Paul Saladino· MD
metformin is a great example like we talked about yes here's a molecule somewhat derived from plants again there is a derivative of metformin in french lilacs okay um which is essentially a toxin like this is a plant defense chemical explanatory should be on that okay cool the mechanism i'll say this and then i'll pull up the study that we were talking about with hypospadias so the mechanism of metformin is super interesting so people think that it's a complex one inhibitor but it doesn't inhibit complex one at physiologic concentrations it actually does this it's like really deep biochemistry i did a podcast with petro dobromielski from hyperlipid talking about this on my show because i got really into biochemistry so it's glycerophosphate dehydrogenase which is a part of the it's a part it's after glycolysis that regenerates nadh in the early steps of glycolysis like that's what metformin appears to inhibit and that's part of the mechanism functionally what that means is that the good thing about metformin is it shuts down inappropriate gluconeogenesis at the level of the liver in people who are insulin resistant