Hi Nick,
Reading your post and your age brings tears to my eyes. I know it's not much comfort to say, but I'm right there with you in the anxiety. I'm glad leslie posted about the trials above. I truly think there are things we can do to try to prevent progression. I've been sniffing around the medical literature and saw some papers that talked about Metformin as well. One author wrote that progression prevention should be given more attention, and that Metformin has relatively few side effects so is worth the clinical trials. Obvi work with your docs before taking any meds and supplements. At some point I hope to organize my collection of journal articles and will ask the moderators whether I can share a list of links.

Re. anxiety/mental health: As a newly-minted psychotherapist and therapy client, I've been doing some Internal Family Systems (IFS) work on identifying and then working with the parts of me that frantically protect me, like the "researcher," "the distractor," and the "worst case scenario mist." I've had mixed results with some success. This morning was the first time I permitted myself to really feel those feelings of fear and anger - the ones that my protectors were hoping I'd avoid. It wasn't attractive and I probably said some awful things, but it felt more authentic than "thought-stopping" and other behavioral techniques. So finding a good therapy that fits with your approach may be worth a shot. Acceptance-based therapies like ACT and DBT may be helpful.

Joining a local MM support group has offered mixed results as well - I've met wonderful folk (I'm the baby of the group) but am probably also exposed to the other side of the fence a bit more than my liking. However, the networking benefits are real! If you find a MM support group and join with MGUS, you get a gaggle of elders with a wealth of recommendations, experience, and connections 😀

Keep us posted.