What is Metformin?

Metformin (metformin hydrochloride) is a biguanide medication first approved for type 2 diabetes in the 1990s. It reduces hepatic glucose production, improves insulin sensitivity, and has a strong safety record spanning decades of use.

Beyond diabetes, metformin has attracted intense interest from the longevity research community. It activates AMPK, reduces mTOR signaling, and has shown lifespan extension in animal models. The TAME trial (Targeting Aging with Metformin) is the first major human trial testing metformin specifically for longevity.

Common side effects include GI symptoms — nausea, diarrhea, cramping — especially when starting. Extended-release formulations significantly reduce GI issues. Metformin can also deplete B12 over time; tracking supplements alongside your dose is important.

Metformin Dose Escalation

500mg
Week 1–2

Start low to minimize GI side effects

1,000mg
Week 3–4

Divided doses — 500mg twice daily

1,500mg
Week 5–6

Intermediate therapeutic dose

2,000mg
Maintenance

Standard max therapeutic dose for T2D

Tracking Features

FAQ

What are standard metformin doses?

Start at 500mg once or twice daily with meals. Titrate up to 1,000–2,000mg/day over 4–6 weeks. Extended-release versions reduce GI side effects and can be taken once daily with dinner.

How do I reduce GI side effects?

Always take with food, start low and go slow, and consider switching to extended-release formulation. Tracking which meals trigger symptoms with Shotlee helps identify your best timing.

Can metformin be combined with GLP-1s?

Yes — metformin and GLP-1 medications are frequently combined for type 2 diabetes management. They have complementary, additive mechanisms for blood sugar control.

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