Should I take metformin for aging?

The antidiabetic drug metformin has been gaining lots of attention. This fame is well deserved since it extends lifespan in worms, mice, and there’s a clinical trial going on for human aging1. If you feel you’re getting older you might ask yourself should I should take metformin too? There’s just one thing to consider.

Aging and diabetes are accompanied by a decrease in cardiorespiratory fitness (your ability to supply oxygen to your muscles), glucose control, and insulin sensitivity. A powerful way to counteract this is by activating a beneficial gene called AMPK. Metformin activates this gene2 and so does exercise3. So, what if you combine them, double goodness?

Actually it might cancel out. One study showed that in healthy elderly who exercised, giving metformin seemed to stop the beneficial adaptations their mitochondria underwent to exercise4. Ok, well if you’re thinking about your aging, you’re probably already exercising to do something about it. So should you just take metformin and forget about exercising? Consider this: metformin has been shown to reduce progression from prediabetes to diabetes by ~31%, while just doing 150 minutes of moderate intensity exercise per week can reduce it by ~58%5. Thats for diabetes, it could be that the benefits of exercise for aging may outweigh metformin too.

So the answer: more research is needed.

But the gut feeling: if you are sedentary while aging, metformin might be for you, just like it is for diabetics. If you’re already taking care to exercise though (and eat well), then sorry, but you should probably just stick to that. Recent research has shown that your gut microbiome might be responsible for some of metformin’s benefits though, so maybe your personal microbiome might hold the answer6.  Be wise though: consult a doctor before any self-medication.

Going deeper…

Barzilai N, Crandall J, Kritchevsky S, Espeland M. Metformin as a Tool to Target Aging. Cell Metab. 2016;23(6):1060-1065. [PubMed]
Musi N, Hirshman M, Nygren J, et al. Metformin increases AMP-activated protein kinase activity in skeletal muscle of subjects with type 2 diabetes. Diabetes. 2002;51(7):2074-2081. [PubMed]
Richter E, Ruderman N. AMPK and the biochemistry of exercise: implications for human health and disease. Biochem J. 2009;418(2):261-275. [PubMed]
Konopka A, Laurin J, Schoenberg H, et al. Metformin inhibits mitochondrial adaptations to aerobic exercise training in older adults. Aging Cell. December 2018:e12880. [PubMed]
Knowler W, Barrett-Connor E, Fowler S, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403. [PubMed]
Sun L, Xie C, Wang G, et al. Gut microbiota and intestinal FXR mediate the clinical benefits of metformin. Nature Medicine. 2018;24(12):1919-1929. doi: 101038/s41591-018-0222-4
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