ARB's (ex: Telmisartan) + SGLT2 (ex: Empagliflozin/Jardiance) are god's gift to bodybuilders

[bbxtreme]

I was only moaning on another thread about downsizing and taking foot of the push pedal when getting past 40.

So this means I take 10mg of jardiance and that covers me for 2g of test? Got it

Joking. lol

That’s pretty much what everyone wants to hear when we start these threads. Lol

10mg of Jardiance= more test
2.5mg of Nebilivol= more HGH

Sad part is that many guys actually do think this way in this sport.

 

[Muay Thai]

I asked because I had never heard of potassium being an issue with telmisartan until one of the info collectors here brought it up. I've been on telmisartan since 2018, consume tons of potassium (I know this because I track it in MyFitnessPal), and I've never had an issue - nor have I heard of or seen anyone having an issue.

We have to stop fearmongering with things that could possibly happen to 1% of users because we're likely scaring away people who need to be taking this medicine.

oh how many diet bases i have designed to tally macros with that website lol

 

[nothuman]

I asked because I had never heard of potassium being an issue with telmisartan until one of the info collectors here brought it up. I've been on telmisartan since 2018, consume tons of potassium (I know this because I track it in MyFitnessPal), and I've never had an issue - nor have I heard of or seen anyone having an issue.

We have to stop fearmongering with things that could possibly happen to 1% of users because we're likely scaring away people who need to be taking this medicine.

THANK YOU

 

[nothuman]

I’m the middle ground regarding my stance on all this- I believe there is a time and place to use everything. I also believe if you use medications pre-maturely you eliminate options for when you “truly” need it down the road.

Yea there two schools of thought here. I lean more on the side of taking a small dose of "insert drug/supplement here" to prevent problems before they occur.

Of course, carefully monitoring labs and vitals are important in case someone needs to make any changes.

 

[Type-IIx]

No they're not. ARBs diminish hypertrophy and SGLT-2 inhibition is of less benefit than the incretin class (e.g., GLP-1, combined GIP, agonists) for bodybuilding outcomes (cutting, recomp, bulking), as pure GDAs, rather than insulin sensitizing agents.

 

[danieltx]

No they're not. ARBs diminish hypertrophy and SGLT-2 inhibition is of less benefit than the incretin class (e.g., GLP-1, combined GIP, agonists) for bodybuilding outcomes (cutting, recomp, bulking), as pure GDAs, rather than insulin sensitizing agents.

Does the diminishment of hypertrophy from ARBs have any statistical significance in a bodybuilder who's using multiple AAS, GH, etc.?

 

[bbxtreme]

No they're not. ARBs diminish hypertrophy and SGLT-2 inhibition is of less benefit than the incretin class (e.g., GLP-1, combined GIP, agonists) for bodybuilding outcomes (cutting, recomp, bulking), as pure GDAs, rather than insulin sensitizing agents.

Studies? Asking for personal curiosity.

 

[nothuman]

No they're not. ARBs diminish hypertrophy and SGLT-2 inhibition is of less benefit than the incretin class (e.g., GLP-1, combined GIP, agonists) for bodybuilding outcomes (cutting, recomp, bulking), as pure GDAs, rather than insulin sensitizing agents.

We are talking about health outcomes for bodybuilders. Not hypertrophy and fat loss

 

[aHarness]

I’m on Telmisartan and Nebivolol

Both can increase K+ levels

Not a big deal, just don’t overdue it on the K+

That said. Since Jardiance seems to have some sort of electrolyte activity at the level of the kidney…

Would this be additionally problematic (a 3rd med that will increase serum K+ levels) or does it antagonize this and thus, impart a welcomed “side effect”?

Thanks

Empagliflozin and serum potassium in heart failure: an analysis from EMPEROR-Pooled

Hyperkalaemia frequently leads to interruption and discontinuation of neurohormonal antagonists, which may worsen heart failure prognosis. Some studies suggested that sodium-glucose cotransporter 2 inhibitors reduce hyperkalaemia, an effect that may have important ...

www.ncbi.nlm.nih.gov

I'm always borderline or actually out of range on the low end for sodium so FOR ME, these are a definite no go even if I had no concerns as stated above.

…. Any reason you don’t just increase your sodium intake?

 

[aHarness]

SGLT-2 inhibition is of less benefit than the incretin class (e.g., GLP-1, combined GIP, agonists) for bodybuilding outcomes (cutting, recomp, bulking)

Maybe less beneficial, but if no drawbacks with all the health benefits what’s the issue?

 

[Type-IIx]

Maybe less beneficial, but if no drawbacks with all the health benefits what’s the issue?

We are talking about health outcomes for bodybuilders. Not hypertrophy and fat loss

There are risks to each of these drugs. I've written about them variously on this board.

ARBs:

1. Renal disease and failure
2. Hypotension, including risk of falls and coma, death
3. Diminished hypertrophy

Particularly when used "prophylatically," in those who do not have hypertension.

See:

https://www.professionalmuscle.com/forums/index.php?threads/bp-meds-possibly-linked-to-kidney-damage.170611/page-3#post-3125724

https://thinksteroids.com/community/threads/telmisartan-and-arbs-ace-inhibitors-are-not-a-preventive-cure-all-for-aas-users.134408554/

SGLT-2 inhibitors:

1. Renal failure
2. Hypotension, including risk of falls, coma, death
3. Hyperlipidemia (increased LDL)

Given the overlap of these particular severe side effects with not only one another (hazarding us to not combine them) & with not merely elevated, but indeed compounded risks for bodybuilders, I'd go ahead and say it's unwise to combine these "prophylactically" under any circumstance.

These drugs are used to treat medical conditions, disorders, diseases, pathologies. Not for (respectably & respectfully bro) jacked guys on social media to promote to healthy bodybuilders.

Interventions, when rational, are judged by a balancing of tradeoffs – to wit, Risks versus Rewards.

Risks are probabilistic, a function of probability * severity. To rationally consider the use of any PED (an intervention), one must be at least able to think in terms of expected value, a concept from probability & statistics. Until you apply expected value, at least roughly, using at least fuzzy logic, to a decision (that necessarily involves some tradeoff), your decisionmaking about using any drug is probably pretty terrible.

At the heart of the issue, often, as here, is that people – including notably, you, bro! – don't even understand the risks of what you are promulgating here as "God's gift to bodybuilders."

Note: What I am not saying: ARBs & ACE inhibitors aren't fantastic first-line treatments for hypertension (see links above), and/or that SGLT-2 inhibitors aren't useful for bodybuilders that are hyperglycemic. I've also written about SGLT-2 inhibitors with special reference to the continuum of rhGH adjuvants (moving along the continuum from least to most potent and from glucose disposal to increased IGF-I bioavailability). SGLT-2 inhibitors are discussed in Bolus: A Practical and Reference Guide for the Use of Recombinant hGH and GH Secretagogues [available soon], in the Practical section, that discussed protocols, adjuvant drugs, and principles, and use cases.

 

[Type-IIx]

Studies? Asking for personal curiosity.

I'm really glad you asked because it's a kick in my hole to finish the article I've been writing about this.

I hope you'll forgive me for holding these cards a bit close to my chest, since this is a novel topic for the bodybuilding community, and I intend to write about this topic for financial remuneration.

I'll merely leave you with the following "zoomed-out" view, and see how far you get with your own learning, since this is were I began to unravel this:

Genes & Polymorphisms:
* ID ACE (rs4646994)

ACE ID genotype and the muscle strength and size response to unilateral resistance training - PubMed

ACE ID genotype is associated with the contralateral effects of unilateral RT, perhaps more so than with the muscle strength and size adaptations that result from RT.

pubmed.ncbi.nlm.nih.gov

 

[aHarness]

SGLT-2 inhibitors:

1. Renal failure

Could you go into detail on this?

including notably, you, bro! – don't even understand the risks of what you are promulgating here as "God's gift to bodybuilders."

Uh… do you think I’m someone else?

I haven’t said for anyone to or to not take ARBs or SGLT2 inhibitors

Edit: I see you tagged someone else in reply too, so I assume you mean nothuman? Apologies.

 

[svenrpb]

I'm really glad you asked because it's a kick in my hole to finish the article I've been writing about this.

I hope you'll forgive me for holding these cards a bit close to my chest, since this is a novel topic for the bodybuilding community, and I intend to write about this topic for financial remuneration.

I'll merely leave you with the following "zoomed-out" view, and see how far you get with your own learning, since this is were I began to unravel this:

Genes & Polymorphisms:
* ID ACE (rs4646994)

ACE ID genotype and the muscle strength and size response to unilateral resistance training - PubMed

ACE ID genotype is associated with the contralateral effects of unilateral RT, perhaps more so than with the muscle strength and size adaptations that result from RT.

pubmed.ncbi.nlm.nih.gov

So when your BP isn´t above 120/80, you wouldn´t add telmisartan for the potential other benefits?

 

[nothuman]

There are risks to each of these drugs. I've written about them variously on this board.

ARBs:

1. Renal disease and failure
2. Hypotension, including risk of falls and coma, death
3. Diminished hypertrophy

Particularly when used "prophylatically," in those who do not have hypertension.

See:

https://www.professionalmuscle.com/forums/index.php?threads/bp-meds-possibly-linked-to-kidney-damage.170611/page-3#post-3125724

https://thinksteroids.com/community/threads/telmisartan-and-arbs-ace-inhibitors-are-not-a-preventive-cure-all-for-aas-users.134408554/

SGLT-2 inhibitors:

1. Renal failure
2. Hypotension, including risk of falls, coma, death
3. Hyperlipidemia (increased LDL)

Given the overlap of these particular severe side effects with not only one another (hazarding us to not combine them) & with not merely elevated, but indeed compounded risks for bodybuilders, I'd go ahead and say it's unwise to combine these "prophylactically" under any circumstance.

These drugs are used to treat medical conditions, disorders, diseases, pathologies. Not for (respectably & respectfully bro) jacked guys on social media to promote to healthy bodybuilders.

Interventions, when rational, are judged by a balancing of tradeoffs – to wit, Risks versus Rewards.

Risks are probabilistic, a function of probability * severity. To rationally consider the use of any PED (an intervention), one must be at least able to think in terms of expected value, a concept from probability & statistics. Until you apply expected value, at least roughly, using at least fuzzy logic, to a decision (that necessarily involves some tradeoff), your decisionmaking about using any drug is probably pretty terrible.

At the heart of the issue, often, as here, is that people – including notably, you, bro! – don't even understand the risks of what you are promulgating here as "God's gift to bodybuilders."

Note: What I am not saying: ARBs & ACE inhibitors aren't fantastic first-line treatments for hypertension (see links above), and/or that SGLT-2 inhibitors aren't useful for bodybuilders that are hyperglycemic. I've also written about SGLT-2 inhibitors with special reference to the continuum of rhGH adjuvants (moving along the continuum from least to most potent and from glucose disposal to increased IGF-I bioavailability). SGLT-2 inhibitors are discussed in Bolus: A Practical and Reference Guide for the Use of Recombinant hGH and GH Secretagogues [available soon], in the Practical section, that discussed protocols, adjuvant drugs, and principles, and use cases.

Telmisartan is good for kidneys

Conclusions: Telmisartan effectively and safely reduced blood pressure and brought about regression of proteinuria in diabetic and nondiabetic, hypertensive, proteinuric patients with chronic kidney disease, even in those with mild-to-moderate chronic renal failure.

Effect of telmisartan on blood pressure control and kidney function in hypertensive, proteinuric patients with chronic kidney disease - PubMed

Telmisartan effectively and safely reduced blood pressure and brought about regression of proteinuria in diabetic and nondiabetic, hypertensive, proteinuric patients with chronic kidney disease, even in those with mild-to-moderate chronic renal failure.

pubmed.ncbi.nlm.nih.gov

As far as hypotension goes, that’s very unlikely unless their blood pressure is low to begin with, and they could easily stop it if that happens. It’s usually not strong enough to make someone go into hypotension unless they’re using a high dose

 

[nothuman]

SGLT-2 inhibitors:

1. Renal failure
2. Hypotension, including risk of falls, coma, death
3. Hyperlipidemia (increased LDL)

Given the overlap of these particular severe side effects with not only one another (hazarding us to not combine them) & with not merely elevated, but indeed compounded risks for bodybuilders, I'd go ahead and say it's unwise to combine these "prophylactically" under any circumstance.

These drugs are used to treat medical conditions, disorders, diseases, pathologies. Not for (respectably & respectfully bro) jacked guys on social media to promote to healthy bodybuilders.

Interventions, when rational, are judged by a balancing of tradeoffs – to wit, Risks versus Rewards.

Risks are probabilistic, a function of probability * severity. To rationally consider the use of any PED (an intervention), one must be at least able to think in terms of expected value, a concept from probability & statistics. Until you apply expected value, at least roughly, using at least fuzzy logic, to a decision (that necessarily involves some tradeoff), your decisionmaking about using any drug is probably pretty terrible.

At the heart of the issue, often, as here, is that people – including notably, you, bro! – don't even understand the risks of what you are promulgating here as "God's gift to bodybuilders."

Note: What I am not saying: ARBs & ACE inhibitors aren't fantastic first-line treatments for hypertension (see links above), and/or that SGLT-2 inhibitors aren't useful for bodybuilders that are hyperglycemic. I've also written about SGLT-2 inhibitors with special reference to the continuum of rhGH adjuvants (moving along the continuum from least to most potent and from glucose disposal to increased IGF-I bioavailability). SGLT-2 inhibitors are discussed in Bolus: A Practical and Reference Guide for the Use of Recombinant hGH and GH Secretagogues [available soon], in the Practical section, that discussed protocols, adjuvant drugs, and principles, and use cases.

You could be doing harm here by saying SGLT2’s are bad for kidneys. There are people here who think of you as an authority figure but they will really hurt themselves if they’re concerned about their kidneys and they decide NOT to take Jardiance or another SGLT2. You would be doing a service to yourself and the bodybuilding community if you issued a correction. It would also show a sign of strength on your part for being humble enough to do so.

This is straight from the national kidney foundation’s web site

“SGLT2 inhibitors are effective at slowing the progression of kidney disease, reducing heart failure, and lowering the risk of kidney failure and death in people with CKD and type 2 diabetes. SGLT2 inhibitors also protect the kidneys in people with CKD who do not have diabetes”

Sodium-glucose cotransporter-2 (SGLT2) inhibitors

www.kidney.org

Renal Protection with SGLT2 Inhibitors: Effects in Acute and Chronic Kidney Disease

This review offers a critical narrative evaluation of emerging evidence that sodium-glucose co-transporter-2 (SGLT2) inhibitors exert nephroprotective effects in people with type 2 diabetes.The SGLT2 inhibitor class of glucose-lowering agents has recently ...

www.ncbi.nlm.nih.gov

As for hypotension and increased LDL: Again, rare side effects and very minor effects

 

[bbxtreme]

I'm really glad you asked because it's a kick in my hole to finish the article I've been writing about this.

I hope you'll forgive me for holding these cards a bit close to my chest, since this is a novel topic for the bodybuilding community, and I intend to write about this topic for financial remuneration.

I'll merely leave you with the following "zoomed-out" view, and see how far you get with your own learning, since this is were I began to unravel this:

Genes & Polymorphisms:
* ID ACE (rs4646994)

ACE ID genotype and the muscle strength and size response to unilateral resistance training - PubMed

ACE ID genotype is associated with the contralateral effects of unilateral RT, perhaps more so than with the muscle strength and size adaptations that result from RT.

pubmed.ncbi.nlm.nih.gov

I’m curious to see how you connect the dots to show an ARB decreases hypertrophy. After this I have an idea of where you’re going with the argument.

However, the basis for that would be a second hand hypothesis or a theory unless there is a direct study showing this, which there is not to my knowledge. The opposite actually as it was directly tested in elderly patients and found to have no benefit one way or another.

Source:

Effect of Angiotensin System Inhibitors on Physical Performance in Older People – A Systematic Review and Meta-Analysis

Preclinical and observational data suggest that angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) may be able to improve physical performance in older people via direct and indirect effects on skeletal muscle. We ...

www.ncbi.nlm.nih.gov

Even if there as a direct impact on hypertrophy from using an ARB, the data on the pro’s would out weigh the con’s. I.e. if there was a 2% decrease in hypertrophy would you ever see or notice it? No. But would you have a healthier bodybuilder resulting in more muscle mass overall given all the benefits? Absolutely.

I could on and I respect your dedication to research, but the last thing we want to be doing in bodybuilding is steering people away from beneficial medications who need them due to second or third hand hypotheses.

Better said- if you’re coaching a national level competitor who’s maxing out their weight, gear, etc. Surely you would not forgo the use of an ARB over this.

Just my opinion and thoughts on it all as sometimes we can lose ourselves in the research and forget real life application.

 

[bbxtreme]

I’m curious to see how you connect the dots to show an ARB decreases hypertrophy. After this I have an idea of where you’re going with the argument.

However, the basis for that would be a second hand hypothesis or a theory unless there is a direct study showing this, which there is not to my knowledge. The opposite actually as it was directly tested in elderly patients and found to have no benefit one way or another.

Source:

Effect of Angiotensin System Inhibitors on Physical Performance in Older People – A Systematic Review and Meta-Analysis

Preclinical and observational data suggest that angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) may be able to improve physical performance in older people via direct and indirect effects on skeletal muscle. We ...

www.ncbi.nlm.nih.gov

Even if there as a direct impact on hypertrophy from using an ARB, the data on the pro’s would out weigh the con’s. I.e. if there was a 2% decrease in hypertrophy would you ever see or notice it? No. But would you have a healthier bodybuilder resulting in more muscle mass overall given all the benefits? Absolutely.

I could on and I respect your dedication to research, but the last thing we want to be doing in bodybuilding is steering people away from beneficial medications who need them due to second or third hand hypotheses.

Better said- if you’re coaching a national level competitor who’s maxing out their weight, gear, etc. Surely you would not forgo the use of an ARB over this.

Just my opinion and thoughts on it all as sometimes we can lose ourselves in the research and forget real life application.

A few more for you:

Conclusions​

The use of ARBs is associated with a reduction in frailty and age-related loss of muscle mass and strength.

https://onlinelibrary.wiley.com/doi/full/10.1002/rco2.31#:~:text=Conclusions,of%20muscle%20mass%20and%20strength.

“Losartan, a blood pressure (BP) lowering angiotensin II (AngII) receptor type 1 (ATR1) blocker (ARB) with unique anti-transforming growth factor-β (TGF-β) properties, can protect muscles in various types of MD such as Duchenne MD, suggesting a potential benefit for LGMD2B patients.”

Angiotensin II receptor blocker losartan exacerbates muscle damage and exhibits weak blood pressure-lowering activity in a dysferlin-null model of Limb-Girdle muscular dystrophy type 2B - PubMed

There is no cure or beneficial management option for Limb-Girdle muscular dystrophy (MD) type 2B (LGMD2B). Losartan, a blood pressure (BP) lowering angiotensin II (AngII) receptor type 1 (ATR1) blocker (ARB) with unique anti-transforming growth factor-β (TGF-β) properties, can protect muscles in...

pubmed.ncbi.nlm.nih.gov

 

[Golden]

You could be doing harm here by saying SGLT2’s are bad for kidneys. There are people here who think of you as an authority figure but they will really hurt themselves if they’re concerned about their kidneys and they decide NOT to take Jardiance or another SGLT2. You would be doing a service to yourself and the bodybuilding community if you issued a correction. It would also show a sign of strength on your part for being humble enough to do so.

This is straight from the national kidney foundation’s web site

“SGLT2 inhibitors are effective at slowing the progression of kidney disease, reducing heart failure, and lowering the risk of kidney failure and death in people with CKD and type 2 diabetes. SGLT2 inhibitors also protect the kidneys in people with CKD who do not have diabetes”

Sodium-glucose cotransporter-2 (SGLT2) inhibitors

www.kidney.org

Renal Protection with SGLT2 Inhibitors: Effects in Acute and Chronic Kidney Disease

This review offers a critical narrative evaluation of emerging evidence that sodium-glucose co-transporter-2 (SGLT2) inhibitors exert nephroprotective effects in people with type 2 diabetes.The SGLT2 inhibitor class of glucose-lowering agents has recently ...

www.ncbi.nlm.nih.gov

As for hypotension and increased LDL: Again, rare side effects and very minor effects

My friend is taking an ace inhibitor, beta blocker and SGLT2 inhibitor for issues with his heart. I know they monitor his blood work for issues with kidneys but he’s been on over a year and said his kidney values haven’t moved over that period.

 

[nothuman]

My friend is taking an ace inhibitor, beta blocker and SGLT2 inhibitor for issues with his heart. I know they monitor his blood work for issues with kidneys but he’s been on over a year and said his kidney values haven’t moved over that period.

I’m not sure what he’s using to determine that. Is he getting a Cystatin C?

In any case, not moving is better than getting worse. Who’s to say it wouldn’t have been worse had he not done that?