Extension— a magazine I have greatly admired for
years—unleashed what might be properly called "metformin
mania." Consider the title of the article in its
November 2010 issue : "The drug virtually everyone
should ask their doctor about." Here is a revealing
quote from the same article: "...that aging humans
can derive benefit from an antidiabetic drug called
metformin." I point out that the magazine did not
promote the use of this antidiabetic drug for
diabetics but for people without diabetes.
Type 2 diabetes is
caused by insulin receptor dysfunction resulting
from toxicities of foods, environment, and thoughts.
Excess insulin (hyperinsulinemia) so produced is
inflaming, fattening, and cellular grease-building.
For most individuals who are unwilling to take
responsibility for their health, address these
issues, control insulin toxicity, and possibly de-diabetize
themselves, metformin indeed is a good drug.
However, this is a far cry from advising people
without diabetes to take the drug for improving
health. This is as illogical as prescribing
metformin for the so-called polycystic ovary
syndrome, another form of insulin toxicity caused by
the trio toxicities of foods, environment, and
thoughts, in which insulin toxicity plays a crucial
Metformin and Inflammatory Markers
told its readers that metformin is good for people
without diabetes because it positively affects some
genetic pathways. Specifically, it inhibits some
inflammatory pathways, including AMPK and stabilizes
the age-accelerating complex called mTOR. It failed
to mention that these pathways are also activated by
toxicities of foods, environment, and thoughts. So,
metformin does not correct the underlying problems,
just controls their consequences. There is no
evidence that it does so long-term.
The article also
cited studies in which the drug extended the life
span of mice. Extension of life spans of animal
species with drug, of course, is old news. In animal
experiments, the extension of life span is always
associated with birth defects, tissue development
disorders, and metabolic derangements. Serious
students of human biology do not allow such studies
to be used as justification of using drugs.
Certainly, to date, there is no evidence that humans
ever live longer with drugs tested in animals.
Metformin and Cancer Risk
underscored the point that metformin suppresses a
cancer inducing protein called human epidermal
growth factor receptor-2 (HER-2) and asserted that
the drug "can stop cancers from developing." Next it
cited a study that showed that "metformin use by
humans is associated with a substantial (56%)
reduction in the risk for developing breast cancer."
In the past, Life Extension has also claimed that
risk of breast cancer can be reduced by spices,
foods, and nutrients. For example,
Life Extension in its September
2005 issue explained its vision of a simple
business plan for immortality in which a grand spare
parts relacement industry will allow people to live
happily forever. Consider the following quote: 'It
is only a matter of years — decades at most — until
futuristic technologies will entirely
reverse-engineer the human machine.'
Such claims, in
reality, are half truths and untruths. Medical
literature is replete with reports of cancer risk
reduction of foods, spices, and drugs. Taken at
their face values, all cancers could be eradicated
from the face of the earth by just taking three or
more such substances. Alas, that will not happen.
The risk reduction games are mere number games.
Again serious students of human biology learn early
in their lives about the frivolousness of such
claims. Incremental toxicities of foods,
environment, and thoughts will continue to fan the
epidemics of cancer.
Metformin for Treating Cancer
be used to treat forms of cancer that cannot be
treated with surgery or radiotherapy? It is possible
its anti-inflammatory effects may prove to be
beneficial in certain cases. So, it would be prudent
to explore this possibility when the other therapies
fail to control the tumor. I do hope that the
Metformin mania will not lead to the replacement of
effective therapies for cancer—when complete
surgical excision of the growth can be reasonably
expected, for instance—to the great detriment of the
patient. Regrettably I have seen that in many cases.
Metformin for Thyroid Disorders and Hepatitis C
interesting references to Metformin in the
literature are suggestions for its use for treating
hypothyroidism and Hashimoto thyroiditis. The drug
in some cases is reported to have lowered TSH
levels, possibly without affecting thyroid hormone
levels. Since I find TSH level to be the more
reliable test in monitoring the effectiveness of
thyroid replacement in these entities, it is not
clear how that would prove to be useful.
It has also been
suggested that the use of Metformin and AICAR,
another anti-diabetes drug be considered in the
treatment of hepatitis C. Since fatthy change of the
,iver frequently coexists with hepatitis C, this may
indeed be a suitable approach.
Metformin for Treating Diabetes
generally a good first-line drug for type 2
diabetes. It appears to reduce the cumulative
insulin and IGF-1 exposures. That clearly is
desirable. However, in some cohorts—older
individuals with a lower body mass index, for
instance— metformin was no better than placebo in
preventing diabetes. The stage for the development
of Type 2 diabetes is set by long-standing insulin
toxicity. So my goal in caring for individuals with
type 2 diabetes is help them de-grease the cell
membranes to free up insulin receptor protein
embedded in the grease, eliminate insulin toxicity,
and seakk de-diabetization. In this setting, I am
not interested in prescribing Metformin. Rather, I
want to safely discontinue all anti-diabetes drugs,
including Metformin. My approach then is radically
different from the advice of
Life Extension. This is why I consider the
position taken by
Life Extension injudicious at this
time. I will gladly change it if and when it is
tolerated well by most diabetics. It has few
negative effects—stomach upset is the most common
adverse effect—and carries a low risk of symptomatic
episodes of low blood sugar (hypoglycemia). Buildup
of lactic acid is an uncommon but serious adverse
effect of the drug.
1. Julius Goepp.
The drug virtually everyone shouls ask their doctor
Extension, November, 2010.
2 Van Zile J. On building bridges
toward immortality. Life Extension, September 2005,
3. Knowler WC, Barrett-Connor E,
Fowler SE, et al. Reduction in the incidence of type
2 diabetes with lifestyle intervention or metformin.
N Engl J Med. 2002;346(6):393–403.