8 ms·

Metformin Promises to Extend Life for a Nickel a Pill

63 points by deegles 9y ago

gscott 9y ago
The older I get, the more I want the blood of teens.
- JohnTHaller 9y ago
  It's a great emo band name.
  - api 9y ago
    "The Blood Boys" Best punk band name EVER.
snikeris 9y ago
Anyone taking this off-label?
- hendersoon 9y ago
  When a type 2 diabetic enters remission after losing weight and/or gastric bypass, they are typically kept on metformin forever, because it's cheap and they obviously have a risk factor for diabetes. Metformin is very, very widely prescribed. That said, lactic acidosis, while rare, can actually kill you. So I wouldn't take metformin without consulting a doctor.
pavement 9y ago
In 2014 alone, Americans filled 76.9 million prescriptions for metformin, and some of those prescriptions went to Barzilai himself. (He’s been taking the drug since he was diagnosed with prediabetes around six years ago.) https://en.wikipedia.org/wiki/Metformin https://en.wikipedia.org/wiki/Metformin Metformin is in the biguanide class. It works by decreasing glucose production by the liver and increasing the insulin sensitivity of body tissues. The most serious potential side effect of metformin use is lactic acidosis; this complication is very rare, and the vast majority of these cases seem to be related to comorbid conditions, such as impaired liver or kidney function, rather than to the metformin itself.
stupidcar 9y ago
While I'm certain it's a very respectable school, "Albert Einstein College of Medicine in the Bronx" sounds like the place a sitcom character pretending to be a doctor would invent as their alma mater.
- arkades 9y ago
  It's pretty solid and, for medical residencies, its internal medicine program routinely draws from the same pool of applicants as MGH, NYP, and Sinai. It's a pretty solid program all around. (I didn't go there, but know plenty of folks that did.)
- caycep 9y ago
  And Howard Dean is a proud alumnus!
candiodari 9y ago
Warning: metformin works by interfering with the mechanism cells use to, well, essentially request food. Whilst yes, chronically working on too little energy has been proven to extend lifespans, you will not like the side effects. For one it makes you stupid. Obviously it interferes with everything requiring effort, from running to sex. There are cell types in your body that will, when faced with an energy shortage simply consume themselves. Usually, this means trading a sudden death for permanent damage, for example heart muscle cells. This means that when faced with an energy shortage they will kill themselves. An overdose of Metformin can cause this to occur on a large scale and when that happens, your life is somewhere between over and very short. Do not take any medication without being aware of the side effects and getting advice from a doctor (and let me spoil the surprise: your doctor will advise against both metformin and calorie restriction. He will be happy to prescribe you a placebo. You would be surprised how calming taking one can be) There are other treatments that extend life, like taking aspirin daily, and other metabolism blockers, anti inflammatories and blood thinners. All come at a serious cost (DO NOT take aspirin daily unless you're happy to bleed to death with any major injury) which makes a lot of sense if you think about it.
- hendersoon 9y ago
  Do you have any evidence for the claims that metformin negatively impacts intelligence and energy?
  - candiodari 9y ago
    Energy, yes. Intelligence, not directly. But I can provide links that caloric restriction diets do (that means diets that are sufficiently strict that you lose weight no matter what weight you currently have). (And that's in adults, in children they cause total disasters) Since this is the working mechanism of that drug, I felt it relevant to put there.
    - hendersoon 9y ago
      Please cite sources or stop spreading FUD. I'm not a physician, but I've heard that like many life-saving drugs, Metformin's working mechanism is not yet well understood. It's a vast oversimplification and likely completely _wrong_ that Metformin has the same effect as calorie restriction. If that was so, logic dictates that Metformin would be effective for weight loss. It isn't.
Joyfield 9y ago
But holy DAMNED does it give diarrhea. (Diabetic here, not using it since a couple of years)
- nikolay 9y ago
  Yeah, but only to 20% of those who try it. For them, there's a slow release version, but I don't think it's widely available - I tried finding Glucophage SR in Europe with no success! Anyway, I'm among the lucky 80% of those without side effects. I'm not diabetic; I take it for biohacking reasons.
  - dogma1138 9y ago
    You can buy Glucophage SR and Metformin SR online in the UK pretty easily, google and it's in the first 10 results.
    - nikolay 9y ago
      They don't ship to the US, and the price is not a nickel per pill either!
      - dogma1138 9y ago
        ~100 pills go for 20-30 GBP (depending on the brand, and strength), that's 20-30p per pill, it's not a nickel but it's not much more expensive (it's about a quarter on the lower end) and this is from online pharmacies without a real prescription (it's a self filled form "consultation") these usually take a premium since they know you aren't ordering those because an actual doctor prescribed them for you. I'm pretty sure if you are actually prescribed these for diabetes by your GP you'll pay a fraction of that cost under the NHS.
  - SwellJoe 9y ago
    "I'm not diabetic; I take it for biohacking reasons." Did you just say to your doctor, "Hey, doc, I'm trying to live forever here, can you hook me up with some metformin?" I often wonder about this, when it comes to folks using drugs for off-label purposes. I know there are doctors that are amenable to prescribing things like anti-depressants on patient request, but a diabetic drug seems a harder sell.
myth_drannon 9y ago
A really great podcast on the subject by Tim Ferris (I think it's one of his best). They also talk about Metformin https://tim.blog/2016/10/20/my-life-extension-pilgrimage-to-easter-island/ https://tim.blog/2016/10/20/my-life-extension-pilgrimage-to-...
reasonattlm 9y ago
The results for metformin in animal studies are all over the map, with many studies showing no results on life span or health span. A great many people have taken metformin for a long time with no great and obvious results. Short-lived species have far more plastic life spans in response to metabolic adjustment in comparison to humans; the two most reliable and sizable effects on mice (growth hormone receptor knockout and calorie restriction) do not have similarly sizable effects in humans. Laron syndrome sufferers and calorie restriction practitioners do not live significantly longer than others. The one and only reason why metformin is getting into trials is as a political lever to get the FDA to acknowledge aging as a medical condition with defined causes for which treatments will be approved. Metformin couldn't really be rejected in the way the FDA likes to reject a lot of things because it is so widely used and has been so widely used for a long time. The future of human longevity is not tinkering with metabolism to try to push it to be a little more like calorie restricted metabolism. That is a waste of time and effort. It is enormously expensive to carry out the work to try to understand metabolism well enough to adjust it safely. Hell, look at the past 20 years of work on calorie restriction: how much has been spent, how many man-years focused on it, and the research community is still only scratching the surface on how to induce similar effects via therapies. Yet there is another approach, one that is far more cost-effective in time and money. Repair the causes of aging. Look at removal of senescent cells: in a bare few years, and at far less cost than has been spent on calorie restriction mimetic development, researchers have demonstrated robust effects and reversal of numerous age-related conditions in mice. Unlike metformin and similar drugs, the results are consistent, sizable, and produce rejuvenation in old individuals, not just a slight slowing of aging. There is an enormous difference between the bad way forward (typified by metformin) and the good way forward (typified by senolytics). In the former we all die on the same schedule as our parents and grandparents. In the latter we can gain decades or more of additional healthy life.
- deegles 9y ago
  Could you post some links? Any idea when these therapies will hit human trials?
  - reasonattlm 9y ago
roceasta 9y ago
>You could also be able to shrink the suffering and enormous expense that accompanies cancer, heart disease, dementia, and all the other plagues of growing old. No. It could at best defer the health costs. We need to stop being passive about this and embrace the idea of (1) life extension technologies for those who want, (2) assisted suicide for those who don't. When this philosophical shift happens we can get much more serious about life extension research and mental well-being (purpose; reasons to live) and reduce the vast expenditures on palliative care for those who are merely waiting around to die.
pbarnes_1 9y ago
If you don't manage taking metformin with large enough meals etc, you get wonderful "metformin moments" (i.e. uncontrollable diarrhea like you've got food poisoning). Gotta weigh up those risks. :)
- gozur88 9y ago
  My dad was on that stuff and he decided his quality of life was so low he wouldn't take it under any circumstances.
- nikolay 9y ago
  Only 20% of patients get this and for them, there's the sustained/extended release version - Metformin ER, or Glucophage SR/XR.
rscho 9y ago
As an MD, I find those "take this miraculous drug we've known for years and live long" fads pretty ridiculous. People are far too confident in medical "research". If you know some statistics, read medical papers before bed and have a good laugh!
dpeterson 9y ago
From reading the article, it seems the health benefits may, primarily, be attributed to having lowered blood sugar? I've also seen a number of references saying just eating less has the ability to extend life. So, could it be that sugar, in general, is really really bad for us? If you don't have diabetes, could you get the same benefits Metformin provides simply cutting as much sugar out of your diet as possible? The article reads like a distraction for the masses from the research being done for billionaires to extend their lives. "Hey, don't feel so bad about all the billionaires working on super fancy life extending treatments you can't afford. You can take a cheap little pill to live longer too."
- Asooka 9y ago
  Yes, yes, yes, yes, and yes. If you manage to just cut out all fructose from processed sources (i.e. fruits are ok, anything containing table sugar - glucose+fructose, or high-fructose-corn-syrup is out), you'll be much better off than most people. Also don't forget to eat flax seed to keep your omega-6:omega-3 ratio close to optimal, and take your vitamins. But even then, metformin might help you live even longer and better. More studies needed. And even then, these are just things to keep your body's own systems functioning optimally. I can't imagine what real anti-aging drugs might do.
nikolay 9y ago
You need to supplement with calcium and B-12 [1], though... but B-12 supplementation causes cancer [2]. Oh, well... [1]: https://selfhacked.com/blog/uses-benefits-metformin/ https://selfhacked.com/blog/uses-benefits-metformin/ [2]: https://news.ycombinator.com/item?id=15099760 https://news.ycombinator.com/item?id=15099760
caycep 9y ago
Granted, you'd get a huge increase in survival signal just by reducing everyone's diabetes, but maybe I'm just being cynical... (i guess since this is HN the solution would be to design a statistical model that corrects for anti diabetic effect to try and demonstrate non-diabetic related anti-aging effects...)
- SwellJoe 9y ago
  Given how many people in the western world are pre-diabetic due to diet and lifestyle, maybe curing that would be a miraculous result in and of itself. I mean, it wouldn't directly help those of us who aren't on that path, but in terms of general societal health and average lifespan, it still seems pretty great. I like it when people don't die. It could potentially save all of us some money, too.
- aoeusnth1 9y ago
  Irrc, in one of the articles posted about Metformin on HN a couple weeks ago, they discussed how diabetes patients on Metformin were living longer and had less cancer than people with diabetes who were on other diabetes medications. That does seem to counteract the effect you were suggesting.
nikolay 9y ago
Dr. Ward Dean is a huge supporter of taking Metformin and it fits his Neuroendocrine Theory of Aging [1] [2]. You can watch a short video about it here [3]. [1]: http://warddeanmd.com/articles/neuroendocrine-theory-of-aging-chapter-1/ http://warddeanmd.com/articles/neuroendocrine-theory-of-agin... [2]: http://warddeanmd.com/articles/neuroendocrine-theory-of-aging-chapter-2/ http://warddeanmd.com/articles/neuroendocrine-theory-of-agin... [3]: https://www.youtube.com/watch?v=5bdoiHdhjbM https://www.youtube.com/watch?v=5bdoiHdhjbM

63 points by deegles 9y ago

gscott 9y ago

The older I get, the more I want the blood of teens.

JohnTHaller 9y ago
It's a great emo band name.
- api 9y ago
  "The Blood Boys" Best punk band name EVER.

snikeris 9y ago

Anyone taking this off-label?

hendersoon 9y ago
When a type 2 diabetic enters remission after losing weight and/or gastric bypass, they are typically kept on metformin forever, because it's cheap and they obviously have a risk factor for diabetes. Metformin is very, very widely prescribed. That said, lactic acidosis, while rare, can actually kill you. So I wouldn't take metformin without consulting a doctor.

pavement 9y ago

In 2014 alone, Americans filled 76.9 million prescriptions for metformin, and some of those prescriptions went to Barzilai himself. (He’s been taking the drug since he was diagnosed with prediabetes around six years ago.) https://en.wikipedia.org/wiki/Metformin https://en.wikipedia.org/wiki/Metformin Metformin is in the biguanide class. It works by decreasing glucose production by the liver and increasing the insulin sensitivity of body tissues. The most serious potential side effect of metformin use is lactic acidosis; this complication is very rare, and the vast majority of these cases seem to be related to comorbid conditions, such as impaired liver or kidney function, rather than to the metformin itself.

stupidcar 9y ago

While I'm certain it's a very respectable school, "Albert Einstein College of Medicine in the Bronx" sounds like the place a sitcom character pretending to be a doctor would invent as their alma mater.

arkades 9y ago
It's pretty solid and, for medical residencies, its internal medicine program routinely draws from the same pool of applicants as MGH, NYP, and Sinai. It's a pretty solid program all around. (I didn't go there, but know plenty of folks that did.)
caycep 9y ago
And Howard Dean is a proud alumnus!

candiodari 9y ago

Warning: metformin works by interfering with the mechanism cells use to, well, essentially request food. Whilst yes, chronically working on too little energy has been proven to extend lifespans, you will not like the side effects. For one it makes you stupid. Obviously it interferes with everything requiring effort, from running to sex. There are cell types in your body that will, when faced with an energy shortage simply consume themselves. Usually, this means trading a sudden death for permanent damage, for example heart muscle cells. This means that when faced with an energy shortage they will kill themselves. An overdose of Metformin can cause this to occur on a large scale and when that happens, your life is somewhere between over and very short. Do not take any medication without being aware of the side effects and getting advice from a doctor (and let me spoil the surprise: your doctor will advise against both metformin and calorie restriction. He will be happy to prescribe you a placebo. You would be surprised how calming taking one can be) There are other treatments that extend life, like taking aspirin daily, and other metabolism blockers, anti inflammatories and blood thinners. All come at a serious cost (DO NOT take aspirin daily unless you're happy to bleed to death with any major injury) which makes a lot of sense if you think about it.

hendersoon 9y ago
Do you have any evidence for the claims that metformin negatively impacts intelligence and energy?
- candiodari 9y ago
  Energy, yes. Intelligence, not directly. But I can provide links that caloric restriction diets do (that means diets that are sufficiently strict that you lose weight no matter what weight you currently have). (And that's in adults, in children they cause total disasters) Since this is the working mechanism of that drug, I felt it relevant to put there.
  - hendersoon 9y ago
    Please cite sources or stop spreading FUD. I'm not a physician, but I've heard that like many life-saving drugs, Metformin's working mechanism is not yet well understood. It's a vast oversimplification and likely completely _wrong_ that Metformin has the same effect as calorie restriction. If that was so, logic dictates that Metformin would be effective for weight loss. It isn't.

Joyfield 9y ago

But holy DAMNED does it give diarrhea. (Diabetic here, not using it since a couple of years)

nikolay 9y ago
Yeah, but only to 20% of those who try it. For them, there's a slow release version, but I don't think it's widely available - I tried finding Glucophage SR in Europe with no success! Anyway, I'm among the lucky 80% of those without side effects. I'm not diabetic; I take it for biohacking reasons.
- dogma1138 9y ago
  You can buy Glucophage SR and Metformin SR online in the UK pretty easily, google and it's in the first 10 results.
  - nikolay 9y ago
    They don't ship to the US, and the price is not a nickel per pill either!
    - dogma1138 9y ago
      ~100 pills go for 20-30 GBP (depending on the brand, and strength), that's 20-30p per pill, it's not a nickel but it's not much more expensive (it's about a quarter on the lower end) and this is from online pharmacies without a real prescription (it's a self filled form "consultation") these usually take a premium since they know you aren't ordering those because an actual doctor prescribed them for you. I'm pretty sure if you are actually prescribed these for diabetes by your GP you'll pay a fraction of that cost under the NHS.
- SwellJoe 9y ago
  "I'm not diabetic; I take it for biohacking reasons." Did you just say to your doctor, "Hey, doc, I'm trying to live forever here, can you hook me up with some metformin?" I often wonder about this, when it comes to folks using drugs for off-label purposes. I know there are doctors that are amenable to prescribing things like anti-depressants on patient request, but a diabetic drug seems a harder sell.

myth_drannon 9y ago

A really great podcast on the subject by Tim Ferris (I think it's one of his best). They also talk about Metformin https://tim.blog/2016/10/20/my-life-extension-pilgrimage-to-easter-island/ https://tim.blog/2016/10/20/my-life-extension-pilgrimage-to-...

reasonattlm 9y ago

The results for metformin in animal studies are all over the map, with many studies showing no results on life span or health span. A great many people have taken metformin for a long time with no great and obvious results. Short-lived species have far more plastic life spans in response to metabolic adjustment in comparison to humans; the two most reliable and sizable effects on mice (growth hormone receptor knockout and calorie restriction) do not have similarly sizable effects in humans. Laron syndrome sufferers and calorie restriction practitioners do not live significantly longer than others. The one and only reason why metformin is getting into trials is as a political lever to get the FDA to acknowledge aging as a medical condition with defined causes for which treatments will be approved. Metformin couldn't really be rejected in the way the FDA likes to reject a lot of things because it is so widely used and has been so widely used for a long time. The future of human longevity is not tinkering with metabolism to try to push it to be a little more like calorie restricted metabolism. That is a waste of time and effort. It is enormously expensive to carry out the work to try to understand metabolism well enough to adjust it safely. Hell, look at the past 20 years of work on calorie restriction: how much has been spent, how many man-years focused on it, and the research community is still only scratching the surface on how to induce similar effects via therapies. Yet there is another approach, one that is far more cost-effective in time and money. Repair the causes of aging. Look at removal of senescent cells: in a bare few years, and at far less cost than has been spent on calorie restriction mimetic development, researchers have demonstrated robust effects and reversal of numerous age-related conditions in mice. Unlike metformin and similar drugs, the results are consistent, sizable, and produce rejuvenation in old individuals, not just a slight slowing of aging. There is an enormous difference between the bad way forward (typified by metformin) and the good way forward (typified by senolytics). In the former we all die on the same schedule as our parents and grandparents. In the latter we can gain decades or more of additional healthy life.

deegles 9y ago
Could you post some links? Any idea when these therapies will hit human trials?
- reasonattlm 9y ago

roceasta 9y ago

>You could also be able to shrink the suffering and enormous expense that accompanies cancer, heart disease, dementia, and all the other plagues of growing old. No. It could at best defer the health costs. We need to stop being passive about this and embrace the idea of (1) life extension technologies for those who want, (2) assisted suicide for those who don't. When this philosophical shift happens we can get much more serious about life extension research and mental well-being (purpose; reasons to live) and reduce the vast expenditures on palliative care for those who are merely waiting around to die.

pbarnes_1 9y ago

If you don't manage taking metformin with large enough meals etc, you get wonderful "metformin moments" (i.e. uncontrollable diarrhea like you've got food poisoning). Gotta weigh up those risks. :)

gozur88 9y ago
My dad was on that stuff and he decided his quality of life was so low he wouldn't take it under any circumstances.
nikolay 9y ago
Only 20% of patients get this and for them, there's the sustained/extended release version - Metformin ER, or Glucophage SR/XR.

rscho 9y ago

As an MD, I find those "take this miraculous drug we've known for years and live long" fads pretty ridiculous. People are far too confident in medical "research". If you know some statistics, read medical papers before bed and have a good laugh!

dpeterson 9y ago

From reading the article, it seems the health benefits may, primarily, be attributed to having lowered blood sugar? I've also seen a number of references saying just eating less has the ability to extend life. So, could it be that sugar, in general, is really really bad for us? If you don't have diabetes, could you get the same benefits Metformin provides simply cutting as much sugar out of your diet as possible? The article reads like a distraction for the masses from the research being done for billionaires to extend their lives. "Hey, don't feel so bad about all the billionaires working on super fancy life extending treatments you can't afford. You can take a cheap little pill to live longer too."

Asooka 9y ago
Yes, yes, yes, yes, and yes. If you manage to just cut out all fructose from processed sources (i.e. fruits are ok, anything containing table sugar - glucose+fructose, or high-fructose-corn-syrup is out), you'll be much better off than most people. Also don't forget to eat flax seed to keep your omega-6:omega-3 ratio close to optimal, and take your vitamins. But even then, metformin might help you live even longer and better. More studies needed. And even then, these are just things to keep your body's own systems functioning optimally. I can't imagine what real anti-aging drugs might do.

nikolay 9y ago

You need to supplement with calcium and B-12 [1], though... but B-12 supplementation causes cancer [2]. Oh, well... [1]: https://selfhacked.com/blog/uses-benefits-metformin/ https://selfhacked.com/blog/uses-benefits-metformin/ [2]: https://news.ycombinator.com/item?id=15099760 https://news.ycombinator.com/item?id=15099760

caycep 9y ago

Granted, you'd get a huge increase in survival signal just by reducing everyone's diabetes, but maybe I'm just being cynical... (i guess since this is HN the solution would be to design a statistical model that corrects for anti diabetic effect to try and demonstrate non-diabetic related anti-aging effects...)

SwellJoe 9y ago
Given how many people in the western world are pre-diabetic due to diet and lifestyle, maybe curing that would be a miraculous result in and of itself. I mean, it wouldn't directly help those of us who aren't on that path, but in terms of general societal health and average lifespan, it still seems pretty great. I like it when people don't die. It could potentially save all of us some money, too.
aoeusnth1 9y ago
Irrc, in one of the articles posted about Metformin on HN a couple weeks ago, they discussed how diabetes patients on Metformin were living longer and had less cancer than people with diabetes who were on other diabetes medications. That does seem to counteract the effect you were suggesting.

nikolay 9y ago

Dr. Ward Dean is a huge supporter of taking Metformin and it fits his Neuroendocrine Theory of Aging [1] [2]. You can watch a short video about it here [3]. [1]: http://warddeanmd.com/articles/neuroendocrine-theory-of-aging-chapter-1/ http://warddeanmd.com/articles/neuroendocrine-theory-of-agin... [2]: http://warddeanmd.com/articles/neuroendocrine-theory-of-aging-chapter-2/ http://warddeanmd.com/articles/neuroendocrine-theory-of-agin... [3]: https://www.youtube.com/watch?v=5bdoiHdhjbM https://www.youtube.com/watch?v=5bdoiHdhjbM