Are ancient compounds the new ‘wonder drugs’?
Fascinated by preliminary research suggesting that metformin, a popular drug for controlling diabetes, may help promote longevity, reduce dementia, and prevent many other conditions. It is also controversial among health-conscious technology digerati. COVID.
With origins dating back to medieval Europe, metformin has been used for decades as a powerful tool for lowering blood sugar levels in diabetics.In those patients, it also offers cardiovascular benefits and weight loss.
Its use in conditions unrelated to diabetes is now increasingly common.Intrigued by early research and promotions on TikTok, Instagram and health-focused blogs, Americans Seeking an “off-label” prescription for metformin for a different condition or using the drug at a different dose than the one FDA approved.
However, experts caution that there is insufficient data to recommend a daily intake.
According to Dr. Peter Chinghong, an infectious disease specialist at the University of California, San Francisco, “We should be very cautious about using off-label metformin at this point.” The evidence has to be really strong if you’re taking drugs for,” he said.
Dr. Marilyn Tan, an endocrinologist at Stanford University, said, “Certainly, many young healthy people take it in hopes of ‘biohacking’ to optimize their health and extend their lifespan in the future. While it’s unlikely to do any harm, Tan said: …is not FDA-approved for these other indications. ”
The history of metformin, or dimethylbiguanide, dates back to the traditional European herbal medicine Galega officinalis, or goat roux. Although it can cause side effects in people with kidney problems, it improves blood sugar control by improving insulin sensitivity, reducing the amount of sugar released from the liver into the blood, and increasing glucose absorption. increase.
It is currently the fourth most widely prescribed drug in the nation. About 20 million Americans were prescribed the drug in 2020.
Intriguing are the preliminary findings, based on animal studies and incomplete non-replicated clinical trials, suggesting that the drug may help slow aging and increase life expectancy. Although the underlying mechanisms remain unknown, it may induce cellular changes that improve the body’s responsiveness to insulin and promote vascular health.
Its reputation has grown with a recent barrage of social media attention, including a viral post by Silicon Valley-based internet entrepreneur and “biohacker” Serge Ferg.
“Have you heard of metformin?” asked one Twitter influencer. NOVOS, a New York City-based longevity company that has included Dr. George Church of Harvard University and other acclaimed scientists on its advisory board, posted on Instagram:
The publicity got a further boost last week when a team at the University of Minnesota reported that about 6% of metformin patients infected with the SARS CoV-2 virus experienced prolonged COVID. This study has not yet been peer-reviewed.
But Chin-Hong says there is a better drug — the FDA-approved virus-killing paxlovid — to reduce the risk of prolonging COVID. “Metformin makes no sense against prolonged COVID from an infectious disease standpoint,” he said. “It’s not an antiviral that carries the cards.”
Off label prescriptions are legal and common. An estimated 20% of all US prescriptions are for off-label use, according to the Agency for Healthcare Research and Quality. For example, beta-blockers are approved to reduce the risk of high blood pressure and heart problems, but are used off-label to treat anxiety.
But off-label prescriptions, where scientific evidence is lacking, can put people at risk of receiving ineffective or harmful treatments, Chin-Hong said.
“In the tech world, people use a lot of things off-label, like for weight loss,” says Chin-Hong. “It’s being promoted by celebrities on TikTok. But using off-labels is always a dangerous practice.”
Doctors have long prescribed metformin off label for these conditions.
— Menstrual irregularities in women with polycystic ovarian syndrome. In the 1990s, metformin was shown to lower testosterone levels in women with this common hormonal disorder, suggesting that metformin may help. However, there is currently no clear evidence to support widespread metformin use in these patients, according to a 2017 University of Chicago analysis.
— Gestational diabetes. Metformin is an effective and safe insulin alternative for women who develop glucose intolerance during pregnancy. It also reduces maternal weight gain and reduces the risk of gestational hypertension, according to her 2016 database review by a doctor at Peking University First Hospital.
— Prevention or delay of diabetes. A 2018 evaluation of 40 studies by a team in Los Angeles supports 20 years of evidence supporting the use of metformin to prevent or delay his type 2 diabetes among high-risk patients or those with elevated blood sugar levels. doing. Base Veterans Administration.
— Weight gain with antipsychotics. A 2017 review of research published by a team at the UCLA Medical Center found that certain patients, especially young and healthy patients, lost weight when they took metformin immediately after taking medications for schizophrenia and other psychiatric disorders. less likely to gain weight. But it won’t help after weight gain has already happened.
Other studies have explored the potential of metformin to:
— Reduce the risk of dementia and stroke. His 2016 analysis by Australian scientists found significantly less cognitive impairment in diabetics given metformin. A 2013 study in Taiwan found that the drug also provided protection against stroke in people with diabetes. did not.
— Slow aging. A 2021 analysis of the results of several large studies by a team from Canada and Qatar show that metformin may induce anti-aging changes in people with diabetes. In this study, diabetics improved their health while they were alive.
“There’s a lot of interest in it, and more research is needed to see if it has even more benefits,” Tan said. No study has conclusively shown a statistically significant benefit.”
“It’s a great diabetes drug,” she said.
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