Longevity Benefits of Metformin
What if I told you that there is an inexpensive FDA approved drug that has been used for over 70 years and it has an excellent safety record, and it shows promise great promise in improving longevity? Would you be interested in learning more about it?
I suspect so, which is why we will discuss the longevity benefits of metformin.
What is Metformin?
Metformin is a drug that has been used to treat diabetes in Europe since 1957 and approved by the FDA for use in diabetes in the US in 1994. Prior to its use to treat diabetes, it was used to prevent flu and malaria. It was used as early medieval times to remedy frequent urination – a sign of diabetes. It is a derivative the French Lilac plant also known as goat’s rue.
Metformin is an AMPK activator which triggers autophagy. Autophagy is a process by which the body rids itself of old senescent (nonfunctional) and damaged cells, proteins, an organelles. Clearing out worn out cells and “parts” creates an environment for functional cells to thrive, thus impacting longevity.
Metformin’s Impact on Health Span
Metformin in clinical trial has been shown to have health span effects that go beyond its ability to lower blood sugar in diabetics. In non-type 2 diabetics it has been shown to delay the onset of diabetes. In type 2 diabetics is has been shown to delay development of cardiovascular disease.
In over 200 studies metformin has been associated with less cancer in patients with type 2 diabetes. Other studies show an association between metformin and delay in cognitive decline and Alzheimer’s disease in both diabetics and non-diabetics. And, it appears to lower mortality in patients with type 2 diabetes compared to patients without diabetes.
The Bannister Study showed that diabetics taking metformin lived the same number of years as people without diabetes which is remarkable given that diabetics on other medications die 10 years sooner than non-diabetics.
Not only that, but diabetic individuals over age 70 taking metformin lived longer than their age-matched non-diabetic peers.
All of that is tremendous benefit for a drug that costs about 5 cents a pill.
Now, a more recent study published in December of 2022 conducted by Keys did not find any longevity benefits of metformin use in diabetics over the general population without diabetes and not taking metformin. The study was not designed to study whether diabetics taking metformin lived longer than diabetics not taking metformin, so the study findings do not necessarily mean that there are not longevity benefits from metformin in diabetics.
Longevity benefits of metformin have been seen when specific conditions (diabetes, cancer, heart disease, dementia) have been studied.
What is now needed is clinical prospective study to assess the longevity benefits of metformin. We will get to that downstream in this article.
Metformin Risks When Prescribed for Longevity
In addition, to being an AMPK activator, metformin is a weak mTOR inhibitor. See our article, Incredible Life Extension Benefits of Rapamycin for a more detailed discussion on mTOR. By inhibiting mTOR, metformin interferes with anabolic or tissue building processes such as building muscle. This would be the biggest concern for the use of metformin as a longevity medicine.
Studies show that patients on metformin who engage in resistance training do not gain the same amount of muscle mass as those not on metformin but they do gain muscle. But, there is no difference in their muscle strength compared to those not taking metformin. So while they may not gain as much muscle, the muscle metformin patients build is stronger gram for gram of muscle.
Is Aging a Disease?
Neither the FDA nor the Department of Health and Human and Services (HHS) consider aging a disease. Drugs are studied and approved to treat specific illness and conditions. Since aging is not considered a disease there has been little interest in developing “anti-aging drugs” by pharmaceutical companies. See our article, Why an Anti-aging Drug Can Never Legally Exist.
Basically if there is “no disease” there can be “no drugs”. If aging were considered a disease, then pharmaceutical companies would be incentivized to spend the one billion dollars plus it now takes to bring a drug to market.
Metformin is the focal point of the TAME trial (tame aging with metformin) which has yet to start. The study is being conducted by Nirs Barzilai, MD who is professor at the Albert Einstein School of Medicine and director of the Institute for Aging Research. This is a clinical prospective study.
The TAME trial will be a groundbreaking study serving as a framework and data springboard for the longevity field in attempts to study other drugs with high potential for repurposing for aging. One of its main purposes is to get the government to rethink its position and recognize aging as a disease. If that were to occur we are likely to see an explosion of new drugs and the re-purposing of existing drugs to fight aging.
The TAME trial will involve 3,000 participants at 14 centers (250 patients per center) age 65 to 79. The trial is anticipated to last 4 to 6 years depending on funding. Patients will receive either metformin or a placebo.
Once the trial starts and the longevity benefits of metformin become known, we will stare that with you.
Should You Start Longevity Interventions?
It’s hard to know when to start interventions that may increase longevity. Generally, the earlier you start the likely you are to obtain more benefit. Some patients want to wait until a definitive study has been completed and showed benefit of a particular intervention. Such studies can take years, though, to provide answers.
With metformin there is really good preliminary evidence that it can improve longevity, plus the medication is inexpensive, has seven decades of a safe track record, and is well tolerated in most patients, that you may want to consider taking metformin for longevity purposes before stronger evidence becomes available. You should discuss further with your physician the longevity benefits of metformin.