It seems Sinclair once again extrapolates nonhuman studies way too far. He’s a bit too sensational on claims without evidence. If you hear him right here, he literally claims a combination of GH, DHEA, and metformin might confer “immortality” (time 1:14) - it’s gotten to the point of hyperbole, not merely strong optimism.
If you have T2D sure - metformin is the first line to treat for T2D, but there’s no real evidence of metformin for “healthy” humans and there’s evidence against it.
His claim of reducing Alzheimer’s may be incorrect - there may be a higher risk of AD and at best perhaps neutral. Not to mention, I’m still iffy about his resveratrol claims that were a complete flop on the ITP. C57BL/6 mice on a high-fat diet + resveratrol weren’t likely to be translatable in the first place and the PI admitted resveratrol and Sinclair bypassed standard review through political pressure.
“Moreover, metformin exposure increased the risk of Alzheimer’s disease (HR: 2.13, 95% CI=1.20-3.79) and vascular dementia (HR: 2.30, 95% CI=1.25-4.22).”
“long-term users of 60 or more metformin prescriptions were at greater risk of developing AD (adjusted OR (AOR) = 1.71, 95% CI = 1.12-2.60)”
https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2012.03916.x
“Among participants with diabetes, worse cognitive performance was associated with metformin use (2.23 [1.05-4.75]).”
The newest meta-analysis here says no benefit or protection (perhaps the negative studies are primarily related to proven increased vitamin B12 and other deficiency risks in metformin that have been corrected with increased awareness over time?):
“Results show that metformin has no significant effect on improving cognitive function or protecting against any dementia including vascular dementia and Alzheimer’s disease, and cognitive impairment as well.”
https://journals.sagepub.com/doi/10.1177/02698811211057304?url_ver=Z39.88-2003
We have seen metformin interfere with exercise in a good amount of humans in a trial. Why not go for exercise which is proven rather than something unproven and potentially negative or maybe at best neutral? We already know Rapa + acarbose > Rapa + met in mice if you’re going to be citing ITP trials.
As for “lower blood sugar must be better” - T1D hospitalized for just one blood sugar extreme = higher risk for dementia. I am aware of a few people who hit hypoglycemia several times and that may have increased their risk. Trying too hard to plug one hole leaves a bump in the road which could be as bad or even worse than the hole in the first place.