Metformin
Metformin is a well-known oral medication traditionally used to manage type 2 diabetes. In recent years, it has gained recognition in longevity and anti-aging medicine due to its impact on insulin sensitivity, mitochondrial health, inflammation, and cellular aging. As a caloric restriction mimetic, Metformin is now widely used off-label to support metabolic health, fat loss, and cellular resilience, with potential to reduce age-related diseases and improve health span.
How does it work?
Metformin targets multiple aging-related pathways through metabolic regulation and mitochondrial support:
AMPK Activation
• Metformin activates AMP-activated protein kinase (AMPK), a key energy sensor that promotes fat oxidation, glucose uptake, and mitochondrial biogenesis—mimicking the effects of fasting.
Insulin Sensitivity & Glycemic Control
• It lowers circulating insulin and glucose levels, helping reduce systemic inflammation and oxidative stress, two hallmarks of aging and metabolic decline.
mTOR Pathway Modulation
• By inhibiting the mTOR pathway, Metformin slows down cellular overgrowth and supports autophagy—a crucial anti-aging process for cellular cleanup and repair.
Benefits
✓ Enhances insulin sensitivity and stabilizes blood sugar
✓ May reduce visceral fat and improve body composition
✓ Supports mitochondrial function and metabolic flexibility
✓ May reduce the risk of age-related diseases (heart disease,
cancer, cognitive decline)
✓ Activates cellular repair pathways (AMPK, autophagy)
✓ Backed by decades of safety data
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Frequently Asked Questions
What can I expect with Metformin treatment?
• Start with 500mg once daily, gradually titrate up to 1000–2000mg daily if tolerated
• Week 1–2: Improved blood sugar and appetite control
• Week 4+: Enhanced energy, fat loss, cognitive clarity
• Full anti-aging and metabolic benefits seen with consistent, long-term use
• Best when combined with fasting, low-glycemic nutrition, and exercise
• Missed dose? Skip and resume at the next scheduled time—do not double up
What are the possible side effects of Metformin?
Common (Typically transient):
• Nausea
• Diarrhea
• Gas or bloating
• Metallic taste
Less Common / Monitor If Present:
• Vitamin B12 deficiency (check annually)
• Lactic acidosis (rare; risk higher in kidney/liver impairment or alcohol abuse)
• Decreased appetite or mild fatigue
Precautions:
- Not recommended in patients with eGFR <30 mL/min
- Caution with alcohol or severe calorie restriction
- Monitor B12 annually with long-term use
- Take with food to reduce GI side effects
