I have bottles stashed throughout my room. Not bottles of drink. Bottles of pills. Inhalers and nasal sprays, too. Prescriptions, supplements, powders, tinctures. My medicine cabinet is full, so are two shelves under my bathroom sink. Shoe boxes are used as storage containers for medications I don’t use every day. Those are stored in the cabinet near our shower, right above the bath towels. Then there’s the bag of meds sealed away in my closet. I stopped using them, but I can’t bring myself to toss them out. Who knows, maybe one of them is a secret cure that I just didn’t recognize. Plus, that bag is worth a small fortune, so I hang onto it like a trendy pair of pants I splurged on but never wear.
In 2019 I had only one prescription, albuterol, for the occasional asthma I suffered during almond harvest here in the California Central Valley. Not anymore. If you’re a Long Covid patient, you’ve probably got a shelf or two (or five) filled with pill bottles, too.
We are trialing these treatments. We’re experimenting, simultaneously en-masse and siloed in our homes. None of these pills are indicated for Long Covid, simply because they have not been studied for Long Covid. Since it’s frustrating and expensive to try medications based on hope alone, I wanted to learn, and then explain, the potential benefit of each one. That way, I could better decide whether I wanted to make a spot for it on my shelf. So I started “The Medicine Cabinet,” a series within my podcast that dedicates an entire episode to a commonly-used treatment. Consider it a medication insert that centers on Long Covid. I describe each medication’s mechanism of action, safety profile, the current FDA-approved indication (if applicable), and the rationale behind its use for Long Covid.
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Most Medicine Cabinet episodes are short, 10-15 minutes, but Friday’s was a bit longer, because there is important new research to cover. The topic is metformin, an old and relatively inexpensive drug that made headlines recently for its remarkable effects against SarsCoV-2. Metformin is a pleiotropic drug, one with several mechanisms of action. It is FDA-approved to treat Type-2 Diabetes, but was originally marketed to treat influenza. COVID-OUT, a project studying several generic medications including metformin, published remarkable data recently that supports its use in acute Covid. Study participants who took metformin early in their infection had substantially lower rates of emergency room visits, hospitalizations, death, and a much lower risk of developing Long Covid than those who took placebo.
In the podcast, I discuss the details of the study, and explain why metformin has been a treatment of interest since the earliest days of the pandemic. I also discuss what this might mean for those of us with Long Covid, and I share how I decide whether a drug is worth making space for.
Find a transcript of the podcast episode on Metformin here. I’m also offering my own reference sheet that might be helpful if, or when, you discuss metformin as an option with your doctor. Or keep it as a reference at home, add to it, and give me feedback on how I can improve the design or content for other medications.
Reference Sheet: Metformin For Long Covid
Listen to all episodes of The Medicine Cabinet series on your favorite podcast app. Search for “Long Covid, MD” or my name, Dr Zeest Khan, on Apple Podcast, Spotify, and other major servers (except Substack, for now). Alternatively, listen for free on my website LongCovidMD.com.
Reach out to let me know how you’re feeling, and if this episode/newsletter helped you. Bye for now! Zeest
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