tankasnowgod
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I've been more interested in the relationship between CO2, Carbonic Anhydrase, and weight recently. I have been wondering if there was any relationship between the use of Acetazolamide/Diamox and Weight Loss. Didn't see too much either in testimonials or in studies, so this recent published case report is interesting-
Acetazolamide promotes decreased consumption of carbonated drinks and weight loss
"An otherwise healthy 48-year-old Caucasian man with long-standing obesity presented to the clinic with complaints of inability to lose weight, despite regular exercise and attempts at dieting, and with a self-reported addiction to carbonated, sugar-sweetened drinks. He indicated drinking ~6–8 non-diet carbonated beverages daily, often with other snacks (i.e. chips and cookies) while at work. Carbonated drinks represented an estimated 32–42% percentage of his daily caloric intake (average of 2613 kcal/day) to sustain 101.4 kg of body weight and body mass index (BMI) of 31.47 kg/m2 (Table 1 and Fig. 2). The patient reported several unsuccessful attempts at decreasing his carbonated drink consumption. At this initial visit, his physical exam was notable for obesity, and chemistry/metabolic and other laboratory testing were otherwise unremarkable (Table 1). Given the large contribution of carbonated drinks to his daily caloric intake, the patient was given a low dose of acetazolamide (125 mg orally daily, off-label use) in an attempt to discourage the consumption of carbonated drinks throughout the day."
The results were very promising after six weeks of follow up-
"On follow-up at 6 weeks after onset of daily acetazolamide administration, the patient exhibited a 4.4 kg weight loss, with a total body weight of 97 kg and BMI of 30.14 kg/m2 (Fig. 2). The patient reported good adherence to acetazolamide treatment, missing ~1–2 doses/week. Furthermore, the patient’s observed weight loss is in agreement with the estimated weight loss of 4.5–6 kg (at an estimated rate of 0.75–1 kg/week), given the reported daily calorie deficit of 828–1104 kcal due to eliminated intake of carbonated drinks. Upon taking acetazolamide, the patient reported that carbonated drinks had a ‘flat’ taste, making it easier for him to avoid their consumption. However, the craving for carbonated drinks was not affected, with occasional consumption of carbonated drinks (1–2 times/week), in spite of the perceived change in taste. The patient denied altered taste of any other food or drink consumed, and overall good tolerance and satisfaction with acetazolamide at this dose. During the treatment period, the patient continued his usual physical activity with regular exercise 1–3 times/week, and made no other modifications to his diet in an attempt to promote further weight loss. However, the patient reported decreased appetite (a documented side effect of acetazolamide) [16] and reduced consumption of some of the snacks that often accompanied his routine consumption of carbonated drinks. The patient reported that the snacks were not as appealing when taken without the carbonated drinks."
While the weight loss seems to be in line with estimated reduced caloric intake, I wonder if there is something else going on here. Diamox is a diuretic, so some of the weight loss might be from excess water. The high number of carbonated drinks the subject was drinking may have been more a craving for CO2 than carbs, calories or sugars, as the acetazolamide seems to reduce intake dramatically, down to occasional consumption of one or two a week.
The intro also mentions that consumption zero calorie carbonated beverages are also associated with weight gain. It's possible that high soda consumption (regular or diet) is simply a marker for low CO2 or high CA, and people are self medicating with whatever is most available to them.
Lastly, the dose was well tolerated-
"The patient denied the occurrence of adverse events that have been associated with acetazolamide administration, such as flushing, ataxia, confusion, seizures, depression, dizziness, drowsiness, flaccid paralysis, headache, paresthesias, visual or auditory disturbances, anaphylaxis, rashes or other skin lesions, diarrhea, melena, nausea, vomiting, hematuria, polyuria, fatigue, malaise, or fever [16]. On laboratory analyses 6 weeks after initiation of acetazolamide therapy, the patient did not exhibit any alterations in his electrolyte and acid–base status, and had normal serum levels of hepatic enzymes and renal function markers (Table 1) [16].
Lastly, the report notes that another patient that started similar therapy is also having good results.
Acetazolamide promotes decreased consumption of carbonated drinks and weight loss
"An otherwise healthy 48-year-old Caucasian man with long-standing obesity presented to the clinic with complaints of inability to lose weight, despite regular exercise and attempts at dieting, and with a self-reported addiction to carbonated, sugar-sweetened drinks. He indicated drinking ~6–8 non-diet carbonated beverages daily, often with other snacks (i.e. chips and cookies) while at work. Carbonated drinks represented an estimated 32–42% percentage of his daily caloric intake (average of 2613 kcal/day) to sustain 101.4 kg of body weight and body mass index (BMI) of 31.47 kg/m2 (Table 1 and Fig. 2). The patient reported several unsuccessful attempts at decreasing his carbonated drink consumption. At this initial visit, his physical exam was notable for obesity, and chemistry/metabolic and other laboratory testing were otherwise unremarkable (Table 1). Given the large contribution of carbonated drinks to his daily caloric intake, the patient was given a low dose of acetazolamide (125 mg orally daily, off-label use) in an attempt to discourage the consumption of carbonated drinks throughout the day."
The results were very promising after six weeks of follow up-
"On follow-up at 6 weeks after onset of daily acetazolamide administration, the patient exhibited a 4.4 kg weight loss, with a total body weight of 97 kg and BMI of 30.14 kg/m2 (Fig. 2). The patient reported good adherence to acetazolamide treatment, missing ~1–2 doses/week. Furthermore, the patient’s observed weight loss is in agreement with the estimated weight loss of 4.5–6 kg (at an estimated rate of 0.75–1 kg/week), given the reported daily calorie deficit of 828–1104 kcal due to eliminated intake of carbonated drinks. Upon taking acetazolamide, the patient reported that carbonated drinks had a ‘flat’ taste, making it easier for him to avoid their consumption. However, the craving for carbonated drinks was not affected, with occasional consumption of carbonated drinks (1–2 times/week), in spite of the perceived change in taste. The patient denied altered taste of any other food or drink consumed, and overall good tolerance and satisfaction with acetazolamide at this dose. During the treatment period, the patient continued his usual physical activity with regular exercise 1–3 times/week, and made no other modifications to his diet in an attempt to promote further weight loss. However, the patient reported decreased appetite (a documented side effect of acetazolamide) [16] and reduced consumption of some of the snacks that often accompanied his routine consumption of carbonated drinks. The patient reported that the snacks were not as appealing when taken without the carbonated drinks."
While the weight loss seems to be in line with estimated reduced caloric intake, I wonder if there is something else going on here. Diamox is a diuretic, so some of the weight loss might be from excess water. The high number of carbonated drinks the subject was drinking may have been more a craving for CO2 than carbs, calories or sugars, as the acetazolamide seems to reduce intake dramatically, down to occasional consumption of one or two a week.
The intro also mentions that consumption zero calorie carbonated beverages are also associated with weight gain. It's possible that high soda consumption (regular or diet) is simply a marker for low CO2 or high CA, and people are self medicating with whatever is most available to them.
Lastly, the dose was well tolerated-
"The patient denied the occurrence of adverse events that have been associated with acetazolamide administration, such as flushing, ataxia, confusion, seizures, depression, dizziness, drowsiness, flaccid paralysis, headache, paresthesias, visual or auditory disturbances, anaphylaxis, rashes or other skin lesions, diarrhea, melena, nausea, vomiting, hematuria, polyuria, fatigue, malaise, or fever [16]. On laboratory analyses 6 weeks after initiation of acetazolamide therapy, the patient did not exhibit any alterations in his electrolyte and acid–base status, and had normal serum levels of hepatic enzymes and renal function markers (Table 1) [16].
Lastly, the report notes that another patient that started similar therapy is also having good results.
