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Metformin vs berberine for longevity — what does the evidence say?
I keep seeing these two compared in longevity circles. Both activate AMPK, both improve insulin sensitivity. Metformin has the TAME trial coming but berberine has some interesting GI microbiome effects. For those of us who are metabolically healthy, is there a clear winner? Or should we skip both and just exercise?
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The honest answer is: exercise beats both. Attia has talked about this extensively. Metformin is a poor substitute for metabolic fitness.
If you're metabolically healthy, the evidence for metformin is actually quite weak. The ITP data in mice was underwhelming, and it may blunt exercise adaptations.
I take low-dose metformin (500mg) only on rest days to avoid the exercise blunting effect. Seems like a reasonable compromise.
Berberine gave me terrible GI issues. Switched to dihydroberberine which is much better absorbed and easier on the stomach.