Majid Ali, M.D.
Metformin is my drug of choice when I have to prescribe it for treating diabetes type 2 when I initiate my diabetes reversal plan. The only serious adverse effect of metformin occurs only in patients with vitamin B complex deficiency. I avoid it for my patients with PCOS (polycystic ovary syndrome syndrome) which is insulin toxicity leading to testosterone toxicity and later to cyst formation in the ovaries.
Now comes the age of “metformin mania” in which the drug is being heavily promoted with irresponsible claims.
Recently, Life Extension— a magazine I have greatly admired for years—unleashed what might be properly called “metformin mania.” Consider the title of the article in its November 2010 issue : “The drug virtually everyone should ask their doctor about.” Here is a revealing quote from the same article: “…that aging humans can derive benefit from an antidiabetic drug called metformin.” I point out that the magazine did not promote the use of this antidiabetic drug for diabetics but for people without diabetes.
Type 2 diabetes is caused by insulin receptor dysfunction resulting from toxicities of foods, environment, and thoughts. Excess insulin (hyperinsulinemia) so produced is inflaming, fattening, and cellular grease-building. For most individuals who are unwilling to take responsibility for their health, address these issues, control insulin toxicity, and possibly de-diabetize themselves, metformin indeed is a good drug. However, this is a far cry from advising people without diabetes to take the drug for improving health. This is as illogical as prescribing metformin for the so-called polycystic ovary syndrome, another form of insulin toxicity caused by the trio toxicities of foods, environment, and thoughts, in which insulin toxicity plays a crucial role.
Metformin and Inflammatory Markers
Life Extension told its readers that metformin is good for people without diabetes because it positively affects some genetic pathways. Specifically, it inhibits some inflammatory pathways, including AMPK and stabilizes the age-accelerating complex called mTOR. It failed to mention that these pathways are also activated by toxicities of foods, environment, and thoughts. So, metformin does not correct the underlying problems, just controls their consequences. There is no evidence that it does so long-term.
The article also cited studies in which the drug extended the life span of mice. Extension of life spans of animal species with drug, of course, is old news. In animal experiments, the extension of life span is always associated with birth defects, tissue development disorders, and metabolic derangements. Serious students of human biology do not allow such studies to be used as justification of using drugs. Certainly, to date, there is no evidence that humans ever live longer with drugs tested in animals.
Metformin and Cancer Risk
Life Extension underscored the point that metformin suppresses a cancer inducing protein called human epidermal growth factor receptor-2 (HER-2) and asserted that the drug “can stop cancers from developing.” Next it cited a study that showed that “metformin use by humans is associated with a substantial (56%) reduction in the risk for developing breast cancer.” In the past, Life Extension has also claimed that risk of breast cancer can be reduced by spices, foods, and nutrients. For example, Life Extension in its September 2005 issue explained its vision of a simple business plan for immortality in which a grand spare parts relacement industry will allow people to live happily forever. Consider the following quote: ‘It is only a matter of years — decades at most — until futuristic technologies will entirely reverse-engineer the human machine.’
Such claims, in reality, are half truths and untruths. Medical literature is replete with reports of cancer risk reduction of foods, spices, and drugs. Taken at their face values, all cancers could be eradicated from the face of the earth by just taking three or more such substances. Alas, that will not happen. The risk reduction games are mere number games. Again serious students of human biology learn early in their lives about the frivolousness of such claims. Incremental toxicities of foods, environment, and thoughts will continue to fan the epidemics of cancer.
Metformin for Treating Cancer
Should Metformin be used to treat forms of cancer that cannot be treated with surgery or radiotherapy? It is possible its anti-inflammatory effects may prove to be beneficial in certain cases. So, it would be prudent to explore this possibility when the other therapies fail to control the tumor. I do hope that the Metformin mania will not lead to the replacement of effective therapies for cancer—when complete surgical excision of the growth can be reasonably expected, for instance—to the great detriment of the patient. Regrettably I have seen that in many cases.
Metformin for Thyroid Disorders and Hepatitis C
Among the interesting references to Metformin in the literature are suggestions for its use for treating hypothyroidism and Hashimoto thyroiditis. The drug in some cases is reported to have lowered TSH levels, possibly without affecting thyroid hormone levels. Since I find TSH level to be the more reliable test in monitoring the effectiveness of thyroid replacement in these entities, it is not clear how that would prove to be useful.
It has also been suggested that the use of Metformin and AICAR, another anti-diabetes drug be considered in the treatment of hepatitis C. Since fatthy change of the ,iver frequently coexists with hepatitis C, this may indeed be a suitable approach.
Metformin for Treating Diabetes
Metformin is generally a good first-line drug for type 2 diabetes. It appears to reduce the cumulative insulin and IGF-1 exposures. That clearly is desirable. However, in some cohorts—older individuals with a lower body mass index, for instance— metformin was no better than placebo in preventing diabetes. The stage for the development of Type 2 diabetes is set by long-standing insulin toxicity. So my goal in caring for individuals with type 2 diabetes is help them de-grease the cell membranes to free up insulin receptor protein embedded in the grease, eliminate insulin toxicity, and seakk de-diabetization. In this setting, I am not interested in prescribing Metformin. Rather, I want to safely discontinue all anti-diabetes drugs, including Metformin. My approach then is radically different from the advice of Life Extension. This is why I consider the position taken by Life Extension injudicious at this time. I will gladly change it if and when it is warranted.
Metformin is tolerated well by most diabetics. It has few negative effects—stomach upset is the most common adverse effect—and carries a low risk of symptomatic episodes of low blood sugar (hypoglycemia). Buildup of lactic acid is an uncommon but serious adverse effect of the drug. Metformin does not address any of the issues of insulin toxicity and testosterone toxicity.
1. Julius Goepp. The drug virtually everyone shouls ask their doctor about. Life Extension, November, 2010.
2 Van Zile J. On building bridges toward immortality. Life Extension, September 2005, page 48.
3. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403.