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Experience with GLP-1, metformin, and Jardiance; and PMR
This is based on my personal experience with GLP-1, metformin, and Jardiance; take from it what you find helpful.
In 2021, I was significantly obese and prescribed GLP-1, metformin, and Jardiance. Over the next few years, I lost a substantial amount of weight and greatly improved my health through a combination of diet and exercise. Dropping back to 2008, I was diagnosed with Polymyalgia Rheumatica: first prednisone, then weekly injections of methotrexate.
With the weight loss in 2021 and the use of medications, the process of improving my PMR was gradual, and I was able to manage taking methotrexate at longer intervals. Eventually, my PMR symptoms lessened, and methotrexate was discontinued.
In 2025, I temporarily stopped taking Jardiance due to a misplaced bottle while packing for a half-marathon trip. I was otherwise stable and assumed that missing Jardiance wouldn't cause any issues. Within days, my PMR symptoms gradually returned and worsened. After 6 weeks, the pain became intense at times, and I eventually found the misplaced bottle of Jardiance. When I resumed Jardiance, the symptoms dramatically decreased and soon vanished. I considered getting the sedimentation rate (ESR) and C-reactive protein (CRP) blood tests; it would have been great for the data.
To experiment, I discontinued Jardiance to see what would happen. As before, the PMR symptoms became noticeable. I restarted Jardiance, and within a few days, all the inflammation disappeared.
I asked whether Jardiance could be affecting the body's inflammation, in addition to GLP-1 and metformin.
I proposed the story to various Chat AIs, and there's no definite answer, just a lot of maybes regarding the drug combinations.
My care team received the same story.
Ferris Watson
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This is an interesting observation about Jardiance
The effect of sodium-glucose co-transporter-2 (SGLT2) inhibitors on blood interleukin-6 concentration:
Conclusion
IL-6 levels are significantly reduced with the use of SGLT2 inhibitors
https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-023-01512-1
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IL-6 is the cytokine implicated in PMR
https://www.pmrandil6.com/il-6-and-pmr/
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2 ReactionsI'm intrigued by this and I will ask my endocrincrinologist about it. I'm past the PMR treated with Prednisone phase after 12 years of continuous Prednisone use. I have been off prednisone for more than 4 years. My endocrinolgist is currently treating me for metabolic syndrome as a complication from my long term Prednisone use. I'm not diabetic but my endocrinologist started me on metformin. He said I should have been on metformin the entire time I was taking Prednisone. Metformin has since been stopped in favor semaglutide (Wegovy)
Metabolic syndrome interests me now since an IL-6 inhibitor called Actemra enabled me to taper off Prednisone. PMR is controlled by Actemra but now I'm dealing with the long term side effects from Prednisone. I have learned that long term Prednisone use results in long term metabolic side effects.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9772659/
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2 ReactionsMike, you have taken on a challenge, having to deal with the "long-term Prednisone use results in long-term metabolic side effects."While researching GLP-1, metformin, Jardiance, and PMR, I asked eight free Chat AIs the same questions and compiled the information into a Google program called NotebookLM. Taking your quote, "long-term Prednisone use results in long-term metabolic side effects." I ask Gemini to create a prompt to ask NotebookLM.
I've attached two PDF files: one with your quote and one with the audio summary in text format, which provides the necessary information.
Summary from the NotebookLM Audio
This audio segment delves into a compelling personal account of Jardiance, a diabetes drug, and its unexpected positive impact on a listener's Polymyalgia Rheumatica (PMR) symptoms. The core of the discussion revolves around an "N of one experiment," highlighting how this individual observation suggests a potential repurposing of Jardiance as a drug, extending its utility beyond its typical indications. The conversation also explores the emerging field of immunometabolism, explaining how drugs like Jardiance, Metformin, and GLP-1 agonists influence the intricate relationship between the immune system and the body's metabolism, potentially offering a steroid-sparing approach to managing inflammatory conditions like PMR while emphasizing the synergistic role of lifestyle changes."
Mike, keep in mind that this is from AI, and AI chats tend to present their best side with a polished, well-worded touch.
I made this audio shareable, so it should work
The audio file is 20 minutes long.
https://notebooklm.google.com/notebook/39be6ca8-52be-46c5-99a3-3a00327077b1/audio
audio segment delves into a compelling personal account of Jardiance, a diabetes drug, and its unexpected positive impact on a listener's Polymyalgia Rheumatica (PMR) symptoms (audio-segment-delves-into-a-compelling-personal-account-of-Jardiance-a-diabetes-drug-and-its-unexpected-positive-impact-on-a-listeners-Polymyalgia-Rheumatica-PMR-symptoms.-.pdf)
_metabolic syndrome and a history of long-term Prednisone (metabolic-syndrome-and-a-history-of-long-term-Prednisone-.pdf)
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