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:
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❞
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.❞
We wondered about the weight loss implications of this, and…
For weight loss
The short version is, it works:
- Effectiveness of metformin on weight loss in non-diabetic individuals with obesity
- Metformin for weight reduction in non-diabetic patients: a systematic review and meta-analysis
- Metformin induces weight loss associated with gut microbiota alteration in non-diabetic obese women
…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:
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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The Most Anti Aging Exercise
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We’ve referenced this (excellent) video before, but never actually put it under the spotlight in one of these features, so here we go!
Deep squats
It’s about deep squats, also called Slav squats, Asian squats, sitting squats, resting squats, or various other names. However, fear not; you don’t need to be Slavic or Asian to do it; you just need to practice.
As for why this is called “anti-aging”, by the way, it’s because being able to get up off the ground is one of the main tests of age-related mobility decline, and if you can deep-squat comfortably, then you can do that easily. And so long as you continue being able to deep-squat comfortably, you’ll continue to be able to get up off the ground easily too, because you have the strength in the right muscles, as well as the suppleness, comfort with range of motion, and balance (those stabilizing muscles are used constantly in a deep squat, whereas Western lifestyle sitting leaves those muscles very neglected and thus atrophied).
Epidemiological note: chairs, couches, and assorted modern conveniences reduce the need for squatting in daily life, leading to stiffness in joints, muscles, tendons, and ligaments. Many adults in developed countries struggle with deep squats due to lack of use, not aging. Which is a problem, because a lack of full range of motion in joints causes wear and tear, leading to chronic pain and degenerative joint diseases. People in countries where squatting is a common resting position have lower incidences of osteoarthritis, for example—contrary to what some might expect, squatting does not harm joints but rather protects them from arthritis and knee pain. Strengthening leg muscles through squatting can alleviate knee pain, whereas knee pain is often worsened by inactivity.
Notwithstanding the thumbnail, which is showing an interim position, one’s feet should be flat on the ground, by the way, and one’s butt should be nearby, just a few inches off the ground (in other words, the position that we see her in for most of this video).
Troubleshooting: if you’re accustomed to sitting in chairs a lot, then this may be uncomfortable at first. Zuzka advises us to go gently, and/but gradually increase our range of motion and (equally importantly) duration in the resting position.
You can use a wall or doorway to partially support you, at first, if you struggle with mobility or balance. Just try to gradually use it less, until you’re comfortable deep-squatting with no support.
Since this is not an intrinsically very exciting exercise, once you build up the duration for which you’re comfortable deep-squatting, it can be good to get in the habit of “sitting” this way (i.e. deep squatting, still butt-off-the-floor, but doing the job of sitting) while doing other things such as working (if you have an appropriate work set-up for that*), reading, or watching TV.
*this is probably easiest with a laptop placed on an object/surface of appropriate height, such as a coffee table or such. As a bonus, having your hands in front of you while working will also bring your center of gravity forwards a bit, making the position easier and more comfortable to maintain. This writer (hi, it’s me) prefers her standing desk for work in general, with a nice ergonomic keyboard and all that, but if using a laptop from time to time, then squatting is a very good option.
In terms of working up duration, if you can only manage seconds to start with, that’s fine. Just do a few more seconds each time, until it’s 30, 60, 120, and so on until it’s 5 minutes, 10, 15, and so on.
You can even start that habit-forming while you’re still in the “seconds at a time” stage! You can deep-squat just for some seconds while you:
- pick up something from the floor
- check on something in the oven
- get something out of the bottom of the fridge
…etc!
For more on all this, plus many visual demonstrations including interim exercises to get you there if it’s difficult for you at first, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Mobility For Now & For Later: Train For The Marathon That Is Your Life!
Take care!
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Chocolate & Health
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Chocolate & Health: Fact or Fiction?
“Chocolate Is Good For The Heart”
“When making chocolate chip cookies, you don’t measure using cups, you measure by heart”
…but how good is chocolate when it comes to heart health?
First, what is heart health?
A healthy heart typically has a low resting pulse rate and a strong, steady beat. This is affected strongly by exercise habits, and diet plays only a support role (can’t exercise without energy from food!).
It is also important to have blood pressure within a healthy range (with high blood pressure being a more common problem than low, so things that lower blood pressure are generally considered good).
- Flavanols, flavonoids, and polyphenols in chocolate contribute to lower blood pressure
- Dark chocolate is best for these, as milk chocolate contains much less cocoa solids and more unhelpful fats
- White chocolate contains no cocoa solids and is useless for this
- Some of the fats in most commercial chocolate can contribute to atherosclerosis which raises blood pressure and ultimately can cause heart attacks.
- If you’re diabetic, you will probably not get the usual heart-related benefits from chocolate (sorry)
The Verdict: dark chocolate, in moderation, can support good heart health.
“Chocolate Is Good For The Brain”
Chocolate has been considered a “brain food”… why?
- The brain uses more calories than any other organ (chocolate has many calories)
- The heart benefits we listed above mean improved blood flow—including to your brain
- Chocolate contains phenylethylamine, a powerful chemical that has a similar effect to amphetamines… But it’s metabolized in digestion and never makes it to the central nervous system (so basically, this one’s a miss; we had a good run with the other two, though!)
The Verdict: dark chocolate, in moderation, can support good brain health
“Chocolate Is An Aphrodisiac”
“If chocolate be the food of love, pass me that cocoa; I’m starving”
Most excitingly, chocolate contains phenylethylamine, the “molecule of love” or, more accurately, lust. It has an effect similar to amphetamines, and while we can synthesize it in the body, we can also get it from certain foods. But…
Our body is so keen to get it that most of it is metabolized directly during digestion and doesn’t make it to the brain. Also, chocolate is not as good a source as cabbage—do with that information what you will!
However!
Chocolate contains theobromine and small amounts of caffeine, both stimulants and both generally likely to improve mood; it also contains flavonoids which in turn stimulate production of nitric oxide, which is a relaxant. All in all, things that are convivial to having a good time.
On the other hand…
That relaxation comes specifically with a reduction in blood pressure—something typically considered good for the health for most people most of the time… but that means lowering blood pressure in all parts of your body, which could be the opposite of what you want in intimate moments.
Chocolate also contains zinc, which is essential for hormonal health for most people—the body uses it to produce testosterone and estrogen, respectively. Zinc supplements are popularly sold to those wishing to have more energy in general and good hormonal health in particular, and rightly so. However…
This approach requires long-term supplementation—you can’t just pop a zinc tablet / bar of chocolate / almond before bed and expect immediate results. And if your daily zinc supplementation takes the form of a 3.5oz (100g) bar of chocolate, then you may find it has more effects on your health, and not all of them good!
The Verdict: dark chocolate, in moderation, may promote “the mood”, but could be a double-edged sword when it comes to “the ability”.
“Chocolate Is Good During Menstruation”
The popular wisdom goes that chocolate is rich in iron (of which more is needed during menstruation), and indeed, if you eat 7oz (150g) of dark chocolate made with 85% cocoa, you’ll get a daily a dose of iron (…and nearly 1,000 calories).
More bang-for-buck dietary sources of iron include chickpeas and broccoli, but for some mysterious reason, these are not as commonly reported as popular cravings.
The real explanation for chocolate cravings is more likely that eating chocolate—a food high in sugar and fat along with a chemical bombardment of more specialized “hey, it’s OK, you can relax now” molecules (flavanols/flavonoids, polyphenols, phenylamines, even phenylethylamine, etc) gives a simultaneous dopamine kick (the body’s main “reward” chemical) with a whole-body physiological relaxation… so, little wonder we might crave it in times of stress and discomfort!
The Verdict: it helps, not because it serves a special nutritional purpose, but rather, because the experience of eating chocolate makes us feel good.
Fun fact: Tiramisu (this writer’s favorite dessert) is literally Italian for “pick-me-up”
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Never Enough – by Dr. Judith Grisel
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We’ve reviewed books about addiction before—specifically about alcohol, at least. This one’s more general in that it covers different addictions.
On the other hand, it’s also more specific, in that it covers them from the author’s field: neuroscience.
…and experience too. The author had a plethora of addictions (the serious kind), got sober, and then undertook to study neuroscience. Her hope was to help others avoid, or escape from the same as‚ what she went through.
Dr. Grisel (as she now is) takes a methodical approach in this book. She works her way through the addictive mechanisms of a broad selection of common drugs, explaining each.
The focus here is on neutral explanations, rather than the propagandizing scaremongering that failed at least one generation. Why each drug is alluring, what it really does do—and the neurological price it exacts, down to the molecular level.
She also covers risk factors for addiction; genetic, epigenetic, and environmental. There’s no “if you were stronger”, or “these people made bad choices”, so much as… Many addicts were, in effect, sabotaged from before birth.
That doesn’t mean that to become addicted or not is just fate, but it does mean… There but for the grace of factors completely outside of our control go we.
Why is this useful to us, be we a reader without any meaningful addiction (we’re not counting coffee etc here)? Well, as this book illustrates and explains, many of us could be one (more) mishap away from a crippling addiction and not know it. Forewarned is forearmed.
Bottom line: almost all of us are, have been, or will be touched by addiction in some way. Either directly, or a loved one, or a loved one’s loved one, or perhaps a parent who gave us an epigenetic misfortune. This book gives understanding that can help.
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Yoga that Helps You on the Loo
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How This Video Helps You Poo
When you’re feeling a bit bloated, Yoga With Bird’s 10-minute yoga routine promises to help you release…your gas. And, perhaps, more.
From a tabletop flow to soothing twists, each pose allows you to sync your breath with movement, helping to promote organic relief.
With options to modify with pillows for extra support, this video (below) caters to everyone needing a digestive reset.
Other Toilet Tricks
If yoga isn’t your thing, or you’re interested in trying to use different methods to make your visits to the bathroom a bit easier, we’ve spoken about the ways to manage gut health, and use of probiotics or fiber, and even the prevention of hemorrhoids.
Namaste and goodbye to bloat!
How was the 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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The Sugary Food That Lowers Blood Sugars
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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
❝Loved the article on goji berries! I read they are good for blood sugars, is that true despite the sugar content?❞
Most berries are! Fruits that are high in polyphenols (even if they’re high in sugar), like berries, have a considerable net positive impact on glycemic health:
- Polyphenols and Glycemic Control
- Polyphenols and their effects on diabetes management: A review
- Dietary polyphenols as antidiabetic agents: Advances and opportunities
And more specifically:
Dietary berries, insulin resistance and type 2 diabetes: an overview of human feeding trials
Read more: Which Sugars Are Healthier, And Which Are Just The Same?
As for goji berries specifically, they’re very high indeed in polyphenols, and also have a hypoglycemic effect, i.e., they lower blood sugar levels (and as a bonus, increases HDL (“good” cholesterol) levels too, but that’s not the topic here):
❝The results of our study indicated a remarkable protective effect of LBP in patients with type 2 diabetes. Serum glucose was found to be significantly decreased and insulinogenic index increased during OMTT after 3 months administration of LBP. LBP also increased HDL levels in patients with type 2 diabetes. It showed more obvious hypoglycemic efficacy for those people who did not take any hypoglycemic medicine compared to patients taking hypoglycemic medicines. This study showed LBP to be a good potential treatment aided-agent for type 2 diabetes.❞
- LBP = Lycium barbarum polysaccharide, i.e. polysaccharide in/from goji berries
- OMTT = Oral metabolic tolerance test, a test of how well the blood sugars avoid spiking after a meal
For more about goji berries (and also where to get them), for reference our previous article is at:
Goji Berries: Which Benefits Do They Really Have?
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Dodging Dengue In The US
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Dengue On The Rise
We wrote recently about dengue outbreaks in the Americas, with Puerto Rico declaring an epidemic. Cases are now being reported in Florida too, and are likely to spread, so it’s good to be prepared, if your climate is of the “warm and humid” kind.
If you want to catch up on the news first, here you go:
- UN health agency cites tenfold increase in reported cases of dengue over the last generation
- Puerto Rico has declared an epidemic following a spike in dengue cases
- Dengue fever confirmed in Florida Keys as US on watch for rise in mosquito illness
Note: dengue is far from unheard of in Florida, but the rising average temperatures in each year mean that each year stands a good chance of seeing more cases than the previous. It’s been climbing since at least 2017, took a dip during the time of COVID restrictions keeping people at home more, and then for the more recent years has been climbing again since.
What actually is it?
Dengue is a viral, mosquito-borne disease, characterized by fever, vomiting, muscle pain, and a rash, in about 1 in 4 cases.
Which can sound like “you’ll know if you have it”, but in fact it’s usually asymptomatic for a week or more after infection, so, watch out!
What next, if those symptoms appear?
The good news is: the fever will usually last less than a week
The bad news is: a day or so after that the fever subsided, the more serious symptoms are likely to start—if they’re going to.
If you’re unlucky enough to be one of the 1 in 20 who get the serious symptoms, then you can expect abdominal cramps, repeat vomiting, bleeding from various orifices (you may not get them all, but all are possible), and (hardly surprising, given the previous items) “extreme fatigue and restlessness”.
If you get those symptoms, then definitely get to an ER as soon as possible, as dengue can become life-threatening within hours of such.
Read more: CDC | Symptoms of Dengue and Testing
While there is not a treatment for dengue per se, the Emergency Room will be better able to manage your symptoms and thus keep you alive long enough for them to pass.
If you’d like much more detail (on symptoms, seriousness, at-risk demographics, and prognosis) than what the CDC offers, then…
Read more: BMJ | Dengue Fever
Ok, so how do we dodge the dengue?
It sounds flippant to say “don’t get bitten”, but that’s it. However, there are tips are not getting bitten:
- Use mosquito-repellent, but it has to contain >20% DEET, so check labels
- Use mosquito nets where possible (doors, windows, etc, and the classic bed-tent net is not a bad idea either)
- Wear clothing that covers your skin, especially during the day—it can be light clothing; it doesn’t need to be a HazMat suit! But it does need to reduce the area of attack to reduce the risk of bites.
- Limit standing water around your home—anything that can hold even a small amount of standing water is a potential mosquito-breeding ground. Yes, even if it’s a crack in your driveway or a potted bromeliad.
Further reading
You might also like to check out:
Stickers and wristbands aren’t a reliable way to prevent mosquito bites. Here’s why
…and in case dengue wasn’t bad enough:
Mosquitoes can spread the flesh-eating Buruli ulcer. Here’s how you can protect yourself
Take care!
Don’t Forget…
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Learn to Age Gracefully
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