Metformin, a decades-old drug primarily used to treat type 2 diabetes, is gaining attention for its potential benefits beyond blood sugar control. Emerging research suggests it may play a role in slowing aging, preventing certain diseases, and even mitigating the severity of viral infections.
Metformin's Multifaceted Effects
Metformin's mechanism of action is complex, influencing metabolism, cellular processes, and the body's response to viruses. It is believed to mimic the effects of fasting and exercise by stimulating autophagy, a cellular cleanup and renewal process, and by improving metabolic regulation. Some individuals taking metformin have reported weight loss, typically in the range of 5 to 15 pounds, due to its impact on appetite and blood sugar regulation.
Carolyn Bramante, a researcher at the University of Minnesota, prescribes metformin for patients with diabetes, prediabetes, and weight issues, noting that some patients lose up to 10% or more of their starting weight.
Anti-Aging Potential
Interest in metformin's anti-aging properties is growing, with some researchers suggesting it could delay the onset of age-related diseases such as cancer, cognitive decline, and vision loss. Studies indicate that metformin may delay stem-cell aging, encourage autophagy, and reduce telomere shortening, all of which are associated with the aging process.
Nir Barzilai, Director of the Institute for Aging Research at the Albert Einstein College of Medicine, is a proponent of metformin for healthy aging. He co-authored a 2020 paper in Cell Metabolism outlining how metformin can improve cellular behavior in aging bodies. Barzilai is planning a large-scale trial called "Targeting Aging with Metformin" (TAME) to assess metformin's impact on the incidence of age-related diseases.
Protective Effects Against COVID-19 and Other Infections
Metformin has also shown promise as a prophylactic against severe COVID-19 and long COVID. A 2022 study found that overweight individuals who took metformin as a preventative measure against the virus were less likely to develop severe illness and long COVID. Additionally, a study of US veterans with pneumonia found that those taking metformin were less likely to die.
David Boulware, an infectious disease expert at the University of Minnesota, started taking metformin after contracting COVID-19, hoping to reduce the odds of a severe case. He also continues to take it for weight management, having lost 10 pounds.
Considerations and Cautions
While the potential benefits of metformin are intriguing, experts caution against its indiscriminate use, particularly among young people. Metformin can have side effects, including gastrointestinal upset, and may negatively impact muscle growth and testosterone levels. Some studies suggest it could also harm sperm.
Marco Quarta, CEO and co-founder of Rubedo Life Sciences, emphasizes that metformin is "not a magic pill" and advises caution until further studies confirm its benefits and identify which individuals are most likely to benefit.
Barzilai discourages young people under 40 without diabetes from taking metformin for longevity, citing concerns about its effects on testosterone and muscle. However, he encourages older adults to discuss metformin with their doctors, given the growing evidence of its potential benefits.
The TAME Trial: A Pivotal Study
The planned TAME trial, led by Barzilai, aims to enroll 3,000 older adults at 14 medical centers across the US. The five-year trial will assess metformin's impact on the incidence of a cluster of age-related diseases, including cancer and Alzheimer's. If successful, TAME could be the first study to provide evidence for a new class of anti-aging drugs, called "geroprotectors," potentially leading to their approval by regulatory agencies.
