Metformin for non-diabetics

(Michelle C.) #1

I’ve been nervous to post this, but I’m just going to throw this out there…does anyone use Metformin to “optimize” insulin and (potentially) weight loss? All current signs point that I’m one of those women Dr. Gerber described in the last podcast - insulin sensitive, lab work excellent, but just hold onto weight and difficulty losing it. Insulin test is pending - that said, my A1C has been excellent for years so my provider expects my insulin to be good, but maybe not optimal.

I do strict keto, IF, and up to 72 hour fasting. My latest stall is at 6 weeks.

Thoughts? I know using medication to basically optimize could be controversial. (And berberine hasn’t done anything.)

(Kevin McCarthy) #2

I take 1000 mg per day of metformin, up from 500 mg last year. My primary care physician was totally cool with writing the prescription when I asked. My goals were a wide range of health benefits; my weight after 2.5 years in ketosis is great (same as freshman year college), and my HA1c is 5.0, so weight loss wasn’t my goal. A great survey paper on metformin is available (free full text) here:
www.cell.com/cell-metabolism/pdf/S1550-4131(16)30229-7.pdf

All the best,

Kevin

(Michelle C.) #3

Thanks! I’ve read quite a few LCHF researchers/experts take it and aren’t necessarily diabetic. I’m not sure if that’s true or not. I figured it won’t hurt anything. My A1C fluctuates between 5-5.2, and has been as low as 4.9. But I still carry a bit of excess weight that even on strict keto and fasting is very slow to come off and has stalled for over 6 weeks now. I figure really working on the insulin level can’t hurt the situation I can’t find literature on this application specifically and was curious if anyone here has had any experience with this.

#4

I am very fascinated by this question also. In a lot of the information I’ve come across Metformin is treated as a powerful tool with very little drawback. I believe it was Dominic D’Agostino who said he’d recommend it in low doses and might even take it himself. He was forced to answer a very hypothetical question Tim Ferriss asked him about “what would you do if you were diagnosed with cancer” and IIRC the metformin thing came up then but I know I’ve heard it other places as well.

I know as levels increase there can be some G.I. issues but other than that it seems like a reasonable thing for any insulin resistant person to be inquiring about. We’ve heard from a lot of formerly type II diabetic people who choose to stay on Metformin long after they used keto and/or fasting to get their blood sugar under control. So why not your average insulin resistant person? I think it’s a great question.

I’m not someone who takes any medication nor wants to, but if I was going to start I would feel pretty good about taking something as well-documented as Metformin. A long track record of being highly effective while having virtually zero negative effects? I want to know more.

(Todd Allen) #5

Metformin reduces hyperinsulinemia (and the need for insulin injections) which can help with weight loss. Before trying metformin you should get tested to see if you have significant hyperinsulinemia as some doctors may find that compelling enough to prescribe metformin. Blood sugar testing alone doesn’t distinguish between being insulin sensitive or having elevated insulin.

Metformin has been shown to increase longevity of mice and other organisms in a lab setting. Although it’s not been shown yet to increase longevity of humans living in the wild a few are trying it for this off-label use. However, the general consensus is this is a risky gamble due to it’s other long term side effects such as suppressing the immune system.

(Michelle C.) #6

Full disclosure: I’m an advanced practice nurse (I diagnose and prescribe). I did a lot of research before posting this thinking surely there is info out there. All decent research I could find was regarding weight loss was with diabetics and PCOS and the limited non human longevity studies. That said, I couldn’t find any evidence that optimizing insulin levels even in a relatively insulin sensitive person could hurt anything. Especially at a low dose of Metformin. My working theory is that fully optimizing my insulin will help my body release the fat stores. Fortunately, my PCP extends professional courtesy and is game for letting me “experiment” on my journey. I am hoping maybe a few other non DM2 folks use Metformin off label and can share their experiences.

I am trying to look at all angles before reaching out to Dr. Gerber as he mentioned people like me in the last podcast #74. Unfortunately, information wasn’t provided as to things that may help us insulin sensitive fat holders.

I started 500mg ER last night. I’m eating the same - clean Keto. I guess I’ll have an N=1. So far the only side effect is minimal abdominal cramping which is to be expected. I’ll start extended fasting again after I adjust to the Metformin. (I naturally IF 16/8).

(Tim) #7

Also interested in learning more about this topic. It sounds like Metformin is a relatively safe drug, but as with any drug I’m always worried about possible side effects.

(Erin Macfarland ) #8

I started taking IR metformin for this reason, same situation as you, non diabetic, excellent bloodwork, etc. I have a family history of diabetes plus after having my genes tested I have a genetic predisposition as well. I’m not really sure how much the metformin did for me, as I have recently been recovering from an eating disorder, and had to gain weight. But I continued the metformin. And I’ll tell you, I have gained forty pounds regardless. So it’s not a magic bullet by any means. I say that because obviously recovery from an ED means my body and hunger signals were effed up. And I think the metformin actually lowered my blood sugar too much and I noticed increased hunger as a result. Then I read some studies about metformin damaging mitochondria, which would be in direct opposition to the claims that it is anti aging. So I went off and started taking berberine instead which is said to have equal effects without the mitochondria issue. So, there’s my two cents. I may take it again at some point if my A1c levels look concerning. But it will not prevent weight gain, at least it didn’t in my experience.

(Michelle C.) #9

Good info. Thanks! I got baseline bloodwork the day I started Metformin and am planning q3m bloodwork thereafter. I got a baseline fasting insulin so it will be interesting to see how the Metformin changes that. Maybe I’ll change to the Berberine for the next 3 month interval to compare. I haven’t seen any anecdotal improvement with berberine but don’t have the blood work to back that up.

(Todd Allen) #10

You have a much better background to evaluate this than I, a retired video game coder with no formal biological or medical background, and I wish you the best of luck in your fascinating experiment and hope you share the results.

I also considered metformin but recently began taking a related medication, pioglitazone, for an off label use, shown beneficial in a mouse model of a genetic disease I have. It improves insulin sensitivity but through a pathway contrary to your goal. It is a PPAR-gamma agonist which stimulates adipogenesis. A common side effect is obesity but it can improve health as it also lowers insulin and reduces inflammation and produces a shift to subcutaneous fat versus fat in the liver and other undesirable places.

Curiously though there has been research that merely being a PPAR ligand is primary to pioglitazone’s anti-diabetic effect. And perhaps a new PPAR-gamma antagonist drug may be what both you and I are seeking for somewhat different reasons.

#11

I used Berberine for about 3 months in 2011 and it caused havoc for my gut. Big time pain, burning right into mouth and lips.

Had been on metformin for 18 yr and fine but went Atkins and big went low so quit it and a Dr suggested berberine as a preventive med. All I read sounded good but it wreaked havoc. Once I quit it the gut settled some but burning got worse.After few yr a naturopath finally decided to test me for SIBO and yes I had it.
I felt berberine initiated this.
Have no way to prove it but will never touch the stuff again.
FYI

#12

I have been maintaining a 180 lb weight loss for the past 8 years–but it’s a constant struggle because my body seems determined to get its fat back.

I had read that Metformin can be really helpful to the ‘significantly reduced’ so I asked my endo for it–and he refused. I guess I’m too good at maintaining (he only sees my weight, not my daily struggles). He told me NEVER to take any Rx except when absolutely necessary because there are negatives involved in all of them.

In a way, I’m glad he refused. I went zero and have had a much easier time maintaining as a carnivore. I only ate about 10-15g of carbs when just low carbing, but it’s amazing (to me) how just fish, meat, and fats is satisfying and keeps my weight steady.

(Cathrine Helle) #13

I’m sorry if this is a stupid question, but what is SIBO? (I’m not English :stuck_out_tongue: )

(Sonia A.) #14

SIBO is the acronym for “small intestinal bacterial overgrowth,” defined as excessive bacteria in the small intestine. It causes a lot of symptoms like nausea, diarrhea, joint pain, fatigue…

(Cathrine Helle) #15

Thank you :slight_smile:

#16

Keep us posted, I’m interested in hearing about your experience.

(Michelle C.) #17

Update: Baseline labs back. Prior to starting metformin, my A1C was 5.0. Fasting insulin was 8.7. HOMA-IR 1.8. We will see how it goes after 3 months of metformin. Adjusting to the med just fine. About to bump up to 500mg ER BID. Thus far - absolutely no changes to weight or measurements.

I have a feeling I’m one of those lucky women Dr. Gerber mentioned that are (relatively) insulin sensitive but our body just holds onto fat. Yea…lucky me…

(melinda) #18

I’ve been wondering about adding Metformin myself due to my inability to lose weight as a morbidly obese woman.

(Colleen) #19

Dr Gerber’s words also struck a chord with me too. Yay Us!! :smirk::worried:

(Sonia A.) #20

What’s the normal values for fasting insulin ? How does it correlate with a1c ? In France, we don’t have the fasting insulin test. My a1c is 4.6. Is it possible to deduct my fasting insulin from that ?