I will start rapamycin regimen shortly

I decided to start rapamycin for longevity shortly. It started with my aging dog. He is a 11,5 years old and started to age rapidly in the last year, especially his walking endurance is diminishing and I searched if I could get something to help him with his aging. I ran into rapamycin study and this forum few weeks ago. My husband is a doctor so I can get rapamycin prescription and with going further and back on this topic for few weeks with him, he said he can prescribe it. I have been reading this forum for a while, checked many topics but there is so much information. I am 47, male and in the last year noticed that i get much more tired and need a lot more time to recuperate after physical or mental activity. Reading this forum I realized that effects of aging may be at least kept at bay if not reversed to a certain extent. I would like to check if I understand rapamycin regimen for longevity correctly:

start with 1 mg once a week
progress with increasing the dose 1 mg each week until you reach your target dose (5-10 mg weekly)
(I intend to go for 6 mg)
after you reach your target dose take it for 8 weeks and take 4 weeks off, repeat.

do I understand that correctly?
what test or considerations are crucial at the beginning? which blood tests should I get and what should I consider checking along the way?

I am also considering taking other stuff. I am still out on metformin or acarbose leaning towards taking acarbose… I work out 3-5 times a week and feel form information gathered online that metformin would not be best choice, what do you think? I am considering acabose 50 mg 3x daily

I also consider taking proviron (mesterolone) to boost my free testosterone. Does anyone have any experience with this? I am cosidering taking 25 mg 2x daily. The main rationale was, that it has low liver toxicity and it it easy to take as it is in pill form.

I am also considering taking this Anti-Aging Supplement NAD+ Complex AEON with Nicotinamide, Fisetin, Quercetin, Resveratrol, Astragalus, and more. – Perpetua.Life

I have been taking collagen peptides since 2016, I have been using retin-A (0.05%) since 2016 too.
Reading blueprint regimen I am considering adding some cocoa (high flavonoid variety adding 500 mg flavonoids) and chlorella powder (10 g = aprox. 9 mg of spermidine) to my collagen morning drink.

What do you thing guys? I really appreciate all your help!

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Welcome to the forum.

Instead of taking a pill that makes you fart out carbs I would just not eat the carbs in the first place.

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haha I see where are you coming from, but years ago I tried low carb diet, later I tried paleo aproach, but it is not long term sustainable for me. I like food, I am a foodie, and I like carbs. I try to eat a balanced diet, avoid sugars and excessive carb meals and eat at around 5-15% caloric deficit with around 30% of calories from plant and animal sourced protein. I eat sugar (other from naturally present sugar in fruits) really, once or twice per week… but life without bread, pasta and potatoes (even if I eat this really in moderation considering above) would be a hell for me…

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I too like carbs, pasta - baked potatoes run through the garden - heavy butter and sour cream with cheddar cheese. No heart plaque so going to enjoy it!

Acarbose works for me - on it now almost 4-months. For life extension in rats - lol… it gets the biggest life extension bang - rapamycin and acarbose rule for now.

The drugs with the strongest medical research behind them, with the greatest benefit are:

  1. Rapamycin (up to 15% to 18% lifespan / healthspan improvement if started in late life)
  2. Acarbose (up to 12% to 18% lifespan / healthspan improvement if started in late life)
  3. Rapamycin with Acarbose (up to 37% lifespan improvement if started in early life)
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Hi and welcome to the site. Your approach sounds fine. The whole issue of “vacations” from rapamycin (periods of multiple weeks off from your regular schedule) is still debated. I don’t think most doctors recommend this right now (of those that prescribe), so its an option you can take if you want to be extra cautious. I’m not sure what percent of our forum members actually do this… I think its a minority now.

As far as pre testing (before you start rapamycin) and post testing (after you’ve been on it for 3 to 6 months), I recomend you check out these threads for some ideas.

Here is a really good example of pre and post testing to see the benefits of rapamycin, from a blood test perspective : My Lab and Fitness Results After 3 months of Rapamycin Use

and here: 35 Year Old Active Dude wants to give rapamycin a shot, what metrics to track?

See here too: Pre Rapamycin Lab Work Recommended?

here: Blood Tests and Biomarkers pre-Rapamycin

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good! thank you for links and info! will look more into it…

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Today I got my prescription for rapamycin filled, got some acarbose too. I have my appointment with my primary care doctor in two weeks, so I am reluctant to start with both before getting my blood tests… now that I have the box of pills on my desk it is getting real.

After doing some reading I am thinking of taking rapamycin in 10 days intervals. Starting with 1 mg and increasing the dose to 6 mg every 10 days. I will report back when I start and how it is going. I am pretty excited but a bit scarred at the same time.

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An alternative to acarbose is canagliflozin or empagliflozin. The side effects of acarbose are supposedly pretty bad. Canagliflozin is supposed to have fewer side effects, and empagliflozin still less. I plan to start taking empagliflozin soon.

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I had the same thought but as @RapAdmin pointed out to me this statement may not be entirely accurate as per this thread:

I have started acarbose in the last 48 hours and have to say for me the gas side effects haven’t been that noticeable. But yes your mileage will vary person to person.

Having said that I may combine both acarbose and empagliflozin at some point but need to monitor to make sure i don’t get hypoglycemic.

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Thanks for pointing this out. Fair enough, it may well not be a 1 to 1 replacement. The post by Dr. Rami is focused on peak glucose levels, but that may not be the source of the beneficial effects of SGLTs.

I find it very difficult to find and sift through all the endless threads on this topic, especially when one thread is abandoned and the conversion resumes in another thread, but here’s a good synopsis I found in one of them with links to each of the threads:

Now I’ll have to get some acarbose to try!

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Today I took my first dose of rapamycin. 1 mg in the morning. I felt a little nauseous for an hour afterwards, but I took it on empty stomach… now, few hours later I feel little fidgety, like if drinking too much coffee, but had none in the morning. That is all I have to report on this firs day. My dog (the older) took 1 mg as well. The younger dog I am keeping off rapamycin atm. Maybe we will add it later, depending on the older’s reaction and effect.

Yesterday I took blood tests and was having a general physical at my GP. I told her about rapamycin, she was a bit skeptical, but said that if my husband will supervise and prescribe it to me, probably it will be ok. We have another appointment next week to see the results of all tests I did yesterday.

Next week I am considering adding some other supplements to my daily stack, but nothing mayor. Just some spermidine, NMN, some different flavonols… I have my acarbose recipe filled, maybe I will slowly introduce it, starting with 25mg with each meal and gradually increase it to 100mg.

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I really felt tired in the evening and had a strange headache. I am usually a “headeachy” person, but this headache felt differently. I had a very deep sleep (my apple watch agrees, deep sleep was up from average 30 minutes to almost full hour at 55 minutes), but woke up quite early, slept just 6 hours and 15 minutes.I feel rested and I am ok today. I noticed yesterday my RHR increased from my average of 55 to 65… today it seems a little higher as well.
I think all three side effects are usual. I am just wondering how it will be when I increase the dose.
I also scratched yesterday skin on my hands in the morning, had a red rash in the afternoon, but everything calmed down and healed really nicely overnight (did not use anything). Even scratches are gone… (they weren’t deep, I scratched myself with course sandingpaper)…

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Second dose, nothing much to report. Had a slight headache the next day, could be also stress related. I was kind of tired over the weekend, but good tired (once I read on this forum “after sex tiredness”)… I had also a lot of energy, did some things I was postponing for weeks. So all good. Today I went back to my doctor, to see the results of all the tests I did two weeks ago. Everything normal, have slightly raised levels of HDL (total cholesterol is well under) and Urea. I calculated my Levine phenotypic age, which is 33, Aging.AI.3.0 puts me at 21 years old (I am almost 48).

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ugh… I must have forgotten about this, but my T levels dropped since my last test few months ago and I am now officially diagnosed with hypogonadism (total T below 239), doc is sending me to do MRI of the brain and do all the endocrinology tests and after that probably TRT.

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Was the lower T level independent of your rapamycin use, or do you think it is related?

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It has been for a while that has been low, never dropped below 350, usually around 450, which is still low, but not that low. I took that last test after the first dose, so I can’t be sure whether rapamycin had something to do with it. But have been struggling with feeling tired and lack of energy since December, stopped working out for almost two months, because of a really bad case of RSV in January… I wouldn’t really blame rapamycin.

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My doctor retested some hormones today, got the results back, did not consult her, seeing her next week.

T is up from 233 to 349
free T is 7 (2,01%)
calculated free T is 7,23 (2,07%)
T is still low, free T also, but at least it is improving. I started working out again, maybe this helps and maybe three weeks on rapamycin could have helped or at least didn’t hurt it. I am hoping it will help if not I will consider TRT in the next months.
LH, FSH and SHBG all in normal range.
The problem is that prolactin is slightly raised. Normal range for men cut off is at 15 mine is at 23.
Any ideas how to lower prolactin? It is not in prolactinoma territory, but still…
On Wednesday I am having MRI just to confirm there is no tumor or cyst in the brain that could be responsible for raised levels…

Oh yes, the third dose. Had some raised RHB for an hour or two afterwards and I feel this strange mixture of relaxed, tired and energetic. Nothing else to report here. Dog had his first fight in years today :face_with_open_eyes_and_hand_over_mouth: Last years when we go for a walk he is like, let’s go home, I am done. But these days he is not done… definitely more energetic.

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Not saying this is the case here, but just so you know in case you want to do more prolactin bloodwork:

Something like this happened to me too, and then it turned out to be that the prolactin Labcorp test has issues if you supplement with one of the b vitamins (can’t remember which one it was, was part of a b complex I was taking). When I later re-tested while having paused the b vitamins the prolactin went back to normal.

I believe there also is a Quest test that uses a different type of assay that we also used for the retesting and that one also was in the normal range (and was supposed to not be sensitive to the b vitamin in the same way).

(This may be similar to another thread on the forum that discusses that some other hormone tests have issues with specific b vitamin supplementation too close to the blood draw).

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thx.
My husband agrees that I should retest (he is an MD) and that is not in the hyperprolactinemia range, not even moderately elevated range yet. He said it could be diet (also supplements) or too much protein in diet as my urea is slightly elevated as well which points that I could be eating too much protein (and I do eat a protein rich diet at around 1 gram per pound) and me cycling to the lab might elevate it even little further and he would not be concerned at this point…

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Update:
I took two more weekly doses, now I am at 5 mg weekly. I think I will stick with this dose for a while, might increase it to 6 mg later but I am wary at this point, I will explain below.
First some measurable benefits (I wont be planning any blood test for another two months to not be disturbed by intermediate changes that rapamycin produces and might delay this first test even further not to worry too much if changes happen that would point in the wrong or undesirable direction). Since I am taking acarbose (lately increased to a full dose of 250 mg daily, 100 mg at breakfast, 50 mg lunch and 100 mg at dinner, my lunch is usually more of a snack and usually not carb heavy, breakfast is actually brunch, usually I have granola, oatmeal or bread, sometimes pancakes, waffles or crepes, brioche, croissant, so it is carb rich, dinners are mixed, but I tend to have a ot of vegetables for dinner so no matter if there are lot’s of obvious carbs like pasta/rice/potatoes or not I take 100 mg) some things I am seeing could be effect of acarbose as well. Acarbose is giving me almost none noticeable unwanted side effect, had some increased flatulence at the beginning, similar to when eating fibers, but since this has almost unnoticeable. I got my prescription filled for empaglifozin, but haven’t started yet. Might hang with the idea for few weeks more and do the risk reasearch more in depth.

To return to measurable side effect (wanted and unwanted):

  1. My sleep score is better (my deep sleep time almost doubled) but I sleep considerably less, almost 1 hour less in average, and wake up rested in more energetic. I am a bit concerned about the one hour less total sleep, but might be just seasonal…

  2. my HRV is up 10 points in average since starting rapamycin (on day that I dose and following day it is really high… this is somewhat strange as it really jups to 70-100 and then drops to 30 and then stabilizes at around 45 before the next dose, but still average is up… previously it was more constant, the daily variations were not that high). It is dose dependant, the more rapamycin I take, the more HRV goes up on the dosing day and subsequent days.

  3. My body fat is melting. I noticed fist changes in body composition when I measured my body fat with Navy Fat Calc @Kandice shared a while ago, since then my body scale also showed a drop in body fat of 2,5% and it is visibly starting to show. I did not change my workout routine or diet (maybe I even increased caloric intake some). My weight seems to stay more or less same. Seems ridiculous amount in that short period thinking how hard it was for me to loose 10% BF from 25 to 15% and how it was almost impossible to move down form that with my current diet and workout routine and my T levels. I take acarbose had something to do with it as well.

  4. My stools have become regular, daily… this is something I never experienced in my life, usually I would have them every other or third day, no matter how much fiber/exercise or water I would drink. Now it has been like schedule every morning. Might be the rapamycin or acarbose or combination.

  5. my VO2max dropped almost 3 points (as measured by my apple watch) since starting rapamycin, this is quite worrying, I also noticed that my endurance is suffering as well, not that is worrying me at this point, but I just noticed it and in connection with measured VO2max it is something to keep an eye on.

The above were measurable. Personal observations seems that I might feel less muscle/joint pain (I had this almost “fibromilagic” pain in my body since I was 6 and had an unknown thick infection…) but since taking rapamycin seems a little dulled… especially on the first three days after dosing. Might be placebo or it might be rapamycin. Who knows at this point.
Since starting rapamycin I developed this knee pain in my right knee that I never had before and it is sharp, sometimes almost not noticeable but sometimes really sharp… never had it before, also I don’t remember injuring my knee… the pain started suddenly, like it came out of nowhere and it is persistent (almost third week). Might be rapamycin, might be random.
Two other things seems to bother me and might be rapamycin connected. I suffered from chronic tonsillitis and sinusitis years ago. I haven’t had an active infection in years, but my tonsils and sinuses don’t seem to like me taking rapamycin. Tonsils are chronically enlarged but seem a bit bigger and painful (low grade pain) since started rapamycin and pain seems dose dependent, the more I take, the more it is pronounced. With sinuses I noticed that since few weeks my nose is borderline stuffy all the time, feels like my nasal mucosa is enlarged/swollen. Could this be rapamycin? Might be also spring and allergens in the air that contribute but I never had seasonal allergis in spring, I tend to have seasonal allergy in late summer/autumn (allergic to wormwood).

This is for myself. Dog is taking his rapamycin weekly too. Seems more energetic and interested. Behavior I thought is gone has returned, some of that behavior is also “unwanted” but seems that he feels stronger and more energetic. He is very stubborn dog at least he was when he was young. Last few years he seemed to be loosing this trait, but hey since on rapamycin it is returning in full force. When he was younger when unleashed he would just go and loose himself exploring for 15-30 minutes at the time, that was not the case in last few years, but that is back too. He has chronic arthritis, so he was not really active in last years for that, but since rapamycin he started first to whine (showing that he wants to do something)… lately last week whining stoped but he is more active in doing stuff. If I give you an example, he comes at the door and greets people, last two years he would not come to the door, maybe just raise head on the couch or not even that. Starting rapamycin he would whine laying down when someone was at the door, since last week he stands up and comes to the door. Same with me prepraring food in the kitchen. Last two years he was uninterested, since rapamycin I could hear him whining on the couch if he smelled something form the kitchen, last week, maybe two weeks ago I noticed him coming to the kitchen with a face, I noticed you have something good here, would you care to share it with me…

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