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
- 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
