I’ve started at 14 mg once per week, 2 mg over what I took prior to the compounding pharmacy mess.
I should have everything on track, but the experience piqued my skepticism, so I had a test done.
Because of access to the blood draw and scheduling I had blood taken 48 hours after my weekly dosing (of 14 mg). Not looking for maximum or minimum levels. I just want to make certain I get reasonable levels.
Results → Sirolimus, Lc/ms/ms (mcg/L) = 4.6
Does this give me the blood levels I should expect taking US sourced generic Sirolimus 48 hours after dosing?
Probably a month or more before the rapamycin kicks in again, but I had the following tested as well:
Yes - that dosing seems correct for the dosing you took and the timing, 48 hours after dosing. Here (below) is the typical graph from a test they did with healthy volunteers. (this is dosing measured by people’s surface area, so you need to do a little work to translate that to mg/kg which might be easier for you to compare to your own dosing and weight.
Of course - that just means you have effective sirolimus. We don’t really know much in terms of what the optimal dosing in healthy humans is for longevity purposes. More reading you may want to do on how and why to take the blood/sirolimus test (you may also want to do a trough blood test just before your next dose). How to get a Rapamycin (sirolimus) Blood Level Test
This is most likely the 10-year risk calculator that cardios typically use. Peter Attia is not a fan of it, arguing that we should be calculating 30-year risk if we are interested in longevity. The argument goes that if we were smokers, we should keep smoking until 10-year risk for lung cancer reaches a certain threshold
Some of what you are seeing could be related to the timing of the test after dosing with rapa. I recently got my lipids tested 7 days after and 4 days after dosing (7 mg). My ApoB was 27% higher 4 days compared to 7 days after (75 and 59 mg/dl, respectively). I also got Lp(a) tested both times, and Lp(a) was about 13% lower at 7 days compared to 4 days (193 and 170 nmol/L, respectively), which was interesting because I thought it wasn’t supposed to change much. I still have high Lp(a), so I plan to go to a cardiologist next week and hope to get put on a statin to lower ApoB. But, they may not do it because I’m still at a very low risk due to my numbers and age.
Anyway, you might see significantly lower ApoB if you test 7+ days after your dose. But, if it’s chronically elevated due to rapa, I’m not sure that’s good.
Since I started rapamycin at relatively high doses my lipids shot way up compared to levels before taking rapamycin. Over time, I have been convinced by “Dr. Lipid”, https://twitter.com/Drlipid, and others that keeping lipids within the recognized “normal” range is beneficial. Many cardiologists think lower is better.
After attempting to lower my lipids using Lipitor (atorvastatin) and not wanting to up the dosage, I tried several supplements that are supposed to help lower lipids, but they did not help that much. So after 18 months of rapamycin, I lowered my dosage to 5mg weekly taken with EVOO.
On 5/30/23 I added Pantethine (Coenzyme A Precursor) to my daily stack. This was suggested by John Hemming, but I believe he takes it for other reasons.
So for this test period, I have been taking 40mg of Lipitor after supper and 600 mg of Pantethine. first thing in the morning on an empty stomach.
Wow, I didn’t think this combo would lower my lipid levels so much.
No other supplement combined with Lipitor has had this much effect.
My blood glucose levels are still borderline.
Since I have been on average to higher levels of rapamycin doses for 18 months, I think I will self-experiment with taking a “maintenance” level of rapamycin. LaraPo has been taking 1mg daily if I recall correctly, and one week off. I will try 1mg daily for 5 days then 9 days off.
I am taking berberine, citrus bergamot, cinnamon, and chromium at twice the recommended doses, but they don’t seem very effective. I also take metformin with my rapamycin, but not on days I am not taking rapamycin.
I’m not sure whether you’ve said how old you are. If you are 80, I would be comforted by zero CAC score. If you were 55 or less, then you are among the 75% who also have a zero CAC score. But if you have a genetic predisposition to high LDL, I would find a different doctor.
I think in my case the pantethine seemed to work synergistically with the Lipitor.
As I mentioned I am going to discontinue Lipitor and see if the pantethine alone will keep my lipids in the low normal range. For the immediate future at least I am going to get my bloodwork done monthly.
Here is one older paper. Pantethine seems to have many benefits.