Dear Mark: How Often I Eat Organ Meat and Should You Take Metformin for Longevity?

For today’s edition of Dear Mark, I’m answering a couple questions taken from Instagram followers. Normally every Wednesday, I do a quick Q&A on Instagram. I wasn’t able to get to them last week so I’ll be answering some here on the blog. First, how often do I eat organ meat, and how do I like it? And finally, what’s the deal with using metformin for longevity?

Let’s go:

How often do you eat organ meats?

Maybe twice a month. I should probably do it more.

It’s not that I dislike them. Every time I eat heart or liver, I enjoy it. It’s not something that comes intuitively to me. Because I wasn’t raised in a household where organs were a normal part of the daily diet, I have to remind myself to do it.

If you’re counting marrow, I eat that far more frequently. I order it every time I see it on a menu. I eat lamb chops frequently, which often come with little pockets of marrow.

And personally, I include eggs and shellfish as “organs.” Reason being, you’re eating the entire organism. The whole animal. Well, the egg isn’t an animal yet, but it contains everything one needs to construct an entire animal. These tend to be far more nutrient-dense than muscle meats.

If you’re looking to eat more organs, there are some great options.

You can go the product route. US Wellness carries fantastic organ sausages. Check out the braunschweiger (60/40 blend of grass-fed beef and grass-fed beef liver) or the liverwurst (GF beef, liver, kidney, heart). I’ve crumbled these up into ground beef and mixed into spaghetti sauce.

You can usually ask any butcher to make sausages or meat grinds with different muscle/organ ratios. You could do 70% beef chuck with 15% liver and 15% heart, or whatever ratio you prefer.

Ancestral Supplements does great organs in supplement form.

There are awesome recipes out there that “hide” the organs. I wrote an entire post on slipping organs into normal meals that you don’t even notice.

Or you could just figure out a way to cook organs that you’ll consistently enjoy and consume. Here are some of my favorite ways:

  • Ginger garlic chicken liver: Chop chicken liver into small pieces. In a pan, sauté ginger and garlic in butter or avocado oil. When it’s all softened, add a generous cup of gelatinous bone broth and reduce, reduce, reduce. When it’s getting syrupy, drop in the liver and stir over medium high heat for 2 minutes. The liver will cook quickly without overcooking.
  • Beef liver sashimi: Get the best, freshest organic grass-fed beef liver you can find. Slice thin and marinate in fish sauce, sesame oil, and lemon juice for an hour. Eat raw, or briefly sear in a pan. If eating raw, might be advisable to freeze for two weeks first.
  • Chicken heart skewers: Marinate chicken hearts in lemon juice, soy sauce, and a little bit of honey. Place on skewers and grill over coals or flame.
  • Lamb/beef heart steaks: Slice a heart into steaks. Season with salt and pepper, and place on roasting rack in a 275°F oven for 15 minutes. Remove and sear briefly over high heat on both sides. Do not overcook. It will get tough and inedible.

What’s your take on supplementing Metformin for longevity?

There are certainly reasons to suspect it could help.

Metformin activates AMPK, the same autophagy pathway activated by exercise, fasting, polyphenol consumption, and reduced calorie intake.

Metformin also seems to protect against many of the conditions that kill people, like cancer. It lowers hyperinsulinemia and may protect against insulin-related cancers (breast, colon, etc.). Early treatment during adolescence, for example, protects rats against later tumor growth.

Type 2 diabetics (a population with higher overall mortality) who take metformin live longer than age-matched controls who don’t have diabetes. That’s huge. Type 2 diabetes isn’t enough to offset the longevity gains.

Metformin appears to work on lifespan via hormesis. Diabetics who need it just to keep their blood sugar in check are taking (and should take) it regularly, but if you’re just an experimenter interested in potential life extension, treating it like a hormetic input like fasting or intense exercise is probably a better, safer approach. Instead of daily, maybe intermittently. Cycle it.

It appears that metformin may also act via modulation of the gut bacteria (surprise, surprise). It increases mucus production in the gut, which the resident bacteria are able to feed upon and increase in strength and number. It’s been shown to boost Akkermensia count, the strain commonly linked to leanness and anti-diabetic effects. Some studies have even shown that Akkermensia can improve gut barrier function in obese subjects, so metformin may be especially helpful for this population. Additional effects include reduced carb absorption by the host (that’s you), leaving more to be consumed by gut bacteria (a la resistant starch).

If you don’t want to (or can’t) find real metformin, berberine might be a “natural alternative” to metformin. Like metformin, berberine can activate AMPKlower blood sugar and improve blood sugar control, and enhance short chain fatty acid production by gut bacteria. Being a whole plant extract, berberine isn’t identical to metformin, so I wouldn’t suggest diabetics switch without consulting their doctors, but it is a promising alternative that doesn’t require a prescription. It might be a viable alternative for someone looking to improve their longevity.

Overall, metformin looks promising. I’m not sure it’s an essential part of a longevity-promoting regimen if you’re already fastingtraining, and eating colorful polyphenol-rich fruits, vegetablesspices, and dark chocolate. Many of the populations it seems to help in studies aren’t doing these things and metformin is likely acting as a “healthy living mimetic”—but I’m certainly open to the idea, and await further research.

That’s it for today, folks. Take care and keep the questions coming! If you have anything to add or ask, go for it down below.

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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18 thoughts on “Dear Mark: How Often I Eat Organ Meat and Should You Take Metformin for Longevity?”

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  1. I noticed the link to Ancestral Supplements. Where in the world has Liver King been??? I truly miss his feedback.

  2. My doc took me off Metformin because I have kidney disease, although it isn’t clear that it is harmful. My functional med doc did put me on berberine (Pure Encapsulations Metabolic Xtra).

  3. Speaking of Liver King, based on a post of his at some point, I make it a point to keep a store of dessicated grass fed liver on hand for when I fail to consume the real thing. I think a decent substitute.

  4. Love dear Mark, always an interesting read!

    Since you mentioned eating whole organisms I was wondering if there are any specific nutritional benefits to fish heads? I can get really cheap great fresh fish heads from my fishmonger which are fantastic steamed, and I’m curious as to their nutritional value, I can’t get much data on the heads particularly- surely the eyes and fish brain must have some unique stats and benefits? And while I’m at it… could I overdose on them? how much would be too much too consume each week in your opinion?

    1. Lucky you!

      Use fish heads for the most amazing soup in the world!

  5. Great advice on organ meats. I personally don’t really enjoy the taste of beef liver but think chicken livers are delicious…especially with bacon. And I’ve bought ground beef from local farmers that included organ meat, although I haven’t been doing it lately. I pretty much rely on Ancestral Supplements to get my beef liver. And I would add that in addition to eggs and shellfish, I feel that I am consuming organs when I eat sardines…since I’m eating the whole fish, I’m pretty much getting everything.

  6. Peter Attia has noted that in healthy people (non T2D, no metabolic issues) Metformin blunts the benefits of exercise, especially the primal type of low intensity training. It therefore may decrease mitochondrial function. In other words, the more healthy you are, the less helpful Metformin may be and can possibly make you less healthy, though that is not completely confirmed. Basically, if you’re healthy and primal and do some intermittent fasting here and there you may at best not benefit by taking Metformin, See his podcast with Iñigo San Millán for more details.

  7. Metformin activates AMPK

    Hmm, that gives me pause. When I looked into metformin, before beginning to take it I didn’t come across that fact. Is there a reference for that one? The interaction of AMPK and ME/CFS is a complex one.

  8. Hi

    this looks like a typo:

    Type 2 diabetics (a population with lower overall mortality)

  9. I am concerned that metformin and berberine degrade and/or hamper muscle development.

    1. Maria they did exactly that for me! I am a frequent exerciser and felt horrible when I tried both of them. Muscle atrophy, fatigue, general malaise.

  10. My doctor wants to put me on metformin for pre diabetes, but it scares me. I have changed my lifestyle and signed up with Dr. Mowll and his coaching plan. It’s a struggle, but I am losing weight. I no longer have my gallbladder. ( that got taken out after 5 pregnancies in 4 years!) Anyway, she gave me 3 months to lose a significant amount of weight and bring my A1C back down from 6.0. I am scared. Is metformin the beginning of the end? I dont want an excuse to stay overweight!

    1. Patricia, pre-diabetes is 100% curable, don’t fret! I don’t know who Dr Mowell is, but if he coaches you to eat a diet primarily consisting of high quality meat and above ground vegetables he’s worth sticking with. I cured mine by switching to Paleo about 9 years ago, if you stick with it and avoid “cheat” foods the weight should melt off.

      You can do this, food is for fuel, eat for nutrition not entertainment. The mere fact that you are even here asking these questions gives you a huge advantage!! Seriously, you got this woman, I believe in you.

  11. I wish you would have done an update on the metformin. You just reposted pretty much word for word what you posted back in 2015, surely there must have been more research between then and 2020?