While the scientific community is optimistic about metformin, it’s essential to balance this optimism with a cautious approach, which is why many metformin researchers are pushing to have the Targeting Aging with Metformin or TAME study funded to prove its ability to act as a longevity drug. This will allow it to hop from billionaire circles into the lives of those who need it most.
What is metformin?
Metformin was first approved by the Food and Drug Administration in 1994, though earlier formulations have been around as early as the 1920s. An extract of the French lilac, “it would be a nutraceutical, but it’s actually modulated a little bit,” says Barzilai, who says it was shown to prevent flu and malaria. Eventually, the early stage of the drug was studied to be an effective way to lower glucose levels, which led to its eventual adoption for diabetes. And soon after that, researchers noticed that many of the people who took it had younger-functioning hearts, better blood pressure, and improved cognitive function.
The drug is part of a class of antihyperglycemic drugs called “biguanides,” which are intended to decrease the amount of glucose that the liver produces and your body absorbs, but it also activates an enzyme called “AMP-activated protein kinase” or AMPK, which has been coined the “longevity enzyme.” This enzyme boosts cells’ ability to use energy and could potentially contribute to longevity by reducing age-related cellular stress. And it helps with a process called “telomere attrition.” “Telomeres are like aglets at the end of a shoelace—they protect the ends of the linear chromosomes and help prevent instability,” explains VJ Periyakoil, MD, a professor of medicine at Stanford University. As we age, these telomeres or “aglets” get shorter and shorter until they can’t divide anymore, and when this happens, our tissues age. But metformin blunts this process, keeping telomeres intact and well functioning.
In short, the drug acts via multiple different mechanisms to keep your cells and your body from rapidly undergoing aging processes on a cellular level that ultimately lead to decline and death. But it’s important to note that while many hold up metformin’s promise for longevity through various one-off research studies, a recent longitudinal study couldn’t replicate these results, thus calling them into question. Given this, it’s important for clinical trials—like the TAME study—to come to fruition so that we can deeply understand the true promise of metformin for longevity. Or in other words, it’s crucial to remain skeptical until more large-scale, long-term clinical trials validate metformin’s effectiveness in extending the lifespan.
Who is metformin right for?
Metformin has long been beneficial—and is approved—for people with diabetes. Outside of that, it has been doctors who study the drug say that it has a few indications where it’s particularly helpful: Women with PCOS have been helped by the drug, so, too, have folks above 50, but as for the rest of us, it’s a game of consult your doctor and weigh your options.