#1

A study in 2019 by Aging Cell: Metformin can reduce lean body mass gain by 9.03% and thigh muscle mass gain by 7.07% in a 2019 study (1700mg dose), could it be dose-dependent? Also saw somewhere that Metformin decreased insulin sensitivity by 20%, but it also decreased VO2 Max by 11% so it’s a mixed bag.

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Metformin: A cheap drug may slow down aging. A study will determine if it works (NPR)
Does rapamycin + canagliflozin (or other SGLT2's) synergize well beyond just rapamycin + metformin?
Combining Rapamycin, Metformin, and Meclizine for mtor1 inhibition
#2

I wonder if the mechanism is based on insulin. It’s unclear if things such as berberine, SGLT2’s, and Acarbose also have these deleterious effects.

This rat study on berberine does not show an issue, however

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#3

Association of Acarbose with Decreased Muscle Mass and Function in Patients with Type 2 Diabetes: A Retrospective, Cross-Sectional Study - PMC.

https://www.ncbi.nlm.nih.gov/books/NBK493214/#:~:text=Post-marketing%20reports%20include%20cases,%2C%20metformin%2C%20and%20sulfonylureas%20monotherapy.

“Acarbose may decrease muscle mass and strength in patients with type 2 diabetes mellitus (T2DM). One study found that acarbose decreased skeletal muscle index, handgrip strength, and gait speed more than other drugs, such as insulin, metformin, and sulfonylureas. Acarbose may also delay the absorption of carbohydrates taken to treat hypoglycemia caused by physical activity. When combined with insulin or insulin secretagogues, this can increase the risk of hypoglycemia“

#4

Empagliflozin seems to be good for exercise.

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