Generally, we believe that if you are taking acarbose and rapamycin, it’s not necessary to take metformin. Our thought is that you are already getting cyclical mTOR inhibition with rapamycin. We know the benefits of cyclical mTOR inhibition are profound in stimulating autophagy and deaccelerating the progression of senescence.
Metformin also indirectly inhibits mTOR as a fasting mimetic. The question becomes, if you are already taking rapamycin, do you need additional mTOR inhibition? Our thought is no.
When we look at your bloodwork, there are scenarios that would make metformin a good option for metabolic benefits outside of mTOR inhibition.
Acarbose works on pathways that are independent of mTOR inhibition. Generally speaking, then, for patients taking rapamycin, we prefer them on acarbose for the metabolic benefits that it delivers.