Six Month Rapamycin Update with Lab Work (Finally!)

[Phil_Van_Treuren]

I wanted to wait until I’d been taking Rapamycin for six months before I did any blood tests, and I’m excited to share the results with you guys today! I’m always skeptical when people report effects that might be placebo, so it’s fun to finally have some actual lab work to show you. (Spoiler: it’s all good, except for one thing I’ll share at the end.)

First, a quick review of my situation: I’m male, 46 years old. I take 10mg of Rapamycin every Saturday night. I’ve never had any noticeable effects from it at all (positive or negative). Since last year’s lab work, I’ve also started taking the following stuff every day:

Metformin: 1000 mg
Vitamin B12: 1000 mcg
Vitamin D: 3000 mg
Omega 3: 360 mg
L-Theanine: 200 mg
Magnesium L-Threonate: 1300 mg
Lithium Orotate: 5 mg
Glycine: 2000 mg
Aspirin: 81 mg
NMN: 1000 mg
Tadalafil: 5 mg
L-Carnosine: 1000 mg
Extra Virgin Olive Oil: 1 oz
Apigenin: 600 mg (1 tbsp dry parsley)

Anyway, on to the lab work! On the Levine test, my estimated age has dropped from 41 to 36. Here is the comparison with measurements:

Also, on the Aging.AI test (which I had never used before today), my recent lab work gives me a predicted age of 34 (pretty close to the Levine test).

I’ve gained around 10 pounds in the last six months, but I think that’s because I added 5g creatine daily and am doing more functional strength training.

The only negative development since I’ve started taking Rapamycin is my cholesterol levels, which have really jumped! My total cholesterol is now 255, my triglycerides are 152, my HDL is 54 and my LDL is 173. (Also, my RBC count jumped way up to 5.88, I don’t know what to think about that).

Oh, and one other thing: I had my testosterone tested for the first time, it’s at 595 (which I think is pretty good?)

Anyway, I hope you all find that interesting! I’m glad to take any feedback or questions, and I’ll post another update like this in six months. Thanks again for all of the info you guys share, I really enjoy this forum.

[Agetron]

Congrats Phil – Damn – overall looks fanatastic.

FYI - my LDL-C was that high (171) when I was on 38 mg of rapamycin every 10 days for 4 months last summer. It dropped on its own to 110 and now is steady at 140 since November and now in tests in April which is my normal.

Discovered through tests that my high LDL is genetic… not much can change it… diet or statin - if it is genetic. My Coronary Calcium Score is zero - so I am not going to sweat it.

You might want to look at a Coronary scan in the future. They have sales at different hospitals for $90 bucks during healthy heart month in February - otherwise $295 without insurance.

[Nellie_DeBruyn]

@Agetron DId you listen to Peter Attia’s most recent podcast about familial high cholesterol? It addresses the 0 calcium score.

[Agetron]

Thanks, I think that Dr. Attia has an amazing way with words - and thoughtful descriptions and really enjoy his information. But, he often says - a lot we just don’t know. Heart issues have never played apart in my family that has a 90 years average and no cancers or heart attacks, stints or any heart related or circulatory problems. My wife’s family a whole different scenerio.

That said, I trust my personal physician more. We looked at trying a shot that costs $600 times twice a month for life to cause the receptors to pull more cholesterol out of my blood (my physician said you could go that route - don’t think it is needed in your case). He submitted the request for praluent and the health insurance company reviewed my records and family history and said based on your health - NAH! Link: https://www.praluent.com/about-praluent/
Definitely will look up his Dr. Attia’s podcast – PM me if you have the link. Thanks.

[DrT]

What was your serum phosphate level?

I found mine had halved since I started Sirolimus and was slightly below the “normal” range.

I interpreted this as Sirolimus increasing Klotho. Trans-membrane Klotho is mostly expressed in the kidney and acts to open ion channels to excrete phosphate.
There is evidence that lower serum phosphate may be protective against cardiovascular events.
Generally speaking; higher Klotho = “good”; lower Klotho = “bad”. Especially in the elderly.

[AnUser]

@Agetron

My Coronary Calcium Score is zero - so I am not going to sweat it.

It will probably turn positive if you don’t lower LDL now, or it might do so regardless meaning it is too late.

Genetics doesn’t matter, it still works if you change environment/treatment (my apoB is 100th percentile genetically but I have had 5th percentile…)

[Agetron]

Here is soome information on scores of zero and strioke - heart attacks.

Link: Scan for arterial plaque is better at predicting heart attack than stroke: Newsroom - UT Southwestern, Dallas, Texas.

“For participants with a calcium score of zero, there was a similarly low risk of either a stroke or a heart attack in the coming 10 years – less than 2 percent for either event among all study participant categories, according to the study.”

It has been a year since my last test - will test again next June 2024. Will see.

[drsteve7777]

The calcium index or score can give you a false picture of your heart. You could have a score of 0 and have a coronary event tomorrow and vice versa, you could have a 100 score and never have a stroke or heart attack. The damage you need to look at is total atherosclerosis in your heart, total cm2, or whether you have a soft plaque, hard plaque, or erosive plaque, and where the damage is at. The best test is to go to Cleerly and find a center close to you for a CCTA with Cleerly analysis it is around $1250 for the test, but it shows you everything you want to know about your heart vessels. After you have the scan, then you can decide on statins, PK9 inhibitors, PlaqueX IV, or a stent or angioplasty.
You can have high cholesterol and clean vessels. and never had a coronary event. Also, it is important to get a hsCRP for arterial inflammation in order to interpret your risk status.
Remember that the creatinine test for the renal function is a marker test and when developed people were not taking straight creatine. It will alter your test results. If you worry about heart disease then a cystatin C test is needed.

[desertshores]

@drsteve7777

hsCRP

I am not a big believer in the hs-CRP test. It is more of an indicator of latest inflammation and not necessarily an indicator of chronic inflammation. My hs-CRP tests look like a present indicator. I don’t particularly see them as a reliable indicator of my heart or overall health. If you have several consecutive tests and they are all high then you may have a chronic condition. IMO: One hs-CRP test is not very meaningful.
If you disagree, please explain.

If

[Olafurpall]

Are you sure this is not an error? Did you measure it just once after starting rapamycin or more often? I ask because halving of phosphate levels is enough to take you from above the reference range to below it, which is a massive drop?

I agree with you on Klotho. Phosphate negatively influences Klotho levels and lower levels of phosphate would likely be better in that respect at least.

[Olafurpall]

I think hs-CRP is a useful test for chronic inflammation if you interpret it correctly and measure it several times. Yes, it is an indicator of recent inflammation, therefore you have to take into account anything that might increase it, like if you recently recovered from being sick. But you can still get an indication of your chronic inflammation by measuring it.

I think if you measure hs-CRP several times when not recently sick then you will be able to get a good proxy for your chronic inflammation level. What you have to do is take note of the lowest measurements. Think of it this way. Your hs-CRP level at any time point is likely to be approximated by A+B where A is your baseline chronic inflammation level and B is any acute inflammation. A will be fairly constant while B will change from day to day or week to week based on various acute events. If you measure hs-CRP several times, the lowest measurements will have the lowest B, and as such will mostly reflect the level of A, or the level of chronic inflammation. A person with elevated chronic inflammation may have hs-CRP levels that fluctuate from 1.0-2.0 while a person with very low chronic inflammation may have levels that fluctuate from 0.4-1.0. The former clearly has higher background inflammation since his level never drops below 1.0. The fact that the latter sometimes has levels as low as 0.4 must mean that his chronic inflammation is very low, otherwise his level couldn’t drop that low during periods of unusually low acute inflammation.

In your case, your lowest levels seem to be just above 0.5. Clearly you can dismiss the value of over 4.0 in January as a result of some event.

[DrT]

Oh Dear! Silly me…I mistook the bicarbonate reading for phosphate!

No. Actually I didn’t. My phosphate level was 1.22 on 21/09/18.
It was 1.11 on 05/08/21.
It was 0.58 on 10/05/23.
The readings are in mmol/L.
I started Sirolimus in December 2021.
The “normal” range for Phosphate is given as 0.8-1.5 mmol/L.

[Olafurpall]

With a value that low I would dismiss it as a potential error at the lab. In any case, definitely get phosphate checked again next time you have blood tests.