Metformin also inhibits CYP3A4. I take 1 g of Metformin before Rapamycin to help with higher blood sugar and also to inhibit CYP3A4 more.
In this study, we hypothesize that metformin suppresses the expression of CYP3A4, a main detoxification enzyme and a target gene of PXR, due to SHP up-regulation.
Just a personal opinion based on years of reviewing increasingly good research on the intestinal biome and how long it takes to re-stabilize after taking an antibiotic, I would be be hesitant to take azithromycin for this purpose.
I’ll agree with that statement.
However, the last clinic I ran (Sysco Corporation) I’d see occasional obvious infections and send those folk out to their PCPs.
I do remember one fellow who was adamant… “I won’t take no pills…” I assured him, I don’t prescribe at all, I’m not that level a RN." But, what he had had overt s/s of staph aureus: centrally located “boil,” pus-exuding, warm to the touch and from what he told me, “expanding,” meaning the red/warm area, as well as the pus activity was worse each day for the prior three days.
He went to his PCP confirmed my suspicions and who prescribed an antibiotic and took a sample for culture and yes it turned out to be S. aureus.
The point of this is yes, be hesitant to take any antibiotic but there are times when most of us wilt in our opposition…
Agreed. Not to mention contributing to the entire world’s growing antibiotic resistance. It’s a ridiculous strategy. I stopped taking Rapa because I got such severe acne (a bacterial infection) that I would have had perpetually to be on antibiotics—along with reducing my Rapamycin dosage down to virtually nothing. The calculus doesn’t make any sense.
I share your frustration with finding it very difficult to actually take Rapa. But, I don’t think that our poor experiences are necessarily indicative of anything more general about its efficacy for reducing multiple negative effects of aging.
The data suggests that you and I are the outliers in having intolerable side effects. So, I am mostly dismayed that I can’t take it and get what seem to be actual benefits in reducing age-related decline. Unfortunately, it’s in the nature of medication that as much good as they can do, often side effects make them inaccessible for some.
But, I’m glad you identified the culprit that was making you feel poorly!
Add some caffeine to your stack 
I take 200mg every morning in my supplement pile. And I have a coffee before noon and no additional caffeine after that. I’m consuming less than 300mg before noon.
Some people are very sensitive to caffeine, fortunately I’m not one of them
https://www.sciencedirect.com/science/article/pii/S0149763416300690
Don’t know how much caffeine is in one strong coffee but I do have at least two (most times three) before noon. Usually don’t drink any after that.
The biggest problem with using coffee to “dose” caffeine is that you don’t know what your dose is. There are too many variables when consuming coffee.
That’s why I take a 200mg caffeine pill, I know the dose, I can adjust the dose as required.
Coffee on the other hand, while it has many other benefits from the other compounds in it, is a pretty sketchy way to accurately dose caffeine.
Thats a really high dose, and very suddenly after a 3 month break. Thats equivalent to something like taking a 12mg to 16mg dose of rapamycin.
After a break, I usually slowly work my way back up to the dose I was taking (e.g. 8mg per week, so I would start at 2mg one week, then 4mg/week and then 6mg / week and finally 8mg per week after 4 weeks.
Anyway, you might try a less extreme approach to dosing. I never have had the negative issues you mention that you experience.
When I think of it now you are right, I screwed up. Should have started with 1 plus GFJ and up gradually.
What’s the need for an accurate dose of caffeine?
I am soon to take dose #2, having taken 1mg Zydus 6 days ago. I was thinking of next doing 2, 2mg (total 2mg) and then the following dose, take one with fresh GFJ so maybe 3-3.5mg equivalent. After that I could do 4mg (four 1mg tabs).
Can Zydus 1mg be sliced in half?
Thoughts, anyone?
No. Zydus cannot be sliced in half as you will destroy the protective outer coating and the effectiveness drops to close to nothing as your digestive enzymes destroy the Rapamycin. Don’t do it.
BTW i was totally mistaken. It wasn’t RAPA that caused such severe pain and agony, but it was actually this one “Wholesome Wellness Digestive Enzymes 1000MG Plus Prebiotics & Probiotics Supplement, 180 Capsules, Organic” which a started taking them exactly same day as started RAPA. I left a full review of a product on another forum, but guys be very careful when someone suggest somethings in these boards. You must check one-star reviews because they seem to be the only ones that matter.
Well, that’s good to know. I do always check before slicing meds. I do that w/ my rosuvastatin. Thank you.
Are you just starting out with Rapamycin? Others may disagree but if you’re new to Rapamycin, I would recommend taking only Rapamycin to see how it effects you . 1 mg then 2 then 4 then 6 etc. add the gfj and other stuff later.
Depends on why you consume coffee. If it’s only for “pleasure”, dose doesn’t matter much, other than if one goes hard and consumes quite a bit more importantly the amount of caffeine can vary greatly in a cup of coffee, espresso, etc.
Technically caffeine is classified as a “drug” and it does have an LD50, an extremely high LD50 that would be near impossible to reach with coffee but could easily be exceeded with pure caffeine extract.
For anyone interested in the benefits of caffeine, like any compound, dose matters and that is why I try to manage it.
Yes, I just took my first 1mg last week. I’m going to do 10-day cycling. This is what I was thinking:
1mg
2mg
1 mg + fresh GFJ (~3.5mg equivalent)
4mg
5mg
2mg + fresh GFJ (7mg equivant)
Then stay of tthe 2 + GFJ for several cyles and then do blood tests.
As an older member 83, I can only tell you from my experience. Take the highest you can tolerate for the maximum benefits of rapamycin.
Yes, well aware. We used to give caffeine IV for post spinal headaches. Just never understood taking caffeine as a pill. Prefer coffee. Haven’t really seen it work well as appetite suppressant.