Dave Asprey challenges the conventional longevity drug list, explaining why metformin, rapamycin, and statins fail the human data. Metformin may blunt exercise adaptation and deplete vitamin B12. Rapamycin's mouse-study promise collapsed in the 2025 PEARL trial. Statins come with a steep harm-to-benefit ratio and drain mitochondrial CoQ10. Asprey then walks through a 'yes list' of four repurposed pharmaceuticals — tadalafil, SGLT2 inhibitors, acarbose, and low-dose naltrexone — and explains how each supports metabolism, mitochondrial function, and immune regulation.
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Highlights
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Metformin blunts exercise adaptation and depletes B1200:03:48
Metformin can interfere with the muscle-building signals from resistance training and gradually drain vitamin B12 stores.
Statins carry a 100-to-1 harm-to-benefit ratio and deplete CoQ1000:12:55
According to Asprey, statins help roughly one person in a hundred while silently draining mitochondrial CoQ10, a molecule essential for energy production.
How to talk to your doctor about off-label longevity prescriptions00:31:44
Asprey offers a framework for discussing repurposed pharmaceuticals with a physician — present the data, frame it around metabolic health, and request a low-dose trial.