I think it’s possible to get 15% if you pair Rapamycin with an SGLT2I/Acarbose/Metformin. For someone who would normally live to 95, that would take them to 110. That’s very respectable and reasonable.
4 Likes
Good point. Pairing some drugs results in increased lifespan in animal models beyond the increase of each separately. That includes drugs that alone may not extend lifespan, such as metformin or simvastatin.
Frankly, with the drugs available presently for humans, I think polypharmacy is even more important than in animal models. And individualized precision medicine is especially important. At present, for me, it’s rapamycin, empagliflozin, telmisartan, pitavastatin, bempedoic acid + ezetimibe, and possibly pioglitazone in the near future (still doing literature research on that). Each of us has a unique profile of strengths and vulnerabilities, and addressing our individual weakest links should give us the greatest returns in health/lifespan.
4 Likes
That’s what most, if not everymember of the forum, is doing. 
8 Likes
I’m not trying to argue against Rapa, just saying there is a legitimate argument for not taking it. Everyone who gets positive benefits from Rapa is unfortunately just an n of 1. Medical treatment requires solid scientific studies.
Even if we agree that there is evidence that Rapa is beneficial, would it still be beneficial on top of maximizing all the other beneficial activities?
3 Likes
Marmosets in captivity have a significantly longer lifespan than those in the wild. They get as much sleep and food as they need. Their food is probably nutritious, as I assume they are being fed vegetables instead of pizza, and a nutritionist probably plans their diet. Their stress levels are probably low (maybe too low?) They may even get blood tests regularly by a vet to measure for deficiencies, like normal zoo animals do. The only area where they may not achieve optimal results is exercise. Given all that, Rapamycin extends their lifespan 15% on a near-optimal lifestyle.
Now, let’s take your average American. Diet is crap. Stress is high. Not enough sleep. Obese. Not enough exercise. They rarely go to a doctor for prevention. If anything, Rapamycin would probably help humans more than your average marmoset who leads a pretty optimal lifestyle, IMHO. This is why your typical American dies at 77 and your typical wealthy American dies at 95. As for the rest of us here, we probably don’t live as optimal a lifestyle as the captive marmoset, so why wouldn’t Rapamycin help us? I’m betting it will.
I’d wager that a typical wealthy American on Rapamycin (plus SGLT2I/acarbose/Metformin) can gain an extra 14 years and live to 109 on average with the health of a 95-year-old. Here’s hoping I can celebrate my father’s 110th birthday with him.
7 Likes
Didn’t the marmoset study also highlight negatives/failure of Rapamycin?
This is very similar to my current line of thinking! I feel like we should address the obvious (low hanging fruit), then look at maximising our natural lifespan through exercise, sleep, diet etc. That gets you into the 90+ bracket unless you’re unlucky. To get above that, you need something extra like the polypharmacy.
I made a post a few weeks ago about this idea (though it wasn’t well received). I used UK data, where a male lives to 78.6 on average. If we normalised 7 basic factors (smoking, hypertension, lipids, HBA1C, BMI, 150 mins exercise per week and cut alcohol) that number should be 87 years old. If you “optimised” them, the number should be 93.
Then you can think of pleiotropic effects of the drugs (like statins lowering inflammation, SGLT2i being neuroprotective etc). Maybe that pushes us past 100. And importantly, I am not aware of any significant negatives of weekly low-dose Rapamycin. So at the worst, perhaps it’s a waste of money.
4 Likes
That’s the key…being on national TV and endorsing an immunsosuppressant like Rapamycin to prolong longevity could stir up not only huge controversies but also spell medico-legal issues from citizen, states and federal regulators besides creating public health nightmare.
Imagine individuals hearing about rapamycin and longevity on national TV, creating not only a black market but also consuming in a dangerously risky way jeopardizing their health!!
Imagine a month after the broadcast, ER reporting rapa toxicity, overdose, complications…and soon follow all kind of litigations and investigations!
I am certain his legal counsel advised him regarding how to precisely address the Rapa question.
As he has mentioned many times that there are lots of other things people should do before getting onto Rapa train specially cardiorespiratory fitness, zone 2 training etc.
2 Likes
Some of you guys come up with the weirdest conspiracy theories where you question everyone’s motives. Attia is one of the realest ones there is. He gives his educated opinions and has never once made anything up as a result of some ulterior motive. Not everyone is an asshole like some of you guys think.
7 Likes
I tend to agree, Attia generally seems to explain his changes when they are based on new evidence… Such as his changes on Keto and fasting. Until there is new information, I assume he was honest with the CBS interviewer.
4 Likes
Peter Attia says he’s stopped taking Rapamycin because of mouth sores?
I’m guessing that most people don’t get Aphthous sores (canker sores) often, or at all, and if so, not severely because they would understand Peter Attia’s point. They hurt like hell and he’s already got four years of Rapa benefits.
For me, everything was reasonably ok for first year of using Rapa. However, I now get ulcers EVERY time I take any dose, thats about three years (four in total). My ulcers are large, wide-spread, painful and cause extreme discomfort for about two weeks. My teeth and gums are excellent bar a few minor fill ins. I’ve posted on this site my attempts to reduce the issues. My wife is a GP so I’ve tried almost every treatment.
I’m healthy, fit and don’t take any medications. I eat well, do HIIT training three times a week, live well and have great family and friends. I’ve schooled on the issue and I have mitigated the worst of the problems but I’m still constantly afflicted by the ulcers.
I suspect he’s just stopped to get a break.
5 Likes
I assume you tried the Sabatini mouthwash protocol and it did not work? Based on mechanism of action I thought it should work in almost all cases, but if not, that’s bad luck. It all seems very unpredictable. I think RapAdmin got one when he just started, but then nothing since. I have not had one so far, but I’ve only been on rapa for less than a year and for the past three weeks escalated the dose from 6mg once a week to 10mg and will keep that up for another 2-3 weeks before going back to 6mg. I had my periodontist do a battery of tests on gum and bone health before getting on rapa and come November next week he’ll run the same tests to see if rapa has had any impact (this in the context of getting dental implants, so regarding rapa impact on bone regeneration, if any).
5 Likes
Please post an update once you’ve had that periodontal exam.
Sure. Although in general, my dental hygiene is stellar, so there are no likely changes to gum health; the change we are looking for is in the alveolar ridge anchoring the teeth, and possible impact on osseointegration of the titanium implant.
Hey CT, thank you for the feedback. I haven’t heard of anything called the “Sabatini mouthwash protocol” but I recall he discussed mouth ulcers with Peter Attia and focused on dexamethasone (steroid) mouthwash. This is commonly prescribed by dentists after mouth surgery. In Australia it’s a compounding pharmacy script. I think that in the US it can be found in a compound called “Magic Mouthwash” but that isn’t available here. I’d say dexamethasone is the best treatment I’ve tried but, perhaps like Peter Attia, it didn’t solve the ulcers problem. If Sabatini had further advice please point me at it! Many thanks.
Here you go:
3 Likes
I missed that. Very interesting, and very easy and cheap to do if the import/export channels are open… but if not 
3 Likes
Thank you. Yes, that’s a very interesting hypothesis. I don’t know that anyone has proven this out, or if anyone has tried it with positive results? Matt K. also suggests a rapa toothpaste for periodontal and other general oral benefits.
1 Like
LOL, exactly. He’s just polishing himself for a larger commercial foot print. Near zero new info (IMHO) just polish and promo.
Read his book, tossed it. Too drug-y (statins) too decade old… Nothing new (for me). Today this article; Just buz and promo IMHO nothing new for us. Sure lots new for SAD’ers, sick Americans but thats not us here.
Good luck, curt
4 Likes
A quote from his recent longevity 101 podcast really struck me how big the shift has been from “life extension” to “let’s just try to slow the damage a little”
“I was thinking about this today in the gym actually, I was like, wow, it is really so obvious to me with each passing day that I am completely past my prime physically and cognitively. And I will never again be as physically strong, fit, flexible, free of pain.
Like pick your metrics that all make up physical health span. I will never again reach the pinnacles that I had reached in my late teens and 20s. And similarly, cognitively, I’m basically a moron compared to the person I used to be, in terms of processing speed, problem solving, just raw intellectual horsepower.
Those things are going to decline even further.”
2 Likes
Oddly, in my 85th year, I am more pain-free than I was in my 20s and 30s. In my late 20s, I was being treated regularly for pack pain, and I remember often having headaches. In many areas, I am still as physically strong in terms of raw muscle power because I have been going to the gym, running, and playing tennis most of my life. What I have lost is speed, endurance, and reaction time.
I don’t even remember the last time I had a cold or the flu, at least many decades ago.
What do I attribute this to?
Exercise
Poly pharmacy
Rapamycin (Shortly after starting rapamycin in Dec. 2021, at a relatively high weekly dose, I have been pain-free, including headaches and the typical pain that accompanies old age, arthritis, neuropathic pain, and fibromyalgia.)
Genes
Immunization shots. (Because of the military and my employment in foreign countries, I have received too many shots to remember. Starting from childhood to my most recent flu shot. Among them are mumps, measles, tetanus, diphtheria, pertussis, and yellow fever, etc. My most recent vaccines in the last few years are influenza, COVID-19, shingles, RSV, and pneumococcal. The only one that I had a severe reaction to was the Pfizer COVID-19 vaccine.)
Cognitively, the most significant decline has been in processing speed, the ability to do math problems in my head, and the ability to memorize lists, etc., for any substantial amount of time.
Subjectively, my most significant decline is in energy and endurance, though I still seem okay at the gym.
7 Likes