From several practicing doctors on the internet I heard that a physician can prescribe anything, if they consider it beneficial for the patient.
This aligns with the Hippocrates Oath, which states that a doctor, by the level of their skills and knowledge, must do everything possible* to eliminate the cause of pathology and must use state-of-the-art medical knowledge to do this. So rapamycin prescription for aging (e.g. chronic inflammation, or [find a symptom writable on a prescription]) aligns with this.
So the only reason a doctor does not prescribe rapamycin for conditions mentioned on this forum is that they don’t have enough knowledge and don’t follow state-of-the-art medicine (3.0 etc). Is it worth trying to offer to sign up some patient’s agreement form? By which you confirm that you understand all risks and agree. Like, in some cancer cases (probably when standard treatments do not work) a patient has the right to try experimental treatments and signs a similar agreement form (and the doctor must inform about such options). And you just tell the doctor, like let me be your first rapamycin guinney pig, here’s the dose, here’s the schedule (if you don’t know the ones used on this forum), prescribe it e.g. for chronic inflammation.
I haven’t yet ditched my local medical laws regulating patient’s treatment but I am sure I could find exact formulations, which will justify the prescription of rapamycin for aging and conditions mentioned on this forum.
As both in the US and the EU there already are physicians prescribing rapamycin for aging. Why can they legally do it while rapa is not yet approved for aging-related conditions and others do not?
*To determine what’s actually possible is another topic, but you could also ask about how would you determine that something is possible? Based on a big bunch of previous observations? But we have e.g. N.N.Taleb’s work (Fooled by Randomness, Black Swan etc), for example, showing that informational things with the biggest global impact do not come from a big bunch of previous observations.
I think it comes down to a risk/reward calculation by the doctors (at least in the USA). Rapamycin is not an “evidence-based” treatment for aging yet. Minimal human trials so far, so it’s mostly based on pre-clinical evidence. If doctors do off-label prescribing and something bad happens, there is a lot of risk of legal liability… so most doctors don’t want to go near rapamycin yet. It’s a simple calculus… small incremental gain (revenue, new customers, etc.) and large potential loss (of medical insurance, practice, customers, etc.)…
Doctors in the US can “legally” prescribe rapamycin off-label, but that doesn’t mean they are free of legal consequences if things go wrong. I was talking to a longevity doctor a few months ago about prescribing rapamycin, and while he said he had some significant interest, its not much of a money maker for him; its not like they make much money from prescribing rapamycin… they would much rather sell you a monthly prescription to their longevity health testing and monitoring services where they evaluate you holistically and optimize your blood markers and health, vs. a point drug prescription for a small amount of money. Sadly, rapamycin prescriptions don’t have much economic incentive behind them for doctors. Even if it may be a huge helper to patients.
“Doctors in the US can “legally” prescribe rapamycin off-label, but that doesn’t mean they are free of legal consequences if things go wrong.”
This is the point of patient’s agreement form I mentioned. If a patient agrees to some experimental non-approved treatment, a doctor may not fear legal consequences if things go wrong. Do oncologists prescribing experimental treatment for cancer cases bear any legal liability?
You probably mean some private practices. I mean healthcare covered by social insurance for which I am paying taxes. And at least in my EU country the doctors in this healthcare generally may not make much money from prescribing rapamycin, as they get some government fixed wages.
But it was strange for me to hear from Peter Attia on a podcast that only 10% of his patients take rapamycin. As ~5 mg weekly dose has been established as a minimal standard for enough benefit (especially with grapefruit juice) and minimal risk and the information on this forum and in trials on rapamycin can be a huge placebo efficiency-boosting wrapping.
In actual everyday life patients do not perform placebo-controlled randomized trials on themselves, they always know the drug they are taking. And in practice doctors do not first offer placebos to patients and then the drug. So the standardized information on people taking rapamycin for aging should have at least the same validity as placebo-controlled randomized trials.