Humans have been cheating death for centuries—with average lifespans in the U.S. jumping over 20% in just the past century. We’ve redefined the average lifespan through a combination of common sense (don’t smoke) and groundbreaking-turned-routine science (vaccines, mammograms). But less so with extreme lifespan. Sophocles died at 90; Ramses II lived at least that long. (One person made it past 120 in modern times.)

Now scientists are asking if we can extend lives even farther, or at least make 90, 100, even 120 routine. There are odd tales of hyperbaric chambers, offshore stem cell injections, and even blood infusions from teenagers. However, most antiaging advocates are focused more on extending the number of healthy years.

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Cheap Pills for Life Extension

If you think this is sci-fi and expensive, think again. Two leading candidates (and I stress the word “candidates”) for health or life extension are generic drugs that sell for pennies per pill. You don’t need a university lab or elite clinic to the stars to access them. Just a doctor willing to write a prescription—and quite a few are. The two most-popular of these drugs are metformin, which diabetics take to lower blood sugar, and rapamycin, which transplant patients take to prevent organ rejection.

Turns out, these drugs are really promising for improving the health of mice—where most of the research studies have been done. But scientific efforts are now underway to see if they can also help humans, without imposing serious side effects. The main work is taking place in New York City.

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The Metformin TAME Trial

This year, Dr. Nir Barzilai of Albert Einstein College of Medicine aims to start an unorthodox clinical trial of metformin. His and other people’s research hints that the diabetes medication can also improve immune function, combat cancer and inflammatory diseases, and improve the health of the gut microbiome (bacteria living in the intestines).

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That’s a hard thing to test. Typically researchers study how one therapy affects one disease or aspect of disease—like blood sugar levels, inflammation, build up of blood-vessel plaques. The system isn’t designed for cure-alls—especially since researchers aren’t even certain they will figure out how exactly the drug works. 

Barzilai wants to rethink that model. “[Metformin] targets all the hallmarks of aging. So it’s right in the middle of aging,” he says. “It’s hard to dissect because it also works differently on different organs. So in the immune system, it might work differently than in the liver.” Ultimately, he says, the most important thing is to find a drug that improves health, even if we can’t pin down exactly how it does.

In this spirit, he’s developing a clinical trial called TAME: Targeting Aging with Metformin. It goes against the grain by looking at the full range of effects the drug may have. Barzilai has raised about half the money for the project and still aims to start it this year. 

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The Rapamycin VIBRANT Trial

A few miles down the road, research is even farther along on rapamycin, with a trial that has already commenced. Like metformin, this immunosuppressant drug is suspected to have additional, wide-ranging beneficial effects. They may include improving cellular metabolism and recycling of materials in cells, as well as boosting energy-producing mitochondria.

But the Columbia-led study is focussed on a specific part of the body: ovaries. They deteriorate faster with age than other organs. If rapamycin can slow the process, it might put off menopause, and its attendant health challenges, till later in life. Dr. Yousin Suh leads the study, called VIBRANT: Validating Benefits of Rapamycin for Reproductive Aging Treatment. The team has tested about 15 women so far, over a three-month period. They have tended to be older, though, and she’s hoping to get more data on younger women in the future.

She got help determining a safe dose for younger women by studying hundreds of informal longevity hackers who take rapamycin off-label in the hopes that it will extend lifespan. (We wrote about that study this week.) Another interesting outcome of the hackers study was that none of them showed some of the feared side effects of taking rapamycin, such as muscle loss or harm to the immune system. (The drug’s official use is as an immunosuppressant, but it’s given in higher and more-frequent doses to achieve that result in transplant patients.)

It’s still an open question whether either of these drugs will truly extend healthy life, but at least there may soon be more evidence to address the question.

We’ll explore the full range of life-extending technologies and philosophies in the Spring issue of Worth magazine, due out next month.