9 ms·

Diabetes Drug Metformin Reduces All-Cause Mortality and Diseases of Aging (2017)

107 points by optimalsolver 5y ago

api 5y ago
Could this be replicating what fasting and caloric restriction do?
- nate_meurer 5y ago
  Yes, there's evidence for that. However the jury is still out on whether metformin is a net benefit for people with healthy insulin sensitivity. It appears there are negative effects: Derek Lowe talks about the negative effects of metformin on healthy people: https://blogs.sciencemag.org/pipeline/archives/2019/06/24/me https://blogs.sciencemag.org/pipeline/archives/2019/06/24/me... Peter Attia talks about the same, and some interesting other considerations: https://peterattiamd.com/191013/ https://peterattiamd.com/191013/
  - dcolkitt 5y ago
    Metformin likely blunts the impact of high intensity exercise. But for the 65% of people living sedentary or low activity lives, it’s a straight win. Even for those who are consistent with physical fitness, the downsides can likely be avoided by waiting a few hours after the morning exercise session to dose.
    - electriclove 5y ago
      Right, and wouldn't the non extended release version work well if taken at night and exercise in morning (or vice versa).
  - birriel 5y ago
    Folks that take metformin for anti-aging usually take it on exercise off-days. There was concern about lactic acidosis, but it's beginning to become clear that it mostly arises in patients with comorbidities.
- 238475235243 5y ago
  Yes. And keto, OMAD, etc... They all do the "same thing" in reducing serum glucose and therefore all the downstream bad things that happen. Metformin forms the base plank of novel metabolic cancer regimens too.
  - jcims 5y ago
    >Metformin forms the base plank of novel metabolic cancer regimens too. For which you'll likely have to lie to or find an alternative oncologist who's willing to tolerate adjuvant therapies that aren't 'standard of care'. There are organizations that are developing protocols that include metformin along with statins, anthelmintics and even some antibiotics that are showing promise across a variety of research and even some clinical trials to help fight cancer through a number of mechanisms. Independently they are not likely sufficient to beat cancer but may slow its roll through the body of the patient.
    - CodeWriter23 5y ago
      “alternative” practitioners have been keeping humans healthy for several millennia prior to the existence of the AMA and their so-called “standard of care”.
      - oivey 5y ago
        Sure, but evidence from last several millennia also show they haven’t kept people healthy quite as long.
      - nojokes 5y ago
        Those so called alternative practitioners lack scientific rigor, I am afraid of, or more likely just do not know what they are doing. Exceptions exists of course.
        CodeWriter23 5y ago
        Many have more scientific rigor than AMA acolytes. Not all, of course. And then again the AMA and its ilk have plenty of breakdowns of scientific rigor. Let’s see now, vioxx, valsartan, omeprazole, to name a few. And let’s not forget the completely unscientific circus around hydroxychloroquine and those effectively denied treatment on that pack of lies (research surgisphere to get to the truth there)
pochamago 5y ago
My dad actually switched doctors because his original one refused to prescribe metformin to anyone who wasn't fully diabetic
- deleted 5y ago
  [deleted]
- rscho 5y ago
  And rightfully so given the state of the evidence.
  - staticassertion 5y ago
    What would you consider satisfying evidence? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/ https://pubmed.ncbi.nlm.nih.gov/31405774/ https://pubmed.ncbi.nlm.nih.gov/31405774/ https://pubmed.ncbi.nlm.nih.gov/31954752/ https://pubmed.ncbi.nlm.nih.gov/31954752/ https://ncbi.nlm.nih.gov/pmc/articles/PMC4287273/ https://ncbi.nlm.nih.gov/pmc/articles/PMC4287273/
    - rscho 5y ago
      Years and years of widespread clinical practice would be my standard, but I'll make do with multiple large-scale randomized studies AND precise guidelines if absolutely necessary. As for evidence seeking, clinical research happens to be part of my job so I don't really need assistance, thanks.
      - staticassertion 5y ago
        That seems like a silly standard, but do you.
        rscho 5y ago
        It's the standard of one particular professional with 15y of clinical practice and research who's seen every kind of manipulation and incompetence in medicine. But yeah, it may be silly. We'll see about that in the coming decades I guess.
deleted 5y ago
[deleted]
macinjosh 5y ago
It certainly is a powerful pharmaceutical. It can impact aquatic life that live in treated waste water effluent. "Emerging wastewater contaminant metformin causes intersex and reduced fecundity in fish." https://www.sciencedirect.com/science/article/pii/S0045653515002830 https://www.sciencedirect.com/science/article/pii/S004565351...
- wetpaws 5y ago
  human life > fish life
  - deleted 5y ago
    [deleted]
  - simcop2387 5y ago
    Yes and no. If that's literally allmit does and it doesn't do it to an extreme amount i'd have no issues with it, but it also points to it possibly causing other effects that we need to be looking for and studying so we don;t get caught unaware of it destroying ecosystems that we depend on for our lives too. You have to remeber that we don't exist in isolation drom the environment and if it causes that in fish, it might be causing other problems in us, or in plants and animals that we depend on directly or indirectly.
  - baliex 5y ago
    We’re all living in the same (complex!) ecosystem. It’s possible that the fish you’re relegating to be less important than you are somehow benefiting you in some indirect way
- 8note 5y ago
  If you're already kind of old, you maybe don't want more kids anyways?
birriel 5y ago
Comparison of metformin and berberine based on Cochrane meta-analysis: https://www.youtube.com/watch?v=OPsMMfSQKQ0 https://www.youtube.com/watch?v=OPsMMfSQKQ0
- clumsysmurf 5y ago
  Looked at berberine also, seems toxic to the liver. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867333/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867333/
clumsysmurf 5y ago
Picture seems complicated Our study, performed in C. elegans and human primary fibroblasts shows that there is an age-related decrease in metformin tolerance, which in later life leads to toxicity of all metformin doses tested. This shows possible safety risks of late life administration of metformin to individuals without diabetes," https://medicalxpress.com/news/2020-11-age-decisive-positive-negative-effects.html https://medicalxpress.com/news/2020-11-age-decisive-positive...
- Nevermark 5y ago
  It would be interesting to know if lower doses were tolerated better while still providing some benefit.
MengerSponge 5y ago
The only miracle drugs that I know of are sleep, water, and exercise. Even those have dose-related toxicities! https://peterattiamd.com/metformin-and-exercise/ https://peterattiamd.com/metformin-and-exercise/ If you're healthy enough to exercise, that's probably more effective. Apparently (I haven't tested myself, and I don't know how thorough the literature is) metformin lowers your lactic threshold, which reduces the total amount of work you can do in that state. Do cardio, sleep enough, avoid refined sugar and fats that are solid at room temperature. More than that... godspeed
- Filligree 5y ago
  > avoid refined sugar and fats that are solid at room temperature. This leaves, what, protein and starch? And cooking oil, I suppose, but all forms of meat contain solid fats.
  - ansible 5y ago
    Some oils like rapeseed (canola) aren't that good for you either.
    - fermentation 5y ago
      And coconut oil, which contains quite a bit of saturated fat. Edit: apparently coconut oil is supposed to be solid at room temp. I should get an air conditioner
    - void_mint 5y ago
      These articles always bring up a lot of comments that use the phrase "good for you" or "healthy", but in my experience most of the time a person saying "___ is good for you", they pretty much never quantify how or why. Can you explain, in what capacity oils aren't "good for you" ?
      - shaicoleman 5y ago
        I think the best talk of the health dangers of seed oils is in the following video: Dr. Chris Knobbe - 'Diseases of Civilization: Are Seed Oil Excesses the Unifying Mechanism?' [1] If you're short on time, you can skip directly to the trials data section [2] 1. https://youtu.be/7kGnfXXIKZM https://youtu.be/7kGnfXXIKZM 2. https://youtu.be/7kGnfXXIKZM?t=2020 https://youtu.be/7kGnfXXIKZM?t=2020
rscho 5y ago
This whole comment section is totally delusional regarding the reliability of medical statistics and preliminary data in life science. It's funny (and sad) to see people easily disparaging "state-of-the-art treatments" be so prone to experiment on themselves with moonshot claims.
- myfavoritedog 5y ago
  For decades, we were told that the food pyramid was the ideal healthy diet and that dietary fat was the enemy. It was all bullshit. Eggs are healthy, eggs are unhealthy, eggs are really unhealthy, eggs are healthy, eggs are really healthy. I had trained medical professionals tell me twenty years ago that I was going to ruin my kidneys with my low-carb dieting. Twenty years later, I'm still keeping the weight off and medical science has started to catch up to what I knew just by experimenting on myself with moonshot claims. The biggest problem with medical science (just look at how COVID issues were butchered by politics and celebrity), is that they refuse to just say, "We don't really know." Because all too often, they have no clue. But they are trained to come up with answers and sound confident about it.
  - jopsen 5y ago
    > just say, "We don't really know." That is what OP says. What we open see is that "we don't know" is often equated with "does not work". (I guess that also very frequently how it works out)
  - rscho 5y ago
    There are many things I don't know. However, here's one thing I know to be true: individual experiments do not make for population-level generalizations. Additionally, dieting by reducing or even excluding a single well-known food category when there are many more left appears as less radical than taking a pill that will rebalance your whole metabolism, don't you think? Regarding the "we really don't know" part: one can observe that people here are basing their own shamanic medicine on what they read in scientific papers, suddenly pretending that those papers can be trusted while they'll disparage the theories of clinical practitioners as being old-fashioned and manipulative. Well, it happens that many of those theories are based upon lots and lots of research and certainly more so that the "fad of the day" is. And yes, those theories are often refuted after years of clinical application, which does not bode well for experiments based on "few papers shamanic medicine".
toddh 5y ago
Metformin does have some long term issues. After 10 years it can cause serious lower back pain. Not in everyone, but it's something to be aware of.
healthnut99 5y ago
The only way to get a reliable answer at this point appears to be a large, randomized trial - the TAME trial (https://www.afar.org/tame-trial https://www.afar.org/tame-trial) was supposed to have started in 2020. Although the official website doesn't say so, I found various articles in the press from late 2019 which said they had raised all the $75 million they needed for it (for example, see https://www.longevity.technology/worlds-first-anti-aging-trial-gets-green-light/ https://www.longevity.technology/worlds-first-anti-aging-tri...). After that, it has been radio silence from them - no website updates, no press releases. Although their website says they have clinical sites set up, I haven't been able to find the clinical trials.gov entry for it. I even sent an email to the PI Nil Birzalai (at Montefiore in NYC) a few weeks ago to find out more, but didn't get a response. Does anyone know whether that trial even got off the ground?
Afforess 5y ago
Gwern did some analysis and determined that the ROI for Metformin vs the cost is positive for 45+ and older. https://www.gwern.net/Longevity#metformin https://www.gwern.net/Longevity#metformin
drcode 5y ago
I have been taking metformin for anti-aging purposes for about 6 months now. I decided to take it mainly because the risks are small, and I wanted to counter the natural bias on these sorts of things, which always leans towards "doing nothing". By taking metformin, it means I have a personal stake in the developoment of anti-aging medicines and have a reason to evaluate any newer options that appear (since there may be a reason to switch metformin to another treatment) I feel like taking metformin makes me less biased when it comes to evaluating treatments in the field, even if I think the efficacy of metformin is still an open question. In terms of side effects, I have noted mild gastric upset (I actually wonder if this is part of its mechanism of action, making you less hungry in this way) but little impact on exercise (I take it even on days that I exercise, and I have a fairly heavy exercise routine)
- redis_mlc 5y ago
  > By taking metformin, it means I have a personal stake in the development of anti-aging medicines You sound like an insane person. Talk to somebody you respect and have them explain how you're not going to live forever, and it's not your job to be a voluntary lab rat.
- hungryforcodes 5y ago
  Isn't it supposed to prevent you from absorbing vitamin B12, which is pretty serious.
- rscho 5y ago
  You should be really weary of acidosis. It's dangerous.
cromwellian 5y ago
My mother died from a combination of metformin and colchicine. She had renal insufficiency, the FDA had warned not to prescribe metformin to people with renal insufficiency, and it made her kidneys worse. She had been taking daily low dose colchicine for gout, but the worsened kidney function caused a poisonous level of colchicine to build up. She vomited so much, she lost a too much electrolytes and ended up in the hospital delirious. The hospital thought it was a stroke and tested for that, eventually ruling it out, but the time wasted on thinking it was a stroke, obscured a growing instability in her kidneys, liver, thanks to the insufficiency, colchicine, and bad electrolyte levels. When they infused electrolytes, it swung the pendulum too far in the other direction, and she suffered wild swings in blood levels of potassium, etc. Eventually her kidneys and liver failed at the same time, multiple organ failure, usually for someone in their 60s is not survival. I watched her die slowly over a few days as everything came crashing down. Afterwards, I tried to get the hospital to conduct an autopsy to show overdose of colchicine levels, but the pathology department somehow "wasn't set up for that" and they said I'd have to send her body to some specialist lab. I didn't want to cause anymore pain with the family, so I opted to just bury her. But I definitely see this as medical malpractice. And it's a clear warning to not ignore FDA contraindication warnings, even if your doctor apparently doesn't read up on the latest research or alerts.
deleted 5y ago
[deleted]
ooyy 5y ago
Metabolic syndrome is on the same spectrum of chronic illnesses as type 2 diabetes. It's not surprising that even non-diabetics can benefit from t2d drug metformin considering that only 11% Americans are fully metabolically healthy meaning they meet none of the criteria for metabolic syndrome. But if you are one of these metabolically healthy people, you probably wont benefit from metformin.

107 points by optimalsolver 5y ago

api 5y ago

Could this be replicating what fasting and caloric restriction do?

nate_meurer 5y ago
Yes, there's evidence for that. However the jury is still out on whether metformin is a net benefit for people with healthy insulin sensitivity. It appears there are negative effects: Derek Lowe talks about the negative effects of metformin on healthy people: https://blogs.sciencemag.org/pipeline/archives/2019/06/24/me https://blogs.sciencemag.org/pipeline/archives/2019/06/24/me... Peter Attia talks about the same, and some interesting other considerations: https://peterattiamd.com/191013/ https://peterattiamd.com/191013/
- dcolkitt 5y ago
  Metformin likely blunts the impact of high intensity exercise. But for the 65% of people living sedentary or low activity lives, it’s a straight win. Even for those who are consistent with physical fitness, the downsides can likely be avoided by waiting a few hours after the morning exercise session to dose.
  - electriclove 5y ago
    Right, and wouldn't the non extended release version work well if taken at night and exercise in morning (or vice versa).
- birriel 5y ago
  Folks that take metformin for anti-aging usually take it on exercise off-days. There was concern about lactic acidosis, but it's beginning to become clear that it mostly arises in patients with comorbidities.
238475235243 5y ago
Yes. And keto, OMAD, etc... They all do the "same thing" in reducing serum glucose and therefore all the downstream bad things that happen. Metformin forms the base plank of novel metabolic cancer regimens too.
- jcims 5y ago
  >Metformin forms the base plank of novel metabolic cancer regimens too. For which you'll likely have to lie to or find an alternative oncologist who's willing to tolerate adjuvant therapies that aren't 'standard of care'. There are organizations that are developing protocols that include metformin along with statins, anthelmintics and even some antibiotics that are showing promise across a variety of research and even some clinical trials to help fight cancer through a number of mechanisms. Independently they are not likely sufficient to beat cancer but may slow its roll through the body of the patient.
  - CodeWriter23 5y ago
    “alternative” practitioners have been keeping humans healthy for several millennia prior to the existence of the AMA and their so-called “standard of care”.
    - oivey 5y ago
      Sure, but evidence from last several millennia also show they haven’t kept people healthy quite as long.
    - nojokes 5y ago
      Those so called alternative practitioners lack scientific rigor, I am afraid of, or more likely just do not know what they are doing. Exceptions exists of course.
      - CodeWriter23 5y ago
        Many have more scientific rigor than AMA acolytes. Not all, of course. And then again the AMA and its ilk have plenty of breakdowns of scientific rigor. Let’s see now, vioxx, valsartan, omeprazole, to name a few. And let’s not forget the completely unscientific circus around hydroxychloroquine and those effectively denied treatment on that pack of lies (research surgisphere to get to the truth there)

pochamago 5y ago

My dad actually switched doctors because his original one refused to prescribe metformin to anyone who wasn't fully diabetic

deleted 5y ago
[deleted]
rscho 5y ago
And rightfully so given the state of the evidence.
- staticassertion 5y ago
  What would you consider satisfying evidence? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/ https://pubmed.ncbi.nlm.nih.gov/31405774/ https://pubmed.ncbi.nlm.nih.gov/31405774/ https://pubmed.ncbi.nlm.nih.gov/31954752/ https://pubmed.ncbi.nlm.nih.gov/31954752/ https://ncbi.nlm.nih.gov/pmc/articles/PMC4287273/ https://ncbi.nlm.nih.gov/pmc/articles/PMC4287273/
  - rscho 5y ago
    Years and years of widespread clinical practice would be my standard, but I'll make do with multiple large-scale randomized studies AND precise guidelines if absolutely necessary. As for evidence seeking, clinical research happens to be part of my job so I don't really need assistance, thanks.
    - staticassertion 5y ago
      That seems like a silly standard, but do you.
      - rscho 5y ago
        It's the standard of one particular professional with 15y of clinical practice and research who's seen every kind of manipulation and incompetence in medicine. But yeah, it may be silly. We'll see about that in the coming decades I guess.

deleted 5y ago

[deleted]

macinjosh 5y ago

It certainly is a powerful pharmaceutical. It can impact aquatic life that live in treated waste water effluent. "Emerging wastewater contaminant metformin causes intersex and reduced fecundity in fish." https://www.sciencedirect.com/science/article/pii/S0045653515002830 https://www.sciencedirect.com/science/article/pii/S004565351...

wetpaws 5y ago
human life > fish life
- deleted 5y ago
  [deleted]
- simcop2387 5y ago
  Yes and no. If that's literally allmit does and it doesn't do it to an extreme amount i'd have no issues with it, but it also points to it possibly causing other effects that we need to be looking for and studying so we don;t get caught unaware of it destroying ecosystems that we depend on for our lives too. You have to remeber that we don't exist in isolation drom the environment and if it causes that in fish, it might be causing other problems in us, or in plants and animals that we depend on directly or indirectly.
- baliex 5y ago
  We’re all living in the same (complex!) ecosystem. It’s possible that the fish you’re relegating to be less important than you are somehow benefiting you in some indirect way
8note 5y ago
If you're already kind of old, you maybe don't want more kids anyways?

birriel 5y ago

Comparison of metformin and berberine based on Cochrane meta-analysis: https://www.youtube.com/watch?v=OPsMMfSQKQ0 https://www.youtube.com/watch?v=OPsMMfSQKQ0

clumsysmurf 5y ago
Looked at berberine also, seems toxic to the liver. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867333/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867333/

clumsysmurf 5y ago

Picture seems complicated Our study, performed in C. elegans and human primary fibroblasts shows that there is an age-related decrease in metformin tolerance, which in later life leads to toxicity of all metformin doses tested. This shows possible safety risks of late life administration of metformin to individuals without diabetes," https://medicalxpress.com/news/2020-11-age-decisive-positive-negative-effects.html https://medicalxpress.com/news/2020-11-age-decisive-positive...

Nevermark 5y ago
It would be interesting to know if lower doses were tolerated better while still providing some benefit.

MengerSponge 5y ago

The only miracle drugs that I know of are sleep, water, and exercise. Even those have dose-related toxicities! https://peterattiamd.com/metformin-and-exercise/ https://peterattiamd.com/metformin-and-exercise/ If you're healthy enough to exercise, that's probably more effective. Apparently (I haven't tested myself, and I don't know how thorough the literature is) metformin lowers your lactic threshold, which reduces the total amount of work you can do in that state. Do cardio, sleep enough, avoid refined sugar and fats that are solid at room temperature. More than that... godspeed

Filligree 5y ago
> avoid refined sugar and fats that are solid at room temperature. This leaves, what, protein and starch? And cooking oil, I suppose, but all forms of meat contain solid fats.
- ansible 5y ago
  Some oils like rapeseed (canola) aren't that good for you either.
  - fermentation 5y ago
    And coconut oil, which contains quite a bit of saturated fat. Edit: apparently coconut oil is supposed to be solid at room temp. I should get an air conditioner
  - void_mint 5y ago
    These articles always bring up a lot of comments that use the phrase "good for you" or "healthy", but in my experience most of the time a person saying "___ is good for you", they pretty much never quantify how or why. Can you explain, in what capacity oils aren't "good for you" ?
    - shaicoleman 5y ago
      I think the best talk of the health dangers of seed oils is in the following video: Dr. Chris Knobbe - 'Diseases of Civilization: Are Seed Oil Excesses the Unifying Mechanism?' [1] If you're short on time, you can skip directly to the trials data section [2] 1. https://youtu.be/7kGnfXXIKZM https://youtu.be/7kGnfXXIKZM 2. https://youtu.be/7kGnfXXIKZM?t=2020 https://youtu.be/7kGnfXXIKZM?t=2020

rscho 5y ago

This whole comment section is totally delusional regarding the reliability of medical statistics and preliminary data in life science. It's funny (and sad) to see people easily disparaging "state-of-the-art treatments" be so prone to experiment on themselves with moonshot claims.

myfavoritedog 5y ago
For decades, we were told that the food pyramid was the ideal healthy diet and that dietary fat was the enemy. It was all bullshit. Eggs are healthy, eggs are unhealthy, eggs are really unhealthy, eggs are healthy, eggs are really healthy. I had trained medical professionals tell me twenty years ago that I was going to ruin my kidneys with my low-carb dieting. Twenty years later, I'm still keeping the weight off and medical science has started to catch up to what I knew just by experimenting on myself with moonshot claims. The biggest problem with medical science (just look at how COVID issues were butchered by politics and celebrity), is that they refuse to just say, "We don't really know." Because all too often, they have no clue. But they are trained to come up with answers and sound confident about it.
- jopsen 5y ago
  > just say, "We don't really know." That is what OP says. What we open see is that "we don't know" is often equated with "does not work". (I guess that also very frequently how it works out)
- rscho 5y ago
  There are many things I don't know. However, here's one thing I know to be true: individual experiments do not make for population-level generalizations. Additionally, dieting by reducing or even excluding a single well-known food category when there are many more left appears as less radical than taking a pill that will rebalance your whole metabolism, don't you think? Regarding the "we really don't know" part: one can observe that people here are basing their own shamanic medicine on what they read in scientific papers, suddenly pretending that those papers can be trusted while they'll disparage the theories of clinical practitioners as being old-fashioned and manipulative. Well, it happens that many of those theories are based upon lots and lots of research and certainly more so that the "fad of the day" is. And yes, those theories are often refuted after years of clinical application, which does not bode well for experiments based on "few papers shamanic medicine".

toddh 5y ago

Metformin does have some long term issues. After 10 years it can cause serious lower back pain. Not in everyone, but it's something to be aware of.

healthnut99 5y ago

The only way to get a reliable answer at this point appears to be a large, randomized trial - the TAME trial (https://www.afar.org/tame-trial https://www.afar.org/tame-trial) was supposed to have started in 2020. Although the official website doesn't say so, I found various articles in the press from late 2019 which said they had raised all the $75 million they needed for it (for example, see https://www.longevity.technology/worlds-first-anti-aging-trial-gets-green-light/ https://www.longevity.technology/worlds-first-anti-aging-tri...). After that, it has been radio silence from them - no website updates, no press releases. Although their website says they have clinical sites set up, I haven't been able to find the clinical trials.gov entry for it. I even sent an email to the PI Nil Birzalai (at Montefiore in NYC) a few weeks ago to find out more, but didn't get a response. Does anyone know whether that trial even got off the ground?

Afforess 5y ago

Gwern did some analysis and determined that the ROI for Metformin vs the cost is positive for 45+ and older. https://www.gwern.net/Longevity#metformin https://www.gwern.net/Longevity#metformin

drcode 5y ago

I have been taking metformin for anti-aging purposes for about 6 months now. I decided to take it mainly because the risks are small, and I wanted to counter the natural bias on these sorts of things, which always leans towards "doing nothing". By taking metformin, it means I have a personal stake in the developoment of anti-aging medicines and have a reason to evaluate any newer options that appear (since there may be a reason to switch metformin to another treatment) I feel like taking metformin makes me less biased when it comes to evaluating treatments in the field, even if I think the efficacy of metformin is still an open question. In terms of side effects, I have noted mild gastric upset (I actually wonder if this is part of its mechanism of action, making you less hungry in this way) but little impact on exercise (I take it even on days that I exercise, and I have a fairly heavy exercise routine)

redis_mlc 5y ago
> By taking metformin, it means I have a personal stake in the development of anti-aging medicines You sound like an insane person. Talk to somebody you respect and have them explain how you're not going to live forever, and it's not your job to be a voluntary lab rat.
hungryforcodes 5y ago
Isn't it supposed to prevent you from absorbing vitamin B12, which is pretty serious.
rscho 5y ago
You should be really weary of acidosis. It's dangerous.

cromwellian 5y ago

My mother died from a combination of metformin and colchicine. She had renal insufficiency, the FDA had warned not to prescribe metformin to people with renal insufficiency, and it made her kidneys worse. She had been taking daily low dose colchicine for gout, but the worsened kidney function caused a poisonous level of colchicine to build up. She vomited so much, she lost a too much electrolytes and ended up in the hospital delirious. The hospital thought it was a stroke and tested for that, eventually ruling it out, but the time wasted on thinking it was a stroke, obscured a growing instability in her kidneys, liver, thanks to the insufficiency, colchicine, and bad electrolyte levels. When they infused electrolytes, it swung the pendulum too far in the other direction, and she suffered wild swings in blood levels of potassium, etc. Eventually her kidneys and liver failed at the same time, multiple organ failure, usually for someone in their 60s is not survival. I watched her die slowly over a few days as everything came crashing down. Afterwards, I tried to get the hospital to conduct an autopsy to show overdose of colchicine levels, but the pathology department somehow "wasn't set up for that" and they said I'd have to send her body to some specialist lab. I didn't want to cause anymore pain with the family, so I opted to just bury her. But I definitely see this as medical malpractice. And it's a clear warning to not ignore FDA contraindication warnings, even if your doctor apparently doesn't read up on the latest research or alerts.

deleted 5y ago

[deleted]

ooyy 5y ago

Metabolic syndrome is on the same spectrum of chronic illnesses as type 2 diabetes. It's not surprising that even non-diabetics can benefit from t2d drug metformin considering that only 11% Americans are fully metabolically healthy meaning they meet none of the criteria for metabolic syndrome. But if you are one of these metabolically healthy people, you probably wont benefit from metformin.