February 1, 2023

In this episode the surgeons discuss a review of the literature surrounding the use of the drug metformin to treat aging. They discuss the ethics of considering natural aging as a disease process and they discuss other ways for a population to live longer such as trying to modify social determinants of health.

Hi welcome to another episode of talking with docs i am dr paul zalzel i’m dr bradween dr weaning do you want to live forever do you want to be forever young alphaville so to the people that grew up in the 80s they’re loving that reference well here it is i would say i don’t i don’t know that i do to be honest yeah i don’t i think you’d make a mighty fine 200

Year old it really depends kind of like we’ve talked about in the past and slightly newer terms the difference between lifespan and health span so i just don’t want the number to keep going up i still want to be highly functional and do that that’s a good point there is a big difference between lifespan and health span right life span means you live longer

Health span means you stay healthy longer right so if you can do both maybe then okay all right forever is a long time though chill with yoda yoda yeah sure that team on cocoon well benjamin button well there are lots of uh fictional examples of it but it is now into the science world okay and we thought our viewers should know about this and we learned

About this because some one of our colleagues said hey do you guys want to have you heard about the pill that makes you look younger yeah and then i said you pulled a de niro and taxi driver you talking to me what are you trying to say trying to say and she’s like here to take some of these pills so there’s an article that we’re going to post the link in the

Description and i’m going to read the title because that is long long time so a critical review of the evidence that metformin is a putative anti-aging drug that enhances health span and extends lifespan in addition to good housekeeping and national geographic they use unless you’re getting regular episodes of frontiers in endocrinology you might have missed

This one endocrinologists probably subscribe to that yes but what i picked up from that title was metformin yeah increasing health span and lifespan right so people have probably heard of metformin yeah so metformin is um very scientifically something called a synthetic biguanoid it’s an orally effective insulin sensitizing antidiabetic drug that often is the

First line drug used for type 2 diabetics okay type 2 diabetics people with type 2 diabetes many many of them are on in are on metformin because it helps them sensitize to insulin and bring their glucose levels down okay so our viewers have come to depend on you for fun facts about historical uh references yeah i happen to have a little one i figured i met

Foreman comes well it was first um i think i discovered around 1922 from the french lilac because that plant although toxic was used to treat sweet urine how does someone know that their urine is sweet i don’t want to hopefully by smell i don’t want to know how that diagnosis was made in 1922 certainly now folk medicine right they were using it yeah using

The lilac treat the sweet urine people got better yeah then fast forward to the 50s and the french start extracted metformin from that right and started using that to treat diabetes type 2 diabetes then fast forward another couple of decades a big study out of the uk that said hey look metformin works great treating type 2 diabetics in terms of increasing

Health span right lifespan and stopping some of the complications of diabetes right okay so metformin in type 2 diabetes no question works great can’t great drug now people are taking the leap and saying what if we take metformin and apply it to people who do not have the disease type 2 diabetes and see if that increases their health span and lifespan right

So have there been any trials yes there’s two big trials there’s two trials going on one big one not so big the miles so that was the metformin in longevity study you know how we like fancy names and acronyms yeah miles yeah not a huge study but where they there they gave some people with type 2 diabetes metformin for i think six weeks and looked at their

Cells to see if they are showing signs of anti-aging right and then the tame study so targeting aging with metformin tame yeah and that was a larger study where they’re gonna try it on people without uh type 2 diabetes to see if it does so they can tame aging tamate well that’s a thing now age is aging and disease now we’re treating aging like it’s a disease

Because we’ve got a pill to treat aging we’re walking that line the ethical line ethics the ethics of it is i mean historically yeah science leads ethics we make a scientific discovery before we realize if it’s ethically sound yeah cloning hey look what we can do is it okay to do that yeah right cloning right that’s how we that’s how we came about that’s

Right because we’re the same that’s right you got that um you know going to mars for example should we do it yeah we can’t we’re developing the science to go to mars but should we go to well or even determining gender like in in an embryo or when there’s a fetus you know is that okay or trying to essentially select your kids one way taller blonde or whatever

Right right so we can do it then ethic comes in says should we do it right so same thing with aging should we be designing or repurposing a pill to cure aging right now metformin you might people might say oh it’s big pharma trying to sell pills check the words right out of my mouth yeah the thing about metformin is it’s like 60 years old okay it’s off label

And it’s cheap so when someone’s laughing we’re off patent what does that mean folks people a lot of you might hear that or uh it means a lot of different companies can make it so no one’s really profiting a ton from metformin right so when a drug is first designed that company is given a patent for a certain number of years i send you to help recover a lot of

The money that went into the research because despite what everybody thinks and big farming evil wines just make money they have to put a lot of money in and sometimes it’s risky they can invest tens or even hundreds of millions of dollars into a drug that ends up not working that money can’t be recovered so they’re allowed to sell new kind of uh discoveries for

A certain period of time just being as the only vendor and then it comes off pat and then everyone essentially gets the recipe and then you can make it for cheap okay so it’s off patent so it’s cheap a top patent it’s cheap readily available and safe it’s a really safe drive okay any side effects to metformin some people are like okay i’m gonna go find myself

Some good like metformin and start taking it yeah but there’s commonly you can have some gi side effects bloating diarrhea nausea vomiting however that doesn’t usually preclude its use in someone with diabetes right it can inhibit uptake of b12 by moving 12 use and i think some other long-term uh abdominal liver stuff yeah again very rare but yes definitely

If you’re taking any medication in particular form it needs to be under the supervision of a doctor and at this point it has not been indicated for this so you’re actually not allowed to prescribe it for anti-aging okay so the study with the long complicated title right did it conclude that metformin does increase health span and lifespan in people without

Type 2 diabetes so the answer is it might that’s it right it’s not conclusive but there are some signals and signs in the pre-clinical animal models and some of the early clinical models that yeah there may be something here with this drug it may increase health span and lifespan and the reason that that makes sense is that we all know that even if you’re not

Diabetic studies have shown that when your glucose goes way up after a meal after eating something that has a high glycemic index that high level of sugar in your blood leads to inflammation it can lead to things like heart disease cancer even dementia and other other things that we thought are not really related to sugars and that’s what they’re looking at

Metformin now right it’s reducing the incidence of heart disease cancers um even cognitive decline as well people saw depression as well like the mood disorders the sugar in your bloodstream is a bad problem and if this can regulate it and help your body do what it normally is trying to do can do it better and more efficiently this may help us age either better

Or longer okay so there you go you’re our viewers and we want you to know that the scientists looking at metformin to increase lifespan right okay now some of you might be saying you’re barking up the wrong tree don’t call us dogs but you might be barking up the wrong tree okay and i might agree with you because if you really want to increase lifespan across

A population some of you may argue and i might successfully argue too that instead of looking at a pill to do it look at some of the social determinants of health okay what’s a social determinant of health sounds so fancy we’re off on a tangent here but a social determinant of health is a non-medical thing or factor that affects your health okay so obvious

Examples are your socioeconomic status okay there’s a gradient right there’s a gradient with lifespan and socioeconomic status lower socioeconomic status you don’t live as long yeah that’s a fact that’s a problem but it’s a fact right uh the politics of where you live right access to health care yep access to a job your living arrangement those are all social

Determinants of health that affect your life space right conflict like military like a war right like you’re not having beef no you’re vegan it’s impossible so a conflict for example if i took this article to a war zone and unfortunately that’s not fictional right now there are war zones right now if we took that art and said hey look there’s a pill that

Can make you live longer that person is going to look at you and say you’re a why don’t you stop these bombs from dropping on my head that’s that’s gonna make my city live longer right okay so social determinants of health some argue those are more important than actually what you and i do yeah for sure healthcare so that’s just an argument that some of you

Might be sitting there thinking oh yeah well what about that you’re telling me about a pill to make you live longer why don’t you look at some of the factors that are making people not live longer and if we want to even want to do it you know like you we talked about a little bit before you might run out of money or maybe our world can’t support that number

Of people living that long and then as we age we do require more care and more infrastructure and we’re really not doing even a great job right now at dealing with people as they age so it’s hard to know what the right answer is hi i’m uh dr zalzel your orthopedic surgeon how old are you well i’m 140. i’m going to be operating next to your nerves and arteries

But don’t worry i took him at foreman today that’s right okay having said all that if if someone said here’s a pill that’s totally safe very cheap it’s going to make you live healthier and longer would you take it i would definitely give it some very thoughtful consideration i probably would too i mean i take a multivitamin that’s right so having said all

That we’re just showing both sides of the argument the ethics of it yeah the social determinants of health you know is this the right thing to do we’ll leave it up to you yeah we do the dust settles we just wanted you to know that there is scientists there are scientists working on a pill to make you live longer all right if you like this video please like it

Subscribe to our channel leave a comment let us know we think and remember you are in charge of your own health and maybe one day you are in charge of how long you are going to live well you kind of already are a little bit like we we kind of do that we give you watch this show you’ll live longer we’ll see you next time

Transcribed from video
Does Metformin Make You Live Longer? By Talking With Docs