Just had the thought that a natural corollary of Matt Kaeberlain’s “cure deficiencies first”, is “cycle all supplements and pharma”.
The logic would be: many drugs have side effects because they cause deficiencies. We know about lots of these, but there are also likely to be many unknowns.
So statins may effect CoQ10, ezetimibe may effect Omega3 absorption, metformin … B12 etc etc.
We can of course try to compensate directly. But that only counters known side effects. Would a better strategy be to assume that there are likely to be side effects/deficiencies that we haven’t identified yet, so we should cycle all interventions.
So we should look to treat say Apo b, or high Hba1c through as many strategies as possible cycling them on and off. Otherwise, my argument goes, with any chronic/long term intervention, we run the risk of creating deficiencies - precisely the thing Kaeberlain says we should focus on as a priority.
My bias is to avoid long term dosing of anything, so i may be simply finding some logic support my biases. The counter argument would be, i guess - that this strategy risks missing optimal targets. Also introducing any new drug intervention risks a major side effect reaction?
I do some cycling of some of my meds on an alternating day basis. Just those that may be ‘troublesome’ in their risk:benefit ratio, such as aspirin, colchicine, statin (when I eventually migrate over to rosuvastatin) etc.
In order to ‘qualify’ for alternating day basis the med must have a sufficiently long half life or have scientific evidence that the effect is still present when dosed e.o.d
One problem I had was remembering what I did yesterday (don’t think it’s Alzheimer’s) so I made a peg board to remind me where I got up to with my meds.
Although I think we should recognise a daily cycle, certain micronutrients such as Copper, Selenium and Boron really are needed at a steady state.
Rapamycin is an obvious candidate for cycling. I also cycle other things when there is a good reason, but I think this depends entirely on what the substance is.
I don’t separate out pharma and supplements from other inputs such as food. Food is, however, cycled both by fasting and by eating at specific times. Exercise is cycled to some extent.
I do think some things require long term inputs/dosing, but cycling should be considered for any intervention.
I was thinking more: cycling substitute interventions. So say, a statin for 6 months followed by 6 months of ezetimibe + policosanol each year. Assuming you can reach target apo b, that “feels” less risky than permanent use of either one (if there are no immediate side effects from any of the drugs).
Ditto Metformin and acarbose.
I think yes we should cycle for several reasons but the biggest reason is the one you mentioned:
Use as few as possible powerful drugs with significant side effects. The only way to get off a drug is to find out if you still need it. Of course if you haven’t done anything to correct the problem through lifestyle then the only alternative is switching between drugs to trade side effects. And some issues for some people cannot be resolved via lifestyle so a plan to switch periodically makes sense. Plus you might find a better (less side effects) way to solve the problem with some experimentation.
