Do you tell your doctor you are taking rapamycin?

I had a little cycling accident and ended up in the ER, of course they asked for the medications I take. Would you answer considering the side effects and interactions? From memory I knew of no significant reason to explain. Would you tell and why would a doctor need to know which side effects, interactions, complications should they consider from pulsed doses (most of them will probably just overreact thinking it makes someone immuneno compromised)

I would, he/she needs to know for any contradiction meds, interventions, etc.

If any doctor today hasn’t heard of bio-hackers taking Rapamycin for longevity…living under a rock.

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I don’t think many do. My girlfriend is an oncologist. I told her (last year) I was considering taking rapamycin. She called me crazy, taking an immunosuppressant during a pandemic. I said it’s not an immunosuppressant at all, it actually boosts the immune system. Then she remembered she actually published a paper on everolimus in patients and cell cultures treated with rapamycin that showed the immune response to self and self like was attenuated by sirolimus/everolimus but the response to foreign was (ie virus) was enhanced…

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Agreed. Doctors in general have no idea how rapamycin works, the longevity studies, side effects, interactions, or intermittent dosing.
None. Nothing.
And I find that,for the most part, they’re not particularly interested.

Unfortunately, this lack of knowledge won’t stop them from pontificating on the subject. I suppose that they feel a certain obligation to do so.

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Interesting situation… I definitely tell my primary care physician… but in an ER situation like yours my calculations are more likely to be similar to yours; if I hadn’t just taken the rapamycin in the past few days, I’d probably skip mentioning it just because it would likely throw up all kinds of red flags in their systems and may prevent you from getting appropriate care because the don’t have a clue about pulsed weekly or bi-weekly rapamycin and suddenly think you are an organ transplant patient or have cancer - so suddenly everything gets much more complex than it would likely need to be.

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Agree re overreaction on the part of most everyday ER docs. Not worth the hassle or explanation.

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My last Dr visit for a check up, I brought my usual med list with the vitamins and I added the “anti aging” items, rapa, metformin, NMN, NAC and low dose Lithium.

His first words were “who prescribed this for you.” “I told him I prescribed it”. He said “how did you get the items?” I told him ordered them from India and New Zealand." The then replied “I hope you know what you are doing and I am not responsible for any bad out comes.” I said “I understand you are not responsible for any of this”.

Then it was come back in 6 months instead of the usual year.

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In all fairness to physicians, there is immense legal risk in prescribing rapamycin, and they receive a great deal of warning not to do such things. If a person is prescribed rapamycin and develops a case of cancer, has a cardiac incident and several other possible health problems, even if the rapamycin had nothing to do with it, the doctor would potentially liable. You signing something that you take full responsibility would not necessary shield them (if they had prescribed it). We are talking a possible severe damage to their livelihoods and lives. This is how our world works. Dr. Green has shown tremendous courage in prescribing rapamycin to 1,000 people. I’m sure he is aware of the pitfalls.

Yes - the “first, do no harm” credo is extremely engrained in the medical culture (instead of a risk/reward profile estimation, which admittedly is more complex to implement). And the Medical/Legal industrial complex further penalizes risk-taking by doctors…

As Vinod says:

What I find a little surprising is that in all other developed countries - that have universal healthcare, and where there is no real history of legal/malpractice lawsuits - that you still see such conservative medical care focused on prevention. It seems that Canada, Europe, etc. would have a huge incentive to push into preventative healthcare in the rapamycin model of care… since it directly translates into savings at a population level on healthcare expenses… Sadly, those same countries are also even more conservative when it comes to new therapeutic avenues, so there we are.

I suspect that as soon as we start getting more significant clinical validation of the anti-aging effects of rapamycin et al, you are going to see much faster movement in terms of adoption of anti-aging drugs by the countries with universal healthcare because there is such a huge financial incentive for the governments to do so, and at the same time they all have a vast aging population and all the problems and social security issues that come along with that aging population… so I think the next decade is going to be extremely interesting in this area.

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The mistake you’re making is in thinking that doctors are interested in anti aging. For the vast majority They Are Not.
They want to diagnose and cure disease states.
They may talk about mammograms and colonoscopy.
They don’t even discuss obesity, and multiple studies demonstrate that doctors have more of a bias against the obese than does the general population.
They think that supplements are , at best, a waste of money… At worst, dangerous.
We will all be dead and buried before doctors start prescribing rapamycin for longevity at any meaningful degree.
It has nothing to do with the type of health care, private, public, or otherwise.

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I lived in Germany for seven years and many of the supplements I had been taking were unavailable because German law required supplements to provide proof of benefit, not just no harm done.

I agree with all of that and I am a physician. However, the analogy i like to use is that physicians are trained to be " life guards" and not swim coaches. If you have a gun shot wound, heart attack or appendicitis, please pass on stopping at GNC, your favorite chiropractic office, acupuncture therapist or anti-aging clinic and proceed to your nearby ER. If want help being healthier then please pass your PCP, ER and or OR. Do your own research and find someone that will work with you on your goals. It would be nice if physicians were all trained in health care, but a majority of our training is in disease care.

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Take a look at the statements made by the preventative task force and you’ll have a good idea how most physicians view supplements.

I do as RapAdmin does. I tell my PCP but I don’t mention this to any specialists I might see. I went to a Cardiovascular doctor about a year ago and he “lectured” to me about the harm I was doing to myself regarding Rapamycin, Metformin, and other longevity supplements. He was not talking to me–he was talking “down” to me. I learned from that experience to keep such meds to myself.

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Again, surpassingly, he is not qualified to say any of that to you. You can flip the tables and say what randomized controlled trials do you have to support your arrogant position of lecturing me. What training in supplements, anti-aging and healthspan do you have to make statements on any of your statements? It is not far off of an electrician giving you advice on a plumbing issue. The Cardiologist does have a very valuable position, but usually they are overweight, insulin resistant and see through the lens of disease management. If you have a heart arrhythmia, heart attack, blockage of a coronary artery and they are good at what they do, then I would care or less their position on longevity options for treatment since those are all disease management issues. If you have an ApoE4, MTFHR, elevated Lpa, CIMT c/w an elevated age compared to your age, then most traditional cardiologist are not going to be helpful. Ultimately, don’t expect someone that is not trained to give you answers to questions they are qualified to answer. They are smart and do have a value, but not in all things.

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You shouldn’t hide anything from your doctor that could interfere with them helping you. But also you should not expect them to approve of taking Rapamycin yet. Doctors have a very specific job of applying evidence-based standards of care to your situation in an appropriate way. They don’t prescribe drugs because mouse studies look promising. They don’t prescribe drugs because dog studies look promising. They prescribe drugs because human studies have shown that the risk/reward profile is worth it in a particular situation. We will all be long gone before those studies are completed for rapamycin. Tell them, but be ready for them to think you’re crazy for doing this.

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We’ll said, but the overriding point is that most doctors don’t focus on prevention in general, not just in regards to rapamycin.
Suppose I gave this test to the majority of doctors. How do you think they’d do?
A. I usually check my patients vitamin D levels
B. I discuss the merits of coronary artery calcium scores
C. I regularly discuss the benefits of nuts, anthocyanins, and carotenoids as well as the benefits of resistance training along with aerobic conditioning.
D. None of the above
E. All of the above

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The majority would be “D. None of the above”

Much to my dismay, I’m afraid that you’re right.

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Same situation for me. I told my doctor i take rapamycin, got it from a vet and i told him i take it for mtor supression. He said, where do you get your dosage guidance from. I said Alan Green MD. He said, ok, as long as you know it’s off label use. And then he told me he studied mTor in school. Then we moved on. Although all my patient records now show that i take sirolimus and acarbose. It would show up if i went to hospital and they looked it up.

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