Are we really testing an anti-aging pill? And what does it mean?

The U.S. Food and Drug Administration (FDA) has approved a clinical trial for “an anti-aging pill”. The pill is simply metformin. Metformin is a cheap drug that is safe and effective to treat type 2 diabetes, an old-age disease. While it has been a part of modern medicine for a few decades, Metformin actually comes from the French lilac, a plant used in medicine for centuries.

The study is called TAME for “Taming Aging With Metformin” or MILES for “Metformin in Longevity Study”. The trial has been driven by Nir Barzilai, a reputed professor of medicine.

What does it mean?

  • As far as I can tell, this is the first time the FDA allowed trials to treat aging as a medical condition. The people who will participate are not “sick” per se, they are just “old” and likely at risk to be soon sick because of aging. How this was approved by the bureaucrats of the FDA is beyond me.
  • You probably know people who take metformin. You probably don’t know anyone who is 120. So chances are that this clinical trial will not show that metformin can add decades to your life. However, it was observed that people who have diabetes and take metformin can live longer than otherwise healthy people who do not take metformin. Moreover, mice who take metformin live longer. So it is likely that metformin will have a small positive effect. The gain could be just a few extra months or weeks of health. Note that it is not expected that metformin would extend life by preventing death while letting aging continue. It is likely that if metformin has any effect at all, it will be by delaying diseases of old age.
  • Did I mention that metformin is cheap and safe? That means that if it works, it will be instantly available to everyone on the planet. Indeed, it is cheap enough to be affordable even in developing countries. (TAME is funded by a non-profit, the American Federation for Aging Research.)

If successful, this trial would have shocking implications. It is widely believed that aging is unavoidable and untreatable. Maybe you can lose weight and put on some cream to cover your wrinkles, but that’s about it. However, if it were shown that a cheap drug costing pennies a day (literally!) could delay the diseases of old age even just by a tiny bit… It would force people to rethink their assumptions.

Will it work? We shall know in a few years.

(For the record, I am not taking metformin nor am I planning to take any in the near future.)

Further reading: Description of the clinical trial: Metformin in Longevity Study (currently recruiting).

4 thoughts on “Are we really testing an anti-aging pill? And what does it mean?”

  1. Interesting. I think that a lot of antipathy towards anti-aging research has been caused by the wave of selfish and self centred boomers, and their narcissist ways. Public examples of the worst of this are the Donald Trumps, the Nygards. But we (those born after the boomers) were deeply affected by an economy that “wasn’t ready” for us – many of us form the first generation that is less well off than their parents. The latest generation will even have a shorter lifespan than their parents. The world they left is dirtier, less green, more polluted. At the same time, they have amassed a great deal of wealth, and they fill country clubs and golf courses, and southern resorts and retirement communities, share magazines, tour the country in massive Winnebagos and enjoy the fruits mostly gifted to them by “the greatest” generation.

    In many ways, that generation has failed us, and we hold them in poor regard. And now they are aging, and perhaps we don’t want them to live longer. Because we are cynical, and can “see” that whatever technology is used, it will be yet another thing that helps them more than it helps us.

    1. The latest generation will even have a shorter lifespan than their parents.

      Lifespan is pretty much a monotonic increasing function. There is no sign that it is coming down.

      You will, statistically, live longer than your parents. We have no evidence of any contrary trend.

      And now they are aging, and perhaps we don’t want them to live longer.

      Those most likely to benefit from the anti-aging technology we are developing today are the young people. Sad as it is, we are not going to prevent aging in people who are in their 70s already. Short of a miracle, we won’t rejuvenate them… at best, we could slow the progression of aging. But people who are 12 today stand a good chance of never having to experience aging.

    2. The world they left is dirtier, less green, more polluted.

      This is way off Daniel’s topic, but growing up and living in what used to be one of the most polluted places on the planet, I know something about changes in pollution.

      If you grew up in the Los Angeles area in the 1960’s and 70’s, as did I, you would know pollution was a lot worse! Before pollution controls, most days I could not see the foothills a few miles away. Flying in my father’s airplane, there were many days when you could not see the ground through the smog, from a few thousand feet up. The orange cast to old photographs from that time is due to the color of the air, not nostalgia.

      The population of the greater Los Angeles area has more than doubled since that time, yet the air is dramatically cleaner.

      Today I live in the foothills of south Orange County, and regularly hike in the nature reserves up in the hills. That vantage gives me a regular sample of visibility over a wide area. Some bad days I can see a thin brown smear over central Los Angeles (over 40 miles away). We also have days with lesser visibility due to haze (water vapor in the air), but lacking the orange-brown color of smog.

      Then there are the just flat amazing days! A few days ago, up in the hills, I could clearly see Catalina Island (46 miles), Long Beach (28 miles), the buildings in downtown Los Angeles and Hollywood Hills (50 miles), the range of hills north of the San Fernando Valley (67 miles), and the larger ridge beyond (90 miles).

      Pretty much impossible in the 1970’s.

      There are still not-nice pockets. Downtown Los Angeles and (directly east) San Bernadino get occasional smoggy days. But a brown smear a few hundred feet thick is nothing like the orange-brown murk thousands of feet thick that was a usual occurrence in the 1970’s.

      My uncle when working in Washington D.C. in the 1970’s described the Potomac river as an open sewer. When I first saw the Potomac in 2000, there was no evident pollution. Seems today folk fish from the river.

      The worst pollution now is elsewhere in the world. The “selfish and self-centered” made their part of the world a lot cleaner. Pollution control worked. The difference is amazing.

      (Sorry for hijacking your topic, Daniel. Could not let pass the careless comment about pollution, we I am often reminded of the dramatic change for the better.)

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