I am getting ready to schedule my annual comprehensive panel of blood tests and am wondering how to adjust timing in relation to my rapamycin cycle. I’m currently taking 7.5 mg every 10 days. Is there a preferred point on the rapa cycle that is least likely to affect test values?
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It is likely to have some effect at each point. Best to stop for a month to get a steady state. Look at my high dose topic.
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Personally, I take blood test 2.5 to 3 hours after my rapamycin dose (for me 6 mg weekly) to get my C-max and to know if my product is good.
On 6 mg 2.5 hours later… I should get 3 ng/mL per mg… or for me about 18 ng/mL
At 7.5 mg 2.5 hours post dose, you should measure in at 22.5 ng/mL.
That is only for the sirolimus level
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Try if you only want blood panel not affected by rapamycin do trough draw at end of your cycle… 10 days post dose. If you want… then take dose and return for a second draw 2.5 hours and you get your rapamycin range.
Personally, never noticed an issue on blood panel because I do panel draw this at the end of my 7 day cycle. My trough is under 1 ng/mL – usually .06. Then do a second draw 2.5 hours later post dose of 6 mg.
The bosy takes a while to adjust post trough.
That is true John but if you are taking Rapa on a regular basis and have every intention of continuing on a regular basis you want to know what your body is doing whilst taking it, not after a washout period.
I think it makes sense to do blood tests at the halfway point between regular Rapa doses.
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That’s true. The underlying problem, however, is that the effect changes. Actually probably wearing a CGM during the dosing cycle is quite useful as you would see the ups and downs with glucose. And without a washout you cannot tell what the long term effect is.
I am still working on a 6 weekly (or more) cycle and in fact am planning a dose tomorrow morning. I have already bought my grapefuit. On the other hand I already have CGM records and do weekly blood tests so I see the movement in things like HbA1c.
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I have little experience in this issue but more than once, and from different perspectives, I have asked LLMs to take a deep mechanistic dive on rapamycin, including taking it with sardines, a larger fatty meal, and/or with grapefruit. All guidance on the co-administration was positive about sardines and fatty meal and all advised against taking it with grapefruit for mechanistic reasons based on the original scientific rational for intermittent dosing. I have no opinion on this but would be delighted to learn of other views. Related, when I asked LLMs to do a dose-mechanistic analysis on the 7-day interval, parsing out the institutional driver that we organize our lives in 7-day cycles, the response was a) that dose equivalence would need to be modulated by age due to clearing times and b) that removing convention from the 7-day cycle would probably place the typical interval closer to 10 days, especially for older adults.
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RobTuck,
When I was taking 10 mg weekly on Saturday mornings weekly I did it continuously for four years or more. If I had major blood work tests coming up I would simply do them mid-week (Wednesday). I never noticed any affect on any of the results. However, if you want to be sure skip one cycle so that you can put the tests at about 14 days from the last rapamycin dose.
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Thanks. Since this is my first time on this issue and I’m mostly interested in following up on some legacy metrics. I think I will skip a cycle rather than find myself wondering if a metric I don’t like might have been affected by rapa 
The answer is whether you’re measuring for the peak,trough or the half-life. The half-life for daily transplant users is around 60 hours. I suspect the half-life for weekly users is considerably less when my provider reviewed my latest bloodwork.henoticed a high sirolimus reading. He suggested that I wait a day or two after taking my medication before having blood drawn.
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But surely you need to know if you have a bad metric because of regular Rapa dosing which I assume you are doing most of the year, because that would mean you have a bad metric for most of the year.
Test in the middle between doses and fingers crossed you are still good on all metrics. Then you have absolutely nothing to worry about.
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If we go back to my
records which have essentially been repeated since then, but without the CGM and with blood tests only once a week rather than twice.
Rapamycin causes insulin resistance, the body then adjusts to create more insulin and then there is over reaction causing glucose to go lower and then it comes back. This happens over a period of weeks and if you do a blood test you need to know what you are trying to measure first. I personally think the steady state effects on the body if you were not taking it are most important, but for those people who take it frequently (say more frequently than every 15 days) its effects are likely to be active for a lot of the time and therefore knowing those figures is important.
Hi John
Do you mean that you are taking Rapamycin weekly for 6 weeks and then doing other cellular work for a few weeks? If so then this is what we have started doing and I am thoroughly enjoying.
No. I take it no more frequently than 42 days between doses. Sometimes I delay a dose for social reasons (as I don’t want to be in crowds immediately after the dose).
I have built up to quite a high dose and I think people need to be careful. I don’t recommend emulating me unless you are monitoring a lot of things and know what you are doing.
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