Does anyone here take SGLT2 inhibitors (empagliflozin, dapagliflozin, etc.)?
Have you noticed any impact on performance or progression?
The reason I ask is that, based on some papers, they may put one into a state of mild ketosis. And the keto diet doesn’t seem to work as well as high-carb nutrition for performance, as I understand (with certain caveats, of course).
Also, do you do anything special to minimize the risk of negative impact? For example, take it a few hours after training and never before training?
To clarify: The medication in question was prescribed by my doctor for a health condition. Unfortunately, my doctor couldn’t provide insights on how it may impact training and progression, and there are no studies on trained/healthy individuals. Hence, I’m seeking advice here to consider this factor. Even anecdotes would be helpful.
The “ketosis” associated with SGLT2i is different from dietary ketosis: a rare but dangerous adverse effect of SGLT2i is (often euglycemic) diabetic ketoacidosis, which is caused by dumping glucose in the urine and associated osmotic diuresis. This results in a glucagon/insulin imbalance, leading to ketogenesis, and you end up in a nasty cycle. The good news is this can be abated by simply eating carbs. Triggers for EDKA include infection > insulin noncompliance > pancreatitis ~ surgery.
Now, SGLT2i are used for many, many indications. EDKA will almost only happen if you have diabetes. It’s also quite rare. This class of medications is a total game changer and if you have an indication to take it, you definitely should (I am admittedly SGLT2i-curious as a longevity drug).
Yes, that’s my understanding of the literature as well. I’m not overly concerned about about DKI as the prescription is for a condition other than diabetes. And yes, potential longevity benefits seem interesting.
But I do worry about training. There is little data on whether the impact would be positive/neutral/negative, so I’m interested in stories of people who take training seriously but also take SGLT2 inhibitors for health reasons.
For example, here is just one question if I wonder about: if glucose is lost in urine, would this make maintaining high muscle glycogen stores harder? If so, would this negatively impact one’s high-intensity workouts and long-term progress?