Dr. Kaeberlein's Optispan Podcast Series - Rapamycin and More

In the animal studies that I have looked at rapamycin while inhibiting muscle hypertrophy, also limits muscle loss and helps prevent sarcopenia in all dosage regimens.

" Inhibition of mTORC1 with rapamycin prevents age-related muscle loss. Consistent with the observation that the hyperactive mTORC1 induces muscle damage and loss, inhibition of mTORC1 activity with rapamycin or rapalogs protects aging muscle from atrophy in mice and rats"
Rapamycin protects aging muscle - PMC)%20Inhibition%20of%20mTORC1%20with%20rapamycin%20prevents,muscle%20from%20atrophy%20in%20mice%20and%20rats.

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Be careful with a dose like that as it may put you in the immunosuppressive range of around 5 ng/mL. See this thread for more info. I just switched from 6 mg weekly to 1 mg every other day and plan to test my serum levels after a couple of weeks and every so often to be sure it never goes too high.

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This post in particular: Trying a daily Rapamycin Dose Change - #32 by MAC

The fact that people think rapamycin suppresses the immune system is mainly based on its use for kidney transplants.
There is no evidence that I can find that taking rapamycin in the doses that forum members are taking suppresses the immune system, quite the opposite.
Check out the latest Mat Kaeberlein’s YouTube video where he extensively talks about rapamycin and the immune system.

Rapamycin’s SURPRISING Effects on Aged IMMUNE SYSTEMS

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That study is just about correcting over active mTOR by testing with TSC1 knockout mice. So, yes, over active mTOR as commonly seen in old age does cause sarcopenia and that’s why we use rapamycin to tame that over activity.
“Consistent with the observation that the hyperactive mTORC1 induces muscle damage and loss, inhibition of mTORC1 activity with rapamycin or rapalogs protects aging muscle from atrophy in mice and rats.”
“We believe the ultimate effect of mTORC1 depends upon: 1) how mTORC1 is activated, and 2) for how long mTORC1 remains activated. Akt-dependent, short-term activation of mTORC1 appears usually to be beneficial to cells, whereas Akt-independent, chronic activation of mTORC1 appears to be detrimental to cells. It is well known that mTORC1 is an important anabolic regulator that is essential for cell growth, regeneration, and maintenance of muscle mass,”
“Additional work building on these studies needs to be done which would include: 1) Developing selective mTORC1 inhibitors. Selective mTORC1 inhibitors may minimize side effects that may result from rapamycin-induced suppression of mTORC2, a known activator of Akt. 2) Developing optimal protocols for rapamycin treatment. Optimized dose, dosing frequency, and dosing intervals may help achieve maximum beneficial effect.”

This paper does not say that. It says that rapamycin when used to correct over active mTOR can prevent sarcopenia but that it is very much dose, frequency and interval dependent.

Agree with that, but your idea of taking 1 mg daily will likely get you to what is considered an immunosuppressive serum level of about 5 ng/mL. It’s not at all equivalent or similar to taking 6 mg/wk due to the half life and pharmacokinetics of daily dosing. Read that whole thread I posted above and you’ll see - this post in particular: Trying a daily Rapamycin Dose Change - #32 by MAC

Searching more for “rapamycin and sarcopenia” mainly yields that the the over-activation of mTOR in aging is a major cause of sarcopenia and that use of rapamycin to rebalance mTOR to normal functioning and prevent sarcopenia is a major benefit. However, the questions of dosing, frequency and interval are not resolved.

" While chronic mTORC1 activation is clearly undesirable, acute, temporal increases in mTORC1 activity are important for many processes, including adaptive muscle growth, as well as peripheral nerve regeneration and myelination. As such, rapamycin may inhibit repair processes or remyelination in aging nerves, and thereby exacerbate some deleterious signaling in sarcopenic muscles."

https://www.nature.com/articles/s41467-020-18140-1

"The research team also examined how rapamycin affected the appearance and health of the muscle tissue. The researchers used different doses of rapamycin, referred to as LD (low dose) and HD (high dose), to see which was more effective. The low-dose treatment turned out to be the key. It led to increased muscle mass in aged rats and more healthy muscle morphology, with other positive molecular changes supporting this growth.
In the low-dose RAD001-treated rats, they observed:
An increase in average muscle fiber size, indicating muscle growth.
A reduction in very small, misshapen muscle fibers, a sign often linked to muscle atrophy.
A significant decrease in muscle fibers with central nuclei, indicating less muscle degeneration and regeneration.

The high-dose rapamycin treatment did not provide these benefits, emphasizing the importance of finding the correct dose."

https://gethealthspan.com/science/article/rapamycin-muscle-growth-glass-lab-sarcopenia

" The fact that rapamycin-treated mice are able to compensate for the reduction in mTORC1 activity suggests a number of possibilities. First, it may be that only a small fraction of normal mTORC1 activity is required to maintain mitochondrial function, and that higher or continuously delivered doses of rapamycin, or more potent mTOR inhibitors, will indeed cause overt mitochondrial dysfunction. In support of this, Cunningham et al detected a reduction in the respiratory capacity of soleus muscle (but not gastrocnemius muscle) using only a slightly higher dose than the present study (2.5 mg/kg in 6-week old Balb/c mice,. In these experiments, we have focused on skeletal muscle because the impairment of mitochondrial biogenesis by rapamycin has been previously demonstrated in myotubes, which is consistent with our own findings, and because mTORC1 inactivation has been shown to cause mitochondrial dysfunction in muscle in vivo. Although we also observed no significant effects of rapamycin on the expression of mitochondrial components in the liver, we cannot exclude the possibility that rapamycin may impair mitochondrial function in other tissues or cell types."

https://www.aging-us.com/article/100576/text

This recent post by @RapAdmin in another thread is very applicable:

https://www.rapamycin.news/t/ultrarunning-rapamycin-and-recovery/12955/9?u=ng0rge

From @RapAdmin

“Here is the fundamental trade-off / balance that we are trying to identify the optimal level for: the short-term decrease in mTORC1 / muscle protein synthesis will (in the period immediately following dosing) result in lower levels of muscle growth and regeneration. But, in the long term the periodic inhibition of mTORC1 will increase the lifespan/healthspan of our muscles.And I should mention also, that for most of us who are not elite athletes competing in the Masters series, or exercising 20 or 30 hours a week, this doesn’t really apply. We are not going to notice the minor hit of a once a week or once every two week dose of rapamycin on our muscle growth and regeneration.”

I think that this speaks directly to the tradeoff between daily and weekly/biweekly dosing. Elevated mTORC1 does some good things and we need to be careful about how much and for how long we inhibit it. There can be “too much of a good thing”. I personally would be wary of daily dosing. Matt Kaerberlein, who knows as much as anybody about rapamycin, is being even more conservative by taking “vacations” from his weekly dose. I’m taking note.

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I agree. Watching an older (2 months ago) video with Krister Kaupi and Joan Mannick seems to show; that with Everolimus at least weekly dosing produces fewer side effects.
So, for now, I will stick with my weekly dosing

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I’m not saying daily dosing is bad, just that 1 mg daily might be too much if you want to to avoid immunosuppression. I am currently taking 1 mg every other day, aiming to keep my serum level around 2-2.5 ng/mL and hoping it improves my immune system more effectively. Weekly dosing and the swings in sirolimus levels did not agree with me (had rashes, joint pain, and flares of an inflammatory condition).

Add your questions at this location:

https://x.com/mkaeberlein/status/1772313123703373975?s=20

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It’s good to see that Matt Kaeberlein Optispan channel is gaining traction - he is one of the most knowledgeable scientists in longevity field

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Matt Kaeberlein is inviting those interested in rapamycin to send him questions or topics they’d like covered in future episodes of his rapamycin-focused Optispan podcast (which has been excellent so far). They can be posted on his X page or in the Optispan comments on YouTube. He says that he and his team read every comment.

https://twitter.com/mkaeberlein/status/1772313123703373975

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This is a very good talk. Added to my understanding of rapamycin and senescence

My notes from the rapa discussion near end of podcast

Sapere Bio co-founder and CEO Natalia Mitin experience with Rapa and impact on immune function and related cell senescence (via sapere test)

1mg/wk. then +1mg each week to 5mg
Felt more energy after 1 week. Faster recovery from powerlifting. Lift heavier.
Better brain function…cognition much higher level.

10 weeks then stopped. Felt a decline after stopping. Went back on for 1 month. Felt stable afterwards.

After a few months of washout, started to feel joint aches again. Restarted at 3mg/wk.

Took senescence test before and after (both times). T-Cell exhaustion was improved at 3mg dose but not by 5mg dose. The lower dose was better.

Rapa Improved immune function but not bulletproof. Caught COVID at one point after the rapa experiment and had a collapsed lung. While using rapa, lipids and blood glucose didn’t change but hemoglobin increased.

Kaeberlein says the dose of rapa that provides the best effect on immune senescence can be different from dose that provides best effect on other tissues.

My conclusion: have a goal, measure the effect of rapamycin on progress toward goal, adjust dosing (frequency?) and recognize that a lower dose might be better. This adds an important dimension to the Blagosklonny “high as possible without side effects” thinking. My thinking has definitely shifted with this info.

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THis makes sense.
A lot of medical treatments consists of induction phase (usually by using higher dose of treatment to achieve some desired effect) and maintenance phase (self explanatory).

I wonder if this would apply to rapamycin. Mannick study was only couple of months with the endpoints met… would those patients still benefit from same dosing or would it be better to drop the dose to maintain the effects???

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Matt clearly admitted on his podcast that he has no idea what he’s doing and he’s just purely experimenting.

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Impossible to give this tweet enough likes.

Well said, sir!

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Yikes. Has anyone here signed up?

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Here is a link for practitioners to participate in the use of Saperex testing with their patients.

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