Risk calculus for young(er) women / people for starting Rapa

Hi there, I’m 38 female, and healthy. I am 5’6" and weigh 120 lbs, I exercise 2-4x/week and eat well. I drink, but not too much. I just started a rapa for myself and my dog.
Feeding 1mg / week to my dog
Currently on week 3, am at 3mg for myself but plan to ramp to 6mg / week.

I am interested in delaying aging both for fertility and just extending healthspan because I love to hike, be outside, and move my body more than anything and do not want to loose that before I have to!

I have been lurking on here for a few years. Occasionally I’ve seen passing mentions that there are concerns that rapa might increase the instances of some cancers, but no one seems to think it is serious and I can’t really find much content about it. I’m wondering if that is because it is not a concern, or if it’s because there isn’t evidence, or if its because people would rather not focus on that.

As a young person, my calculus is different than that of an older person - I can afford to “wait and see” if there are side effects of long term rapa use.

What evidence is out there about this topic? How should I evaluate this risk?

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Hi Natalie, good questions.

As a general rule most of the research I’ve seen suggests that rapamycin likely reduces the risk of cancer, and reduces the risk of cancer spreading if you already have cancer. See this paper:

There are many instances of this for many cancers: Frontiers | Rapamycin inhibits oral cancer cell growth by promoting oxidative stress and suppressing ERK1/2, NF-κB and beta-catenin pathways

Another example here in cervical cancer: Rapamycin Reduces Cervical Cancer Cells Viability in Hypoxic Condition | OTT

And slows cancer in many mouse models: Rapamycin extends lifespan and delays tumorigenesis in heterozygous p53+/− mice | Aging

We have another thread on this you may also want to review: Rapamycin - for Cancer Prevention

Rapamycin is well know to slow cell-turnover and proliferation, which is ultimately one of the key causes / contributors of cancer, and the spread of cancer (rapid cell growth). And in fact Rapamycin and its sister molecule (everolimus) is prescribed in some cancer treatment. But rapamycin is not a broadly used in cancer therapies (as David Sabatini, an expert in mTOR and rapamycin said last week in a podcast) because mTOR is needed in healthy cells as well as used by cancer cells - and rapamycin does not shut down mTOR completely (which would kill both healthy and cancerous cells). See here in this video where I’ve queued it up for this part of the discussion: https://youtu.be/L2xjWf6mO_0?si=4j3042rFvW-CVYNI&t=1012

There may be rare instances of situations where rapamycin somehow contributes to some types of cancer growth; for example I saw this one paper where when combined with exercise in this specific mouse model of breast cancer it seemed to increase the tumor burden: https://www.tandfonline.com/doi/full/10.1080/20010001.2019.1647746

I encourage you to talk with specialists in cancer and do more research as this is in no way my area of expertise, I’m just conveying what I’ve seen.

As for dosing - you mention going up to 6mg a week. Most younger women I’ve seen posting about this more typically go for lower doses (though it likely depends on your size/weight). For example the recent podcast with the OBGYN discusses a dosing of 2.5 mg per week, see here: Rapamycin for Fertility and Menopause; Clinical Results and I’ve seen other women around your age talking about doing around 3mg or 4mg per week, but we also have @medaura here who is around your age who has been dosing at 5mg (I believe) before she recently got pregnant and had a baby. So - there is a reasonable range of rapamycin dosing that women seem to be having success with, in similar situations as you.

Generally speaking the lower the dose per week, the lower the risk of side effects.

I’m not going to recommend any specific course of action as I’m not a doctor. I’m just giving you some information that you may want to review and hopefully others will contribute additional thoughts and information.

The biggest risks I suspect for people like you are mouth sores, and acne and or rashes of some sort. These are the most common side effect that may cause you to want to reconsider taking rapamycin.

But as you read the side effects listing we have here you’ll see many other possible and lower frequency issues that people have. Side Effects of Rapamycin (part 2)

Part of the consideration also is your exposure to pathogens. If you work in a hospital and are exposed to a lot of sick people and other infectious agents, you want to be more careful. We’ve had one person here @DeStrider who has mentioned that he got sick a few times when he went into the hospital for some simple procedures. At some doses of rapamycin you may be better protected from some infections, but may be less protected from others… see this example: Too many bacterial infections, have to stop, low WBC

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In mice starting earlier results in living longer

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Hi, I think I can give you some very personal advice. I started taking RAPA when I was 38, and I’ve been keeping track of all the changes since then.
I take 3mg once a week, along with a fresh grapefruit. After two years, here are the benefits I’ve noticed: with exercise, I’ve gained 8 pounds of muscle; I feel a lot better, and almost everyone I meet says I seem full of energy; my cycles have become more regular. However, there’s one clear side effect: RAPA has made my acne worse.
This is just my personal experience, and I hope it helps you.

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Joyce - wow, thats actually a much higher dose than most women I’ve heard of take. Thats potentially equivalent to 9 or 10mg+ a week. Do you dose with grapefruit juice every week pretty consistently?

How have you dealt with the acne - do you take breaks, do you do anything special, or just cover it with makeup or something?

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The dosage does seem a bit high, so for the past three months, I’ve been trying to switch to taking it every other week. As for the acne issue, I haven’t found a better way to deal with it yet.

Compared to the euphoria and youthful energy it brings me, acne is just a minor side effect that I can live with."

As many people know i think weekly is too often.

How long have you been taking it, Joyce?

Hey John, mostly on this forum I’ve seen weekly dosing. Can you point me at anything that shares less frequent dosing being still effective? Would be great if it was

The challenge is one of evidence. I am currently working on a really high dose every 2 months. I think it works quite well, but am not that certain.

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I used to take siroboon, 5mg, with grapefruit juice. Probably roughly equivalent to 5mg without grapefruit juice but with enteral coating. My husband takes 3-4mg, Pfizer, with grapefruit juice. Any dose above that gives him side effects. I plan to go back on Rapa when my baby is weaned and see if I can titrate up until I find my ceiling via side effects of any sort. At my old dose I just felt great and had perfect bloodwork.

I wonder … Rapa does slow down cell turnover. Perhaps that leads to clogged sebum ducts hence acne.

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Thank you! Appreciate this, mostly sounds positive and probably I’ll keep taking it for a while. Yesterday I took 3mg and I definitely noticed that my mouth felt weird, had some trouble sleeping and today I have a headache. I’m pretty small, and generally highly sensitive to meds. I might try 2 or 2.5 next week.

Do you know of any follow up to the young mice breast cancer exercise study? It seems somewhat relevant as my mom did have breast cancer (not genetic) - although, I’m more middle aged than young and I don’t currently have cancer.

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Currently I (38F) take 5mg Rapacan + GFJ (three fresh squeezed grapefruits) biweekly after dinner, so I suspect there is some EVOO as well. I have no side effects other than feeling tired but not in a bad way and needed more sleep in the ~3 days following dosing.

I started taking rapa about a year ago working my way up to 6mg weekly, but switched to biweekly because 1) if I’m going to be tired, better to be tired every other week than every week 2) the idea of taking a higher dose less frequently seems to make sense to me.

My LDL labs came back as slightly high, but my doctor was not concerned about it. I have not had any other side effects and can’t say I feel much different either which I think is about as well as one can be doing in the late 30s. I haven’t had any illnesses and generally feel pretty good. Regarding fertility I have taken continuous birth control since 31, initially yasmin and now nextstellis and do not plan on stopping.

I am considering adding an SGLT2i or acarbose but I am not yet sure how to determine which would be more appropriate and under what protocol. Maybe that should be its own post.

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After adjusting various dosages over the initial three months, I continued with 3 mg per week plus GFJ for almost two years.
About three or four months ago, after seeing everyone’s discussions on the forum and considering my acne, I started trying to reduce the dosage.

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Are you not concerned abt potential unknowns? Why start now vs at an older age when there will be more data and “less to loose” ?

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Mere life extension is a poor substitute for eternal youth. Eternal youth is what everyone from Alexander the Great to Ponce de León was seeking, not mere life extension. “Youth” being the key word.

So, for the young people on this forum, zealously seek out any means to preserve your youth. I have rethought my earlier suggestions about rapamycin. IMO, you should start low-dose rapamycin as early as possible because we have noticeable declines in our early thirties, actually as far as athletic abilities, even earlier.
Hopefully, we will soon have better biometric tests and aging clocks to guide us.

While life extension is better than nothing, it can never capture the pleasures of youth.

I was very fortunate to have had a wonderful and exciting youth. Bad times, too few to remember. If I could relive my years from 15 to 30, I would put it on continuous rewind,

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There are risks and rewards to starting rapamycin earlier than later. There is a discussion thread on the site focused on this: The Case for Starting Rapamycin Earlier in Life (e.g. late 20s) vs middle age (e.g. 50s)

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I would take the risks. The side effects of rapamycin, IMO, are easily mitigated.
Based on the current evidence, this is a no-brainer until something better comes along.
Rapamycin is just a place holder until something far better comes along.

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