonic bacteria.

    The incidence of these farts often decreases the longer you take acarbose, but it’s a good example of there being no free lunch with medications (or supplements). Nearly everything that provides benefits can also have detriments, at least in some people.

    But there’s another reason I’m writing about acarbose today. (I know … isn’t farting reason enough?) Some research suggests it may have interesting health benefits beyond its effects on blood sugar.

    Mice, men, and longevity

    Mouse experiments in the past few years have shown that acarbose increases mouse lifespan, which may partially be due to this drug mimicking some mechanisms of calorie restriction while simultaneously not depending on weight loss for its life extension effect.

    Interestingly, male mice experience this effect at a higher magnitude than female mice, at 22% versus 5% longer lifespans. Researchers hypothesized that the stark difference could be due to a variety of factors, including gonadal hormones in male mice and variance between testing sites during the experiment.

    There are actually several other drugs that are being actively investigated for life extension, including the mainstay diabetes treatment metformin. You’ll see these studies mentioned in the news at times, but take headlines with several grains of salt: mice, fruit flies, and the like are not humans, physiologically or environmentally.

    That doesn’t mean this research is worthless, though. We’ll get into the nitty-gritty of rodent research in a later email.

    Hold up, is acarbose like olestra?

    You might remember the infamous 1990s fat replacement called olestra. It was a fat substitute used in potato chips and other snacks.

    Acarbose and olestra fall into the broad category of compounds that either mimic food or block food digestion, with the goal of preventing overconsumption or mitigating its effects.

    Another interesting compound in this category is the prescription medication Gelesis100, which is an actual drug and not the name of a dystopian future world. Gelesis100 is sold under the name Plenity, and expands in the stomach to increase fullness.

    Now, back to olestra. It was a disaster, to put it mildly. Some people didn’t experience any side effects, while others had anywhere from mild tummy issues to explosive diarrhea. This problem was made worse by the difficulty people have with overeating potato chips. When each additional chip (or bag) makes the diarrhea more explosive, that’s a recipe for product failure.

    Acarbose is different in that its GI side effects seem to often improve at least a little bit over time, plus they often aren’t as severe to start with. Also, olestra was targeted at the mass market as a way to reduce calorie consumption, whereas acarbose is specifically for people with diabetes.

    Perhaps most importantly, acarbose might have interesting health benefits beyond its effect on blood sugar, whereas olestra did not.

    I hope you learned something new in this email. In future emails we’ll be getting more into longevity, animal trials, and potentially even dipping our toes into select prescription drug topics.


    Kamal Patel
    Co-founder, Examine