Metformin or Exercise – What’s Best for Anti-Aging?

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by Nils Osmar. January 10, 2022

The truth is that it’s still an open question. In the video at the bottom of this page, Rhonda Patrick lays out the case for and against taking metformin (for non-diabetics) as an anti-aging drug. But are there other, better reasons to take it?

Metformin is Anti-Cancer

Most studies that have looked at the question suggest that metformin is at least somewhat protective against cancer. In an article called “The beneficial effects of metformin on cancer prevention and therapy“, the authors state:

“Based on recent analyses and studies, metformin reduces the proliferation of cancer cells and the possibility of malignancies in different types of cancer, including gastric carcinoma, pancreatic cancer, uterine cancer, medullary thyroid cancer18 and a number of other cancers, such as prostate, colon, pancreas, and breast, as presented in this review.”

Exercise is Anti-Cancer

According to the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention, exercise is too. Getting ore physical activity is associated with a lower risk of getting breast cancer, prostate cancer, colon cancer, endometrium cancer, and possibly pancreatic cancer. Physical activity appears to regulate hormones that contribute to the development of cancer and help keep the immune system healthy.

Both Activate AMPK

AMPK is considered the “longevity pathway” because of its association with prolonged lifespan in lab animals.

Metformin’s role in AMPK activation was confirmed in this 2015 study:

Recently, we have shown that low metformin concentrations found in the portal vein suppress glucose production in hepatocytes through activation of AMPK. Moreover, low concentrations of metformin were found to activate AMPK by increasing the phosphorylation of AMPKα…

Exercise also activates AMPK:

It has been shown that the activation of AMPK through exercise can promote metabolic health with advancing age. Previous animal studies have shown that physical exercise stimulates AMPK, as well as skeletal muscle glucose uptake…

Both are Anti-Viral

Metformin has also been shown to have some protective effects against lung inflammation related to viral infections according to this study.

Over the past year, several retrospective clinical studies had reported that metformin use by diabetic and obese patients prior to hospital admission for C-19 correlated to reduced severity and mortality….

So has exercise:

We conclude that a high mitochondrial – and related cardiorespiratory – fitness should be considered as protective factors for viral infections, including C-19.

So Why Not Take Metformin?

  • In the study Rhonda is talking about, some people with prediabetes were either given metformin or asked to get 150 minutes of exercise per week.
  • 150 minutes of exercise (without metformin) prevented the progression to diabetes by in almost 60 percent of the participants. Taking metformin alone (without exercise) prevented the progression to diabetes by 30 percent.
  • So in terms of preventing diabetes, exercise appears to be about twice as effective as metformin.
  • In other studies, metformin inhibited improvements in cardiorespiratory fitness after exercise by 50 percent
  • Metformin also diminished diminished whole-body insulin sensitivity and ininhibited mitochondrial capacity.
  • In sum, Patrick’s position is that exercise is better than metformin for preventing diabetes, reversing diabetes, and delaying aging, and for supporting mitochondrial health.

With That Said…

  • … Patrick also acknowledges that not everyone is willing to exercise. We’re in a country (and world) or non-exercisers.
  • So her (tentative) conclusion is that people who can’t, don’t or won’t exercise would likely find their lives and lifespans improved by taking metformin.
  • People who do exercise may be better off skipping the metformin and just exercising.

My Thoughts

The data about exercise is unequivocal; the data about metformin is somewhat contradictory. I understand why some people, like David Sinclair, take it and advocate for it. Sinclair views it as an important anti-aging drug.

  • I do take metformin, though not every day. One reason I take it is because of its possible benefits in the current pandemic. But I’m still unsure whether it’s a good idea to be taking it, particularly because I’ve gotten so heavily into exercise.
  • I’d love to find a pill that could greatly slow or even reverse aging. I agree with the folks who say that rapamycin shows more promise at this point than metformin.
  • Some people, like Sinclair and his father, take metformin (along with NMN and resveratrol) and report excellent results. They both also exercise. But their experiences with it are anecdotal, not a controlled test. It appears from Sincair’s description that the metformin is doing more good than harm. But of course this doesn’t prove it’ll help other people.
  • Re: the related question of whether metformin or berberine is better for anti-aging, the jury’s out. In some respects berberine is looking better.
  • For example, berberine appears to protect the body against a rare condition called lactic acidosis, which can actually be caused by metformin.
  • I’ll be doing a video comparing the two substances soon.

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