I'm sorry that you disagree, but clinical trials nonetheless are indeed the standard for what constitutes proof of hypothesis in the medical community. Anecdotal evidence, meta-analysis, etc. can be, and often are, used to justify opposing points of view; they are not proof of anything. They can suggest potential hypotheses to be tested by randomized clinical trials (preferably double-blind and placebo-controlled), but that is all. I'm aware that they are often offered up as proof in lay publications. That is unfortunate, but it doesn't change what they are: shoddy science and wishful thinking.
There are many who have concerns about metformin. See, e.g., the post immediately following the one Vince links to above (Post #20 under
A new study explores anti-aging properties of metformin). I don't think at present those concerns should stop its being prescribed for Type II diabetes. But that's as far as the present state of the science would seem to go, at least for now.
We are going around in circles a bit, but who knows maybe concentric ones. I think any reasonable person would argue what you refer to as shoddy science, wishful thinking, etc has it's place in the scientific process. Your use of such sweeping pejorative terms looks to me like a smoke screen against reason.
It feels like you are putting 'the medical community' on a pedestal for one. Really? I am fully supportive of our doctors, but their hands are tied by policy, threat of loss of earnings and reputation. The truth is out there if you look with open eyes. How will history regard the great era of SSRIs, opiates and the complete failure of the medical community to recognise the importance of diet and stress during the last century. Do you know how long docs spend studying nutrition?
There are some in the medical community who you claim to speak for who fully acknowledge the value in synthesising the clinical model with the functional and alternative ones, and yes, base some of their treatment practice on reason, not just clinical trials.
You use the word proof, but again, there is no absolute proof. Even from the most robust clinical trial. There are definite problems with double blind placebo studies that don't get mentioned, and they include bias and peculiarities around placebo. Best option? Yes. Perferct? No.
Reason and assigning weight to evidence using your own judgement is the middle way. Denying the existence of things until the next trial 'proves' they exist has taken medicine a long way. People who think like that are needed in science, but so are people who explore possibilities and operate with more freedom of thought. Why can't we tolerate each other without getting bothered if someone doesn't share your world view?
Come back in 20 years and we'll have chipped away at the whack-a-mole approach to symptoms using drugs, and there will be a wealth of practitioners who understand a synergistic approach. Why don't they do comprehensive blood tests on people with depression? They should be doing that instead of writing out another SSRI script. How about mindfulness classes to mediate chronic stress. It works, study or not.
Interestingly, the rise of evidence based medicine as 'the only way' is a relatively new thing, and has tremendous value in some ways, but for some it has become something of an extremist dogma in my opinion.
Now you are pointing out studies to support your position about risks of metformin. These are the same category of studies I have read to form my calculation of risks. Metformin is one of the most prescribed and researched drugs in history, and all you ever hear about in terms of real world outcomes in the media is lactic acidosis. If anyone who doesn't have impaired kidney function, isn't diabetic, morbidly obese or really old thinks they're putting their life on the line taking metformin, don't. You would be wiser to invest your concern taking an extra look before you cross the road. If anyone is interested I will present a reasonable risk analysis of why I say this.
I would be happy to go through the list of dangers raised by Chanlder Marrs, and explain my take on the real world risks, short and long term. I am not against reading rat studies or in-vitro studies, such as some of the material referenced by Marrs.
But it's interesting to balance risks and benefits. I believe metformin is a very strong candidate for something to try in my situation as a short term intervention. There is good evidence it improves gut permeability and supports a microbiome balance that is linked strongly to health outcomes. It's also well documented that although some do not see any real weight loss benefits, there is a definite and substantial cohort with highly resistant visceral fat for whom it can be a very strong trigger. It is known to have positive effect on metabolic syndrome and insulin resistance, and no this effect is not limited to type II diabetics. I do not see any substantial long term risks that would make this a poor decision to try it. Nor do I see it as a cure for anything, but instead a short term tool. Since I've already proven I can maintain diet and training regimes, having done so for 7 years, I have every confidence I will eventually restore balance to my liver, gut and adrenal systems and support this moving forward with a holistic approach.
If anyone wants references to studies, I will happily provide them.
