Aging is inevitable and can impact many aspects of your health and lifestyle. Aging can be accompanied by stiffening joints, decreased energy, increased susceptibility to disease, and more. In addition, the elderly are much more likely to be diagnosed with heart disease, experience a stroke, and develop cancer. In recent years, anti-aging products and therapies have been a hot topic and have been gaining significant publicity.
There are many anti-aging products that are currently available. They boast a variety of benefits from improved skin complexion and cellular health, to better fitness and reduced joint pain. One of the products that is garnering more and more attention is the drug metformin, but can this medication really provide benefits to slow the aging process?
What Is Metformin?
Metformin is generally used by individuals with type 2 diabetes to help control blood glucose levels.
This medication works by reducing the amount of sugar, also known as glucose, released by the liver. In addition to lowering the overall sugar levels in the blood, metformin also helps to increase insulin sensitivity.
Insulin sensitivity is the ability of insulin to take glucose out of the blood and into the cells. Low insulin sensitivity correlates to reduced insulin effectiveness and increased blood sugar levels. Taking metformin may take four to five days to see optimal results. It is often used in conjunction with dietary changes and exercise programs.
How Does Metformin Work?
Metformin is a part of the class of drugs known as biguanides, which inhibit the production of glucose in the liver.
The body transforms glucose into glycogen so that it can be stored in the body on a long-term basis. The liver contains glycogen stores, and when the body is low on energy, it can trigger the liver to break down glycogen to produce glucose.
The liver also produces large amounts of glucose through a process known as gluconeogenesis. This process generates glucose by breaking down sources besides carbohydrates, such as amino acids, lactate, and glycerol.
Generally, this process works well; however, with type 2 diabetes, the effectiveness of insulin is decreased. The body has trouble taking glucose from the blood and transporting it into the cells. Insulin is released from the pancreas, and when cells don’t allow glucose to enter, it is known as low insulin sensitivity. When prolonged, this leads to chronically elevated blood glucose levels, worsening diabetes, and a variety of other health issues.
How Popular Is Metformin?
Metformin is used by around 120 million people around the world, and its wide availability, lack of severe side effects, and affordable cost contribute to its usage. This medication is becoming even more popular due to the various other benefits it can produce.
Why Would You Take Metformin for Anti-Aging?
With age, various health issues can arise as the body begins to break down. However, while aging itself cannot be considered a disease, it is linked to a variety of other processes that can lead to significant health conditions and reduce your life expectancy. Diseases are an especially significant contributor to death rates in industrialized and developed countries.
Because of this, slowing the aging process can help reduce the risk of being diagnosed with potentially harmful diseases and conditions in the future.
While metformin is primarily used to treat type 2 diabetes, research has shown it has the ability to protect the body against a variety of other diseases as well.
Some of these include cancer, inflammation, cognitive decline, dementia, diabetic nephropathy, and more.
In addition to the protective effects, metformin has also been shown to prolong life and promote longevity.
Studies with human subjects have confirmed preliminary results from animal studies. Specifically, multiple studies have examined diabetic and cardiovascular patients and have shown that metformin increased life expectancy, decreased frailty, and reduced risk of dementia and memory loss.
Studies on Metformin
Metformin has been extensively studies, and there are many positive results. Here are the most notable.
1. Metformin: A Hopeful Promise in Aging
Research by Cold Spring Harb Perspect Med. published 2016
Over the last several years, many drugs have been identified as having anti-aging properties and shown promise to promote life extension; one of these drugs is metformin. Cold Spring Harb Perspect Med completed a comprehensive review of various studies, examining the ability of metformin to slow the aging process.
The authors noted that metformin causes a number of therapeutic effects, and this profile makes it an ideal candidate for promoting reverse-aging effects. Initial tests were done in worms, mice, flies, and rats. Many studies on these populations have demonstrated significant improvements in lifespan with long-term metformin ingestion. These same benefits have been seen in humans as well.
2. Repurposing Metformin: An Old Drug With New Tricks in Its Binding Pockets
Researched by Biochem J. Published 2015
In 2015, an article published in the Biochemical Journal examined metformin’s use as an anti-aging strategy. The authors examined the cellular processes and impacts of metformin throughout the body. They also collected data from many studies on insects, animals, and human subjects.
After examining all available data, they found that there was evidence from several organisms that demonstrated significant potential for metformin to be used as an anti-aging strategy. While many possible benefits of metformin have been researched, the authors noted that there are many others that likely have yet to be discovered and that further research is required to establish the full range of benefits metformin may offer.
3. Metformin – Do We Finally Have an Anti-Aging Drug?
Researched By Cell Cycle. Published 2013
In 2013, Vladimir Anisimov published a study examining the role of metformin on the aging process. The author noted that there are nine hallmarks of aging in mammals, including genomic instability, mitochondria malfunction, stem cell destruction, decreased cell-to-cell communication, and others.
He also described that it appears that metformin has the ability to positively impact all nine of these factors. Some potential benefits of metformin that have been found in studies include improved DNA formation and repair, reduced cell mutation rates, lessened cellular stress, and many more. Anisimov further notes that in addition to anti-aging potential, metformin also has shown promise in its ability to slow or stop cancer progression.
4. Metformin as a Tool to Target Aging
Researched by Cell Metab. Published 2016
Due to the evidence that exists supporting metformin as an anti-aging drug, four authors proposed a study design to further evaluate this medication’s potential benefits. The authors noted that health span, which is the time of a person’s life in which they are fully functional and free of chronic illness, was the main outcome to be evaluated.
The authors emphasize the various bodily processes that metformin can benefit, including decreased insulin levels, reduced DNA damage and enhanced repair, lessened inflammation and cell self-destruction, and many more. However, there is still uncertainty regarding the method of impact, being whether metformin impacts multiple pathways and systems simultaneously or effects just a single pathway that trickles down to other processes as well.
Initial studies, especially those done in rodents, provided promising results, demonstrating lifespan increases of 14 percent when metformin was taken starting early in life. Other studies have shown similar increases as well, ranging from four to 20 percent.
However, not all studies had positive results on lifespan. But, after looking at results, it appears that the range of benefits may be related to the dose of metformin provided. This proved to researchers the importance of establishing an effective dose that was not toxic to the human body. After examining all clinical trials, the authors noted that a dose of up to 1,600 to 1,700 milligrams per day is the maximum dose needed to elicit the desired results.
5. TAME: Targeting Aging with Metformin
Researched by the American Federation for Aging Research. Trial is ongoing
The Targeting Aging with Metformin (TAME) Trial is an ongoing research project based on the previous study’s outline and findings. This trial design involves enrolling 3,000 individuals between the age of 65 and 79 for evaluation, and the estimated completion date for the trial is August 2024, lasting a total of six years. Currently, there are 14 different sites across the United States that have been secured and are involved in the trial.
Administering metformin to these individuals will then allow researchers to evaluate outcomes related to heart disease, cancer, dementia, diabetes, Alzheimer’s, and mortality. The study’s goal is to gain approval from the Food and Drug Administration for metformin to be a usable treatment with benefits directly related to aging.
Every medication has side effects, and with Metformin, it is no different. This medication can also have other affects on the body including the following:
While taking Metformin, it can cause all exercise to not have any results
One potential concern with metformin is its effect on exercise. One study in 2018 examined the potential effects of metformin and exercise when used together. It is well known that exercise has protective effects on the heart and lungs and improves insulin sensitivity. Exercise can reduce the incidence of heart disease, lung disease, diabetes, and more.
However, when metformin is used in conjunction with exercise, researchers found that the typical effects of exercise were diminished. The study involved two groups. Both groups received the same exercise training, but only one group received metformin treatment in addition to the training.
The exercise-only group demonstrated improvements in insulin sensitivity and better respiratory function; however, metformin reduced the magnitude to which these benefits were seen. Because of this, more research must be conducted to establish if metformin has an antagonistic effect when used with exercise.
It can cause B12 problems. You can take a B12 supplement to counteract.
Another potential issue with metformin is that it has a permanent negative effect on your body’s ability to absorb vitamin B12. This vitamin plays a critical role in preserving brain function, preventing dementia, improving artery health, and regenerating damaged and destroyed cells.
If you do decide to take metformin, it is critical that you take a high-quality vitamin B12 supplement, preferably in methylated form. This will ensure that your body is still able to obtain an adequate amount of this nutrient, negating any potential negative effects.
When Should You Not Take Metformin
Metformin is contraindicated if you suffer from several different health conditions. You should not use metformin if you have moderate to severe kidney disease, advanced liver disease, metabolic acidosis, or diabetic ketoacidosis. In addition, you should not be taking metformin if you require an x-ray or CT scan that involves injecting dye into your veins.
Metformin is broken down in the kidneys, and this can result in kidney dysfunction when the medication is taken on a long-term basis or at high dosages.
Because of this, if you have serious existing kidney issues or are receiving dye, which must be broken down by the kidneys, you should avoid taking metformin. Metformin also affects liver health by inhibiting certain enzymes that reduce functionality. We’ll discuss more about the effects of acidosis later on.
Metformin generally causes mild side effects. Usually less than other drugs similar to it
Compared to many other drugs used for similar purposes, metformin has very few associated side effects and is quite safe to take. However, there are still many people that stop taking this medication for various reasons.
Metformin puts little, if any, strain on many of the internal organs, is not associated with weight gain, and is also one of the most affordable diabetes medications available on the market.
The main side effects noted negatively impact the gastrointestinal tract. Although these minor side effects can deter individuals from taking this medication.
Possible Side Effects
Some of the most common side effects that can occur with metformin use include:
- Stomach pain
Possible Serious Side Effects
This drug has a black box warning, which is the most serious warning that the Food and Drug Administration issues regarding medications. This warning alerts patients about potential drug effects that may be dangerous and cause serious harm.
The main serious side effect that can be seen with metformin use is lactic acidosis.
Lactic acidosis occurs when lactic acid builds up in the bloodstream. Lactic acid is a byproduct of energy production in cases where oxygen levels are low.
When metformin is broken down within the body, this medication inhibits gluconeogenesis in the liver to prevent extra glucose from being manufactured. As part of this step, an enzyme known as pyruvate carboxylase is inhibited, and this results in the buildup of lactic acid in the bloodstream. Metformin can also inhibit the breakdown of lactic acid, further increasing levels within the blood. When left untreated, lactic acidosis can cause confusion, liver failure, trouble breathing, weakness, cramping, rapid heart rate, and even death.
The FDA has issues a number of warnings regarding metformin use as well:
- Do not take metformin with alcohol. Alcohol can increase your risk of lactic acidosis from metformin by inhibiting your liver function. Alcohol may also raise or lower your blood sugar levels due to its high sugar content and poor nutritional value.
- Do not take metformin if you have moderate to severe kidney injury or disease. Metformin inhibits kidney function and can lead to multiple organ system failure if left untreated. Kidney dysfunction can also increase your risk for having lactic acidosis.
- Do not take metformin if you have liver problems. Liver disease is a risk factor for lactic acidosis, and metformin inhibits liver function and may cause liver failure.
The dosage of metformin you will be prescribed is affected by the type and severity of the condition you are using metformin to treat. Your age, the form of the medication you are taking, and any other existing health conditions you have been diagnosed with all play a role in your dosage. It will also depend on what you are taking Metformin for; diabetes, or anti-aging purposes.
In many cases, your provider will start you off with a low initial dose of metformin. This dosage can then be altered and adjusted over time to ensure the proper benefits are being provided. It is common practice to use the lowest possible dosage to elicit the desired effects. Elderly patients are often prescribed lower doses as well as kidney function is often inhibited. This can lead to reduced medication clearance and elevated or toxic levels in the blood.
There are two different forms of metformin that you may be prescribed: regular and extended release. The extended release version is often tolerated better by many individuals, because the effects are distributed over the course of several hours. However, some people may require the regular dose if they have especially high levels of glucose after a meal.
Metformin is the generic form of this drug. There is also a brand name version of this medication, with the immediate-release form called Glucophage. The extended-release forms are Glucophage XR, Fortamet, and Glumetza.
The immediate-release form comes in dosages of 500 milligrams, 850 milligrams, and 1,000 milligrams. Each of these is taken orally in pill form. The extended-release tablets are supplied in dosages of 500 milligrams, 750 milligrams, and 1,000 milligrams.
For adults, the most common starting dosage for is either 500 milligrams twice a day or 850 milligrams once per day taken with meals. This dosage can be increased up to 2,550 milligrams per day, and any dosages over 2,000 milligrams must be split into three doses each day.
Extended-release medications often begin with a 500-milligram dose once in the evening. This dosage can be increased to up to 2,000 milligrams daily taken in two doses.
For children between 10 and 17, only immediate-release tablets are used for the majority of patients. The typical starting dose is 500 milligrams taken twice per day, with the maximum dosage being 2,000 milligrams per day. This medication has not been studied in children under 10 years of age and should not be used by them until further research has been conducted.
Always Talk to Your Doctor
Metformin is not an over-the-counter medication, and because of this, it must be prescribed by a doctor.
If you feel that metformin may be a good option for you, it is important to speak with your physician as they will help you find out if this medication will be right for you.
This medication can react with other medications and cause serious side effects and health issues. Because of this, your doctor will be able to speak with you and evaluate your current health status, prescription and over-the-counter medications, and potential future health diagnoses. This will allow you to better understand the potential benefits of metformin, and if they are relevant to your specific situation.
The benefits of metformin relating to type 2 diabetes management are well known. The various other potential uses for this medication are becoming more established through various trials. Metformin for anti-aging has becoming increasingly popular.
The current research suggests that metformin can provide a number of benefits including;
- Reduced incidence of cancer and heart disease
- Decreased inflammation
- Slowed cognitive decline and dementia progression
- Improved cellular communication and repair
While further studies may still be needed to confirm results, establish proper dosages, and ensure safety, there is most definitely potential for this medication to be used to slow the aging process. The TAME Trial that is currently taking place should provide significant evidence of the potential benefits of this medication. In the coming years, metformin may become more widely available and used to slow the aging process and increase longevity.