
Unless you’re diabetic or suffer from PCOS, you probably haven’t heard of metformin. This behind-the-scenes drug has been hailed as the “cornerstone” of Type 2 diabetes treatment for years. But outside diabetic circles, it has received very little press…until recently, that is.
In 2019, CNBC published an unusual report. Interviews with dozens of Silicon Valley techies – most of whom do not have diabetes or PCOS – revealed that the richest among us often take this 5-cent-a-pop pill for another “ailment” entirely: aging.
So, what do a centuries-old diabetes medication and the quest for eternal youth have in common?
What is Metformin?
Metformin (brand names: Fortamet, Glucophage, Glumetza, and Riomet) is an FDA-approved drug that primarily treats Type 2 diabetes. This prescription-only drug comes in both pill and liquid forms, with doses ranging from 1,000 to 2,500 milligrams per day.
Though metformin is now readily available to patients ages 10 and over, that wasn’t always the case. In fact, as recently as the 1980s, the FDA staunchly declared that metformin would “never” be approved in the United States.
To understand why, let’s take a brief trip down memory lane.
A Brief History of Metformin
Metformin, much like aspirin or THC, has been used in plant form for hundreds of years.
In medieval Europe, the medicinal herb Galega officinalis was a popular treatment for frequent urination. (We now know that frequent urination is an indicator of diabetes.) The plant went by different names around the world, including French lilac, false indigo, and Spanish sainfoin.
But by the 1950s, Europe once again approved metformin for diabetes treatment. (Unlike phenformin, metformin only rarely causes serious side effects.) The U.S. FDA was far warier, vowing in the 1980s to “never” approve its use again. But public and scientific opinion pushed back as more use cases poured out of Europe. Finally, in 1995, the FDA approved metformin for Type 2 diabetes patients once more.
However, ongoing research suggests that metformin’s benefits may extend far beyond the realm of diabetes.
How Does Metformin Work?
Potential Side Effects
Fortunately, these tend to be relatively mild, and may subside as your body adjusts to the medication. Many healthcare providers also stair-step up metformin doses, slowly increasing to a maximum of 2,500 milligrams per day.
However, some populations are ill-suited for metformin due to underlying risk factors. For example, those at risk of severe kidney disease, metabolic acidosis, or diabetic ketoacidosis generally shouldn’t take metformin.
What are the New Uses for Metformin?
For example, metformin is often prescribed off-label to treat non-insulin-dependent diabetes like pre-diabetes and gestational diabetes. Women with PCOS (polycystic ovarian syndrome) may also take metformin to modulate insulin sensitivity, weight loss, and fertility.
And thanks to its weight loss potential, some doctors use metformin to mitigate weight gain in individuals taking certain antipsychotics.
However, these are just metformin’s generally accepted uses. In recent decades, scientists have become increasingly intrigued by data coming out of studies on Type 2 diabetics and metformin. In particular, research has shown that metformin may have a number of positive – but unintended – consequences.
Metformin’s Unintended Side Effects
Until recently, the FDA has been reticent to approve metformin for large-scale studies outside of the diabetic population. But within this population, scientists have discovered that metformin may:
Metformin and Longevity
Additionally, one small human trial found that metformin may cause changes in bodily processes that protect against aging. And while we can’t pinpoint why, metformin shows a range of unintended and indirect effects that target the aging process, including:
• Boosting cellular metabolism
• Reducing oxidative stress
• Protecting vascular (blood vessel) function
• Boosting cellular health in organ linings
Some research also indicates that metformin’s ability to modulate blood sugar and insulin receptivity contributes to several benefits. For example, it’s well-known that sugar can cause inflammation – and metformin is thought to lower inflammation via hypoglycemic pathways.
Moreover, it’s thought that high insulin levels may promote cancer. Because metformin modulates insulin (and other hormones), it’s possible that the reason metformin is great for diabetics is what gives it such great anti-cancer potential.
The Future of Metformin as an Anti-Aging Superpower
One of metformin’s most ardent supporters is an endocrinologist by the name of Dr. Nir Barzilai, MD. As director of the Institute for Aging Research at the Albert Einstein College of Medicine, he’s spent his life seeking to counteract the effects of aging on the body. And now, he’s heading an unprecedented research trial to prove that metformin may just be an anti-aging miracle drug.
Building on Past Discoveries
• Lived longer
• Suffered fewer cardiovascular events
• Was less likely to suffer dementia and Alzheimer’s
• Got cancer 25-40% less often than other diabetic populations
• Outlived diabetics with cancer on other medications
Additionally, later research from 2014 found that in a study of 90,400 Type 2 diabetics, metformin was more likely to help diabetics live longer. And that was true not only compared to individuals on other anti-diabetic medications, but also non-diabetics who didn’t take the drug.
Spearheading History in the Making
Armed with information from prior research studies, Dr. Barzilai persuaded the FDA to green-light a massive study – and the first of its kind. The study, dubbed TAME (Targeting Aging with Metformin), collected 3,000 people aged 65-79 to look at metformin’s effects on the aging process, including its:
• Cognitive effects
• Cardiovascular potential
• Anti-cancer properties
Through TAME, Dr. Barzilai hopes to demonstrate that metformin usage can delay the onset of age-related diseases. And while he believes metformin could extend an individual’s lifespan, for him, that’s not the ultimate goal. Instead, he hopes to improve people’s quality of life as they enjoy their golden years.
Metformin: A Longevity Wonder Drug in the Making?
Dr. Barzilai’s research hasn’t yet concluded, so the jury is still out on metformin as an anti-aging miracle. That said, multiple smaller, tangential studies suggest that metformin’s potential extends far beyond the realm of Type 2 diabetes.
And though it shows significant anti-cancer, pro-cognition, pro-cardiovascular effects – all of which are crucial to the anti-aging formula – no one quite understands why.
Fortunately, current and future studies plan to examine these potential benefits in full. And while those outside Silicon Valley require a doctor’s prescription to enjoy these benefits, Nir Barzilai hopes to change that soon.
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