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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Brain Health Action Plan – by Dr. Teryn Clarke
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.
The author is a physician and neurologist, and she brings a lot of science with her when she sets out to Alzheimer’s-proof our brains:
- She talks about brain nourishment, and what things in contrast sabotage our brains, and how.
- She talks intermittent fasting, and optimal scheduling when it comes to food, sleep, exercise, and more.
- She talks about how the rest of our health affects our brain health, and vice versa.
The “action plan” promised by the title includes all of those elements, plus such matters as ongoing education, cognitive stimulation, stress management, dealing with depression, and other mostly-brain-based factors.
As such, it’s not just a “for your information” book, and Dr. Clarke does outline suggested goals, tasks, and habits, advises the use of a streak tracker, provides suggested recipes, and in all ways does what she can to make it easy for the reader to implement the information within.
Bottom line: if you’d like to dodge dementia, this book is quite a comprehensive guide.
Click here to check out Brain Health Action Plan, and enact yours!
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Quercetin Quinoa Probiotic Salad
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This quercetin-rich salad is a bit like a tabbouleh in feel, with half of the ingredients switched out to maximize phenolic and gut-healthy benefits.
You will need
- ½ cup quinoa
- ½ cup kale, finely chopped
- ½ cup flat leaf parsley, finely chopped
- ½ cup green olives, thinly sliced
- ½ cup sun-dried tomatoes, roughly chopped
- 1 pomegranate, peel and pith removed
- 1 preserved lemon, finely chopped
- 1 oz feta cheese or plant-based equivalent, crumbled
- 1 tsp black pepper, coarse ground
- 1 tbsp capers
- 1 tbsp chia seeds
- 1 tbsp extra virgin olive oil
Note: you shouldn’t need salt or similar here, because of the diverse gut-healthy fermented products bringing their own salt with them
Method
(we suggest you read everything at least once before doing anything)
1) Rinse the quinoa, add the tbsp of chia seeds, cook as normal for quinoa (i.e. add hot water, bring to boil, simmer for 15 minutes or so until pearly and tender), carefully (don’t lose the chia seeds; use a sieve) drain and rinse with cold water to cool. Shake off excess water and/or pat dry on kitchen paper if necessary.
2) Mix everything gently but thoroughly.
3) Serve:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Tasty Tabbouleh with Tahini ← in case you want an actual tabbouleh
- Making Friends With Your Gut (You Can Thank Us Later)
- Fight Inflammation & Protect Your Brain, With Quercetin
Take care!
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Rethinking Diabetes – by Gary Taubes
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We’ve previously reviewed this author’s “The Case Against Sugar” and “Why We Get Fat And What To Do About It“. There’s an obvious theme, and this book caps it off nicely:
By looking at the history of diabetes treatment (types 1 and 2) in the past hundred years, and analysing the patterns over time, we can see how:
- diabetics have been misled a lot over time by healthcare providers
- we can learn from those mistakes going forwards
Happily, he does this without crystal-balling the future or expecting diet to fix, for example, a pancreas that can’t produce insulin. But what he does do is focus on the “can” items rather than the “can’t” items.
In the category of criticism, one of the strategies he argues for is basically the keto diet, which is indeed just fine for diabetes but often not great for the heart in the long-term (it depends on various factors, including genes). However, even if you choose not to implement that, there is plenty more to try out in this book.
Bottom line: whether you have diabetes, love someone who does, or just plain like to be on top of your glycemic health, this book is full of important insights and opportunities to improve things progressively along the way.
Click here to check out Rethinking Diabetes, and rethink diabetes!
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Hypertension: Factors Far More Relevant Than Salt
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Hypertension: Factors Far More Relevant Than Salt
Firstly, what is high blood pressure vs normal, and what do those blood pressure readings mean?
Rather than take up undue space here, we’ll just quickly link to…
Blood Pressure Readings Explained (With A Colorful Chart)
More details of specifics, at:
Hypotension | Normal | Elevated | Stage 1 | Stage 2 | Danger zone
Keeping Blood Pressure Down
As with most health-related things (and in fact, much of life in general), prevention is better than cure.
People usually know “limit salt” and “manage stress”, but there’s a lot more to it!
Salt isn’t as big a factor as you probably think
That doesn’t mean go crazy on the salt, as it can cause a lot of other problems, including organ failure. But it does mean that you can’t skip the salt and assume your blood pressure will take care of itself.
This paper, for example, considers “high” sodium consumption to be more than 5g per day, and urinary excretion under 3g per day is considered to represent a low sodium dietary intake:
Sodium Intake and Hypertension
Meanwhile, health organizations often recommend to keep sodium intake to under 2g or under 1.5g
Top tip: if you replace your table salt with “reduced sodium” salt, this is usually sodium chloride (regular table salt) cut with potassium chloride, which is almost as “salty” tastewise, but obviously contains less sodium. Not only that, but potassium actually helps the body eliminate sodium, too.
The rest of what you eat is important too
The Mediterranean Diet is as great for this as it is for most health conditions.
If you sometimes see the DASH diet mentioned, that stands for “Dietary Approaches to Stop Hypertension”, and is basically the Mediterranean Diet with a few tweaks.
What are the tweaks?
- Beans went down a bit in priority
- Red meat got removed entirely instead of “limit to a tiny amount”
- Olive oil was deprioritized, and/but vegetable oil is at the bottom of the list (i.e., use sparingly)
You can check out the details here, with an overview and examples:
DASH Eating Plan—Description, Charts, and Recipes
Don’t drink or smoke
And no, a glass of red a day will not help your heart. Alcohol does make us feel relaxed, but that is because of what it does to our brain, not what it does to our heart.
In reality, even a single drink will increase blood pressure. Yes, really:
And smoking? It’s so bad that even second-hand smoke increases blood pressure:
Get those Zs in
Sleep is a commonly underestimated/forgotten part of health, precisely because in a way, we’re not there for it when it happens. We sleep through it! But it is important, including to protect against hypertension:
Short- and long-term health consequences of sleep disruption
Move your body!
Moving your body often is far more important for your heart than running marathons or bench-pressing your spouse.
Those 150 minutes “moderate exercise” (e.g. walking) per week are important, and can be for example:
- 22 minutes per day, 7 days per week
- 25 minutes per day, 6 days per week
- 30 minutes per day, 5 days per week
- 75 minutes per day, 2 days per week
If you’d like to know more about the science and evidence for this, as well as practical suggestions, you can download the complete second edition of the Physical Activity Guidelines for Americans here (it’s free, and no sign-up required!)
If you prefer a bite-size summary, then here’s their own:
Top 10 Things to Know About the Second Edition of the Physical Activity Guidelines for Americans
PS: Want a blood pressure monitor? We don’t sell them (or anything else), but for your convenience, here’s a good one you might want to consider.
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Speedy Easy Ratatouille
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One of the biggest contributing factors to unhealthy eating? The convenience factor. To eat well, it seems, one must have at least two of the following: money, time, and skill. So today we have a health dish that’s cheap, quick, and easy!
(You won’t need a rat in a hat to help you with this one)
You will need
- 3 ripe tomatoes, roughly chopped
- 2 zucchini, halved and chopped into thick batons
- 2 portobello mushrooms, sliced into ½” slices
- 1 large red pepper, cut into thick chunks
- 3 tbsp extra virgin olive oil
- 2 tbsp finely chopped parsley
- 2 tsp garlic paste
- 1 tsp red chili flakes
- 1 tsp dried thyme
- 1 tsp black pepper
- Optional: 1 tsp MSG, or 1 tsp low sodium salt (the MSG is the healthier option as it contains less sodium than even low sodium salt)
- Optional: other vegetables, chopped. Use what’s in your fridge! This is a great way to use up leftovers. Particularly good options include chopped eggplant, chopped red onion, and/or chopped carrot.
Method
(we suggest you read everything at least once before doing anything)
1) Put the olive oil into a sauté pan and set the heat on medium. When hot but smoking, add the mushrooms and any optional vegetables (but not the others from the list yet), and fry for 5 minutes.
2) Add the garlic, followed by the zucchini, red pepper, chili flakes, and thyme; stir periodically (you shouldn’t have to stir constantly) for 10 minutes.
3) Add the tomatoes and a cup of water to the pan, along with any MSG/salt. Cover with the lid and allow to simmer for a further 10 minutes.
4) Serve, adding the garnish.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- The Magic Of Mushrooms: “The Longevity Vitamin” (That’s Not A Vitamin)
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we had 3/5 today!
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
- MSG vs Salt: Sodium Comparison
Take care!
Don’t Forget…
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The Power of When – by Dr. Michael Breus
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There’s a lot more to one’s circadian rhythm than just when one wakes and sleeps. This book goes into that quite deeply!
For example, those items in the subtitle? You could do them all at the same time, but it probably wouldn’t be optimal (although honestly, that does sound like quite a good life!). Rather, there are distinct times of day that we’re going to be better at certain things, and there are distinct times of day when certain things are going to be better for us.
Of course, some items are not so simple as a one-size fits all, so Dr. Breus outlines for us how to figure out our own chronotype (within four main schemas), and how to make that work for us as well as possible.
They style is easy-reading pop-science, with frequent summaries, bullet-points, quizzes, and so forth, making it easy to understand, learn, and apply.
Bottom line: if you feel like your sleep could use a do-over, then this book can help you get it into order—and the rest of your daily activities too!
Click here to check out The Power of When, and optimize your health!
Don’t Forget…
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