March 28, 2023

Metformin for anti aging on TRT? Metformin: Best TRT Add On or Not? What is the metformin for longevity dosage?

Hey trt group this is justin again today i want to talk about metformin and any application it may have to being part of a trt program and the reason i’m bringing this topic up today is because i’ve been getting more and more patients inquiring about metformin and if it has any application to one’s trt protocol so listen up thanks for joining so i want to start

Off by giving y’all some background information on metformin itself and classically historically metformin has been classified as a diabetic medication now it belongs to a class of medications known as the biguanides and actually it was derived from a plant called the french lilac and if i’m not mistaken it was discovered in the 1920s however it did not receive

Fda widespread approval in the u.s until i believe 1995 give or take now there were two others in the same big one eye class prior to metformin buforman and phenformin however they were never widely accepted via fda via the fda as they were known for causing a condition called lactic acid doses and thus their utility was removed now lactic acid doses in those drugs

Primarily occurred in people that had renal impairment but again it was a black box warning and thus those drugs were not approved and hence we have metformin nowadays yes metformin could cause lactic acid doses however the incidence is extremely rare and i’m talking about three or four per 100k patients or give or take um but the main thing is it probably occurs

In people that have renal impairment um also dosages that occurred in or toxicity type doses we’re looking at exceeding four to five grams a day on top of being really impaired and the typical dosage for most patients would be two grams a day maximally for diabetics now also it’s it’s considered contraindication if your gfr is under 30 or if you’re a male and

Your creatinine is greater than 1.5 or a female and your creatinine is greater than 1.4 but if you’ve seen some other videos you know how i feel about using just those strict labs instead i feel like you should get a size statin c as that will give you a more raw accurate evaluation of your kidney function but enough about that background stuff you came here to

Learn more about metformin’s anti-aging benefits well as i mentioned earlier metformin has classically been used as a diabetes drug in its most basic description it is a glucose disposal agent and it does this through a few primary mechanisms one it’s an insulin sensitization agent two it inhibits hepatic gluconeogenesis three it blocks inhibits the absorption

Of glucose from the gi tract and it also increases fatty acid oxidation but it primarily gets its anti-aging benefits by up regulating ampk and ampk is expressed its expressions increased due to metformin it increases it and when that happens it increases fatty acid oxidation and it mimics being in a caloric restricted state in other words metformin acts kind of

Like a caloric restriction mimetic and metformin has other benefits as well there’s studies that show that has anti-cancer properties it can improve your lipids obviously it can improve your glucose profile it can help with cardiovascular health it can improve your endothelial function oh yeah on average over a year’s time most patients lose a couple kilograms of

Weight which i know isn’t very much but hey it’s a small added bonus in terms of adverse effects the most common and principle adverse effect is gastrointestinal distress namely nausea and diary and that’s very common actually i almost anticipate that most patients may have either or to some degree now here’s a good thing it’s very transient it’s self-limiting

And if you can power through that first few weeks then it typically self resolves and you’ll be fine so if that is an issue and it’s persistent and something that you can’t handle then one thing you can do is either back down your dose make sure you take it with food or switch the formulation to an extended release formulation and that should do the trick but

Again it typically self resolves you just got to power through it and another adverse effect that is hardly ever talk about is the possibility that metformin can actually lower your testosterone and hence explaining why it’s often used to treat patients with pcos because pcos is often characterized by hyper androgenism and hyperinsulinemia now does that mean

That metformin could have that adverse effect on patients on trt honestly no i don’t see it happen to them here’s another thing you need to think about most patients who are diabetic also concurrently have low testosterone so in my opinion patients that are diabetic should be evaluated for hypogonadism but again i don’t see this being an implication to lower

Your testosterone if you’re already on trt this is just more or less something you should think about if you’re not on trt but you’re considering getting on metformin for anti-aging purposes is that it could affect your androgen levels misumi is the number one product for acne problems on trt check out the products using the link in the description under this video you

Transcribed from video
Metformin: Best TRT Add On or Not? By TRT and Hormone Optimization