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Jeff Goe's avatar

What about taking micro doses in the otherwise healthy population, meaning no elevated A1C? I've read some articles on low dose metformin in the longevity arena.

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William H Bestermann Jr MD's avatar

Metformin does the same thing as rapamycin. It directly inhibits mTOR. Both rapamycin and mTOR prolong life in other animals. Based on everything this I have read, I believe that lowering sugar is a very small part of the benefit of metformin and ultimately it will be shown to extent healthier life in non-diabetic animals including humans.

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Pat Wood's avatar

I have prediabetes by .10. I took metformin for a bit but it gave me such gastric distress that I quit. Do you have suggestions? I weigh about 200 but should probably be more like 170-180. What dosage would be appropriate?

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William H Bestermann Jr MD's avatar

Prediabetes is a great reason to take metformin and gastric distress is avoidable. Any dose you can tolerate is beneficial because it is blocking the effects of ADMA and activating AMPK. Begin with 500 mg. of the extended release form of meformin and take it with your largest meal. You should tolerate that well. After a month or so, you can increase the tablet size to 750 mg of metformin ER. If that is well tolerated for another month or so, you can increase to 1000 mg a day. That is the dose that I take. If you have mild side effects and you hang in there, they generally get better with time.

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Mick Skolnick, MD's avatar

Bill, I believe that prescribing metformin for pre-diabetes is off-label, but people should be able to persuade their PCP to prescribe it for them by showing them your article. Thank you for making such a good case for it. Best wishes, Mick.

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Alternative Lives R Available's avatar

I have been taking Rapamycin for the last 15 months, a 6mg dose every week for a couple of months, and then a couple of months off.

I suffered from long Covid from the earliest days of the pandemic, and I would say Rapamycin has cleared away the remaining long term effects, especially the 'brain fog', and I would say my cognitive function is as good as it has been since my middle age (I'm now 70.)

A number of other effects were immediately apparent, such as a greater clarity of mind, a renewed interest in writing, and also reading again (I used to be an avid reader, and it dropped away over the years), more energy and greater activity levels. I am also inspired to be inventing again, as I used to do as a business and hobby, but had pretty much stopped in my 60's.

Physically I feel fitter and have noticeably better balance. I also noted that a small dark mole on my arm that had been growing a little over the years, and I had been planning to get checked, has noticeably shrunk away to almost nothing. The reported effects of Rapamycin shrinking some cancers was one of my reasons to take it, due to family history.

The only downside has been a minor but persistent skin infection,and sometimes mouth ulcers, both well documented side effects.

I have also used in on my dog, intermittently for about 8 months, a 7 years old large 100lb Briard, renowned for their excessive personality! A dose of 2mg a week is like rocket fuel for him - he's like a puppy again, pulling on his lead, enthusiastic, hyper inquisitive and full of energy. No noticeable downsides except for me trying to hang on to the other end of his lead!

For clarity, I am not recommending Rapamycin and have no interests, financial or otherwise, in anyone else taking it. You do your own research for info online (of which there is plenty) and make your own decisions.

Regarding dogs, there are now extensive trials by a number of vets and hundreds of pet dogs, regarding life extension and reduction in various illnesses. The point is, these pets share their owners lifestyles and habitats, so may be a good indication of the effects in different environmental circumstances. Search online.

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Ram Krishnan's avatar

Amazing summary and flowchart that gets to the core principles behind longevity, Dr. Bestermann. Many thanks! I wrote a post about metformin as the only feasible drug for longevity and am awaiting the results of the TAME trial. I was pre-diabetic but not so today owing to diet and exercise. I have been wondering if I should proactively take metformin.

https://ramkrishnan.substack.com/p/the-longevity-boom-hype-hope-and

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Bea's avatar

What dose and time of day do you recommend taking metformin for a type 2 diabetic with 6.8 glycated serum glucose and only high glucose levels above 130 when fasting in the morning? What do you think about combining metformin with Jardiance for type 2 diabetes?

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