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Supplement

Metformin

The diabetes drug auditioning for a second career.

Metformin is a first-line diabetes drug that lowers glucose production in the liver. We grade Metformin C+ on evidence and B+ for worth-it at about $4-10 per month.

C+

Evidence

B+

Worth it

Typical cost: $4-10/month

What it does

Metformin is a first-line diabetes drug that lowers glucose production in the liver. Observational studies linked it to lower mortality, which launched the longevity hypothesis now being tested in the TAME trial.

What the research says

  • Associated with lower mortality in observational studies

    Evidence: emerging. Observational only; confounding is a real concern.

  • Lowers blood glucose and HbA1c in diabetics

    Evidence: strong. Established as a diabetes therapy; not in question.

DRAFT: proven drug for diabetes; the longevity case is observational until TAME reports.

What the experts say

Every position links to its source. We include skeptics alongside supporters.

  • Nir Barzilai

    “Metformin is maybe the only drug that we know hits all the hallmarks.”

    Source, 2025-08-19 Champions metformin as the ideal drug for the TAME trial; says TAME is about forcing the FDA to accept aging as a treatable cluster endpoint, since metformin's evidence base is already established.

  • Peter Attia

    “I stopped taking metformin.”

    Source, 2023-09-11 Stopped taking metformin in 2018 after measuring elevated resting lactate, suggesting mitochondrial interference; keeps it for insulin resistance and diabetes but not as a blanket longevity drug for active people.

Is it worth it?

B+

DRAFT: pennies as a generic; the worth-it question is medical, not financial.

Typical cost

$4-10/month

Common form, not a brand recommendation

Dosage contextno established dose

Prescription drug dosed by doctors for diabetes. No established dosage for longevity use.

Safety notes

PRESCRIPTION DRUG. Common GI side effects; long-term use can lower B12. Lactic acidosis is rare but serious, especially with kidney disease. Only under a doctor's care. This page is information, not medical advice.

Longevity Lab Report

Metformin news, graded when it happens.

New studies, dose debates, and expert shifts on metformin, in one email a week. Free.

Changelog

Last updated 2026-10-15

  • 2026-10-15|Batch 1 expansion entry, DRAFT. Grades provisional; expert positions unsourced unless noted.
  • 2026-10-15|Goals/dosage added; prescription flag set where applicable.