On the sebaceous cyst issue. Some clarity here because sebaceous cysts typically have absolutely nothing to do with UTIs.
A sebaceous cyst is initially and usually not infected. They are very common and are basically a sweat gland that gets trapped under the skin and overtime builds us a cheesy substance in a lined cavity. (This is my attempt at layman definition). The back is the most common place.
This often persists for years until they are annoying enough to remove or they become infected. Once infected, they become symptomatic beyond cosmesis. They almost never require hospitalization and frequently respond to antibiotics alone but I&D is frequently helpful. We don’t generally refer to that as surgery. Excision of cysts are often done but usually after the acute infection.
They are in no way associated with the urinary tract. They are from skin. Now, if you get bacteremic from a UTI, then that could potentially infect the cyst although this is not generally something that happens. If you are bacteremic, this is a non serious outcome but there are much worse outcomes.
Now, another option is what I might call the distracted immune system where a cyst with a few bacteria living there is allowed to flourish when the body is sick fighting a UTI. Unrelated to bacteremia. We are this with surgery where people get unrelated infections in the first week after the procedure.
Last option is a mis labeling of a Bartholin’s cyst as a sebaceous cyst. These are still different but more closely related. These cysts are just inside the vaginal wall.
I don’t know where you have read the horror stories since the very first horror one I ever read is your story. That is not to say there aren’t any, but at least I haven’t read/seen one yet.
I have been on 12.5mg EMPA for past two years with no side effects that I can tell, and not much change on FG either. My HA1C is stubborn at 5.2 and has been there pre and after Empa. I also do Metformin 1000mg DR and acarbose with main meal and my FG moved from around 105 to mid 90’s. I’m really surprised that my FG and Ha1c haven’t moved much with all these diabetes drugs I’m taking, good news though is that I’m not diabetic nor pre-diabetic and never was. Because If I were I am not responding much to these drugs, so I’d have to look for something different.
Most of us do antibiotics the day we take rapa, so no need to wait for infection. The day of my rapa i take 100mg doxy and same the next day, then I take 25-50mg daily after. Never had an infection problem since I started this regimen.
not at low doses. apparently, there is some people on these boards that haver been taking doxy 100mg for last 20 years and they said they’ve had no issues. I myself take it only two days at 100mg, then at 25-50mg which is considered sub antibacterial. Actually I’ve only been doing it this way continuously for last three months, but I used to take it 100mg with Rappa for last 3 years on and off and. so far nothing good or bad that I can tell other than no infection of any kind. BTW, I consume a lot of cultured/butter milk and that is believed to help with gut microbiome. Yogurt and kefir are also good but don’t like the taste of either, and really like the taste and texture of buttermilk, plus it is easy to make my own. When I’m about 80% through the container, I just fill it with organic milk, mix it a bit, and leave it out of fridge for 10-12 hours. Walla, perfect buttermilk/kefir in never ending supply LOL.
Thanks for sharing your comments. Well, in my specific case of infection (which was a one-off occurance 2 years ago), the GPs and the clinician at the hospital used all these terms interchageably (sebaceous cyst, abscess and UTI), although I’m not sure what could have led to what. I had symptoms of UTI, along with presence of cyst, infection that was dominant in the pelvic region, however, it was systemic as well (feverish symptoms on a persistent basis for about a couple of weeks).
I have been on rapa for about 2.5 yrs now (been taking it cyclically). Except for very mild ulcers (which only occured a couple of times in my early days of staring on rapa), I never faced any issues… except during that one-off phase 2 yrs ago when I added empagliflozin. It wasn’t a coincidence at all, it was quite obvious to me that my body doesn’t do well when empagliflozin + rapa is taken together.
My A1C toggles between 5.4 to 5.7%, which I’m keen to optimize. It appears there is a strong case that SGLT2i is more effective and more promising that metformin, and has benefits beyond glucose control.
At some stage in the future, I’ll re-experiment adding back empagliflozin (perhaps when I’m cyclically off rapa), titrating carefully and see how it works out.
I don’t think thats accurate at all - I think it’s only a small percent of people who take rapamycin who also take doxycycline. I think a small micro-trend might have started in this area when Peter Diamandis started doing it a few years ago (I think he’s now stopped): Peter Diamandis Longevity Protocol: Weekly 6mg Rapamycin + 100 mg Doxycycline
I do keep doxy on hand just in case I get an infection, but I’ve only used it once in 6 years of rapamycin dosing.
Meant to use “some” of us not most. I only know 4 of us already and four is definitely not most LOL. I’m sort of intrigued though by Doxy, especially at sub antibacterial doses. There is some literature on its benefits, and I believe one of our docs (at least) on here has supported it.
I am Microdosing terzepatide. I am planning to titrate up to 1.25 if no issues arise and am at .75 currently. Normal Starter dose is 2.5. My understanding is that bone remodeling occurs overwhelminging as a consequence of weight loss and I don’t plan to lose much weight. I have already seen a meaningful effect on my glucose and am taking it for Long Covid as well as cardiovascular effects secondary to glucose. I am using a CGM to monitor the glucose effect. I have read it is the length of time at higher values (some use 140 or above) that have negative cardiovascular effects and that a CGM is the way to look for those spikes. My HbA1c is below pre diabetic. My genetics predisposes me to spikes.
Every dose, started at 2.5mg and up to 10 and all the doses were bad for fatigue and also major stomach issues. Obviously, I’m not a doctor and It is true we respond differently but GLP1’s by their own nature should have nothing to do with regards to curing long covid. At best you won’t have major symptoms but still you might lose a bit of weight and with that a bit of muscle also (just the way it is), thus you’ll feel even more tired, and at worst your long covid symptoms will multiply by a factor of 20 LOL.
Dr. David Kaufman is the main clinician who has been reported using micro-dosed tirzepatide for long Covid. He described positive results for a large fraction of patients he treated. That finding, I suspect, contributed to Scripps saying initially that tirzepatide was top of their list for testing for Long Covid and they now have a large clinical trial in process. Scripps is testing at the full doses you used — had they not done so they would have needed a phase 1 study to show that a lower dose was safer than a higher dose. And the manufacturer might well not have gone along with the lower dose—the manufacturer does NOT sell lower doses. Kaufman’s protocol starts at either .25 or .5 per week. .25 is 1/10 the normal starting dose. And the protocol titrates up very slowly. The argument is that many long covid patients have MAST cell and digestive issues in Long Covid and the discussions I have heard about microdosing tirzepatide are focusing on these patients and similar ones with MAST cell issues. These patients are argued to have disturbed and very sensitive guts (I know I do) and it is argued CANNOT take the higher doses without serious problems—it sounds like the stomach problems you had. I did see one online post from a participant in the Scripps study who said some patients had to drop out because of the digestive issues as they ramped up to 15–full dose. So far at .75 I am fine. I plan on adding .25 per month to my dose until I reach 1.25. Some argue for going up to 2.5 max — your starting dose. If all goes well it will be 6 more weeks before I get to my first 1.25 dose. So far I am fine and I can definitely see the effects in my CGM. It may be a while before I know if it has a long covid effect. I will probably lose very little if any weight at 1.25 so shouldn’t be a muscle loss either. Will see.
There is a very serious concern about erythritol (mentioned above) use. See AI:
The primary controversy surrounding erythritol centers on emerging research suggesting it may increase the risk of cardiovascular events, such as heart attacks and strokes, by making blood platelets “stickier” and more prone to clotting. [1]
The safety debate surrounding this popular zero-calorie sugar substitute involves several key arguments:
Increased Clotting and Heart Risks
The Research: Studies spearheaded by the Cleveland Clinic found that consuming 30 grams of erythritol—the amount typically found in a single serving of some “sugar-free” or “keto-friendly” foods—causes a massive spike in blood erythritol levels. This spike activates human blood platelets, increasing the likelihood and speed of blood clot formation. [1, 2, 3, 4]
The Evidence: People with the highest levels of erythritol in their blood were observed to be roughly twice as likely to experience a major cardiac event over a three-year period. [1, 2]
Impact on Brain and Blood Vessel Health
Cellular Studies: Recent [2025/2026] cell research indicates that erythritol can impair the cells lining brain blood vessels. It has been shown to increase harmful oxidative stress and reduce the production of nitric oxide, which is a compound needed to keep blood vessels relaxed and widened. [1, 2]
Gastrointestinal Distress
Like other sugar alcohols (e.g., xylitol, sorbitol), consuming erythritol in excess can cause gastrointestinal side effects. Because it is not fully absorbed by the small intestine, it can ferment in the colon or draw water into the intestines, leading to bloating, gas, and diarrhea. [1, 2, 3, 4, 5]
The Counter-Argument: Correlation vs. Causation
Natural Production: Erythritol is naturally produced by the human body in small quantities. Some researchers argue that elevated erythritol levels in the blood might be a marker of underlying metabolic issues or disease (such as diabetes or obesity), rather than the direct cause of them. [1, 2, 3, 4]
Regulatory Stance: Both the U.S. Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) classify erythritol as Generally Recognized as Safe (GRAS). Regulatory bodies have historically maintained that it is a safe alternative to added sugars. [1, 2, 3]
Weekly. While a really low dose, I am seeing meaningful results on a CGM. While the effects of meds do increase monotonically with dose, they typically do so at a decreasing rate. So I am getting some real benefit before hitting the bad digestive effects. This is not a dose that the mfg supports but they do sell in vials and you can buy syringes to choose that lower dose. All I have noticed is a slight bit of digestive upset on day 2 which is when the concentration is highest—not a troubling effect just noticeable. I will probably hold at this dose a little longer than 4 weeks if it does not disappear. My appetite is unaffected and I have not lost weight.
Currently a RCT is starting investigating SGLT2i in patients with isolated hypertension - so patient without diabetes, no HF and no CDK. “Normal” patients except for their hypertension:
Funding is through the very reputable EU-Horizon program and the coordinators are located in Germany. So they probably are going to do a reasonable job, being very thorough and taking care of every possible detail (see the long list of clinical outcomes). To be sure to do the best possible job and get the ideal results (sufficient data for the long list of clinical outcomes), they intend an end date of June 2032 (unblinding) - so the results are gonna be published a year later:
If you are on the fence about starting a SGLT2i, you may want to check this thread again in the year 2033 to make up your mind one way or another.
