Latest / Intellectual Medicine / Should You Take Metformin For Anti-aging?

Transcript

Should You Take Metformin For Anti-aging? · Intellectual Medicine

• 0:00
  What we noted in diabetics who are on metformin compared to
• 0:03
  those who are using other drugs, they both had blood sugar
• 0:06
  lowering value, but the folks on metformin had benefit above and
• 0:10
  beyond that, lower incidence of heart attacks, lower incidence
• 0:14
  of cancer, better metabolic markers, a decrease in body
• 0:19
  weight, reduction in percent body fat.
• 0:21
  What was going on and might this be extrapolated toward others
• 0:26
  such that we could use it even though we're not diabetics?
• 0:31
  Question. Is metformin the first anti
• 0:35
  aging drug? Well, some people think so.
• 0:39
  Metformin is a drug use for diabetics.
• 0:42
  It was FDA approved in 1995. Initially there was a lot of
• 0:46
  concern about its potential to do harm, kidney damage because
• 0:50
  of other drugs that were similar to it.
• 0:52
  Turns out it's extraordinarily safe.
• 0:54
  So the drugs been around now for what, over 30 years?
• 0:58
  I remember when it came out of him prescribing it that long.
• 1:01
  Wonderful drug for diabetics. But what about anti aging and
• 1:04
  why do we think it might help people live longer and have anti
• 1:08
  aging attributes? Because that's what's been seen
• 1:12
  in diabetics. What we noted in diabetics who
• 1:14
  were on metformin compared to those who are using other drugs,
• 1:18
  they both had blood sugar lowering value, but the folks on
• 1:21
  metformin had benefit above and beyond that.
• 1:24
  A lower incidence of heart attacks, lower incidence of
• 1:28
  cancer, better metabolic markers, a decrease in body
• 1:32
  weight, reduction in percent body fat.
• 1:34
  What was going on? And might this be extrapolated
• 1:38
  toward others such that we could use it even though we're not?
• 1:42
  Now, some of you are jumping on that train.
• 1:45
  I get it. It kind of makes sense.
• 1:47
  We need to do anti aging therapy before we have proof that it's
• 1:51
  going to work. Humans live a long time.
• 1:54
  That type of proof takes decades.
• 1:56
  We don't have that time. So we're stuck between two
• 2:00
  spots, right? You don't want to jump in too
• 2:02
  soon. It's something that's unproven
• 2:04
  or harmful and you don't want to wait.
• 2:06
  You know, recently the black box warning on testosterone has been
• 2:10
  removed and that oh what, 20 years?
• 2:13
  We've known for that long that testosterone and hormone therapy
• 2:17
  does not increase cancer risk, does not increase heart disease
• 2:20
  risk. The point is that it takes
• 2:22
  conventional medicine 20 years to catch up to where we live in
• 2:27
  the here and now. Anti aging.
• 2:29
  Why not? Why is aging not being attacked
• 2:32
  as a pathological process that can be altered?
• 2:35
  I get it. Chronologically, you can't
• 2:37
  change the number. We must die at some point.
• 2:40
  But all the things we associate with aging are modifiable.
• 2:44
  So let's go back to metformin. What's going on with metformin?
• 2:48
  Well, there are several things that recommend it.
• 2:50
  On a cellular level, it enhances the AMPK pathway.
• 2:56
  Adenosine monophosphate activated protein kinase
• 3:00
  pathway. AMPK.
• 3:02
  What does that mean? It's the pathway that the cell
• 3:05
  utilizes. When it needs energy, it flips
• 3:09
  the mechanisms of the cellular activity into a catabolic
• 3:13
  process, not focusing on growth, focusing on energizing.
• 3:18
  The other side of that coin is the M Tor pathway.
• 3:21
  Meth, kinetic target of rapamycin.
• 3:24
  M Tor is anabolic, pushes cell growth and division.
• 3:27
  AMPK energizes but blunts the M Tor effect that has a net
• 3:33
  positive effect on cellular health.
• 3:36
  Too much M Tor pushes cells into aggressive reproduction and
• 3:41
  senescence. This happens as we get older, M
• 3:44
  Tor becomes more dominant. So having an AMPK to kind of
• 3:48
  balance that, you need both, right?
• 3:50
  You got to have energy, but you also want to grow the cell.
• 3:53
  But you want to grow too much because then it becomes
• 3:55
  senescent, kind of grungy, grungy cells, not good.
• 3:58
  And it can increase the risk of cancer.
• 4:01
  So that may be the cellular mechanism.
• 4:04
  How cool is that? Now we're getting down to
• 4:06
  cellular anti aging. That's where it's at.
• 4:09
  Maybe the metformin has something to offer us, but
• 4:13
  there's more to the story. The other thing metformin can
• 4:15
  do, it can lower blood sugar. Sugar is after all, an essential
• 4:21
  element. It's what the cells live on.
• 4:23
  But too much sugar, pro inflammatory, carcinogenic,
• 4:27
  atherosclerotic. How much is too much?
• 4:30
  It's hard to know, right? It's hard to know because blood
• 4:32
  sugar moves around so much, but the hemoglobin A1C, that's the
• 4:37
  number you should know. A lot of people know their
• 4:39
  cholesterol. Maybe you know your weight.
• 4:42
  You should know your percent body fat.
• 4:43
  If you're a man, you want to be below 20, a woman below 30,
• 4:46
  ballpark numbers. How about your A1C, the sweet
• 4:49
  spot? So an A1C is a three month
• 4:52
  average of what your blood sugar is.
• 4:54
  They measure it with a blood test.
• 4:56
  Now, after three months, it'll gradually shift.
• 5:00
  But three month intervals, why? That's how long red blood cells
• 5:03
  live for and hemoglobin the heme, if you will, as that red
• 5:07
  blood cell attracts sugar to it. Think of it like a glazed
• 5:11
  doughnut. More sugar in the broth, more
• 5:14
  glazing on the doughnut. That's your hemoglobin A1C on
• 5:17
  the red blood cell. All right, So what does the
• 5:19
  number mean? The higher the number, the worse
• 5:22
  it is for you in general, but there are some thresholds worth
• 5:25
  note. Worth noting between 5.0 and 5.4
• 5:29
  is the sweet spot. That's where there's the
• 5:32
  greatest longevity and the least amount of chronic disease
• 5:35
  states. 5.0 to 5.4. How about if it's higher than
• 5:40
  that? It creeps up.
• 5:42
  A threshold of about 5.7 is worth being mindful about.
• 5:46
  If you go above 5.7, there's an increase across the board.
• 5:50
  Cancer, heart disease, dementia, shortening lifespan, all of it.
• 5:55
  So that's not good. You get all the way up to 6.46
• 5:59
  point 4 and now you're a diabetic.
• 6:01
  Getting that number down can be helpful.
• 6:03
  How about if it goes too low? It depends on who you are.
• 6:06
  If you're an otherwise healthy, strapping, robust human and your
• 6:09
  hemoglobin A1C is 4.8, that's not a problem.
• 6:12
  If you're sickly weak, if you eat poorly, if you have chronic
• 6:17
  illness and it's below 5.0, that could be a red flag.
• 6:21
  So universally 5.0 to 5.4. Whatever intervention you do,
• 6:26
  whether it's metformin, whether it's exercise, whether it's
• 6:29
  nutritional modification, check it at three month intervals.
• 6:32
  Keep yourself in that sweet spot.
• 6:34
  So blood sugar correlates with some of the benefit and PK
• 6:37
  pathway may have something to do with it.
• 6:39
  We also know the metformin reduces inflammatory mediators.
• 6:43
  That's a good thing. What about aging?
• 6:45
  What about life extension? Well, there's a trial that's
• 6:48
  been designed and it's currently in its formative stage.
• 6:52
  It's called the TAME trial. The trial to it's targeted
• 6:57
  targeting aging with metformin. TAME TAMEI swear they come up
• 7:02
  with the acronym first, then the study.
• 7:04
  So the goal of the study is to determine can metformin affect
• 7:08
  some of the biomarkers and some of the known consequences of
• 7:13
  aging? Can it actually extend life?
• 7:15
  Well, it's easier to judge its effect on chronic illnesses than
• 7:19
  on life extension. That's a tough one.
• 7:22
  I mean, if you're destined to live to be 60 and you do anti
• 7:25
  aging and you live to be 65, you never knew that you were
• 7:29
  destined to die at 60 because you made it to 65, which you're
• 7:32
  still thinking that's kind of short and it is My point is that
• 7:35
  we will never know exactly. Therefore you have to make your
• 7:39
  decisions with the best information at hand.
• 7:42
  Metformin, nice drug, but there's some caveats in 65 year
• 7:47
  old men, metformin was shown to interfere with muscle growth
• 7:51
  when they did strength training. Well, that kind of makes sense
• 7:53
  when you think about how it works, right?
• 7:55
  Activates the blood sugar dynamic, the energy building
• 7:59
  dynamic, if you will, blunting the growth dynamic.
• 8:02
  So in a vacuum, old other men weightlifting on metformin,
• 8:07
  little bit less muscle development.
• 8:09
  Those men, however, were not on testosterone.
• 8:12
  In my world, everybody's on it. If you're a man in your past 60,
• 8:16
  absolutely. If you're a woman, you're past
• 8:18
  50. Yes.
• 8:19
  Let's set that aside though. We know that metformin also
• 8:22
  improved biomarkers of aging. Well, that's kind of cool.
• 8:25
  However, because of its uncertain value regarding
• 8:29
  longevity and because of its research based evidence
• 8:34
  primarily happening in people that have metabolic syndrome, I
• 8:38
  believe that metformin has value in people that are at risk, but
• 8:43
  not for people who are lean, fit and athletic and healthy.
• 8:46
  If you are a little overweight, if your blood sugar is greater
• 8:49
  than the hemoglobin A1C is greater than 5.7, if you are in
• 8:54
  fact a diabetic, if you are elevated triglycerides and
• 8:58
  cholesterol, and if you're somebody that doesn't have a
• 9:02
  nutritional lifestyle that is optimized, metformin is for you.
• 9:06
  It helps reduce some of the consequences that your genetic
• 9:11
  endowment and your lifestyle have imposed on you.
• 9:14
  I mean, some people have high triglycerides, no fault of their
• 9:17
  own, have high sugar, no fault of their own, struggle with
• 9:20
  their weight, right? Metabolic genetic metformin,
• 9:24
  great drug, lowers percent body fat, lowers blood sugar,
• 9:27
  extraordinarily safe. Be cautious.
• 9:29
  There are some drug interactions.
• 9:31
  Do not do this on your own people.
• 9:33
  I know you can get everything online now, literally
• 9:36
  everything, but it would be a fool who tries to be his own
• 9:39
  doctor or nurse practitioner. Find somebody you can work with.
• 9:42
  This is generic cheap drug, but it's not benign.
• 9:45
  It can interact with other drugs.
• 9:46
  So I like it for certain people. For anti aging.
• 9:49
  I do not think it's a universal anti aging benefit if you have
• 9:53
  cancer. It's a different calculation
• 9:56
  because metformin has some unique anti cancer attributes
• 10:00
  that may be worth applying even if you're otherwise lean and
• 10:03
  fit. Now side effects of metformin,
• 10:06
  sour stomach diarrhea, those can be problematic.
• 10:10
  Some people just can't take it. If you take a drug that's
• 10:12
  supposed to be preventative life extending or enhancing your
• 10:17
  health and it makes you unwell, just stop.
• 10:19
  That goes for supplements as well.
• 10:21
  Your body's telling you something.
• 10:22
  If you can't tolerate metformin, what about berberine?
• 10:25
  Berberine is a natural herbal supplement been used for
• 10:28
  thousands of years to help control blood sugar and for
• 10:31
  other purposes. Yes, it does lower blood sugar
• 10:34
  almost as good as metformin, but they work through different
• 10:37
  mechanisms Metformin is more effective in the liver, in the
• 10:40
  muscle, a little more potent lowering blood sugar.
• 10:43
  Berberine works more in the gastrointestinal tract,
• 10:46
  enhancing microbiota nice agent if you're struggling with your
• 10:50
  sugar correlates with some weight loss, that's a good
• 10:53
  thing. So if you're the metabolic
• 10:54
  profile person and you can't take metformin, berberine is
• 10:58
  Next up. How about combining them?
• 11:00
  Yeah, you could do that. You'll get even better blood
• 11:02
  sugar lowering effect if that's a concern.
• 11:05
  Remember, there's such a thing as too low.
• 11:08
  Although these drugs can't push you into a danger zone, maybe
• 11:11
  make you feel a little bit weak, but they're not going to make
• 11:13
  you pass out. So metformin for anti aging
• 11:16
  patient dependent. If you're a metabolic syndrome,
• 11:19
  high triglyceride, overweight family history, you've got
• 11:23
  elevated blood pressure, elevated blood sugar, hemoglobin
• 11:26
  A1C greater than 5.7. It's a great play for the rest
• 11:29
  of you Otherwise fit, healthy eating well, there are better
• 11:33
  things you can do. We'll be talking about those
• 11:35
  down the road. Anti aging.
• 11:36
  Why not? Neutralizing the adverse effect
• 11:39
  of the aging process. Yeah, we can do that, right,
• 11:42
  gang? Thanks for your attention, your
• 11:44
  time. Be talking to you soon.
• 11:45
  Bye now. None.