[HN Gopher] Diabetes Drug Metformin Reduces All-Cause Mortality ...
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Diabetes Drug Metformin Reduces All-Cause Mortality and Diseases of
Aging (2017)
Author : optimalsolver
Score : 94 points
Date : 2021-06-12 19:22 UTC (3 hours ago)
(HTM) web link (pubmed.ncbi.nlm.nih.gov)
(TXT) w3m dump (pubmed.ncbi.nlm.nih.gov)
| cromwellian wrote:
| My mother died from a combination of metformin and colchicine.
| She had renal insufficiency, the FDA had warned not to prescribe
| metformin to people with renal insufficiency, and it made her
| kidneys worse. She had been taking daily low dose colchicine for
| gout, but the worsened kidney function caused a poisonous level
| of colchicine to build up. She vomited so much, she lost a too
| much electrolytes and ended up in the hospital delirious. The
| hospital thought it was a stroke and tested for that, eventually
| ruling it out, but the time wasted on thinking it was a stroke,
| obscured a growing instability in her kidneys, liver, thanks to
| the insufficiency, colchicine, and bad electrolyte levels.
|
| When they infused electrolytes, it swung the pendulum too far in
| the other direction, and she suffered wild swings in blood levels
| of potassium, etc. Eventually her kidneys and liver failed at the
| same time, multiple organ failure, usually for someone in their
| 60s is not survival. I watched her die slowly over a few days as
| everything came crashing down.
|
| Afterwards, I tried to get the hospital to conduct an autopsy to
| show overdose of colchicine levels, but the pathology department
| somehow "wasn't set up for that" and they said I'd have to send
| her body to some specialist lab. I didn't want to cause anymore
| pain with the family, so I opted to just bury her. But I
| definitely see this as medical malpractice.
|
| And it's a clear warning to not ignore FDA contraindication
| warnings, even if your doctor apparently doesn't read up on the
| latest research or alerts.
| [deleted]
| MengerSponge wrote:
| The only miracle drugs that I know of are sleep, water, and
| exercise. Even those have dose-related toxicities!
|
| https://peterattiamd.com/metformin-and-exercise/
|
| If you're healthy enough to exercise, that's probably more
| effective. Apparently (I haven't tested myself, and I don't know
| how thorough the literature is) metformin lowers your lactic
| threshold, which reduces the total amount of work you can do in
| that state.
|
| Do cardio, sleep enough, avoid refined sugar and fats that are
| solid at room temperature. More than that... godspeed
| Filligree wrote:
| > avoid refined sugar and fats that are solid at room
| temperature.
|
| This leaves, what, protein and starch? And cooking oil, I
| suppose, but all forms of meat contain solid fats.
| ansible wrote:
| Some oils like rapeseed (canola) aren't that good for you
| either.
| fermentation wrote:
| And coconut oil, which contains quite a bit of saturated
| fat.
|
| Edit: apparently coconut oil is supposed to be solid at
| room temp. I should get an air conditioner
| void_mint wrote:
| These articles always bring up a lot of comments that use
| the phrase "good for you" or "healthy", but in my
| experience most of the time a person saying "___ is good
| for you", they pretty much never quantify how or why.
|
| Can you explain, in what capacity oils aren't "good for
| you" ?
| shaicoleman wrote:
| I think the best talk of the health dangers of seed oils
| is in the following video:
|
| Dr. Chris Knobbe - 'Diseases of Civilization: Are Seed
| Oil Excesses the Unifying Mechanism?' [1]
|
| If you're short on time, you can skip directly to the
| trials data section [2]
|
| 1. https://youtu.be/7kGnfXXIKZM
|
| 2. https://youtu.be/7kGnfXXIKZM?t=2020
| void_mint wrote:
| > in rats
|
| So we're deriving that an entire class of foods aren't
| "good for you", because of a specific outcome in a study
| conducted on rats?
|
| _edit_
|
| Also, the effect produced on the rats was weight gain. Is
| all weight gain bad? Oils aren't "good for you" because
| "weight gain"? So, if a person's goal was to gain weight,
| would oils be "good for them"? And if yes, isn't this
| just way too broad a statement ("oils aren't good for
| you") to have any value?
| shaicoleman wrote:
| Indeed, not all animal trials are valid in humans, and
| your skepticism is warranted.
|
| In the rest of the video he discusses how it affects
| human health, along with the data to support that
| assertion.
|
| It's seed, vegetable and hydrogenated oils that are bad
| for you and are correlated with obesity, heart disease,
| diabetes and cancer.
|
| Coconut oil, olive oil and butter are fine.
| ivankolev wrote:
| The dose makes the poison. Everything in excess is
| detrimental.
| basch wrote:
| >refined sugar
|
| I wouldn't personally consider rolled oats, rolled barley, or
| rolled rye to be refined sugars, nor are they quite in the
| white rice, potato, corn, flour starch category, despite
| flattening a "grass seed/fruit" being a type of "processing."
|
| Furthermore, oversimplifying food advice tends to leave out
| conversation of how food breaks down. The main ways are time,
| grinding, heat, fermentation. Fermentation gets a bit of an
| asterisk at the end of hard rules lists. They may say no
| dairy but then exempt fermented dairy. Lactofermentation of
| oats will be less starchy than uncooked oats.
| throwaway34241 wrote:
| Well, there's a bit more variety there than cooking oil - I
| think the "healthy fat" category usually includes nuts,
| avocados, olive oil, salmon, etc. I don't think chicken
| (including the skin) is supposed to be bad either. [1]
|
| From my understanding of the available evidence, these fats
| are supposed to be more healthy than other animal fats /
| butter (saturated fat). [2] Whether saturated fats are bad or
| not depends on what you compare them to - they seem less
| healthy than say, olive oil, but might win out over refined
| carbs. And the most clearly bad one is trans fat which has
| the strongest evidence against it.
|
| [1] https://www.hsph.harvard.edu/nutritionsource/2012/06/21/a
| sk-...
|
| [2] https://www.hsph.harvard.edu/nutritionsource/what-should-
| you...
| lambdaba wrote:
| Avoiding "solid fats" aka saturated fats is bad advice. The
| science behind saturated fats being harmful has been debunked
| and even some government agencies have rescinded the
| recommendation to avoid them.
|
| On the contrary, it's the liquid fats that are more often
| harmful, especially linoleic acid (aka omega-6).
| myfavoritedog wrote:
| Isn't it amazing how they can make such confident
| recommendations about these dietary issues without having the
| data (real data, not some bs study) to back it up? They end
| up reversing themselves over and over, utterly destroying
| societal trust in the field of dietary medicine.
| void_mint wrote:
| > avoid refined sugar and fats that are solid at room
| temperature.
|
| Why?
| rscho wrote:
| This whole comment section is totally delusional regarding the
| reliability of medical statistics and preliminary data in life
| science. It's funny (and sad) to see people easily disparaging
| "state-of-the-art treatments" be so prone to experiment on
| themselves with moonshot claims.
| [deleted]
| gremloni wrote:
| No matter what, the underlying reality, is that there are
| certain chemical you can take in the right amount per person to
| give you the best health possible. We might not be there for a
| while but studies help us in that direction.
| rscho wrote:
| Yes, I agree. But not all studies. There is a substantial
| proportion of studies that are just statistical noise, and a
| smaller but still substantial part that are outright fraud.
|
| However, individual experiments are not studies in the
| academic sense. Especially if they are not formally reported
| so that the experience is not lost in time.
| myfavoritedog wrote:
| For decades, we were told that the food pyramid was the ideal
| healthy diet and that dietary fat was the enemy. It was all
| bullshit.
|
| Eggs are healthy, eggs are unhealthy, eggs are really
| unhealthy, eggs are healthy, eggs are really healthy.
|
| I had trained medical professionals tell me twenty years ago
| that I was going to ruin my kidneys with my low-carb dieting.
| Twenty years later, I'm still keeping the weight off and
| medical science has started to catch up to what I knew just by
| experimenting on myself with moonshot claims.
|
| The biggest problem with medical science (just look at how
| COVID issues were butchered by politics and celebrity), is that
| they refuse to just say, "We don't really know." Because all
| too often, they have no clue. But they are trained to come up
| with answers and sound confident about it.
| rscho wrote:
| There are many things I don't know. However, here's one thing
| I know to be true: individual experiments do not make for
| population-level generalizations. Additionally, dieting by
| reducing or even excluding a single well-known food category
| when there are many more left appears as less radical than
| taking a pill that will rebalance your whole metabolism,
| don't you think?
|
| Regarding the "we really don't know" part: one can observe
| that people here are basing their own shamanic medicine on
| what they read in scientific papers, suddenly pretending that
| those papers can be trusted while they'll disparage the
| theories of clinical practitioners as being old-fashioned and
| manipulative. Well, it happens that many of those theories
| are based upon lots and lots of research and certainly more
| so that the "fad of the day" is. And yes, those theories are
| often refuted after years of clinical application, which does
| not bode well for experiments based on "few papers shamanic
| medicine".
| jopsen wrote:
| > just say, "We don't really know."
|
| That is what OP says.
|
| What we open see is that "we don't know" is often equated
| with "does not work".
|
| (I guess that also very frequently how it works out)
| [deleted]
| healthnut99 wrote:
| The only way to get a reliable answer at this point appears to be
| a large, randomized trial - the TAME trial
| (https://www.afar.org/tame-trial) was supposed to have started in
| 2020. Although the official website doesn't say so, I found
| various articles in the press from late 2019 which said they had
| raised all the $75 million they needed for it (for example, see
| https://www.longevity.technology/worlds-first-anti-aging-tri...).
| After that, it has been radio silence from them - no website
| updates, no press releases. Although their website says they have
| clinical sites set up, I haven't been able to find the clinical
| trials.gov entry for it. I even sent an email to the PI Nil
| Birzalai (at Montefiore in NYC) a few weeks ago to find out more,
| but didn't get a response. Does anyone know whether that trial
| even got off the ground?
| Afforess wrote:
| Gwern did some analysis and determined that the ROI for Metformin
| vs the cost is positive for 45+ and older.
|
| https://www.gwern.net/Longevity#metformin
| macinjosh wrote:
| It certainly is a powerful pharmaceutical. It can impact aquatic
| life that live in treated waste water effluent.
|
| "Emerging wastewater contaminant metformin causes intersex and
| reduced fecundity in fish."
|
| https://www.sciencedirect.com/science/article/pii/S004565351...
| 8note wrote:
| If you're already kind of old, you maybe don't want more kids
| anyways?
| wetpaws wrote:
| human life > fish life
| simcop2387 wrote:
| Yes and no. If that's literally allmit does and it doesn't do
| it to an extreme amount i'd have no issues with it, but it
| also points to it possibly causing other effects that we need
| to be looking for and studying so we don;t get caught unaware
| of it destroying ecosystems that we depend on for our lives
| too. You have to remeber that we don't exist in isolation
| drom the environment and if it causes that in fish, it might
| be causing other problems in us, or in plants and animals
| that we depend on directly or indirectly.
| baliex wrote:
| We're all living in the same (complex!) ecosystem. It's
| possible that the fish you're relegating to be less important
| than you are somehow benefiting you in some indirect way
| [deleted]
| drcode wrote:
| I have been taking metformin for anti-aging purposes for about 6
| months now. I decided to take it mainly because the risks are
| small, and I wanted to counter the natural bias on these sorts of
| things, which always leans towards "doing nothing".
|
| By taking metformin, it means I have a personal stake in the
| developoment of anti-aging medicines and have a reason to
| evaluate any newer options that appear (since there may be a
| reason to switch metformin to another treatment) I feel like
| taking metformin makes me less biased when it comes to evaluating
| treatments in the field, even if I think the efficacy of
| metformin is still an open question.
|
| In terms of side effects, I have noted mild gastric upset (I
| actually wonder if this is part of its mechanism of action,
| making you less hungry in this way) but little impact on exercise
| (I take it even on days that I exercise, and I have a fairly
| heavy exercise routine)
| birriel wrote:
| Comparison of metformin and berberine based on Cochrane meta-
| analysis:
|
| https://www.youtube.com/watch?v=OPsMMfSQKQ0
| clumsysmurf wrote:
| Looked at berberine also, seems toxic to the liver.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867333/
| toddh wrote:
| Metformin does have some long term issues. After 10 years it can
| cause serious lower back pain. Not in everyone, but it's
| something to be aware of.
| api wrote:
| Could this be replicating what fasting and caloric restriction
| do?
| nate_meurer wrote:
| Yes, there's evidence for that. However the jury is still out
| on whether metformin is a net benefit for people with healthy
| insulin sensitivity. It appears there are negative effects:
|
| Derek Lowe talks about the negative effects of metformin on
| healthy people:
|
| https://blogs.sciencemag.org/pipeline/archives/2019/06/24/me...
|
| Peter Attia talks about the same, and some interesting other
| considerations:
|
| https://peterattiamd.com/191013/
| birriel wrote:
| Folks that take metformin for anti-aging usually take it on
| exercise off-days. There was concern about lactic acidosis,
| but it's beginning to become clear that it mostly arises in
| patients with comorbidities.
| dcolkitt wrote:
| Metformin likely blunts the impact of high intensity
| exercise. But for the 65% of people living sedentary or low
| activity lives, it's a straight win. Even for those who are
| consistent with physical fitness, the downsides can likely be
| avoided by waiting a few hours after the morning exercise
| session to dose.
| electriclove wrote:
| Right, and wouldn't the non extended release version work
| well if taken at night and exercise in morning (or vice
| versa).
| 238475235243 wrote:
| Yes. And keto, OMAD, etc... They all do the "same thing" in
| reducing serum glucose and therefore all the downstream bad
| things that happen.
|
| Metformin forms the base plank of novel metabolic cancer
| regimens too.
| jcims wrote:
| >Metformin forms the base plank of novel metabolic cancer
| regimens too.
|
| For which you'll likely have to lie to or find an alternative
| oncologist who's willing to tolerate adjuvant therapies that
| aren't 'standard of care'.
|
| There are organizations that are developing protocols that
| include metformin along with statins, anthelmintics and even
| some antibiotics that are showing promise across a variety of
| research and even some clinical trials to help fight cancer
| through a number of mechanisms. Independently they are not
| likely sufficient to beat cancer but may slow its roll
| through the body of the patient.
| CodeWriter23 wrote:
| "alternative" practitioners have been keeping humans
| healthy for several millennia prior to the existence of the
| AMA and their so-called "standard of care".
| oivey wrote:
| Sure, but evidence from last several millennia also show
| they haven't kept people healthy quite as long.
| nojokes wrote:
| Those so called alternative practitioners lack scientific
| rigor, I am afraid of, or more likely just do not know
| what they are doing. Exceptions exists of course.
| hellbannedguy wrote:
| The magic of placebo. Chiropractic school dropout, with
| the bonus of having a ex girlfriend who was a Herbal
| Doctor. A Naturopath? I forget.
|
| What really sealed the deal was this one professor.
| Attractive lady whom spoke like she was addressing the
| United Nations. I still remember the time she told me to
| show the class my Coccyx. I was relieve I had good
| underware on.
|
| Back to the most rediculious statement from the red
| lipstick mouth of a PhD. (I comment on her appearance
| because she was cute. So--please don't take it any other
| way. I know there are people waiting to pounce.)
|
| She stated,
|
| "We have over 15 upper cervical techniques, and they All
| work equally well." Studies, and Placebo Effect are
| conviently never talked about at that school."
|
| That said, I feel most modern medicine is not much
| better.
|
| Placebo rules in every healing art.
|
| The kid in front of me, at Chiro school, was the spitting
| image of health. I was actually jealous. He was getting
| weekly adjustments. He was getting something called a
| Rotary Adjustment.
|
| He was biking with his wife, and father in-law on a sunny
| Saturday. He stopped peddling, and fell over. Died of a
| massive stroke, at 25.
|
| While I'm here. Sharon Stone was a big Chiro fanatic. Out
| of the blue she developed bilateral aneurisms, or tears?,
| in her neck. A world renowned vascular surgeon happened
| to be giving a talk at UCSF. The hospital asked him to
| perform the delicate surgery. It was obviously
| successful.
| rscho wrote:
| And choloroquine! Let's not forget chloroquine. It can beat
| anything.
| 238475235243 wrote:
| This is easy in the US, check out Care Oncology.
| jcims wrote:
| That's who we used, they made it very simple. Our
| oncologist was not pleased though.
| rscho wrote:
| Haha. I'm so happy and relieved that I don't have to
| practice in the US anymore.
| clumsysmurf wrote:
| Picture seems complicated
|
| Our study, performed in C. elegans and human primary fibroblasts
| shows that there is an age-related decrease in metformin
| tolerance, which in later life leads to toxicity of all metformin
| doses tested. This shows possible safety risks of late life
| administration of metformin to individuals without diabetes,"
|
| https://medicalxpress.com/news/2020-11-age-decisive-positive...
| Nevermark wrote:
| It would be interesting to know if lower doses were tolerated
| better while still providing some benefit.
| pochamago wrote:
| My dad actually switched doctors because his original one refused
| to prescribe metformin to anyone who wasn't fully diabetic
| rscho wrote:
| And rightfully so given the state of the evidence.
| staticassertion wrote:
| What would you consider satisfying evidence?
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839379/
| https://pubmed.ncbi.nlm.nih.gov/31405774/
| https://pubmed.ncbi.nlm.nih.gov/31954752/
| https://ncbi.nlm.nih.gov/pmc/articles/PMC4287273/
| rscho wrote:
| Years and years of widespread clinical practice would be my
| standard, but I'll make do with multiple large-scale
| randomized studies AND precise guidelines if absolutely
| necessary. As for evidence seeking, clinical research
| happens to be part of my job so I don't really need
| assistance, thanks.
| staticassertion wrote:
| That seems like a silly standard, but do you.
| rscho wrote:
| It's the standard of one particular professional with 15y
| of clinical practice and research who's seen every kind
| of manipulation and incompetence in medicine. But yeah,
| it may be silly. We'll see about that in the coming
| decades I guess.
| staticassertion wrote:
| I'm not planning to take metformin but it was discovered
| a century ago and has been in use for half that time. A
| quick look shows me that it's the 4th most prescribed
| medication in the US. I find it hard to understand how
| this would not satisfy "years and years of widespread
| clinical practice", at least with regards to
| understanding negative implications.
|
| But as you said, you can do your own research, so I'll
| leave things where they stand. You just sound more like
| someone who's annoyed by pop-science more than someone
| who actually has strong opinions about the article or
| Metformin.
| rscho wrote:
| I am well aware of the downsides of metformin since
| someone ends up in my ER because of it most weeks. So
| you'll excuse me if an off-label and very new potential
| indication is not an immediate go for me. When we want to
| open a new indication for a particular drug, evaluation
| of the risk-benefit ratio for this particular indication
| has to be performed. There are many factors at play and
| results are completely unpredictable.
|
| As for the rest no, I'm all for pop-science because it's
| what stimulates the interest of the masses. The problem
| in my eyes is more that academic medical studies
| available to the wider public are akin to a very sharp
| saw, and people will get cut if they don't know what
| they're doing.
| staticassertion wrote:
| Yeah I'd recommend you open up with information like that
| in the future, just right off the bat. It's a lot more
| interesting and at least somewhat useful.
| [deleted]
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