Drugs · Brain health technique
Metformin
Evidence grade: Context Dependent
An oral drug, metformin (Glucophage®, Riomet®, Fortamet®, Glumetza®), that lowers hepatic glucose output, improves peripheral insulin sensitivity, and activates cellular AMPK pathways.
- Practice
- Drugs
- Principle
- Treatment
- Tactic
- Metabolic & Vascular Optimization Drugs
- Health domains
- metabolic
- Evidence grade
- Context Dependent
- Strength of evidence
- Medium
- Cost
- High
- Effort
- Low
- Time commitment
- Low
How to practice Metformin
Take 500–2000 mg daily with meals under physician supervision. Start low and titrate slowly to minimize GI side effects. Monitor B12 annually. Most beneficial in insulin resistance, prediabetes, or metabolic syndrome. Avoid off-label longevity use without medical monitoring; benefits derive from metabolic normalization, not direct neuroprotection.
The evidence behind Metformin
Strong observational data link metformin use in diabetes to lower dementia risk and all-cause mortality. Mechanistically, metformin improves mitochondrial efficiency and reduces oxidative stress. RCTs show mixed cognitive effects: benefits mostly in insulin-resistant individuals; neutral in metabolically normal adults.
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