Dr. Nir Barzilai: Can This Drug Slow Aging? The Science Behind Metformin

Mark Hyman

Feb 7, 2024

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Dr. Nir Barzilai is a geroscientist, Chaired Professor of Medicine and Genetics, and the founder and principal investigator of the Einstein Nathan Shock Center and the Glenn Center for Excellence in Biology of Aging. He also studies families of centenarians that have provided genetic and biological insights on the protection against aging—with several drugs developed based, in part, on these paradigm-changing studies. He is also leading the TAME (Targeting/Taming Aging with Metformin) trial to prove to the FDA that aging can be delayed and to allow for next-generation interventions.

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In this episode we discuss (audio version / Apple Subscriber version):

The hallmarks of aging (9:01 / 7:10)
What causes the hallmarks of aging? (15:40 / 13:49)
Dr. Barzilai’s research on centenarians (23:16 / 21:25)
Why living to 100+ years is good for the economy (24:54 / 23:03)
What enables someone to live to 100 years old? (29:30 / 25:20)
Taking growth hormone and Metformin have different effects based on your age (36:58 / 32:48)
The connection between HDL cholesterol and longevity (43:36 / 39:26)
Dr. Barzilai’s research on Metformin (56:23 / 52:13)
How Metformin works in the body and on muscle growth (1:04:51 / 1:00:41)
Dr. Barzilai’s personal longevity (1:42:05 / 1:37:55)

Learn more about the Longevity Genes Projec

Mindsip insights from this episode:

Understand metformin's impact on muscle quality and strength

While metformin may lead to smaller muscles during exercise, it appears to improve muscle quality, resulting in the same strength from less mass.

#metformin

#muscle

Avoid metformin if under 50 for optimal health

Metformin is not recommended for healthy individuals with a biological age under 50, as the trade-offs are not beneficial for a young body.

#biological-age

#metformin

Avoid supplement cocktails to prevent antagonistic effects

Combining many longevity supplements or drugs may have antagonistic effects, as seen with metformin and exercise, challenging the 'more is better' approach.

#longevity

#supplement

Prioritize SGLT2 inhibitors for longevity benefits

SGLT2 inhibitors are ranked as the most promising repurposed drug for longevity, even ahead of metformin, due to their broad benefits on kidney disease, heart disease, and overall mortality.

#longevity

#SGLT2

Prove aging as targetable condition through TAME trial

The TAME trial is designed not just to study metformin, but to prove to the FDA that aging itself is a targetable condition, which would pave the way for all future longevity drugs.

#aging

#metformin

Recognize genetic factors over lifestyle in centenarians' longevity

Many centenarians are overweight or were smokers, suggesting their extreme longevity is due to protective genes rather than perfect lifestyle choices.

#genetics

#longevity

Leverage longevity genes to counteract disease risk

Superagers can have genes associated with diseases like Alzheimer's (APOE4) but don't get sick because they also possess longevity genes that slow the aging process.

#genetics

#longevity

Avoid growth hormone therapy for elderly with genetic impairments

Sixty percent of centenarians have a genetic trait that impairs growth hormone action, and giving growth hormone to the elderly is likely not a good idea.