Acarbose

Competitive inhibitor of alpha-glucosidase enzymes in the brush border of the small intestine. Delays carbohydrate digestion and glucose absorption, flattening postprandial glucose spikes without affecting fasting glucose or insulin secretion. Undigested carbohydrates pass to the colon where fermentation produces short-chain fatty acids, potentially providing additional metabolic and microbiome benefits.

Half-life

2 hours

Bioavailability

1-2% (oral, acts locally in gut lumen)

Route

oral

Evidence tier

T1 — Multiple RCTs

Optimization pillars

cellular-health · anti-aging

References

3 peer-reviewed

Dose ranges

Three tiers ordered by aggressiveness. Tier chips on every OPTIMIZE intervention let you filter the catalog by your evidence tolerance.

conservative

25 mg with meals

Postprandial glucose control

moderate

50 mg with meals

Standard dosing

aggressive

100 mg with meals

Maximum per-meal dose

Monitoring

fasting-glucose
hba1c
fasting-insulin
alt
ast

Contraindications

inflammatory-bowel-disease
intestinal-obstruction
hepatic-cirrhosis
chronic-malabsorption

References

PMID:24245150Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial — JAMA, 2003
PMID:24247220Acarbose improves healthy aging and protects from metabolic syndrome in mice — Aging Cell, 2014
PMID:26582579Acarbose, 17-alpha-estradiol, and nordihydroguaiaretic acid extend mouse lifespan preferentially in males — Aging Cell, 2016

Notes

Acarbose is the longevity compound that works by doing almost nothing systemically. Less than 2% bioavailability. It sits in your gut lumen and slows down carbohydrate digestion. That is the entire mechanism. And yet the ITP mouse data shows significant male lifespan extension, and the STOP-NIDDM trial demonstrated cardiovascular risk reduction in humans. The insight is that postprandial glucose excursions are not benign metabolic noise. They are repeated glycation events, oxidative stress pulses, and insulin spikes that compound over decades. Acarbose flattens the curve. The GI side effects — gas, bloating — are the undigested carbohydrates reaching your colon. They diminish with dose titration and dietary adjustment. Start at 25mg per meal. Let your microbiome adapt.

This is not medical advice

Discuss with a licensed clinician before starting, stopping, or changing any compound. This page documents what the research literature describes — it is not a prescription.

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