PRP and rapamycin - should they mix?

Need some advice, friends. I have a PRP (Platelet Rich Plasma) treatment scheduled soon for my shoulder. Given that PRP is supposed to introduce “growth factors” to my shoulder to help it heal, I’m wondering whether I should skip my rapamycin dose that week (or longer?) or continue with the weekly rapamycin regimen as usual?

Any thoughts and reasons on why or why not would be greatly appreciated.

Thank you in advance.

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I did it twice now. Shoulder, then last time it was my elbow on the same side. They both worked pretty well. I skipped my dose,so it was 3 weeks between doses, one week after the injection before I took my Rapa. Rapa seemed to help the pain quite a bit. It seemed to reduce inflammation. I don’t think it hurts the PRP at all. I was taking Natto for the elbow and I think that may have slowed down the repair process by a couple months, but it still worked. I would quit that if I had to do it over.

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Interesting! Thank you for sharing. Great to hear PRP worked well for you.

I’ve had this shoulder issue for a long time - a gymnastics injury 25 years ago. I would agree, rapa does seem to reduce pain/inflammation.

I also consume natto. Why do you believe natto slowed down your recovery after PRP?

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Since we do not have good data, I think stopping it would be wise. You would probably be fine since it is more of a local treatment than a systemic treatment. I use PRP with hit or miss results and usually do not adjust medications before use unless on blood thinners. Good luck and I hope it works!

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I would definitely skip the dose. Rapa lowers inflammation and you need an inflammatory response for tissue regeneration. Several members have reported slower wound healing while on Rapa.

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Somebody on here said you need fibrin to be laid down to do the healing. Natto cuts up the fibrin. Since it’s not essential I quit it from abundance of caution. But I was taking it when we did my elbow for a while and it did not work till I quit.

I read all the material I got from the doc and he never mentions it. I should ask I suppose but doctors don’t always know about things like that.

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Since my understanding of PRP therapy is that part of its mechanism of action is to actually stimulate some inflammation to initiate tissue remodeling (thus why it’s advised to not take other anti-inflammatory meds before or after PRP injections), I’d also skip the rapa if I were going to do PRP.

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But it doesn’t need to be inflammed for the whole healing period does it? With my shoulder it was in pain for years so bad I couldn’t throw a ball, it felt like my arm would go with the ball. We did PRP and I could use it normally and in just a few months it was cured. I used Rapa the whole time excluding the first week.

With the elbow, again I waited too long and it was pretty bad. After the surgery I helped my daughter build a privacy fence ( two days ) and it was a little irritated after but I thought inflammation was good so tried to ignore it. I used ultrasound when it really hurt and that actually worked. Started taking Rapa after a week and the pain would be gone for the first week, then since I’m biweekly it would start to act up. I suffered this way for maybe 4 months. Finally had the idea to fast with the Rapa and a miracle happened. The lump disappeared and the pain was gone after just 2 days. After that it healed. AMPK? Dunno, but the fast started the process and even after 4 months it worked maybe 80%.

I have not done a lot of reading on this subject, just going by what my doc taught me and my experience.

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How long of a fast?
What do you mean by combining the fast with rapa?

I just fast 14 hours before my dose (over night), then after dosing I fast for another 24. I’ve been doing it most of the time since. It increases mtor2 and activates AMPK. I don’t have much in the way of details, but it really helped my arm heal and seems to kill inflammation.

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@Bicep, it’s interesting that rapa can help long term/chronic injuries feel better by reducing inflammation - at least from what I have read as well as my own experience. My shoulder has been hurting for a very long time - it was from an injury 25 years ago. It has been getting progressively worse so much so that I couldn’t even brush my teeth without pain in my shoulder.

However, after starting rapa, it has certainly reduced my pain (I suppose it’s because it reduced the inflammation in the shoulder).

But I can appreciate that initially PRP acts through a different mechanism, perhaps by causing some inflammation initially to kick off the healing process.

I might skip a dose and wait a week or two before resuming my rapa dosing. So perhaps I might leave 3 weeks between rapa dosing like you did.

Thank you for your thoughts on this. Great to hear that PRP worked for you.

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PRP kept me out of having to have surgery for a torn labrum in my left hip. The surgeon said “let me know when (not if) it becomes painful enough for surgery”. I had a PRP injection (VERY painful recovery for several days), and that was 12 years ago.

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@Davin8r, wow, that so great to hear! Sounds like you were in enough pain to consider surgery and PRP eliminated the need for surgery. That gives me hope. Thank you!

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Yes! I just wish I’d known what to expect post-PRP. I was limping around in excruciating pain all day at work the next day. No idea how I managed to see 30 patients. It might be easier with a shoulder, depending on if it’s your dominant hand.

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I have had around 6 intra articular prp injection for my shoulder cartilage problem. I take 6 mg rapa 2 days before the treatment and then fast untill I get the PRP. My reasoning behind that is it upregulates autophagy. After PRP I try not to move my shoulder a lot for 4 days. For me it completely takes away the pain for 4-5 months

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I wonder if you would have gotten better results if you’d held off on the pre-injection rapamycin. 6 injections seems like a lot. It only took one for my torn hip labrum, and 2 for my wife’s chronic severe ankle sprain injury. Of course, different musculoskeletal problems are different, so maybe your issue is just more severe.

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I think the skill of the doctor makes all the difference. I tried a different guy on the elbow for 1/3 the price and he did it in about 4 minutes flat. I didn’t even feel a difference. Nothing.

I called him up and he said come anytime. For the money, I thought people would be lined up. Nope. Got in next day. Lol

I get great results from my prp injections. Half the cartilage of my shoulder is gone, probably caused by heavy lifting for 15 years. Thanks to the PRP I am pain free and I can still do everything I want physically. The shoulder specialist told me I would need shoulder replacement surgery in a couple of years 5 years ago…

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Very timely for me. I tore labrum and bicep etc. Did a lot of PT and chiropractic (fantastic!). Did a prp mid November and laid off the rapamycin for all the reasons in other answers. Also have been doing Neprinol (natto serrapeotidase combo) annually for a month for fifteen years for artery hygiene. Skipped that too. So, got to 90% better then started to get worse in the last few weeks and I’ve decided to do the surgery next week. I’ll stay off the rapa and enzymes for about 3 months. I made the switch to cyclodextrin for my annual artery cleanse. My fingers are crossed.

CharGPT’s response was interesting. I originally asked ChatGPT if I should take Rapamycin with PRP treatment and it responded that it’s not a medical doctor and to consult with a professional.

However, I just decided to ask a question: “How does mTOR activation affect PRP treatment?”

ChatGPT responded:

“ mTOR (mammalian target of rapamycin) is a key regulator of cell growth and metabolism. Activation of mTOR is associated with cell proliferation. PRP (Platelet-Rich Plasma) treatment involves using a concentration of a patient’s own platelets to promote tissue healing and regeneration.

While mTOR activation can play a role in cellular processes, its relationship with PRP treatment is complex and context-dependent. Some studies suggest that mTOR inhibition may enhance the regenerative effects of PRP, as it could modulate cellular responses and promote a more favorable environment for tissue repair.

However, the interaction between mTOR activation and PRP treatment can vary based on specific conditions and therapeutic goals. It’s crucial to consult with a healthcare professional who can provide personalized advice considering your health status and the specific details of your PRP treatment.”

Based on that, even though I avoided Rapamycin the week of my PRP treatment and the week after, I decided to take Rapamycin this morning (9 days post treatment).

I actually had another motivation to get back to taking Rapamycin again and that’s because my plantar fasciitis really started to flare up in past few days. I believe Rapamycin really helps calm down plantar fasciitis. I’m curious if any of you have had any experience with plantar fasciitis and Rapamycin. It would be great to hear your thoughts on this.

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