Connection between metabolic dysfunction and brain disorders
Can you discuss the current scientific state of the discussion regarding connection between metabolic dysfunction and diseases like Alzhiemer's, ADHD, etc? Chris Palmer has a recent book on the subject, but I imagine the field is changing quickly and new materials and understanding must be coming online.
Effect of GLP1 agonists combined with anabolic agents to prevent muscle loss
Background: There have been some promising results from the combination of semaglutide and bimagrumab in phase 2 trials, which showed that this combination reduced fat mass while keeping or even slightly increasing lean mass. (Since Versanis got bought by EL I assume the next set of trials will use tirzepatide or something else from their stable.) Bimagrumab seems to stimulate anabolism or at least prevent catabolism of muscle tissue along a very different axis than other anabolic agents, but could you get a similar effect with other combinations? My question: Do you have any data or thoughts about combining a GLP1 RA with TRT (in men) or low dose T/SARM/??? in women to go along with the baseline of weight training and enough protein intake.
Prediabetes and 1. Metformin 2. Inositol 3. Nocturnal hypoglycemia 4. Realistic targets
Hi, I am a 43 year old woman and just found I have prediabetes as seen with a CGM. (My A1C is still showing as below prediabetic.) I am at a healthy weight, already rarely eat simple carbs and limit carbs altogether, and exercise regularly. My parents both have Type 2 DM and 23andMe tells me I am at high risk for DM as well. Several questions: 1. Metformin: Should I start taking metformin? Or what would be the indications to take it or not? 2. I had a nutritionist recommend an Inositol supplement to help with glycemic regulation. Do you have opinions on that? 3. I have been having episodes of nocturnal hypoglycemia (e.g. 30-40 mins with a reading of 53), which have been accompanied by night sweats (now I know why I get those!). How should I think about that? Will improving my metabolic health generally help with those too? Is it something to worry about? 4. I know you said you try to have your patients never spike above 140. As an example, I spike to 175 with a cup of cottage cheese and 100g of blueberries. Should I cut the blueberries? Or exercise a lot more? Or always take a walk after eating? Is it a realistic goal for me to have no more glucose spikes above 140, especially without medication? Thanks so much!
using CGM readings to pinpoint zone 2 from zone 3
I understand that body movement facilitates getting blood glucose to the muscles and thereby lowers glucose levels in the blood stream as recorded by CGMs. I've also experienced work-outs that increase glucose levels in the blood. So, at some point, the body switches from escorting blood glucose into muscles, to adding more glucose into the blood stream; and this is recorded in CGM readings that show an initial lowering of blood glucose and then an increase in blood glucose. I'm assuming this correlates with increased workout intensity stress and am curious about the moment when the body decides to switch and increases blood glucose during a workout. Can I use my live CGM readings (in addition to my heart rate monitor) to pinpoint when my body transitions from zone 2 to zone 3 by correlating it with the moment my blood glucose levels begin to rise?