#73

Interesting paper on weight loss with metformin. It certainly blunts my appetite when taking 1,000 mg x twice a day.

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#74

I want to take quercetin for said HDAC inhibiting effect but I generally have low confidence on supplement quality. Would Hydroxychloroquine be a decent alternative? It’s widely available and cheap as dirt.

#75

Sorry, but I don’t know.

#76

Is it preventing it, or is it treating and masking it?

#77

What is the real reason you are so down on metformin?

It’s baffling how anyone can be so “down” on metformin, especially when the mountain of evidence supporting its use is undeniable. Are you really going to cling to your contrarian stance just because it doesn’t align with your narrow preconceptions? Metformin isn’t just a random pill—it’s the gold standard for type 2 diabetes, backed by decades of research and clinical success. You’re dismissing a drug that provides effective glycemic control, reduces cardiovascular risks, and doesn’t cause weight gain or dangerous hypoglycemia. And let’s not forget—it’s cheap. So what’s the real issue here? The facts don’t fit your narrative? Maybe it’s time to step out of the echo chamber and pay attention to the overwhelming evidence rather than doubling down on your baseless opinions.

There’s a reason metformin is the first-line therapy.

Effective glycemic control
Low risk of hypoglycemia
Weight neutrality or modest weight loss
Cardiovascular safety
Cost-effectiveness
Safer than SGLT2 Inhibitors
Several studies have suggested that it may reduce the risk of cardiovascular events and mortality.

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#78

The main reason is that it’s cheap and came on the market long ago.

But SGLT2 alone seems as good as SGLT2 + metformin: Effects of SGLT2 Inhibitors with and without Metformin in High-Risk, Treatment-Naïve Patients with Diabetes

More and more papers are pushing SGLT2 as first-line treatment for T2D: Canagliflozin - Another Top Anti-aging Drug - #699 by adssx

My guess is that once there’s a cheap generic SGLT2, low-dose metformin + flozin will become the first-line treatment for all diabetics. Plus one GLP-1RAs (but we’ll have to wait a long time for a good generic pill) for those who need to lose weight.

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#79

It is absolutely so in Italy. Sad but true, GPs apparently prescribe just the most inexpensive drugs, sometimes it seems no matter the gravity of the condition. For more expensive pharmaceuticals, there must be something like a therapeutic program issued by a hospital or some other health structure.

#80

I have no love affair with metformin. In fact, I would just as soon not take it.
I have pre-diabetes numbers, age-related IMO because my BMI has been 22 or lower for quite some time.
Metformin causes me some gastric distress, but it works.
I have a prescription for Jardience in an attempt to switch from metformin. It simply does not work as well as metformin. IMO it is about 50% less effective than metformin in the dosage prescribed by my doctor and does not bring my fasting glucose below 100.
What do you think would be the reasonable maximum dosage of Jardience?
At this point, I am not sold on it.

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#81

@desertshores I have seen no HbA1c impact from my SLGT2 inhibitor (dapa).

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#82

I agree that SGLT2i seem to have no impact on HbA1c in non-diabetic individuals. @desertshores: it’s possible that in your case metformin is the best solution. Acarbose might be interesting as well. And/or a GLP-1RA that does not cause too much weight loss such as dulaglutide.

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#83

Yes, I have found that SGLT2I does not lower a prediabetic HBA1C. Metformin does. However, the SGLT2I has done a great job getting me to drink more water and lose weight.

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#84

To prevent pre-diabetes, I think the best will be proven to be GLP-1RAs. Recently, it was shown that “Tirzepatide reduced the risk of developing type 2 diabetes by 94% in adults with pre-diabetes and obesity or overweight”.

Would it work for non-overweight people? I don’t know; it would be good to look at the results of the above study stratified by BMI. I guess we’ll have more data soon.

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#85

No: here is a paper showing that metformin shortens lifespan in old worms, and wildly speculating that it will shorten lifespan in the elderly.

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#86

Before they reach clinical trials, drugs have to be found effective in animal models (usually rodents) and tested for basic safety in two other mammalian species. After all that, 90% of drug candidates in clinical trials fail.

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#87

I must’ve missed this.

I began dosing like this for just a month with no discernable effects either way.

I had labs done three months ago so when I get my labs done next month I’ll be able to see if it moved any numbers.

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#88

Thanks for the correction!
I should realise by now…never trust memory alone!

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#89

It makes a case for a possible mechanism for how metformin does what we already know it does in people with diabetes; it says nothing compelling about its use by normoglycemic people one way or the other.

Attia definitely did not look only at lactate. He also looked at the clinical trials that show that it impairs adaptations to both aerobic and resistance training exercise; the fact that the 2014 study claiming to show that diabetics who use metformin live longer than nondiabetics who don’t doesn’t actually show that; and the fact that it flopped in the ITP and in other lifespan studies done in normally-living mice.

#90

Thanks for posting the information on Metformin and HIV. This was previously unknown to most of us who are living with HIV. In 12 years of treatment for this chronic infection, all I ever hear is about the expensive antiretroviral medications from big pharma. Larry.

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#91

I haven’t read everything in this thread and imagine this has already been posted, but I just read this and passing it along if helpful… probably a repeat!

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#92
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