Canagliflozin vs Spermidine

Mechanism

SGLT2 inhibitor originally developed for type 2 diabetes. Blocks glucose reabsorption in kidneys, creating a mild glucose deficit that activates AMPK and mimics caloric restriction. Extended lifespan in male mice in the ITP.

Contraindications

• Type 1 diabetes (DKA risk)
• Severe renal impairment (eGFR <30)
• History of recurrent UTIs

Mechanism

Spermidine is an endogenous polyamine that induces autophagy primarily through inhibition of the acetyltransferase EP300 (p300), leading to hypoacetylation of multiple autophagy-related proteins and subsequent activation of the core autophagy machinery (Atg5, Atg7, Beclin-1). It promotes mitophagy (selective clearance of damaged mitochondria) and is essential for the hypusination of eukaryotic translation initiation factor 5A (eIF5A), a post-translational modification critical for TFEB-mediated lysosomal biogenesis. Spermidine also reduces age-related inflammation by suppressing NF-kB signaling and promotes cardiovascular health through improved endothelial nitric oxide bioavailability.

Standard Dosing

Research indicates 1-6 mg/day orally for longevity and autophagy support. Epidemiological data associates >80 micromol/day dietary spermidine intake with reduced cardiovascular mortality.

Timing

Morning with or without food. Some protocols suggest taking before a fasting period to potentiate autophagy (fasting naturally increases endogenous spermidine synthesis).

Cycle Duration

Ongoing. Endogenous spermidine levels decline with aging, suggesting lifelong supplementation may be beneficial.

Side Effects

• Generally very well-tolerated
• Mild GI discomfort at higher doses
• Headache (rare)

Contraindications

• Known hypersensitivity to polyamines
• Pregnancy and breastfeeding (insufficient safety data at supplemental doses)
• Active malignancy (polyamines promote cell proliferation in rapidly dividing cells — debated)
• Wheat allergy (if from wheat germ source)

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