My CGM data while on Rapamycin

[wrap-a-mice-in]

Mini-update: No new CGM data since my last 2 needed to be replaced early by Dexcom.

But last week I took 1mg and saw no effect on my BS. I expected this since my 2mg dose seemed to stop affecting my BS after about 2-3 days which from my understanding is the half-life of rapamycin.

I took 3mg last night before bed but was not wearing a CGM so I have no updates yet. My replacements should be arriving next week so I’ll have data for the next dose. I’ll probably do 3mg again.

Also, re: the survey on this forum showing only ~10% of people reported glucose dysregulation, I wonder how many people simply didn’t know when they responded to the survey because they aren’t using a CGM and aren’t aware of the acute glucose spikes which even regular bloodwork wouldn’t show if the dose is low enough. It wouldn’t show up in FBG and only move the needle slightly higher for hba1c if they only had dysregulation for a few days.

[drjoanne1953]

I wear a CGM because I am a Type 2 Diabetic. I started rapamycin several weeks ago, starting with 1 mg the first week, 2mg the second & so on. When I get up to 4mg my Blood sugar was way out of wack so I backed off to 3 mg but my morning fasting Blood sugar is 150 . When I was not on rapamycin it usually stayed below 130. Is there any benefit in even taking rapamycin at 3 or 2 mg? I do not want to mess with my diabetes Any data on taking low doses of rapamycin?

[Beth]

I have questions about spiking and what is acceptable for good heart health, etc.

I just started wearing a cgm again, which I hadn’t done for a few months, and it does appear that my spikes are a lot higher again.

In general, I try to eat things that don’t spike my glucose too often because I seem to spike very easily (my first day wearing a cgm a couple years ago, I had Thai veggies, tofu and rice and went to 230-ish)

Since then, I started metformin. I rarely have oatmeal/regular pasta/bread/rice these days, and while I do have spikes, until starting rapa in March, by eating my restrictive diet and taking metformin, I most often have kept my spikes controlled in the 140-150 (not the case if I have anything I shouldn’t). But this has all changed.

I also started berberine last week.

My spikes don’t last but I am going well above 150 quite frequently.

My question is:

In your opinion, what level of spikes are ok before you take action? (Additional drugs or even less ‘cheating’ with crazy things like healthy berries). Some say high spikes are fine if they come down quickly, but no one ever says what ‘high’ is… or how quickly ‘quick’ is.

And for a deeper dive… how many during the day, how long, what is a good baseline? I tend to eat between 6am-4pm, so I’m all over the place during that time, but from 6pm-6am, I’m mostly near 100-ish. (I can’t tell exactly because unless I just haven’t figured it out yet, you can’t go back and look at specific times and exact levels with the freestyle libre 3… you can easily get granular with the dexcom).

PS, I keep putting off my post rapa bloodwork because it involves a 40 minute drive and skipping my morning latte, so I’ve been lazy about it! I will do that in the next two weeks

[Barnabas]

@Beth

you can’t go back and look at specific times and exact levels with the freestyle libre 3

If you go to LibreView.com and create an account, you can see some nice reports and even download CSV spreadsheets with granular data.

[Beth]

THANK YOU! I was googling and watched videos but never found this… appreciate it!

[ng0rge]

@Beth

I have questions about spiking and what is acceptable for good heart health

For some very good info on blood sugar spikes and CGMs, see my post (and thread) here:
https://www.rapamycin.news/t/good-energy-new-book-by-casey-means-metabolic-health-mitochondria-and-cgms/14530/8?u=ng0rge

It says - If you just want to hear Casey Means’ insight on CGMs (useful) go to the Huberman podcast above and listen to the segment from 2:19:30 - 2:33.

And here’s the link to the YouTube podcast to watch those 13 minutes.

https://www.youtube.com/watch?v=8qaBpM73NSk&list=PL_v7HcCd-Od9povq_lcxMV_iXZ_waSK0y

[Beth]

I just watched and that was very interesting!

I wish they showed concrete examples when discussing this because I’m still not sure how my numbers fit in here, or any other conversations. I hear them say, it’s ok to spike if you come down quickly… but if spike too high (what number is that?) and you come down quickly, it’s a crash and that is bad…

[John_Hemming]

There is a threshold for the spike at around 8/140 which means a different metabolic pathway is being used.

[SilentWatcher]

@wrap-a-mice-in

Also, re: the survey on this forum showing only ~10% of people reported glucose dysregulation

As mentioned by @Angel_Myers, CGMs from Abbott and Dexcom can be inaccurate in the lower range of 80-120 mg/dL. You can use a conventional blood glucose monitor to confirm this.

Additionally, I recommend looking into lithium supplementation.

Correcting lipid/glucose side-effect

I have reduced my intake of rapamycin to once every 2 or 3 weeks to stabilize the negative glucose effect. Currently, I view this glucose intolerance as part of the therapeutic effects of the starvation-mimicking drug rapamycin (Once again on rapamycin-induced insulin resistance and longevity: despite of or owing to; Mikhail V. Blagosklonny). There are some studies that point out that “combination of lithium with rapamycin canceled the latter’s effects on lipid metabolism” (A triple drug combination targeting components of the nutrient-sensing network maximizes longevity). In my n=1 experiment, adding lithium orotate substantially stabilized the glucose side effect (take 1mg daily and 2-3mg on rapa-days).

[RapamycinCurious]

@Correcting lipid/glucose side-effect

There are some studies that point out that “combination of lithium with rapamycin canceled the latter’s effects on lipid metabolism”

There is a study that finds that — in fruit flies.

[John_Hemming]

@RapamycinCurious

There is a study that finds that — in fruit flies.

Which is why I think we need a bit more of a focus on multiple N=1 biohacking.

[Beth]

John, are you saying that after 140 is when I should worry? I wasn’t sure what 8/140 meant (the ‘8’)

I guess I need to consider taking a higher dose of metformin or perhaps consider adding acarbose that seems to be very popular here.

[Barnabas]

I was confused at first too, but I think 8 is in different units. 140 would be mg/dL. 8 would be mmol/L.

[wrap-a-mice-in]

Last week’s 3mg was uneventful. I took it friday night before sleeping so I’d be in a fasted state before and after the dose.

This friday, I forgot and took it saturday afternoon after lunch. I waited until my BG was stable ~3 hours after the meal and took 4mg. After about 45 minutes I noticed my BG rose about 25 mg/dL and I had to exercise it off. When I sat back down it went up slightly again before stabilizing.

I think this is more evidence that taking rapamycin immediately shuts down or lowers insulin production in me and I should avoid taking it while not fasted.

First week, took 2mg 30 min after a meal → big spike
Third week, took 3mg in a fasted state and didn’t eat for 8 hours after dosage → no spikes while I slept
Fourth week, took 4mg 3 hours after a meal → small spike

[John_Hemming]

The strict conversion is 8 mmol/L or 144 mg/dL, but people tend to think of thresholds of 10 mg/dL.

Ideally, however, your body would keep glucose levels below the point at which I think the inositol pathway gets engaged. A quick google search did not find a good reference for this. If people want one I will put some time in. I probably recorded the reference when I found this useful bit of information.

[Neo]

@John_Hemming

this. If people want one I will put some time in. I probably recorded the reference when I found this useful bit of information.

Yes, that would be very valuable John!

[John_Hemming]

This comes from starting with the Polyol pathway and Chris MasterJohn has written about this here:

323: Why Should Postprandial Glucose Be Kept Under 140 mg/dL?

When blood glucose rises above 140 mg/dL, this is the approximate point at which it spills into the polyol pathway at a greater-than-normal rate, which represents a suboptimal state of metabolism that is likely to hurt antioxidant status and compromise detoxification pathways as well as the recycling of vitamin K and folate. It must be kept in mind that a healthy person will adapt to glycemic loads they consume regularly. Thus, a one-time spike above 140 mg/dL should never be used to conclude anything whatsoever. Only repeated spikes above this level with repeated consumption of the same glycemic load over several days to several weeks should be used as a cause for concern.

This may be better as well

So polyol pathway is why glucose should always be kept under 140?

​ Quote Question: Why should postprandial blood glucose be kept under 140 milligrams per deciliter? Short Answer: When blood glucose rises above 140 mg/dL, this is the approximate point at which it spills into the polyol pathway at a greater-than-normal rate, which represents a suboptimal state of metabolism that is likely to hurt antioxidant status and compromise detoxification pathways as well as the recycling of vitamin K and folate. It must be kept in mind that a healthy person will adapt to glycemic loads they consume regularly. Thus, a one-time spike above 140 mg/dL should never be used to conclude anything whatsoever. Only repeated spikes above this level with repeated consumption of the same glycemic load over several days to several weeks should be used as a cause for concern. is it also bc glucose is converted to fructose in the pathway? ​

[Karl92651]

Glucose will increase with stress, and rapamycin seems to simulate stress in the body. I wonder if the increase is similar to the increase you see with stress. When diabetics are stressed, it is difficult to control their glucose. Any non-diabetics out there using a continuous glucose monitor and taking rapamycin?

[Beth]

That would be me. I’ve had a couple conversations with my doc this week because my cgm is showing my rapa is causing very abnormal spiking… I’m prone to it anyway and take metformin, but it’s nuts since rapa (it’s what it was before starting metformin)

[Beth]

This is very helpful, thank you!
After texting my doc my cgm data showing my spike going over 200, we just talked and he suggested instead of taking metformin twice during the day that I experiment with taking it before bed. I didn’t understand why but he explained when taken before bed, it can help affect cortisol in the morning. Doing that might help me self regulate all day. I don’t really understand it nor do I need to, but I’ll give it a shot. If this doesn’t work, we will then see how I tolerate acarbose (he said gi effects are likely). Thoughts?