Gimme Some of That Goat's Rue

I take one in the morning and one at night.

Nearly a year ago I commented on the off-label benefits of metformin:

Metformin, which I've been taking since August for type II diabetes,

affects a variety of age-associated cellular functions, including improving metabolism, tamping inflammation and boosting the mitochondria. It also has a long history of use in people, with a good safety profile.

In other words Metformin may extend my life, and not just because it treats diabetes.

Word has spread about Metformin's benefits, and it's become a popular new drug with the young, healthy, and diabetes-free crowd.

Is an ancient compound the new “wonder drug”?

Metformin, a common medication to control diabetes, has become the controversial darling of tech’s health-conscious digerati who are enticed by preliminary research suggesting it might help promote longevity, reduce risk of dementia and prevent a whole host of other conditions – including, most recently, long COVID.

With origins that date back to Medieval Europe, metformin has been used for decades as a powerful tool to lower blood sugar in people with diabetes. In those patients, it also offers cardiovascular benefits and weight loss.

Now, it is increasingly popular for use in conditions that have nothing to do with diabetes. Intrigued by early studies and promotion on TikTok, Instagram and health-focused blogs, Americans are seeking “off-label” prescriptions for metformin, using the drug for a different condition than what is FDA-approved...

Metformin, or dimethylbiguanide, traces its history back to a traditional herbal medicine in Europe called Galega officinalis, or goat’s rue. While it can cause side effects in people with kidney problems, it improves blood-sugar control by improving insulin sensitivity, reducing the amount of sugar released by the liver into the blood and increasing glucose absorption.

It is now the fourth most widely prescribed medication in the nation. About 20 million Americans were prescribed the drug in 2020.

What is tantalizing are preliminary findings — based on animal studies and imperfect clinical trials that have not been reproduced — that hint that the drug may help slow aging and increase life expectancy. While the underlying mechanism remains unclear, it may create cellular changes that improve the body’s responsiveness to insulin and boost blood vessel health.

Its reputation has grown with a recent barrage of social media attention, including a viral posting by Silicon Valley-based internet entrepreneur and “biohacker” Serge Fague, who described taking two grams of the medication every day.

“Have you heard about metformin?” asked one Twitter influencer. The New York City-based longevity company NOVOS, which has enlisted Harvard’s Dr. George Church and other highly esteemed scientists to its advisory board, posted on Instagram: “Metformin: The secret to anti-aging?”....

Off-label prescribing is legal and common. An estimated 20% of all prescriptions in the U.S. are for off-label use, according to the Agency for Healthcare Research and Quality. Beta-blockers, for instance, are approved to reduce risk of high blood pressure and heart problems but are used off-label to treat anxiety. But off-label prescriptions may put people at risk of receiving ineffective or even harmful treatment if there is a lack of scientific evidence, said Chin-Hong.

“In tech circles, people use a lot of things off-label — for example, for weight loss,” said Chin-Hong. “It’s promoted by celebrities on TikTok. But it’s always a dangerous enterprise to use something off-label.”

Doctors have long prescribed metformin off-label for these conditions:

• Menstrual irregularities.

• Gestational diabetes mellitus.

• Prevention or delayed diabetes.

• Weight gain from antipsychotic medicines.

Other studies looked at the potential of metformin to:

• Reduce the risk of dementia or stroke.

• Slow aging.

Under my current drug plan I pay less than $20 for 180 500-mg tablets. In addition to lowering blood sugar from potentially hazardous levels, Metformin helps me to lose weight and possibly to live longer. Some of the best things in medicine are nearly free.