Metformin
Glucophage · Antidiabetic (longevity research)
What it is
The first-line type-2 diabetes drug for 60 years, adopted by the longevity crowd after diabetics on it appeared to outlive non-diabetics in one famous (and heavily criticised) analysis. Cheap, everywhere, and the subject of the long-delayed TAME trial.
What human evidence shows
Bulletproof for diabetes. For longevity in healthy people: the Bannister analysis that started it all has known survivorship flaws, mouse data is mixed, and one consistent human finding CUTS AGAINST the hype — metformin blunts part of the adaptation to exercise (VO2max and muscle gains). For someone training hard, it may subtract more than it adds.
Risks
GI distress is common and real. B12 depletion with long use (worth testing). Lactic acidosis is rare and mostly a kidney-function story. The quiet cost for this audience is the exercise-adaptation blunting — taking a longevity drug that eats your training response is a bad trade nobody advertises.
Legal status
US: prescription-only (not scheduled). Widely prescribed off-label.
Evidence base
established literature
Large human evidence base: several phase 3 or 4 trial reports, plus multiple meta-analyses or systematic reviews.
- phase 3/4
- 356
- randomised
- 3,563
- reviews
- 1,350
- human trials
- 4,260
Counts are of published papers, not distinct trials, and measure how much research exists — not whether this works or is safe for you.
Research (12)
- Understanding and overcoming metformin gastrointestinal intoleranceDiabetes Obes Metab · 2017
- Metformin and the gastrointestinal tractDiabetologia · 2016
- Metformin--mode of action and clinical implications for diabetes and cancerNat Rev Endocrinol · 2014
- Metformin: historical overviewDiabetologia · 2017
- Metformin: Is it a drug for all reasons and diseases?Metabolism · 2022
- Metformin-associated lactic acidosis: Current perspectives on causes and riskMetabolism · 2016
- Metformin and Systemic MetabolismTrends Pharmacol Sci · 2020
- A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends LifespanFront Endocrinol (Lausanne) · 2021
- Metformin derivatives - Researchers' friends or foes?Biochem Pharmacol · 2023
- Metformin: A Promising Antidiabetic Medication for Cancer TreatmentCurr Drug Targets · 2023
- Metformin - a new approachPediatr Endocrinol Diabetes Metab · 2021
- MetforminEndocrinol Metab Clin North Am · 1997
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