SCIENCE & RESEARCH
Metformin
Background and history
- Oral diabetes medicine that helps control blood sugar levels
- FDA approved drug to treat diabetes
- An oral tablet derived from natural compounds in the French Lilac plant
- Used successfully for over 60 years with an outstanding safety record
- On the World Health Organization’s Model List of Essential Medicines, a catalog of the most effective, safe, and cost-effective therapies
Longevity benefits
- Lowers ESR (erythrocyte sedimentation rate), a marker of inflammation in the body
- Lowers risk of colon and pancreatic cancer
- Reduces risk of cognitive impairment
- Lowers rate of dementia
- Reduces risk of macrovascular disease
- Provides weight loss in some patients
- Reduces chances of diabetes
Note: Metformin has not been approved by FDA for these uses, but there are multiple studies that have shown these benefits (see below). Learn more about “off label” uses.
Research and studies
GI Cancers
A study conducted at M.D. Anderson Cancer Center involving 973 patients and 863 controls: “Metformin use was associated with reduced risk of pancreatic cancer…”
A retrospective study of 62k patients in UK: “Metformin use was associated with lower risk of cancer of the colon or pancreas…”
A case-control study of 450K US veterans who underwent colonoscopy between 1999 and 2014: “Metformin was associated with a 14% statistically significant reduced rectal cancer odds …”
A representative population study of 800k individuals: “Metformin can reduce the incidences of several gastroenterological cancers…”
Cancer Risk
In a study among patients with high-risk operable breast cancer without diabetes: “…the addition of Metformin vs placebo to standard breast cancer treatment did not significantly improve invasive disease–free survival.”
A retrospective study of 3,800 men conducted in Ontario, Canada: “Increased cumulative duration of metformin exposure after Prostate Cancer diagnosis was associated with decreases in both all-cause and Prostate Cancer-specific mortality…”
A study involving 1,300 patients in Netherlands: “Metformin use was associated with lower cancer mortality compared with non users…”
Ovarian Cancer
A Mayo Clinic study evaluated the association between Metformin and the prognosis in ovarian cancer across 240 women (60 cases and 178 controls). Study had a heavy emphasis on the survival comparisons between diabetic women who had ovarian cancer and took Metformin (cases) and non-diabetic women who had ovarian cancer (controls). “The results from our study demonstrate that Metformin intake independently predicts better survival in patients with ovarian cancer.”
A study of 27 ovaries showed that scarring of the ovaries occurs with age and Metformin maybe able to halt that process: “Metformin abrogates age-associated ovarian fibrosis…”
Type 2 Diabetes
Can people with Type 2 Diabetes live longer than those without? Surprisingly, yes they can, if they are treating it with Metformin. This was the finding of a study of 78k people with type 2 diabetes, compared to a control group of 78k people without diabetic controls. Patients with type 2 diabetes who were taking Metformin had longer survival than did non-diabetic control matches.
Diabetes Prevention
A diabetes Prevention Program Group study showed that lifestyle intervention or Metformin significantly reduced diabetes development over 15 years. “At year 15, the cumulative incidences of diabetes were 55% in the lifestyle group, 56% in the Metformin group, and 62% in the placebo group.”
Cognitive Impairment
A study of 365 people aged 55 and over, who were followed for 4 years: “Controlling for age, education, diabetes duration, fasting blood glucose, vascular and non-vascular risk factors, Metformin use showed a significant inverse association with cognitive impairment.”
A study of 67,731 participants who were non-demented, non-diabetic, aged 65 or over at baseline, from January 2004 to December 2009: “Diabetes is associated with an increased risk of dementia. The risk effect becomes weaker provided that participants take sulfonylureas or Metformin rather than thiazolidinediones for a longer period”
Weight Loss
A study of 154 patients over a 6 month period in Germany: “Metformin is an effective drug to reduce weight in a naturalistic outpatient setting in insulin sensitive and insulin resistant overweight and obese patients…”
Fertility
A study of 43 women in Ohio: “Metformin-induced resumption of normal menses in 39 of 43 (91%) previously amenorrheic women with the polycystic ovary syndromes…”
Macrovascular
A study of 390 patients in a randomized, placebo-controlled trial with a follow-up period of 4.3 years: “Metformin did, however, reduce the risk of macrovascular disease after a follow-up period of 4.3 years…”
How it works
Background and History
For an organism to survive, there has to be a balance between the anabolic processes which generate energy, and catabolic processes that use this energy for fuel. The balance is especially important when energy intake is low and cells don’t have an adequate supply to meet the demand. In such cases, organisms avoid crisis by implementing biological austerity measures, reallocating limited resources from growth and reproduction to self-preservation and survival. Significantly, organisms in this “thrifty” state show remarkable resistance to multiple age-onset pathologies.
Metformin delivers this effect by limiting metabolic reactions in mitochondria, thereby slowing down the process by which our cellular powerhouses convert macronutrients to energy. This results in less ATP production, which in turn activates AMPK, an enzyme that senses when a cell has low energy levels. When low levels are detected, AMPK activates multiple pathways to implement biology austerity measures, promoting several energy production benefits.
Cellular energy benefits
- Glucose uptake (Shaw 2005)
- Increased insulin sensitivity and thus decreased insulin levels
- Fatty acid uptake
- Induced fatty acid oxidation
- Decreased IGF-1 signaling (Liu et al., 2011)
- mTOR1 inhibition, the major regulator of cell growth and proliferation (Kickstein et al., 2010; Nair et al., 2014; Pérez-Revuelta et al., 2014)
- Induces autophagy (Song et al., 2015; Xie et al., 2011)
- Reduction in chronic inflammation (Saisho, 2015)
- Reduction in accumulation of oxidative damage
- Reduction of endogenous production of reactive oxygen species (ROS) (Batandier et al., 2006; Bridges et al., 2014; Zheng et al., 2012)
- Switches off energy-consuming processes
- Slows down rate of DNA damage (Algire et al., 2012)
Important safety information and side effects
As with any prescription product, there may be side effects. Generally, the vast majority of side effects will subside after the gradual use of the product over 3-4 weeks.
Most common Metformin side effects
- Gastrointestinal discomfort (diarrhea, nausea, bloating)
- Reduction of Vitamin B12 levels, please supplement Vitamin B12
Most people start with a small dose to avoid stomach discomfort (½ or 1 tablet per day with food, increasing to what has been prescribed on the bottle). We commonly use the extended release (ER) version of Metformin to reduce stomach discomfort.
Note: Metformin is commonly stopped a week before any surgical procedure or medical diagnostic requiring contrast, such as a CT scan. If you are not sure if you need to stop Metformin, please ask the doctor ordering the test or procedure.
For a full list of possible side effects, click here.
Possible drug interactions
Tell your doctor and pharmacist if you are allergic to Metformin, any of the ingredients of Metformin liquid or tablets, or any other medications. Ask your pharmacist or check the manufacturer’s patient information for a list of the ingredients.
Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: amiloride (Midamor); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); beta-blockers such as atenolol (Tenormin), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, InnoPran); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem, Cartia, Diltzac, others), felodipine, isradipine, nicardipine (Cardene), nifedipine (Adalat, Afeditab CR, Procardia), nimodipine (Nymalize), nisoldipine (Sular), and verapamil (Calan, Covera, Verelan, in Tarka); cimetidine (Tagamet); digoxin (Lanoxin); diuretics (‘water pills’); furosemide (Lasix); hormone replacement therapy; insulin or other medications for diabetes; isoniazid (Laniazid, in Rifamate, in Rifater); medications for asthma and colds; medications for mental illness and nausea; medications for thyroid disease; morphine (MS Contin, others); niacin; oral contraceptives (‘birth control pills’); oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); phenytoin (Dilantin, Phenytek); procainamide; quinidine (in Nuedexta); quinine; ranitidine (Zantac); triamterene (Dyrenium, in Maxzide, others); trimethoprim (Primsol); or vancomycin (Vancocin). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Read more here.
Explore Metformin
- Activates Longevity Pathways
- Helps reduce blood sugar levels
- Reduces risk of colon and pancreatic cancer
- Reduces risk of cognitive impairment and dementia
- Reduces risk of macrovascular disease
- Facilitates weight loss
- Lab tested for purity
Starting at $25/mo