Longevity 101: What is Metformin?
What is Metformin, and why are scientists and clinicians excited about its potential to help slow down aging and improve health?
Metformin originates from the plant Galega officinalis or French lilac, goat’s plant or goat’s rue. This plant was fed to goats to improve milk production. It grows as a perennial herb, 3 feet tall, with purple, blue or white flowers and was used in the Middle Ages to treat frequent urination, a side effect of diabetes. The Native American Seminole tribe used the insecticide roterone, found in the roots of Galega officinalis, in fishing. Fish were stunned by roterone, and were much easier to catch. This plant has powerful properties and is now widely considered poisonous.
Metformin was first described by scientists in 1920. Chemists found that they could make the active compound from this plant, guanidine, more tolerable to be ingested by bonding two guanidines together forming a biguanide. This compound, which could lower blood sugar, was first synthesized in 1929. However, insulin had also been discovered during this time and became the more popular option for controlling blood sugar. Metformin was neglected and ignored until 1950 when metformin was used to treat influenza. Doctors noted metformin decreased glucose levels.
In 1958, Metformin was finally released in the United Kingdom as a treatment of lowering blood sugars. This drug was clinically developed and called Glucophage (“glucose eater”). Glucophage was released in the United States in 1995 and quickly became a popular medicine. Finally after half a century, it’s potential was realized. Metformin has now become the world’s most widely prescribed anti-diabetic agent and is universally recommended as the first therapy for Type 2 diabetes, accounting for more than 83 million prescriptions in the U.S. alone.
In recent years, scientists and clinicians have been investigating Metformin as more than just a glucose-control drug. Rather, one that could provide significant longevity benefits and address specific hallmarks of aging for both diabetics and non-diabetics. In fact, Metformin is currently undergoing study in a large scale FDA approved anti-aging clinical trial, the Targeting Aging with Metformin Trial.
So, how does Metformin work, and why are so many scientists and clinicians excited about its potential to help slow down aging and improve healthspan?
In simple terms, Metformin lowers blood sugar levels – and it does so in two ways. Metformin both reduces how much glucose is released from the liver into the bloodstream, and it helps the cells of your body to absorb more glucose from the bloodstream. The benefits of improved blood sugar levels range from weight loss to lowered heart attack and stroke risk to reduced inflammation and a reduction in stress hormones. Since metformin does not cause hypoglycemia (low blood sugar), it can be safely utilized in a variety of diseases such as pre-diabetes, gestational diabetes, polycystic ovary disease, sleep apnea, osteoporosis and cancers.
Metformin’s potential benefits however appear to extend far beyond its ability to control sugar. Metformin is potentially associated with lower risks of:
All-cause mortality
Pre-diabetes and diabetes
Dementia
Certain types of cancer
In several clinical studies, Metformin was associated with lower incidence of multiple age-related diseases as well as all-cause mortality in both diabetics and non-diabetics.
A landmark study from the U.K. followed 78,000 diabetics over several years to determine which treatment helped them live as close as possible to non-diabetics. To the researchers surprise, diabetics who took Metformin actually outlived non-diabetics. A recent meta-analysis showed that Metformin reduced all-cause mortality and diseases of ageing independent of its effect on diabetes control. In that study diabetics taking Metformin had significantly lower all-cause mortality compared to non-diabetics, as did diabetics taking Metformin compared to diabetics not taking Metformin. Metformin users also had reduced cancer compared to non-diabetics and cardiovascular disease (CVD) compared to diabetics receiving non-metformin therapies.
Metformin has been associated with lower risk of developing diabetes. Perhaps the largest study supporting this is the Diabetes Prevention Program (DPP), sponsored by the National Institute of Health from 1996-2001. The study followed 3,000 people over 5 years. The study concluded that participants who took Metformin lowered their chances of developing type 2 diabetes by 31 percent compared with participants who took a placebo.
Metformin has been associated with reduced risk of dementia. A 2017 study published in Neurology of over 17,000 diabetic patients aged 65 or older were followed for 5 years to determine the risk of dementia. The study concluded that risk is reduced when taking Metformin. Similarly, a smaller 2014 study of approximately 365 individuals, aged 55 or older, concluded Metformin use showed a significant inverse association with cognitive impairment.
There are multiple published studies showing an association between the use of Metformin and reduced risk of certain types of cancer.
The Mayo Clinic completed an ovarian cancer study and concluded that diabetic women who took Metformin had better survival than non-diabetic women who did not take Metformin. This is extremely impactful, as ovarian cancer is the 5th most common cancer in women, as well as the deadliest, with a mortality rate of 65%. A very recent study in men with advanced prostate cancer published June 2021 showed Metformin to significantly improve cancer free survival.
Metformin has been demonstrated to have weight loss benefits, too. The aforementioned Diabetes Prevention Program (or DPP) published a ten year follow-up study that concluded Metformin patients lost an average of 2.5kg (or 5.5 pounds) and maintained most of that weight loss throughout the 10 year follow-up.
If you’d like to learn more about Metformin and our anti-aging protocols to see if they are right for you, contact our clinic for an in person or online visit - DrFabio.com.
About The Center for Integrative Healing & Wellness
Dr. Fabio Almeida M.D. ABOIM, ABNM, ABOM is the founder and director of the Center for Integrative Healing & Wellness at the CIVANA Carefree Resort. Dr. Fabio is a triple board-certified physician with expertise in Integrative & Functional Medicine/Oncology, Molecular Imaging and Obesity. He served as an Assistant Professor of Radiology & Radiation Oncology, and subsequently as the Director of Molecular Imaging for the University of Arizona Medical Center in Tucson Arizona. Dr. Fabio is a fellow of the Integrative Medicine Program at the University of Arizona, where he acquired expertise in integrative medicine, herbal medicine, nutrition, fitness, acupuncture, and stress management. He is published in several peer-reviewed journals and book chapters in radiology, oncology, cardiology, nutrition, and information science.
At the Center, Dr. Fabio and his team offer concierge adult primary care and a wide variety of personalized integrative, holistic and anti-aging therapies (traditional medicine, nutrition, culinary medicine, herbal/botanical, lifestyle, weight loss, hormone balance, fitness, energy medicine) to address all our client’s longevity and health care needs.