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See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog/ One of my patients asked me why I was putting her on Metformin if she wasn’t really diabetic yet, another woman I was consulting on asked why I’d put her on a dangerous drug, and another patient with Fatty Liver refused to take Metformin because it is for Diabetes and not for Fatty Liver! These patients made it clear that I had to create a Healthcast and blog about the miracle drug, Metformin. Metformin has been around since 1994 while early in my private practice. Metformin quickly became the first line therapy for type 2 diabetics. was the first line of treatment for type 2 diabetics. In that 40 years using Metformin for diabetes has opened a whole range of other diseases and conditions that Metformin can be used for, such as: Reducing risk of Cancer recurrence, all cancers Weight loss Lowering triglycerides Treating insulin resistance Treating Prediabetes Mood Disorders, Psychiatric problems Decreases NAFL from becoming Liver cancer Polycystic ovarian Disease Infertility Aging and the symptoms of aging People on Metformin have a lower rate of mortality How does Metformin work? Metformin exerts its hypoglycemic effects by: decreasing glucose production from the liver increasing insulin receptors’ sensitivity in various body tissues increasing secretion of growth differentiating factor, which reduces appetite and calorie intake. When I find a patient with signs of Diabetes, a high HBA1C, and or an elevated fasting Insulin level (above 10), or consistently elevated FBS I prescribe Metformin for patients who don’t have AODM yet, but who will progress to it if they are not treated and learn to eat low glycemic foods, and to exercise. Generally, the patients that I label with Metabolic Syndrome, revert to normal and don’t proceed to AODM. I also use this drug for weight loss because most weight gain in women after 40 is because they have become menopausal and have a loss of testosterone which causes them to gain weight and become insulin resistant. Metformin, Diet and Exercise all work together to reverse the process and decrease a woman’s chance of getting AODM. What medical Diseases and Problems Do I use Metformin for? Other patients who may or may not have IR, but who have elevated liver enzymes from Non-Alcoholic Fatty Liver Disease (NAFL) are placed on Metformin to reverse this problem as well. I have seen many patients who thought they were doomed to having fatty liver and possibly developing Liver Cancer, become healthy, lose weight and normalize their previous Fatty Liver. High Triglycerides (TGs) are generally from too many simple carbs over time and increase as insulin resistance gets worse with aging and length of time eating the wrong diet. Diet and exercise are necessary to drive the TG down to normal, but patients rarely stick to these lifestyle measures unless they see a visible change in their body composition. Metformin can make that possible and be the factor that leads patients to a healthier lifestyle. “Cancer Loves Sugar” so I try to explain that the 2 largest factors in recurrence of a cancer or even getting any cancer are obesity and dysregulation of blood sugar with insulin resistance. Both can be transformed by diet exercise and metformin! You can literally decrease your cancer risk by losing weight and not eating simple carbohydrates. Elevated Prolactin levels that are not in the tumor range are lowered in both men and women with Metformin. The article in the latest Psychiatry Today shows a use for Metformin for mood disorders. Psychiatrists use metformin ER to decrease the weight gain often caused by anti-psychotics. They also find that metformin increases repair in the brain and activates the brain to increase Motivation, cognition, and dopamine. This is a benefit for patients who may be on antipsychotics for life and need help with the side effects. Countering Inflammation that causes osteoporosis, degenerative brain diseases, frailty and arthritis. Antiaging is stimulated by Metformin..how does it work? Improving nutrient sensing Enhancing autophagy Enhancing intracellular communications Protecting against macromolecular damage Delaying stem cell aging Modulating mitochondrial function Regulating gene transcription Lowering telomere attrition How Do I prescribe Metformin? There are two types of Metformin, the short acting form of metformin which is made to be taken with each meal to manage BS after eating for diabetics only, and the long-acting type of Metformin, which is called Metformin ER or XR, and this is the type I use for every other problem including IR, and Prediabetes. The long-acting form must be taken with a meal, or it simply will not work! Generally, the dose is started with on 500 XR tablet with the largest meal of the day, then increasing each week to the max of 4 x 500XR tablets per day if needed. I write smaller doses for less severe dysregulations, and larger for severe IR, Obesity, and higher weight individuals. Don’t take Metformin plain for the conditions above unless you have Diabetes and need help lowering your blood sugar. For patients who are on either form of Metformin for long periods of time, Methyl B12 should be prescribed as Why are we all not on this drug? The FDA works slowly and even though many of these attributes of Metformin are known in the medical community, doctors tend not to use a drug that is not approved by the FDA…even though medical studies have proved its benefit! For those of us who know that the FDA may never look at this drug for any other uses, and that our patients need it now for reasons other than metabolic syndrome, we forge ahead and use it off label for the reasons above! Ask your doctor about this inexpensive medication that can do you so much good!