After reading the healthspan assessment of metformin, I wonder why for example Dr. Brad Stanfield a highly respected physician, came away with his study on metformin.. that he would no longer use it due to recent findings. I am currently using metformin, but now I wonder? Can someone speak to this challenge with different assessments from well respected voices. Thank you!
Hello! Excellent question; thank you for bringing this forward.
Some clinicians interpret the current evidence as “promising but not proven.” Dr. Stanfield may be emphasizing the gap between strong preclinical/observational data and the lack of definitive human outcome trials in healthy populations.
Dr. Stanfield and experts alike believe that in people who already have very good metabolic health, especially those interested in regular exercise, the benefits may be uncertain or significantly diminished. The available data would suggest that it may very well be the case.
Although the TAME trial is still underway, full results are several years away at this point [1]. Nonetheless, we are excited about the trial and support dedicated research related to aging so that we can have a more concrete answer to some of the lingering questions and to help avoid extrapolations.
Although there is considerable mechanistic data to suggest that metformin may enhance longevity, most studies have been conducted in clinical pre-diabetic patients, older age groups, or animals [2]. Using metformin in “healthy, optimized” individuals is not expected to convey the same magnitude of benefit(s).
According to the research, the vast majority (>90%) of the adult population in the U.S. lacks cardiometabolic health [3]. Some estimates indicate that over 50% of adults are either diabetic or pre-diabetic [4].
Dr. Stanfield doesn’t recommend metformin for healthy, non-diabetic people purely for longevity, citing limited benefit and concerns like possible blunting of exercise gains. His interpretation of the evidence to date is solid and aligns with Healthspan’s views.
Key Takeaways:
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Stanfield’s caution about metformin as a “longevity pill” in healthy people lines up with ITP results: metformin hasn’t shown the robust, reproducible lifespan extension that other medications have, especially in people without existing metabolic challenges.
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Where metformin does remain strong is glucose/insulin control and related clinical uses. Dr. Stanfield supports and prescribes metformin for patients with pre/diabetes.
I hope this helps!
References:
2. https://pubmed.ncbi.nlm.nih.gov/31029144/
3. https://pubmed.ncbi.nlm.nih.gov/35798448/
4. https://jamanetwork.com/journals/jama/fullarticle/2434682