Rapamycin and Acarbose effect on bone health

#26

Total T is 30.7 nmol/l (885 ng/dL), free T 246 pmol/l (71 pg/mL), E2 0.1 nmol/l (27 pg/mL).

I had no urine test, but blood calcium levels were tested and they were in the middle of the reference range.

#27

I appreciate all the comments. I talked earlier in the week with the endocrinologist, and her “final” diagnosis was that caloric restriction is the root cause of my elevated SHBG and osteopenia. This is consistent with ChatGPT’s analysis, although the doctor didn’t know that it could be rapa and/or acarbose driving CR mimicking effects in my body, rather than eating too little. I will take an indefinite break from rapa and acarbose based on this.

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#28

I entered my blood marker data into a PhenoAge calculator. My result was 19.6 years lower biological age than my chronological age, which is surprisingly good. Michael Lustgarten has the best known value at 22.6 years, but mine is better than people like David Pascoe 17.1 years and Bryan Johnson 8.8 years. On the longevity world cup I would #5 with this result.

Sorry for the not so humble flex, but clearly, I have done something right with my health. Just need to adjust things now and find a better balance so that SHBG gets much lower and my bone health turns around.

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#29

Candle flower, I’ll give a second vote for “The Doctor Doug Show” on YouTube. He has many videos with excellent information on bone density. He does incorporate some product promotions and his OsteoCollective website, but he has to make money in some way. So, I don’t mind and usually ignore his commercials.

HIs approach to improving bone density involves diet, exercise, some supplements if needed and peptides/SARMS/hormones. He covers all the bases my doctor never mentioned.

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#30

I looked around after Candleflower recommended him, but even though I can tell there is a ton of good info in there, I unfortunately put too much time into a few videos that didn’t tell me much (a long video of why AlgaeCal is great, a video on the background on peptides).

Having said that, I did see one that convinced me to seriously consider a vibration plate. I know some people on here talk about them. I would only use it enough if I put it in the bathroom and stand on it while doing things like brushing my teeth etc.

Can you share which peptides and supplements he recommends (other than d,k,calcium) or point me to any good videos.

#31

Beth,

He has a lot of videos on a wide array of topics related to bone density. The ones labeled “paid promotion” I generally avoid. Or, if he is obviously promoting a specific product I’m not overly interested. But, here is an example of just one I found useful: https://www.youtube.com/watch?v=m9wavucJfu0 . I usually watch one, sometimes two each morning. I suggest using ChatGPT to search for the Dr Doug Show, plus a specific topic you want to see.

If the following link works it is one of his monthly presentations via Zoom. He takes about 10 minutes up front for introductory material, then I believe about 30 minutes of useful material. Then, there are some commercials, followed by Q&A from his viewers. It’s been a while, but I believe that’s the gist of it.

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#32

That was great. My doc is against the bone drugs, but I never understood why until now. If I understood it correctly, in addition to the risk of jaw and bone fracture, the most compelling piece of info is that while you are on them, it keeps you from building bone by all the things we are doing, like resistance training.

Is this your understanding as well?

I assume not, but if there is a place to access more zooms without being a paying member, I’d love to know.

#33

Hi Jay yes he seems like the real deal, I need to listen to him more often. He sure is for high protein, against a plant based diet, and for dairy. He said he respects Mark Hyman a lot but does not agree with him re dairy. He’s not much for the bone drugs either but will use for some situations. I have several issues that discourage weight lifting but I gotta start doing something. I haven’t had a DEXA in 4.5 years but before that I went 7 years and had one only because I broke my femur. To my surprise there was no change, which I attribute to the HRT. If I get another and it’s down I might join his paid program.

#34

Beth if you get one stay away from the Marodyne Dr Doug says it’s useless. I think most get the Power Plate. I have superior canal dehiscence (ear hole) and the one I had gave me disabling vertigo for a couple weeks. It was just a 240 dollar one but I’m staying away from any vibration as had to have a craniotomy for the other ear in 2010 and trying to avoid another.

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#35

My old TMJ doc worked with folks who had jaw degeneration from bone drugs and on his walls hung pictures - that was enough for me.

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#36

Another thing that convinced me to stay away is that my mother had a friend who was on Fosamax and every time she fell she broke a bone but my mother, who had pretty severe osteoporosis but never took any of those drugs, and had three or four pretty bad falls before she died at 92, never broke a bone. I had heard these drugs will show a better density on the DEXA but it’s not quality bone and can actually make it easier to break. I never know what to believe but seeing what happened with my mom vs her friend convinced me there was likely some truth to that.

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#37

Thank you for all this feedback!

I didn’t understand the issue, but I did learn here and from my doc to avoid drugs if at all possible. Fortunately I was able to get improvement on my own over this past year, according to my DEXA… so I’ll stay the course.

You know, you bring up a good point about the plates. If I invest in one, I will be certain to find one with a good return policy. My PT gets a bad reaction from them, and now I’ve heard this about you, too! I get motion sick crazy easily, so I have wondered if I could deal with them!

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#38

Beth,

I suspect most of the Zoom presentations have similar data, but I don’t know. He is summarizing what he thinks is important and he follows it with a promotion about The OsteoCollective.com likely in each Zoom presentation.

You can join one of his presentations for free. At the bottom of each of his basic videos on YouTube you will find a link to join one of his Zoom presentations and another link to join the OsteoCollective.com . I am not promoting joining the OsteoCollective, but if you want to try it for 7 days free I believe that option is available. I am currently doing that with the $20/month plan where I pay by the month. So far, it’s just excessive in terms of the “hand holding” approach it takes with lots of little video courses that I find useless. However, I suppose there are people who don’t seek information on their own and need detailed support. Not me! So, I’ll probably cancel tomorrow.

Here is a link to join one of his Zoom presentations. The date you see likely does not matter. You’ll be scheduled for the next upcoming presentation. When I provided my information I gave a throw away email address and my first name only if my memory serves me correctly. Here is the link: Masterclass

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#39

A lot of the discussion here is drifting away from rapamycin and acarbose, and toward bone drugs specifically. Opinions are expressed, but there is a much richer knowledge base on bone drugs in other threads more focused on those, and therefore will be more illuminating for those who are interested in these drugs, as the topic is quite complex and not at all one sided “drug bones bad”. It might be worth exploring the subject in those dedicated threads - I’m not urging people to stop discussing these drugs here, just that there is more information in these other threads. Some of those are:

This is a complicated subject. There are plenty of studies showing big advantages of bisphosphonates in bone durability and health outcomes in appropriately chosen cohorts. A case can be made that they are even geroprotective and there are pleiotropic benefits. I am by no means defending these drugs or advocating for their use, just pointing out that it’s a very complicated matter. I myself have NO osteoporosis or osteopenia, and I am having dental implants and I’m still contemplating a 1 year course of Acontel (risedronte) - I have even purchased it from India - I might do that because I’m also thinking of taking low dose pioglitazone, and I think that might offset some possible negatives from pio. Bottom liine - you have to be very discriminating and careful before you take or not take a given medication. These are drugs with potentially serious side effects, but each of our situations is quite specific and precision medicine means tailoring treatment to your case, and not some general hot take. YMMV.

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#40

Nice. Also make sure to double check it with the LWC calculator as well. Although it was originally a fork of Steele’s calculator, it added sanity checks to handle missing U-curves from pheno age. See my correspondence with Steele on GitHub about this: PhenoAge Calculation Bug Disclosure: Missing U-Shaped Curves for Biomarkers · Issue #2 · ajsteele/bioage · GitHub

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#41

Work on lowering SHBG. Low T will make this an uphill battle. High T will make it easy.

Post your full hormone panel from blood test if you feel comfortable.

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#42

Sure, below are my lab results. Any observations?

Testosterone & Related

  • Total Testosterone
    • 30.7 nmol/L → ~885 ng/dL
  • Free Testosterone (calculated)
    • 246 pmol/L → ~71 pg/mL
  • Sex Hormone–Binding Globulin (SHBG)
    • 114–118 nmol/L
  • Estradiol (E2)
    • 0.10 nmol/L → ~27 pg/mL
  • Luteinizing Hormone (LH)
    • 4.4 U/L
  • Prolactin (PRL)
    • 207 mU/L → ~9.7 ng/mL
      (Conversion: 1 ng/mL ≈ 21.2 mU/L for men)

:small_blue_diamond: Thyroid

  • Thyroid-Stimulating Hormone (TSH)
    • 2.28 mU/L → 2.28 µIU/mL
  • Free T4 (thyroxine)
    • 12.1 pmol/L → ~0.94 ng/dL

:small_blue_diamond: Parathyroid / Vitamin D

  • Parathyroid Hormone (PTH, intact)
    • 4.4 pmol/L → ~41 pg/mL
  • Vitamin D (25-OH D)
    • 73 nmol/L → ~29 ng/mL
#43

Woah your SHBG is insanely high that is messed up. Mine was 52 and the clinic I’m with thought this was really high and holding back my free testosterone. I felt TERRIBLE with that.

Funny thing is your total testosterone is pretty good, in fact it is above the reference range on Australian labwork. But your SHBG being so high is making you almost have a form of hypogonadism. None of your testosterone is free to act in your system.

I ended up starting TRT to permanently alter my hormone profile for the better. This increase in testosterone lowered my SHBG, leading to more free and total testosterone. On injectable TRT I lowered it by 25 points. Cream lowered it by 15 points.

One thing you could try is proviron, which is an oral steroid. It is known to lower SHBG quite well. It might be possible that you take this for a short period and it allows your hormones to adjust.

There are other supplements as well you could try like boron and others that supposedly lower SHBG, but nothing is as surefire as TRT and/or proviron.

Longer term TRT is healthier. Proviron in a short burst should be ok but I can’t say for sure if it would fix the issue.

Depending on your age you might want to just get on TRT. But do look into ways of lowering SHBG first. Your diet will be a factor as you said before. I know the carnivore diet and possibly keto diet can cause high SHBG as well, it’s funny veganism can do the same.

You should start taking a protein powder to supplement if you are not already. It would be convenient if you were open to using a whey protein isolate because of its amino acid profile, this might be what you need. But I’m not sure if you’re vegan for moral reasons. If you’re vegan for health reasons, consider broadening the diet with whey protein isolate, 1 scoop in morning and 1 in evening.

The point I’m making is you have a lot of options. I’d start with dietary, then supplements, then either proviron or TRT.

#44

Thanks. The SHBG seems to explain the osteopenia and it is bit of mystery what caused it, but doctor thinks the underlying reason is caloric restriction.

What I will try now to increase SHBG:

  • I try to eat a bit more and also increase the amount of fat I get
  • 9mg boron per day (previously 3mg)
  • No CR mimicking medications
  • Grudgingly, I replaced my soy intake with whey protein

Will test again in November and see if these actions have an impact on my SHBG

Moreover, to combat my osteopenia from other angles, I also:

  • Doubled my vitamin D supplementation to 4000 IU
  • Added plyo exercises to my gym routine, runs with a weight vest to my cardio program, and daily dog walks with the weight vest
#45

You could likely still keep taking rapamycin and just drop the acarbose by the way. Acarbose directly restricts calories where rapamycin just mimicks it from what I understand.

But maybe stop both and reintroduce rapamycin by itself after you’ve solved this issue.