Why Peter Attia Changed his mind on METFORMIN
Summary
TLDRIn this video, the speaker discusses the journey of physician influencer Peter Attia with metformin, a drug used for diabetes. Initially, a 2014 study suggested metformin's potential for longevity and anti-cancer effects. Attia, impressed by its ability to activate AMPK and suppress mTOR, began taking it. However, a subsequent study raised concerns about increased mortality rates in healthy individuals using metformin. Attia ceased its use after realizing it elevated his lactic acid levels, indicating impaired mitochondrial function. The story emphasizes the importance of scientific evidence in making health decisions.
Takeaways
- ๐จโโ๏ธ Peter Attia, a respected physician influencer, initially started taking metformin for longevity but later stopped.
- ๐ The script discusses a 2014 study suggesting metformin's potential anti-inflammatory and anti-cancer effects, which influenced Attia's decision to take it.
- ๐ฌ Metformin, also known as Glucophage, is a medication used to lower blood sugar levels in diabetics by facilitating sugar entry into cells.
- ๐งฌ Metformin is believed to activate AMPK and suppress the mTOR signaling pathway, potentially inducing autophagy, a process of cellular renewal.
- ๐ A follow-up study cast doubt on metformin's longevity benefits, especially in healthy individuals, which contributed to Attia's decision to stop taking it.
- ๐ซ The 2012 study indicated increased mortality in diabetics taking metformin, contrasting with its potential benefits in non-diabetics.
- ๐ The script highlights the importance of understanding the nuances and limitations of studies when making health decisions.
- ๐๏ธโโ๏ธ Metformin's mechanism of action involves binding to complex one of the electron transport chain in mitochondria, partially blocking energy production.
- ๐ Metformin use can be inferred from elevated baseline lactic acid levels, indicating reduced oxygen availability to mitochondria.
- ๐ Upon discontinuing metformin, Attia's lactic acid levels returned to normal, suggesting improved mitochondrial function and oxygen utilization.
- ๐ฌ The script emphasizes the value of scientific inquiry and adapting decisions based on evolving evidence, as demonstrated by Attia's experience with metformin.
Q & A
Why did Peter Attia initially start taking metformin?
-Peter Attia started taking metformin because he believed in its potential for longevity, influenced by a study suggesting metformin might have anti-inflammatory or anti-cancer effects.
What is metformin primarily used for?
-Metformin, also known as Glucophage, is primarily used to lower blood sugar levels by helping sugars cross into cells and out of the bloodstream, particularly in diabetic patients.
What is the potential side effect of metformin mentioned in the script?
-The script mentions that metformin might cause an increase in lactic acid levels, which could indicate that the mitochondria are not getting enough oxygen.
What is the function of AMPK and mTOR in the context of metformin?
-In the context of metformin, AMPK is increased in activation, and the mTOR signaling pathway is suppressed, which might induce autophagy, a process where cells recycle their components.
Why did Peter Attia eventually stop taking metformin?
-Peter Attia stopped taking metformin after a subsequent study suggested it might not have the longevity benefits previously thought and could potentially increase mortality rates in certain populations.
What does the mitochondria's electron transport chain do, and how does metformin affect it?
-The mitochondria's electron transport chain is responsible for trading ions and making energy. Metformin binds to complex one, partially blocking this energy production, which can lead to an increase in lactic acid production.
What is the significance of measuring baseline lactic acid in relation to metformin use?
-Measuring baseline lactic acid can indicate whether metformin is affecting the mitochondria's ability to meet the cell's oxygen demands. An increase in lactic acid suggests that the mitochondria are not getting enough oxygen, which can be a sign of metformin's effect.
What was the outcome of the 2012 study mentioned in the script regarding metformin and mortality rates?
-The 2012 study showed an increased mortality rate in diabetic patients taking metformin, but this did not seem to be the case for healthy individuals with normal blood sugar levels.
How does the script describe Peter Attia's approach to using science to make decisions about metformin?
-The script describes Peter Attia's approach as evidence-based, where he initially started taking metformin based on scientific literature and later stopped after new evidence emerged, demonstrating a willingness to change his mind in light of new data.
What is the role of autophagy in the context of metformin and longevity?
-Autophagy is a process where cells recycle their components and is potentially induced by metformin. It is believed to play a role in longevity, which is one of the reasons Peter Attia was interested in the drug's effects.
What does the script imply about the importance of continuous learning and adapting to new scientific findings?
-The script implies that continuous learning and adapting to new scientific findings are crucial, as demonstrated by Peter Attia's decision to stop taking metformin after new studies challenged its benefits for longevity.
Outlines
๐ Metformin's Impact on Longevity and Cellular Energy
The paragraph discusses the journey of Peter Atia, a physician influencer, who initially started taking metformin for its potential longevity benefits. Metformin, also known as glucophage, is a medication used to lower blood sugar levels by facilitating sugar movement into cells. A 2014 study suggested metformin might have anti-inflammatory or anti-cancer effects, prompting Atia's interest. However, a subsequent study cast doubt on these benefits, particularly for healthy individuals. The paragraph delves into the cellular mechanics of metformin, explaining its binding at complex one of the mitochondria's electron transport chain, which can lead to increased lactic acid production when oxygen demands are not met. This insight led Atia to monitor his lactic acid levels, ultimately influencing his decision to discontinue metformin use due to its potential interference with cellular oxygenation and energy production.
๐ฌ Science-Driven Decision Making: Metformin Reconsidered
In this paragraph, the narrative focuses on the scientific approach Peter Atia took in deciding to use metformin and later to discontinue its use. Initially, Atia was persuaded by the potential longevity benefits suggested by early research. However, as new data emerged, he reassessed his decision. The paragraph emphasizes the importance of being open to new scientific evidence and adjusting one's actions accordingly. It highlights Atia's commitment to evidence-based medicine and his willingness to change his stance in light of new findings, showcasing a model for science-informed personal health decisions.
Mindmap
Keywords
๐กMetformin
๐กLongevity
๐กAMPK
๐กmTOR
๐กAutophagy
๐กMitochondria
๐กElectron Transport Chain
๐กLactic Acid
๐กZone 2
๐กCyanide
Highlights
Peter Atia, a physician influencer, initially took metformin for longevity but later stopped.
Metformin, also known as Glucophage, is a drug used to lower blood sugar in diabetics.
A 2014 study suggested metformin might have anti-inflammatory or anti-cancer effects.
Metformin is believed to increase AMPK activation and suppress mTOR signaling, potentially inducing autophagy.
A 2012 study indicated increased mortality with metformin use in diabetics but not in healthy individuals.
A subsequent study cast doubt on metformin's previously assumed benefits for longevity.
Metformin's mechanism of action involves binding to complex one in the mitochondria, partially blocking energy production.
Blocking the electron transport chain can be lethal, as seen with cyanide poisoning.
Metformin use can be detected by measuring baseline lactic acid levels, which increase due to oxygen demand.
Peter Atia monitored his lactic acid levels and found they were elevated while on metformin.
After stopping metformin, Peter Atia's lactic acid levels returned to baseline, indicating improved oxygen delivery to mitochondria.
The decision to stop taking metformin was based on scientific evidence and its impact on lactic acid levels.
Peter Atia's approach to metformin use exemplifies evidence-based decision-making in health practices.
The narrative highlights the importance of re-evaluating health choices in light of new scientific findings.
The story emphasizes the role of personal health metrics, like lactic acid, in making informed decisions about medication.
The initial belief in metformin's longevity benefits was challenged by further research and personal health data.
Transcripts
a few years ago Peter Atia one of my
favorite physician influencers started
taking metformin for longevity I did not
agree with that but I could not tell you
why and usually I love his thinking and
his reasoning behind why he does things
this past year he stopped taking it I
can't wait to tell you why this story
actually begins with a study in 2014 it
was looking at longevity and Metformin
metformin also called glucophage is
something that I've written
prescriptions for since my first day as
being a physician it lowers blood sugar
by helping sugars cross into the cells
and get out of the bloodstream a very
powerful Improvement in diabetics and it
does not have the risk of lowering the
blood sugars too much this study along
with several other signals in the
literature said that metformin might
have an anti-inflammatory or even an
anti-cancer Effect one of the reasons I
love Peter AA is he would go into
extreme detail explaining how metformin
increases the activation of ampk and it
suppresses the signaling pathway through
rabam or mtor and although I love that
information most of you probably don't
care that much what that means to you is
that foran might induce
autophagy years later a repeat study
looking at a very similar population and
the impact on what this drug was doing
for healthy people not those with high
blood sugar pumped the brakes a bit
saying eh it might not have done what we
thought it was doing when looking at
these two studies the first study that
came out in 2012 showed that while
metformin did lower those blood sugars
if you were diabetic there appeared to
be an increased mortality when you took
metformin in that setting however that
did not seem to be the case in the
people who were healthy and had normal
blood sugars which is why Peter AA said
he was going to take it years later the
secondary study came out looking at did
this in fact increase the mortality rate
of the people taking metformin and again
that's essentially what was found the
problems with the study and the nuances
about whether or not we should trust the
information is something I'll let Peter
AA and his team of fantastic nerds
explain the punchline was he stopped
taking the medication because longevity
is really what Dr AA is reaching for in
order to explain what made me nervous
about taking
metformin I need to explain how it works
inside this vacu or organel inside your
cells this is my favorite a mitochondria
the PowerHouse of our body it's where
energy is made here is my favorite part
of the human body this electron chain
transport that's on the outer membrane
of that mitochondria it's where ions are
traded and energy is made and if you
block any of these proteins trading ions
you will stop life metformin binds right
here in complex one with a partial
blocking of this energy to make sure you
understand how powerful this part of
your body is when you take cyanide it
completely blocks this transport and of
course causes death within minutes one
way to tell if somebody's taking their
metformin is to measure their Bas line
lactic acid when your mitochondria has
all the oxygen it needs no lactic acid
is made but as soon as you start to
inhibit that one place in the chain you
will make lactic acid because the oxygen
cannot meet the demands of the cell and
in this case it's because of where
metformin was binding Peter AA routinely
checks his lactic acid to prove that
he's in zone two for his workout but as
he was establishing that he noticed that
the metformin was causing his lactic
acid to be increased when he stopped the
drug his lactic acid went back down to
Baseline and his ability to measure Zone
2 was much more accurate the point is
that when met foran was on board the
signal telling us that the mitochondria
wasn't getting enough oxygen was the
elevated Lac IC acid as soon as he
stopped that it went back to normal
lactic acid you might have learned about
this in middle school where they said
yes when you're running really fast your
muscles will hurt they probably blamed
lactic acid now it turns out that's not
why your muscles were hurting but the
concept that you couldn't get enough
oxygen to the mitochondria and therefore
your lactic acid Rose now that part was
true as Peter AA lived with a constantly
elevated lactic acid because of his met
foran the question he was trying to
answer was was met foran elongating his
life or was it cutting it shorter the
best part of this story is that Peter AA
Used the science to make the first
decision and then learned more and made
the second decision I've changed my mind
too check it
out
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