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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Millet vs Rye – Which is Healthier?
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Our Verdict
When comparing millet to rye, we picked the rye.
Why?
In terms of macros, they’re about equal on protein, and rye has more carbs and fiber, the ratio of which give it the lower glycemic index, so we say rye wins this category.
In the category of vitamins, millet has more of vitamins B1, B2, B6, and B9, while rye has more of vitamins A, B5, E, and K. Notionally, that’s a 4:4 tie, though rye’s margins of difference are an order of magnitude greater, so we say rye takes a marginal victory on this one.
When it comes to minerals, there’s nothing to debate here: millet has more copper, while rye has more calcium, manganese, phosphorus, potassium, selenium, and zinc. An easy win for rye on this one.
Adding up the sections gives the overall win to rye, but there is one other thing worth mentioning: millet is naturally gluten-free, but rye is not, so if you are avoiding gluten for any reason, you’ll want to pick the millet in this case.
See also: Gluten: What’s The Truth?
Aside from that, by all means enjoy either or both, in moderation! Diversity is good.
Want to learn more?
You might like to read:
Grains: Bread Of Life, Or Cereal Killer?
Enjoy!
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The Yoga of Breath – by Richard Rosen
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You probably know to breathe through your nose, and to breathe with your diaphragm. But did you know you’re usually only breathing through one nostril at a time, and alternate between nostrils every few hours? And did you know how to breathe through both nostrils equally instead, and the benefits that can bring?
The above is one example of many, of things that make this book stand out from the crowd when it comes to breathing exercises. Author Richard Rosen has a deep expertise in this topic, and explains everything clearly and comprehensively, without leaving room for ambiguity.
While most of the book focuses on the mechanics and physical techniques of breathing, he does also cover some more mindstate-related things too—without which, it wouldn’t be yoga.
If the book has a downside, it’s that its comprehensive nature could be off-putting to readers new to breathing work in general. However, since he does explain everything from the ground up, that’s no reason to be put off this book, iff you’re serious about learning.
Bottom line: if you’d like a deeper understanding of breathwork than “breathe slowly through your nose, using your diaphragm”, this book will teach you depths of breathing you probably didn’t know were possible.
Click here to check out The Yoga of Breath, and catch yours!
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Cannabis & Heart Attacks
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For many, cannabis use has taken the place that alcohol used to have when it comes to wanting a “downer”, that is to say, a drug that relaxes us as opposed to stimulating us.
Indeed, it is generally considered safer than alcohol ← however this is not a strong claim, because alcohol is much more dangerous than one would think given its ubiquity and (in many places, at least) social acceptability.
We’ve talked a bit about cannabis use before, in its various forms, for example:
Cannabis Myths vs Reality ← a very good starting point for the curious
And one specifically about the use of THC gummies (THC is the psychoactive compound in cannabis, i.e. it’s the chemical that gets people high, as opposed to CBD, which is not psychoactive) as a sleep aid:
Sweet Dreams Are Made of THC (Or Are They?)
And for those skipping the THC, we’ve also written about CBD use, including:
CBD Oil: What Does The Science Say? and Do CBD Gummies Work?
So, about cannabis and heart attacks
Alcohol is a relaxant, and yet it can contribute to heart disease (amongst many other things, of course):
Can We Drink To Good Health? ← this is mostly about red wine’s putative heart health benefits, how the idea got popularized, and how it doesn’t stand up to scrutiny when actually looking at the evidence.
And cannabis, another relaxant? Not so good either!
New research has shown that cannabis users have a higher risk of heart attacks, even among younger and otherwise healthy individuals. This is based on analyzing data from 4,636,628 relatively healthy adults.
Specifically, the data showed that even young healthy cannabis users get:
- Sixfold increased risk of heart attack
- Fourfold increased risk of ischemic stroke
- Threefold increased risk of cardiovascular death, heart attack, or stroke
We mention the otherwise “relatively healthy” nature of the participants, because it’s important to note that less healthy people (who were perhaps using cannabis to self-medicate for some serious condition) were not included in the dataset, as it’d skew the data unhelpfully and it’d make the risk look a lot higher than the risk levels we mentioned above.
The mechanisms by which cannabis affects heart health are not fully understood, but hypotheses include:
- Disrupting heart rhythm regulation
- Increasing oxygen demand in the heart muscle
- Causing endothelial dysfunction, which affects blood vessel function
Further, heart attack risk peaked one hour after cannabis use, and while this doesn’t prove causality, it certainly doesn’t make cannabis look safe.
You can read the paper in its entirety here:
Want a safer way to relax?
We recommend:
- No-Frills, Evidence-Based Mindfulness
- Meditation Games That You’ll Actually Enjoy
- Which Style Of Yoga Is Best For You?
- 7 Kinds Of Rest When Sleep Is Not Enough
- Better Sex = Longer Life (Here’s How)
Enjoy!
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Planning Festivities Your Body Won’t Regret
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The Festive Dilemma
For many, Christmas is approaching. Other holidays abound too, and even for the non-observant, it’d be hard to escape seasonal jollities entirely.
So, what’s the plan?
- Eat, drink, and be merry, and have New Year’s Resolutions for the first few days of January before collapsing in a heap?
- Approach the Yuletide with Spartan abstemiousness and miss all the fun while simultaneously annoying your relatives?
Let’s try to find a third approach instead…
What’s festive and healthy?
We’re doing this article this week, because many people will be shopping already, making plans, and so forth. So here are some things to bear in mind:
Make your own mindful choices
Coca-Cola company really did a number on Christmas, but it doesn’t mean their product is truly integral to the season. Same goes for many other things that flood the stores around this time of year. So much sugary confectionary! But remember, they’re not the boss of you. If you wouldn’t buy it ordinarily, why are you buying it now? Do you actually even want it?
If you really do, then you do you, but mindful choices will invariably be healthier than “because there were three additional aisles of confectionary now so I stopped and looked and picked some things”.
Pick your battles
If you’re having a big family gathering, likely there will be occasions with few healthy options available. But you can decide what’s most important for you to avoid, perhaps picking a theme, e.g:
- No alcohol this year, or
- No processed sugary foods, or
- Eat/drink whatever, but practice intermittent fasting
Some resources:
Fight inflammation
This is a big one so it deserves its own category. In the season of sugar and alcohol and fatty meat, inflammation can be a big problem to come around and bite us in the behind. We’ve written on this previously:
Positive dieting
In other words, less of a focus on what to exclude, and more of a focus on what to include in your diet. Fruity drinks and sweets are common at this time of year, but you know what’s also fruity? Fruit!
And it can be festive, too! Berries are great, and those tiny orange-like fruits that may be called clementines or tangerines or satsumas or, as Aldi would have it, “easy peelers”. Apple and cinnamon are also a great combination that both bring sweetness without needing added sugar.
And as for mains? Make your salads that bit fancier, get plenty of greens with your main, have hearty soups and strews with lentils and beams!
See also: Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
Your gut will thank us later!
Get moving!
That doesn’t mean you have to beat the New Year rush to the gym (unless you want to!). But it could mean, for example, more time in your walking shoes (or dancing shoes! With a nod to today’s sponsor) and less time in the armchair.
See also: The doctor who wants us to exercise less; move more
Lastly…
Remember it’s supposed to be fun! And being healthy can be a lot more fun than suffering because of unfortunate choices that we come to regret.
Take care!
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Learn to Age Gracefully
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Elderhood – by Dr. Louise Aronson
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Where does “middle age” end, and “old age” begin? By the United States’ CDC’s categorization, human life involves:
- 17 stages of childhood, deemed 0–18
- 5 stages of adulthood, deemed 18–60
- 1 stage of elderhood, deemed 60+
Isn’t there something missing here? Do we just fall off some sort of conveyor belt on our sixtieth birthdays, into one big bucket marked “old”?
Yesterday you were 59 and enjoying your middle age; today you have, apparently, the same medical factors and care needs as a 114-year-old.
Dr. Louise Aronson, a geriatrician, notes however that medical science tends to underestimate the differences found in more advanced old age, and underresearch them. That elders consume half of a country’s medicines, but are not required to be included in clinical trials. That side effects not only are often different than for younger adults, but also can cause symptoms that are then dismissed as “Oh she’s just old”.
She explores, mostly through personal career anecdotes, the well-intentioned disregard that is frequently given by the medical profession, and—importantly—how we might overcome that, as individuals and as a society.
Bottom line: if you are over the age of 60, love someone over the age of 60, this is a book for you. Similarly if you and/or they plan to live past the age of 60, this is also a book for you.
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Insights into Osteoporosis
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝I would like to see some articles on osteoporosis❞
You might enjoy this mythbusting main feature we did a few weeks ago!
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