Metformin For Weight-Loss & More

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Metformin Without Diabetes?

Metformin is a diabetes drug; it works by:

  • decreasing glucose absorption from the gut
  • decreasing glucose production in the liver
  • increasing glucose sensitivity

It doesn’t change how much insulin is secreted, and is unlikely to cause hypoglycemia, making it relatively safe as diabetes drugs go.

It’s a biguanide drug, and/but so far as science knows (so far), its mechanism of action is unique (i.e. no other drug works the same way that metformin does).

Today we’ll examine its off-label uses and see what the science says!

A note on terms: “off-label” = when a drug is prescribed to treat something other than the main purpose(s) for which the drug was approved.

Other examples include modafinil against depression, and beta-blockers against anxiety.

Why take it if not diabetic?

There are many reasons people take it, including just general health and life extension:

One of the cheapest diabetes drugs on the market can also slow aging and extend your life span. Here’s how

However, its use was originally expanded (still “off-label”, but widely prescribed) past “just for diabetes” when it showed efficacy in treating pre-diabetes. Here for example is a longitudinal study that found metformin use performed similarly to lifestyle interventions (e.g. diet, exercise, etc). In their words:

❝ Lifestyle intervention or metformin significantly reduced diabetes development over 15 years. There were no overall differences in the aggregate microvascular outcome between treatment groups❞

Source: Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up

But, it seems it does more, as this more recent review found:

Long-term weight loss was also seen in both [metformin and intensive lifestyle intervention] groups, with better maintenance under metformin.

Subgroup analyses from the DPP/DPPOS have shed important light on the actions of metformin, including a greater effect in women with prior gestational diabetes, and a reduction in coronary artery calcium in men that might suggest a cardioprotective effect.

Long-term diabetes prevention with metformin is feasible and is supported in influential guidelines for selected groups of subjects.❞

Source: Metformin for diabetes prevention: update of the evidence base

We were wondering about that cardioprotective effect, so…

Cardioprotective effect

In short, another review (published a few months after the above one) confirmed the previous findings, and also added:

❝Patients with BMI > 35 showed an association between metformin use and lower incidence of CVD, including African Americans older than age 65. The data suggest that morbidly obese patients with prediabetes may benefit from the use of metformin as recommended by the ADA.❞

Real World Data: Off-Label Metformin in Patients with Prediabetes is Associated with Improved Cardiovascular Outcomes

We wondered about the weight loss implications of this, and…

For weight loss

The short version is, it works:

…and many many more where those came from. As a point of interest, it has also been compared and contrasted to GLP-1 agonists.

Compared/contrasted with GLP-1 agonists

It’s not quite as effective for weight loss, and/but it’s a lot cheaper, is tablets rather than injections, has fewer side effects (for most people), and doesn’t result in dramatic yoyo-ing if there’s an interruption to taking it:

Comparison of Beinaglutide Versus Metformin for Weight Loss in Overweight and Obese Non-diabetic Patients

Or if you prefer a reader-friendly pop-science version:

Ozempic vs Metformin: Comparing The Two Diabetes Medications

Is it safe?

For most people yes, but there are a stack of contraindications, so it’s best to speak with your doctor. However, particular things to be aware of include:

  • Usually contraindicated if you have kidney problems of any kind
  • Usually contraindicated if you have liver problems of any kind
  • May be contraindicated if you have issues with B12 levels

See also: Metformin: Is it a drug for all reasons and diseases?

Where can I get it?

As it’s a prescription-controlled drug, we can’t give you a handy Amazon link for this one.

However, many physicians are willing to prescribe it for off-label use (i.e., for reasons other than diabetes), so speak with yours (telehealth options may also be available).

If you do plan to speak with your doctor and you’re not sure they’ll be agreeable, you might want to get this paper and print it to take it with you:

Off-label indications of Metformin – Review of Literature

Take care!

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  • Brown Rice vs Wild Rice – Which is Healthier?

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    Our Verdict

    When comparing brown rice to wild rice, we picked the wild.

    Why?

    It’s close! But there are important distinctions.

    First let’s clarify: despite the name and appearance, wild rice is botanically quite different from rice per se; it’s not the same species, it’s not even the same genus, though it is the same umbrella family. In other words, they’re about as closely related as humans and gorillas are to each other.

    In terms of macros, wild rice has considerably more protein and a little more fiber, for slightly lower carbs.

    Notably, however, wild rice’s carbs are a close-to-even mix of sucrose, fructose, and glucose, while brown rice’s carbs are 99% starch. Given the carb to fiber ratio, it’s worth noting that wild rice also has lower net carbs, and the lower glycemic index.

    In the category of vitamins, wild rice leads with more of vitamins A, B2, B9, E, K, and choline. In contrast, brown rice has more of vitamins B1, B3, and B5. So, a moderate win for wild rice.

    When it comes to minerals, brown rice finally gets a tally in its favor, even if only slightly: brown rice has more magnesium, manganese, phosphorus, and selenium, while wild rice has more copper, potassium, and zinc. They’re equal in calcium and iron, by the way. Still, this category stands as a 4:3 win for brown rice.

    Adding up the categories makes a modest win for wild rice, and additionally, if we had to consider one of these things more important than the others, it’d be wild rice being higher in fiber and protein and lower in total carbs and net carbs.

    Still, enjoy either or both, per your preference!

    Want to learn more?

    You might like to read:

    Take care!

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  • Exercises for Aging-Ankles

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    Can Ankles Deterioration be Stopped?

    As we all know (or have experienced!), Ankle mobility deteriorates with age.

    We’re here to argue that it’s not all doom and gloom!

    (In fact, we’ve written about keeping our feet, and associated body parts, healthy here).

    This video by “Livinleggings” (below) provides a great argument that yes, ankle deterioration can be stopped, or even reversed. It’s a must-watch for anyone from yoga enthusiasts to gym warriors who might be unknowingly crippling their ankle-health.

    How We Can Prioritise Our Ankles

    Poor ankle flexibility isn’t just an inconvenience – it’s a direct route to knee issues, hip hiccups, and back pain. More importantly, ankle strength is a core component of building overall mobility.

    With 12 muscles in the ankle, it can be overwhelming to work out which to strengthen – and how. But fear not, we can prioritise three of the twelve: the calf duo (gastrocnemius and soleus) and the shin’s main muscle, the tibialis anterior.

    The first step is to test yourself! A simple wall test reveals any hidden truths about your ankle flexibility. Go to the 1:55 point in the video to see how it’s done.

    If you can’t do it, you’ve got work to be done.

    If you read the book we recommended on great functional exercises for seniors, then you may already be familiar with some super ankle exercises.

    Otherwise, these four ankle exercises are a great starting point:

    How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

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  • Take Care Of Your “Unwanted” Parts Too!

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    Meet The Family…

    If you’ve heard talk of “healing your inner child” or similar ideas, then today’s featured type of therapy takes that to several extra levels, in a way that helps many people.

    It’s called Internal Family Systems therapy, often “IFS” for short.

    Here’s a quick overview:

    Psychology Today | Internal Family Systems Therapy

    Note: if you are delusional, paranoid, schizophrenic, or have some other related disorder*, then IFS would probably be a bad idea for you as it could worsen your symptoms, and/or play into them badly.

    *but bipolar disorder, in its various forms, is not usually a problem for IFS. Do check with your own relevant healthcare provider(s), of course, to be sure.

    What is IFS?

    The main premise of IFS is that your “self” can be modelled as a system, and its constituent parts can be examined, questioned, given what they need, and integrated into a healthy whole.

    For example…

    • Exile is the name given to parts that could be, for example, the “inner child” referenced in a lot of pop-psychology, but it could also be some other ignored and pushed-down part of oneself, often from some kind of trauma. The defining characteristic of an exile is that it’s a part of ourself that we don’t consciously allow ourselves to see as a current part of ourself.
    • Protector is the name given to a part of us that looks to keep us safe, and can do this in an adaptive (healthy) or maladaptive (unhealthy) way, for example:
      • Firefighter is the name given to a part of us that will do whatever is necessary in the moment to deal with an exile that is otherwise coming to the surface—sometimes with drastic actions/reactions that may not be great for us.
      • Manager is the name given to a part of us that has a more nurturing protective role, keeping us from harm in what’s often a more prophylactic manner.

    To give a simple illustration…

    A person was criticized a lot as a child, told she was useless, and treated as a disappointment. Consequently, as an adult she now has an exile “the useless child”, something she strives to leave well behind in her past, because it was a painful experience for her. However, sometimes when someone questions and/or advises her, she will get defensive as her firefighter “the hero” will vigorously speak up for her competence, like nobody did when she was a child. This vigor, however, manifests as rude abrasiveness and overcompensation. Finally, she has a manager, “the advocate”, who will do the same job, but in a more quietly confident fashion.

    This person’s therapy will look at transferring the protector job from the firefighter to the manager, which will involve examining, questioning, and addressing all three parts.

    The above example is fictional and created for simplicity and clarity; here’s a real-world case study if you’d like a more in-depth overview of how it can work:

    American Journal of Psychotherapy | The Teenager’s Confession: Regulating Shame in Internal Family Systems Therapy

    How it all fits together in practice

    IFS looks to make sure all the parts’ needs are met, even the “bad” ones, because they all have their functions.

    Good IFS therapy, however, can make sure a part is heard, and then reassure that part in a way that effectively allows that part to “retire”, safe and secure in the knowledge that it has done what it needed to, and/or the job is being done by another part now.

    That can involve, for example, thanking the firefighter for looking after our exile for all these years, but that our exile is safe and in good hands now, so it can put that fire-axe away.

    See also: On Being Reactive vs Being Responsive

    Questions you might ask yourself

    While IFS therapy is best given by a skilled practitioner, we can take some of the ideas of it for self-therapy too. For example…

    • What is a secret about yourself that you will take to the grave? And now, why did that part of you (now an exile) come to exist?
    • What does that exile need, that it didn’t get? What parts of us try to give it that nowadays?
    • What could we do, with all that information in mind, to assign the “protection” job to the part of us best-suited to healthy integration?

    Want to know more?

    We’ve only had the space of a small article to give a brief introduction to Family Systems therapy, so check out the “resources” tab at:

    IFS Institute | What Is Internal Family Systems Therapy?

    Take care!

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Related Posts

  • Melatonin: A Safe, Natural Sleep Aid?
  • Antihistamines for Runny Nose?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝Do you have any articles about using Anti-Histamines? My nose seems to be running a lot. I don’t have a cold or any allergies that I know of. I tried a Nasal spray Astepro, but it doesn’t do much.?❞

    Just for you, we wrote such an article yesterday in response to this question!

    The Astepro that you tried, by the way, is a brand name of the azelastine we mentioned near the end, before we got to talking about systemic corticosteroids such as beclometasone dipropionate—this latter might help you if antihistamines haven’t, and if your doctor advises there’s no contraindication (for most people it is safe for there are exceptions, such as if you are immunocompromised and/or currently fighting some infection).

    You can find more details on all this in yesterday’s article, which in case you missed it, can be found at:

    Antihistamines’ Generation Gap: Are You Ready For Allergy Season?

    Enjoy!

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  • Anti-Inflammatory Khichri & Tadka

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is halfway between a daal and a risotto; it’s delicious and it’s full of protein, fiber, heathy fats, and flavors. And those flavors? Mostly from health-giving phytochemicals of one kind of another.

    You will need

    For the khichri:

    • 1 oz chana dal
    • 1 oz red lentils
    • 1 oz brown lentils
    • 1 oz quinoa
    • 4 oz wholegrain basmati rice
    • 1 tbsp chia seeds
    • 1 tsp ground turmeric
    • ½ tsp MSG or 1 tsp low-sodium salt

    For the tadka:

    • 2 tbsp avocado oil (or other oil suitable for high temperatures—so, not olive oil on this occasion!)
    • ¼ bulb garlic, thinly sliced
    • 1 fresh red chili (adjust per heat preferences)
    • 1 fresh green chili (adjust per heat preferences)
    • 1 tsp cumin seeds
    • 6 curry leaves
    • 12 twists of freshly ground black pepper

    To serve:

    • Optional: flatbreads or poppadoms
    • Optional: lemon wedges or lime wedges
    • Optional: chopped cilantro or parsley

    Method

    (we suggest you read everything at least once before doing anything)

    1) Simmer the khichri ingredients in 5 cups of water, stirring occasionally if necessary, until it has a risotto-like consistency; this will probably take about 30–40 minutes. This time can be greatly reduced by using a pressure cooker, but obviously you won’t be able to check or stir, so do that only if you know what you’re doing cooking those grains and pseudograins in there, and what settings/timings to use for your specific device.

    2) Make the tadka when the khichri is nearly ready, by heating the 2 tbsp of avocado oil in a skillet until very hot but not smoking, Add the rest of the ingredients from the tadka section, and cook until the garlic is nice and golden.

    3) Pour the tadka over the khichri to serve, with any of the optional accompaniments we mentioned.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • With all this bird flu around, how safe are eggs, chicken or milk?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Enzo Palombo, Swinburne University of Technology

    Recent outbreaks of bird flu – in US dairy herds, poultry farms in Australia and elsewhere, and isolated cases in humans – have raised the issue of food safety.

    So can the virus transfer from infected farm animals to contaminate milk, meat or eggs? How likely is this?

    And what do we need to think about to minimise our risk when shopping for or preparing food?

    AS Foodstudio/Shutterstock

    How safe is milk?

    Bird flu (or avian influenza) is a bird disease caused by specific types of influenza virus. But the virus can also infect cows. In the US, for instance, to date more than 80 dairy herds in at least nine states have been infected with the H5N1 version of the virus.

    Investigations are under way to confirm how this happened. But we do know infected birds can shed the virus in their saliva, nasal secretions and faeces. So bird flu can potentially contaminate animal-derived food products during processing and manufacturing.

    Indeed, fragments of bird flu genetic material (RNA) were found in cow’s milk from the dairy herds associated with infected US farmers.

    However, the spread of bird flu among cattle, and possibly to humans, is likely to have been caused through contact with contaminated milking equipment, not the milk itself.

    The test used to detect the virus in milk – which uses similar PCR technology to lab-based COVID tests – is also highly sensitive. This means it can detect very low levels of the bird flu RNA. But the test does not distinguish between live or inactivated virus, just that the RNA is present. So from this test alone, we cannot tell if the virus found in milk is infectious (and capable of infecting humans).

    Rows of milk bottles in supermarket fridge
    It’s best to stick with pasteurised milk. Amnixia/Shutterstock

    Does that mean milk is safe to drink and won’t transmit bird flu? Yes and no.

    In Australia, where bird flu has not been reported in dairy cattle, the answer is yes. It is safe to drink milk and milk products made from Australian milk.

    In the US, the answer depends on whether the milk is pasteurised. We know pasteurisation is a common and reliable method of destroying concerning microbes, including influenza virus. Like most viruses, influenza virus (including bird flu virus) is inactivated by heat.

    Although there is little direct research on whether pasteurisation inactivates H5N1 in milk, we can extrapolate from what we know about heat inactivation of H5N1 in chicken and eggs.

    So we can be confident there is no risk of bird flu transmission via pasteurised milk or milk products.

    However, it’s another matter for unpasteurised or “raw” US milk or milk products. A recent study showed mice fed raw milk contaminated with bird flu developed signs of illness. So to be on the safe side, it would be advisable to avoid raw milk products.

    How about chicken?

    Bird flu has caused sporadic outbreaks in wild birds and domestic poultry worldwide, including in Australia. In recent weeks, there have been three reported outbreaks in Victorian poultry farms (two with H7N3 bird flu, one with H7N9). There has been one reported outbreak in Western Australia (H9N2).

    The strains of bird flu identified in the Victorian and Western Australia outbreaks can cause human infection, although these are rare and typically result from close contact with infected live birds or contaminated environments.

    Therefore, the chance of bird flu transmission in chicken meat is remote.

    Nonetheless, it is timely to remind people to handle chicken meat with caution as many dangerous pathogens, such as Salmonella and Campylobacter, can be found on chicken carcasses.

    Always handle chicken meat carefully when shopping, transporting it home and storing it in the kitchen. For instance, make sure no meat juices cross-contaminate other items, consider using a cool bag when transporting meat, and refrigerate or freeze the meat within two hours.

    Avoid washing your chicken before cooking to prevent the spread of disease-causing microbes around the kitchen.

    Finally, cook chicken thoroughly as viruses (including bird flu) cannot survive cooking temperatures.

    Are eggs safe?

    The recent Australian outbreaks have occurred in egg-laying or mixed poultry flocks, so concerns have been raised about bird flu transmission via contaminated chicken eggs.

    Can flu viruses contaminate chicken eggs and potentially spread bird flu? It appears so. A report from 2007 said it was feasible for influenza viruses to enter through the eggshell. This is because influenza virus particles are smaller (100 nanometres) than the pores in eggshells (at least 200 nm).

    So viruses could enter eggs and be protected from cleaning procedures designed to remove microbes from the egg surface.

    Therefore, like the advice about milk and meat, cooking eggs is best.

    The US Food and Drug Administration recommends cooking poultry, eggs and other animal products to the proper temperature and preventing cross-contamination between raw and cooked food.

    In a nutshell

    If you consume pasteurised milk products and thoroughly cook your chicken and eggs, there is nothing to worry about as bird flu is inactivated by heat.

    The real fear is that the virus will evolve into highly pathogenic versions that can be transmitted from human to human.

    That scenario is much more frightening than any potential spread though food.

    Enzo Palombo, Professor of Microbiology, Swinburne University of Technology

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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