Metformin help please

[Grapple333]

So I want to take metformin for all it preventative properties. My family has a strong history of diabetes (dad, paternal grandpa, and aunt in maternal side)so that could be a matter of time. I have elevated ldl which it reduces, and run on the high side of blood pressure. I also seem to retain fat around my waste which I believe is the reason for my elevated estrogen. I’ve inquired with my doctor about metformin in the past and he dismissed it based on my a1c which was borederline pre diabetic but not quite there. He is a reasonable man as he got me going with trt when I posted levels in the 200s. Can someone help me formulate a no nonsense approach with legit studies that this is something I should try as a low dose preventative measure at 500 mg twice a day. I’d be happy to reference him the ampk benifits but don’t understand them in there entirety and don’t know how solid the studies were. Or maybe the most recent peer reviewed article from a credible source stating the reasons why my current stats make me a candidate.

 

[Vince Carter]

Remember he needs a medical recognized diagnosis to prescirbe it, in particularly for any insurance coverage you have. It's not a matter of it being good for you or him being reluctant, if he can't provide diagnosis "X", insurance rejects it and then you're kind of in a rock and hard place. That doesn't mean he's wrong or right, but with a strong family history it makes sense.

 

[CoastWatcher]

As @Vince Carter noted, doctors follow standards of care. In this litigious age deviating from a standard of care opens him to a potential lawsuit. There are studies showing all sorts of benefits bestowed by Metformin, and many doctors will prescribe it more readily.

Where does your A1c sit?

 

[Sean Mosher]

Nelson has a decent amount of studies here on this site you could present to your doctor as well.

 

[Vince]

Is Metformin a Miracle Drug ? : Nelson Vergel Explains

 

[DragonBits]

So I want to take metformin for all it preventative properties. My family has a strong history of diabetes (dad, paternal grandpa, and aunt in maternal side)so that could be a matter of time. I have elevated ldl which it reduces, and run on the high side of blood pressure. I also seem to retain fat around my waste which I believe is the reason for my elevated estrogen. I’ve inquired with my doctor about metformin in the past and he dismissed it based on my a1c which was borederline pre diabetic but not quite there. He is a reasonable man as he got me going with trt when I posted levels in the 200s. Can someone help me formulate a no nonsense approach with legit studies that this is something I should try as a low dose preventative measure at 500 mg twice a day. I’d be happy to reference him the ampk benifits but don’t understand them in there entirety and don’t know how solid the studies were. Or maybe the most recent peer reviewed article from a credible source stating the reasons why my current stats make me a candidate.

You could eat a lot of carbs and sugary things for a month before an A1C test, likely that would put your A1c over the top, assuming your A1C is borderline, which is 5.6 with 5.7 pre-diabetic with Labcorp.

A1C tends to be weighted towards more recent blood glucose readings.

You could also ask for a glucose tolerance test, that might indicate you have insulin resistance already. Before taking the test, ask your doctor if he would prescribe metformin based on the results of that test.

 

[Mountain Man]

I had been considering metformin until I ran across this in a podcast: The Dark Side of Metformin (& What I Use To Support My Blood Sugar).

I’d wait until there is more definitive results.

 

[dnfuss]

So I want to take metformin for all it preventative properties. My family has a strong history of diabetes (dad, paternal grandpa, and aunt in maternal side)so that could be a matter of time. I have elevated ldl which it reduces, and run on the high side of blood pressure. I also seem to retain fat around my waste which I believe is the reason for my elevated estrogen. I’ve inquired with my doctor about metformin in the past and he dismissed it based on my a1c which was borederline pre diabetic but not quite there. He is a reasonable man as he got me going with trt when I posted levels in the 200s. Can someone help me formulate a no nonsense approach with legit studies that this is something I should try as a low dose preventative measure at 500 mg twice a day. I’d be happy to reference him the ampk benifits but don’t understand them in there entirety and don’t know how solid the studies were. Or maybe the most recent peer reviewed article from a credible source stating the reasons why my current stats make me a candidate.

Metformin is a drug. All drugs have side effects, some worse than others. The benefit from taking a drug should outweigh its risks to justify being on it. The primary benefit of metformin is lowering elevated blood sugars.

What is your latest HgbA1c? What is your average fasting blood sugar on arising? Within one and two hours after meals? You need to start by at least knowing the answers to those questions.

 

[DxHypo]

So I want to take metformin for all it preventative properties. My family has a strong history of diabetes (dad, paternal grandpa, and aunt in maternal side)so that could be a matter of time. I have elevated ldl which it reduces, and run on the high side of blood pressure. I also seem to retain fat around my waste which I believe is the reason for my elevated estrogen. I’ve inquired with my doctor about metformin in the past and he dismissed it based on my a1c which was borederline pre diabetic but not quite there. He is a reasonable man as he got me going with trt when I posted levels in the 200s. Can someone help me formulate a no nonsense approach with legit studies that this is something I should try as a low dose preventative measure at 500 mg twice a day. I’d be happy to reference him the ampk benifits but don’t understand them in there entirety and don’t know how solid the studies were. Or maybe the most recent peer reviewed article from a credible source stating the reasons why my current stats make me a candidate.

I got started on Metformin for the same reason after reading about all the good things it was suppose to do. I'm not diabetic either but I do have the "dawn phenomenon" where overnight fasting glucose is mildly elevated. Metformin didn't seem to help this at all for some reason. The gastrointestinal side effects that put many people off Metformin did go away after I switched to taking it post-meal rather than pre-meal. But the big issue I had which put me off my Metformin experiment is the fatigue. I'm not sure whether it was the acid load from buildup of lactic acid which was responsible for this or something to do with the way Metformin depletes B12. I never checked B12 with labs but I get plenty in my diet and take vitamins. For me, the fatigue side effect was enough to put me off Metformin. YMMV.

 

[Vince]

After being on metformin for a few years. I did get my vitamin B12 levels checked and they were lower but still in a good range. The next time I had them checked they were way over the top of the range. So I did lower my supplement of B12.

 

[DragonBits]

I have been using metformin now for ~ 6 months.

It does help with my blood glucose, and more significant for me, it decreased my appetite. Though I get the feeling it's more effective in the beginning.

But since I am more aware of what I am eating and cutting down on carbs, maybe that is what is more important. I am certain I could control my BG just by lifestyle changes, but MET helps.

Once I reach my weight goal of losing 30-38 lbs and getting to 138-130lbs, I will go off metformin and see how it affects me. I know metformin causes depletion of Vitamin B12, Folic Acid and CoQ10, leading to feelings of tiredness, but I don't think that has happened to me.

I do take high potency B vitamin complex and extra CoQ10.

 

[Guided_by_Voices]

You might investigate Berberine since it seems to do all the good things that metformin does but without some of the bad things. Examine.com is a good place to start. The question about metformin (and probably berberine) is whether it helps people who have low insulin (and blood sugar) and up-regulated fat-burning via diet, fasting and activity. It appears that it may have an anti-aging and anti-cancer affect that goes beyond its other affects, but that is likely but not proven. I personally take it (low dose) when I am eating higher carb (alternating with berberine) and rarely take it when I am eating lower carb. Most of us need to make decisions long before we can expect better information to be available.

 

[Systemlord]

I get an uncontrollable cough on metformin, it's relentless and only wears off towards the end of it's half life. Voice changes and throat hurts.

 

[DragonBits]

I had been considering metformin until I ran across this in a podcast: The Dark Side of Metformin (& What I Use To Support My Blood Sugar).

I’d wait until there is more definitive results.

At my age of 66, I no longer say I will wait for more definitive results.

But I have no expectations of cancer, the only person I can think of from all my relatives, aunt/uncles, etc, that had any sort of cancer was an uncle that had leukemia.

Diabetes, that's a different story.

 

[Ardoc2]

I'm not familiar with the source for that article but I'm always leary of any "information" that goes on to promote a product. Especially one with a brand-name instead of just an ingredient name, in this case "Kion Lean"

 

[dnfuss]

You might investigate Berberine since it seems to do all the good things that metformin does but without some of the bad things. Examine.com is a good place to start. The question about metformin (and probably berberine) is whether it helps people who have low insulin (and blood sugar) and up-regulated fat-burning via diet, fasting and activity. It appears that it may have an anti-aging and anti-cancer affect that goes beyond its other affects, but that is likely but not proven. I personally take it (low dose) when I am eating higher carb (alternating with berberine) and rarely take it when I am eating lower carb. Most of us need to make decisions long before we can expect better information to be available.

Berberine is not something to fool around with. It does seem to work to some degree, but it may do so by affecting your liver in potentially dangerous ways. It has not undergone the rigorous testing process to which all FDA-approved prescription drugs are subjected, much less evaluated for adverse side effects after years of prescribed use (see, e.g., sulfonylurea drugs (increased likelihood of heart attack), the incretin drugs (can damage the pancreas), and Avandia and Actos (can cause severe osteoporosis)). The near-unanimous view of responsible clinicians, which I share, is that berberine currently should not be prescribed for the treatment of diabetes or pre-diabetes.

To achieve truly normal blood sugars, metformin needs to be combined with a low-carbohydrate diet, which is the primary foundation of any prescription to normalize serum glucose. Attempting to do so without it is not likely to yield the desired result.

 

[wernerbrewer]

In the comments of the "The Dark Side of Metformin (& What I Use To Support My Blood Sugar).":


"Dave says:
February 5, 2019 at 3:53 pm
Thanks Ben for continuing to write and think about this. Ben’s recent Rogan interview, Sinclair’s Rogan interview, and Attia’s interview with Nir Barzilai have all been great resources of information on this topic. Here’s my synthesis of those sources of information and something to consider or to push me back on. This is from the viewpoint of longevity:

1. Metformin is a refined herbal medicine dervied from French lilac / Galega officinalis / Goat’s Rue. So, it has some basis in natural remedies. In fact, I think one can get French Lilac as a supplement, but I’ll leave that out of this discussion.

2. I can’t speak to Ben’s supplement line, but in general the downside of berberine, bitter melon, etc. is that as supplements they are not regulated, whereas FDA has tight regulation of metformin, which is a good for quality.

3. Metformin’s method of action is varied and it’s potential longevity impact is suspected to go beyond blood sugar management. Perhaps related, my understanding from Attia is that it is a much stronger AMPK activator than these other alternatives. Therefore, I think there is grounds for suspecting that metformin is the strongest longevity compound out of those being discussed here. Admitedly, this is somewhat at odds with the argument that exercise and metformin are not additive and Dr. Clouatre’s comments.

4. It sounds like Ben is settling on a consistent dosage of rock lotus and bitter melon, probably based on his Dexcom results. The reduced efficacy of longterm usage of that combo is not clear to me. My observation is that there is a large buffet of varied compounds such as ACV, berberine, ceylon cinnamon, bitter melon, metformin, lotus rock, gymnema sylvestre, etc. This buffet allows for a varied/rotating and (if desired) a conservative, as-meal-needed approach. I am speculating a bit here, but the strengths of such an approach would be to minimize unknown risks, minimize possible dependence / reduced efficacy, and to gain varied activation of longevity pathways. I would suspect such an approach would include further minimizing the (arguably low-already) performance, lactate, and b-12 issues of metformin. Further, half-life of metformin is around 6 hours, so rotating usage of it would allow it time to clear out of your system. I feel clearing the system would be a long-term efficacy benefit and I am not convinced of the argument that the acute-efficacy would be approaching zero with intermittent metformin usage.

5. Metformin can also be less expensive than most supplements. 6. Putting all these points together, this varied/rotating and (if desired) as-meal-needed usage model is a potential way to employ some of the benefits of metformin while minimizing its downsides. Further, by utilizing the other compounds, the ratio of usage could be customized for an individual’s parameters and daily fit (such as fasting, exercise, etc). In other words, just treat metformin like another tool in the toolbox. For all tools, none are probably perfect so, if possible, minimize their downsides and leverage their upsides.
Reply

1. Ben Greenfield says:
   February 5, 2019 at 7:19 pm
   This is a very good thought pattern. I'm also going to be interviewing a physician soon who uses metformin to pick their brain about best use/best practices to avoid some of the issues I discuss in this article."

EDITED for clarity.

-SW

 

[wernerbrewer]

He also mentions having some other experts in anti-aging (Dr Sandra Kaufmann ?) or physicians who use metformin to have a discussion soon...

 

[Nelson Vergel]

I loved the way Metformin improved my IBS but, after a few weeks, my fatigue was horrible. I no longer take it but reconsidering now restarting it with this protocol:

Weight Loss Combo: Effect of Leucine plus Metformin and Sildenafil Combination on Weight and Metabolic Parameters