Question 271 of 433
What do the trials actually show about metformin and aging?
The short answer
Metformin is useful for established indications, but a healthy-person longevity benefit remains unproven.
The case for it: metformin lowers insulin and blood sugar, calms a cellular growth pathway, and reduces inflammation. An early study found that people with diabetes on metformin outlived similar people without diabetes, though later analyses did not confirm it. In the Diabetes Prevention Program it cut progression to diabetes by 31 percent.
The case against: it did not extend life in the federal mouse program. In two studies of older adults it blunted the gains in fitness and muscle from exercise. It lowers vitamin B12 over time and commonly upsets the stomach. And the trial designed to settle the question, called TAME, has gone without full funding for a decade.
Who should take it: people with diabetes, prediabetes that is progressing despite lifestyle change, or polycystic ovary syndrome. If you are lean, active, and have normal blood sugar, I would not.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
ROBUST for diabetes care and selected diabetes prevention; NOT DEMONSTRATED for lifespan in healthy non-diabetic adults.Evidence grade (draft mapping)FNot demonstrated / insufficientARobust human trialsPart 19, Q271 · Part sources
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.