Here’s how metformin, a promising anti-aging drug, works

“Research to date suggests that this molecule, originally derived from a plant (Galega officinalis), may help extend our lifespan by directly affecting the activity of cellular processes that determine the rate of aging. Now, slowing down aging is not achieved by just taking a pill. It is a combination of several factors: genetics, diet, lifestyle…,” explains Professor Antonio Ayala, professor of biochemistry and molecular biology at the University of Seville and vice-president of the Spanish Society of Anti-Aging and Longevity Medicine (SEMAL). ). The expert explains why this drug, sold in Spain under different brand names, is heard by all researchers.

Oral antidiabetic agents

Metformin is traditionally prescribed to lower blood sugar levels. In fact, it is the drug of first choice in the treatment of diabetes in our country, and its mechanism of action is mainly by inhibiting the production of glucose in the liver. However, several clinical studies conducted in recent years have identified other potential and promising uses of metformin, notably its ability to slow down aging.

“Luck” of genetics

“To understand the effect of metformin as an anti-aging drug, we must take into account that the rate at which a person ages depends largely on his genes and lifestyle. It has always been said that the genetic part is 30% and our daily routine (diet, exercise, stress levels…) is 70%, but the reality is completely different. There are people who have such strong genetics that they will live many years even if they smoke or are sedentary, while others who take great care of themselves are not so lucky. And I say luck because the way this percentage is distributed is a lottery,” explains Professor Ayala.

Why does this work?

Well, metformin affects a genetic part that is “serial” and cannot be changed. “Let’s say there are two types of genes in our body: those that will allow us to live long, we will call them green, and others that shorten our lifespan, we will call them red. Well, among these green genes, there is one called AMPK, which controls energy and cellular metabolism. And to live longer, it would be better if it were as active as possible,” he explains.

What happens is that since we can’t directly target genes unless we undergo gene therapy, “what we do is interfere with the protein that they make, which has a very clear function: to monitor the energy levels of the cell.” The moment the level drops, this enzyme takes the initiative to stop the loss of energy and thus prevent the death of the cell. And how does he do it? Well, it inhibits all processes that consume energy and stimulates those that produce it. That is, he does the same thing that anyone who has problems with money would do: cut expenses and look for additional income,” the vice president of SEMAL clearly explains.

And this is where metformin comes to the rescue. This molecule helps the protein maintain the required level of energy in cells. On the one hand, it helps to suppress pathways that use energy, such as the production of glucose, fat… (reduces costs), and on the other hand, it stimulates their production (additional income) through a process called autophagy. , which consists of recycling all cellular components that have already completed their function or have minor defects. In other words, it clears out all the debris that accumulates in the cells to convert it into energy, which keeps the cell young as it does not accumulate toxic waste responsible for diseases such as dementia, cancer or diabetes. The effect of metformin as an anti-aging drug is precisely by stimulating autophagy: by producing less cellular waste, we age more slowly.

But this process is activated not only by this drug. “Limiting the number of calories we eat per day and regular exercise has the same effect on our body as this medicine,” adds Professor Ayala.

Who can accept this?

This prescription-only medication can be taken by anyone over a certain age (30, 40, 50 years and older), but not everyone needs it. “A person with generous genetics who takes care of himself does not need to resort to these kinds of drugs. It is enough to control your diet and exercise. In addition, it can only be prescribed as an anti-aging agent. That is, if a specialist prescribes it as an anti-aging drug, he does so on his own responsibility, since in Spain it is only sold as an oral anti-diabetic drug. In fact, until aging is considered a disease, specific drugs cannot be prescribed to prolong life.

Metformin is available in tablet form. When treating diabetes, patients usually take two 800 mg tablets per day. each, whereas the doses used for anti-aging are lower at 400 to 500 mg. In case of anti-aging treatments, the best time to take them is at night as the effect on the body is stronger.

Side effects

The most common is the appearance of problems with the gastrointestinal tract, but it is not the only one. Metformin reduces vitamin B12 levels, so it can also cause anemia. People taking this drug should get regular checkups and exercise because another side effect is decreased muscle mass.