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NMU 302 – Taking Metformin to Treat COVID-19 Infection Prevents Development of Long COVID Syndrome

Nutrition/Natural Medicine Update No 302 (September 06, 2023)

with Dr. James Meschino

Topic: Taking Metformin to Treat COVID-19 Infection Prevents Development of Long COVID Syndrome

Source: The Lancet (March 2023)


A study published in April 2023 in the Journal of Clinical Endocrinology & Metabolism showed that having higher vitamin D blood levels above 58 umol/L (23.2 ng/ml) significantly reduces the risk of developing Long COVID Syndrome after the initial infection has been resolved. In March 2023 another important study involving Long COVID was published in the Lancet. This study showed that compared to taking a placebo, if a patient is treated with the diabetic drug Metformin at the onset of mild to moderate COVID-19 infection, it reduces their risk of developing Long COVID syndrome by up 64% – provided they start taking Metformin within the first four days of symptoms. The effective Metformin dose was 500 milligrams on the first day, 500 milligrams twice a day for the next 4 days, and then 500 milligrams in the morning and 1,000 milligrams in the evening for the remaining 9 days (a total of 14 days).

The study was designed to test Metformin against the drug Ivermectin (an antiparasitic drug, which has become popular among some groups as a potential treatment for COVID-19), and against Fluvoxamine (an antidepressant drug, which has shown promise in COVID-19 treatment). More specifically, between January 2021 and February 2022, researchers tested three oral medications – metformin (typically, used to treat type 2 diabetes), ivermectin (an antiparasitic), and fluvoxamine (an antidepressant) – in a clinical trial across the U.S. called COVID-OUT. The people being studied, investigators, care providers, and others involved in the study were blinded to the randomized treatments. The trial was decentralized, with no in-person contact with participants.

The researchers included patients who were ages 30-85 who were overweight or obese, had documentation of a confirmed COVID-19 infection, had fewer than 7 days of symptoms, had no known prior infection, and joined the study within 3 days of their positive COVID-19 test. The study included monthly follow-up for 300 days. The results showed that Metformin treatment was effective in preventing Long COVID by 42-64%. The sooner the patient starts on Metformin the better the preventive effect. On the other hand, neither Ivermectin nor Fluvoxamine showed any protective effect against the development of Long COVID. So, if you develop a COVID-19 infection, be sure that your blood vitamin D level is above 58 umol/L (23.2 ng/ml) and ask your doctor to start you the drug Metformin, using the dosing schedule I have outlined in this report. These appear to be two important ways to prevent COVID-19 infections from evolving into Long COVID syndrome, which can really be life altering in a very negative way.

I have included the reference for this information in the text below.


Burmante C and Buse J. Outpatient treatment of COVID-19 and the development of Long COVID over 10 months: A multi-center, quadruple-blind, parallel group randomized phase 3 trial. The Lancet. March 2023.

Breakthrough Study: Diabetes Drug Helps Prevent Long COVID. Medscape March 9, 2023. Carolyn Crust.

di Fiippo et al. Low vitamin D levels are associated with long COVID Syndrome in COVID-19 survivors. Journal of Clinical Endocrinology & Metabolism. April 13, 2023.

Eat Smart, Live Well, Look Great,
Dr. Meschino

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