This may be the wrong place to ask this given I often see an aversion to seeking medical supervision as we bio-hack our way to immortality, but was wondering if anyone could recommend doctors who perform telemedicine re longevity interventions. I am assuming most will be US based given ability to prescribe off-label and the burgeoning interest in longevity therapies there. I am not looking for prescriptions (thank you IndiaMart), just a professional to provide oversight and keep me up-to-date on latest treatments/dosages. I think my experience with rapa indicates that having a doctor to discuss concerns and approaches with can be important (I had an atypical adverse reaction as detailed on these forums). While I was seeing Dr Green and am grateful for his input, he tends to focus almost exclusively on rapa and I want someone who employs a broader toolkit (metformin, acarbose, canagliflozin) as I seek to re-evaluate my approach.
Any and all suggestions welcome! My thx in advance
Its going to be really hard to find these … but I definitely think there is a huge need for this type of thing. Most doctors in the US are only licensed to practice in the state they live in, so are unlikely to offer telemedicine services out of state (and out of country)…
The best option are likely the longevity clinics that are starting to pop up all around the world…
Matt Kaeberlein’s Optispan:
Perhaps Peter Attia’s new website (not sure exactly what he’s going to be offering here):
Thx RapaAdmin. I’ll look into these options, though I do note expense is a factor. I am willing to pay telemedicine prices and that’s the limit. As I say I may not have discontinued rapa (simply introduced lower dosage or extended time between dosing) but for Dr Green saying it seemed as if-based on my likely reaction and data available-I should discontinue as the issue was more cosmetic (at least initially). I’m glad I kept that check on my predilections. But at my age and health it would be a tad frivolous to be expending on some of these in person clinics that also try to cross sell any number of additional services—I’ve diligenced similar services before and they all want to get me to sign up to broader functional medicine offerings or less convincing options (cryomedicine, supplement/meal plans etc) at staggering expense.
I do note I blasted out emails to many of the doctors on the prescribers list provided on this site…one has responded saying he could assist and maybe others will revert after weekend. I suppose some doctors interpret their licenses more liberally than others or certain states are more permissive as I have no connections to the state this doctor practices in…nor did I with Dr Green either.
Update: So as I mentioned before I reached out to many -though not all-doctors on the prescribers list who are in the US re providing a supervisory function as I try other (non rapa) therapies via telemedicine.
One requires me to be in the US (CA or CO) to initiate the telemedicine consult, which though a hassle I can do as I visit occasionally for both family and work. How anyone can verify this I have no clue, but I feel being upfront and honest is preferable for all parties. Its a shame as this doctor asked probing questions, seemed genuinely interested in my medical history and cited the ITP studies. He was also quite clear that acarbose on a diet with a fair degree of wheat would be less than ideal for my GI. But access limitations is an issue for me and this would mean delaying start of any new regime until I could get to CA.
Three others are quite happy to provide telemedicine even when I am outside the US. Of these, the first did not respond to whether their practice extended beyond rapamycin. The second prescribes acarbose and metformin but seemingly not canagliflozin, at least from the email correspondence. The third confirmed they prescribe all three. How comfortable they would be to NOT prescribe and simply supervise my regime, so that I can continue to source my cheap generics via IndiaMart, I am not altogether certain. For these three practices the fee would be $495, $195 and $150 respectively per telemedicine consult.
@RapAdmin let me know if I should provide the names here for purposes of updating the prescribers list. May also prove beneficial to hear if anyone has exposure to these doctors for purposes of assessing their approach.
Sure - in the interest of other people in the same situation as you (of which there are many I bet), it would be great if you could post the doctors that may support your telemedicine approach to longevity. I do think this is likely the best way for people outside of the major metro areas of the USA.
Great-so in the interest of transparency. I am a US citizen with family links to CA and who visits NY for work, but resides abroad. This was obviously a factor (the US citizenship) in Dr. Green deciding he could take me on as a “patient” for my rapamycin intervention. I have no idea (except in one case discussed below) if the other doctors who responded to my request for telemedicine took my ties to the US into consideration when deciding if they could provide such services to me. I will say though that no-one asked for any formal identification.
Claude Fortin MD (Colorado Ageless Institute): The doctor I identified as being very engaged in the email correspondence. Requires me to be in CA or CO for telemedicine services. Price uncertain.
Bradley S. Rosen, M.D. (MTOR MD) who many of you will prob be aware of: charges $475 for telemedicine consult. Has yet to respond if his practice extends to metformin, acarbose and canagliflozin (as opposed to just rapamycin).
Dr. Robb Bird, NMD, FAARM (Transform You): $195 for telemedicine consult. No mention of canagliflozin but does prescribe other two drugs.
Steven E. Warren MD DPA (Regenerative Wellness Center): charges $150 for telemedicine consult. Prescribes the three drugs discussed. [UPDATE: It seems I snuck in at this rate and they are now charging $300 for new consults; see below for what transpired]
I hope this is somewhat informative. If anyone has any views as to whom may provide the more insightful and helpful service I’d be happy to hear.
Hiya. From what I have found the approach is not uniform and depends entirely on the doctor.
**Dr Green was much more informal when I spoke with him prior to initiating rapamycin. He asked about medical history but did not require any test taking/results, blood or otherwise. He suggested I may be interested in looking into genetic testing to determine my APOE profile and predilection for dementia (which would have influenced his dosing recommendation) but as it was he based the (initial) rapa dosage on my age and general good health (conveyed by myself). I believe lab works were not required because I am a fair bit younger than his normal patient (late 30s). I have read he is more stringent with other patients. The consult was around 40 minutes (booked for 30 I believe but Dr Green seemed relaxed) and he charged around $350.
**Dr Rosen indicated he would need to review recent bloodwork before recommending therapy. Consults are 90minutes apparently.
** Dr Fortin did not specify if he required certain tests or how long the consults were and I did not pursue as I can only avail myself of his services when in CA or if I ever find myself in CO.
**Similar situation for Dr Bird, although I did not ask about specifics because I decided I would simply proceed with the one option who did not require me to be in a specific place to initiate a consult, confirmed they could prescribe all the drugs of interest to me and who-fortuitously- was also the cheapest, that being:
**Dr Warren. His consults are 15-20minutes, although when referring to the amount of time he was specifically addressing a question I had regarding the follow-up process/frequency. Perhaps the initial consult is longer, but can always report back on that. He recommended follow-ups every 3 months initially, extending to biannual depending on the situation and updated lab results. He did specify lab work was required prior to commencing treatment.
I presume medical history will be taken-I mean if you are asking for lab work I would assume this would also occur at a minimum.
Will update if I proceed with Dr Warren. 95% certain I will.
Hi there @Melih . Rather unfortunate update re Dr Warren’s pricing.
When e-mailing the practice’s general email address, the Dr. responded to me from his own e-mail and did not cc or discuss my enquiry with the office manager. Dr Warren quoted me $150 but when I called to book the consult and told the receptionist (who I also believe is the office manager) that I was not sure of the specific service but that the doctor had quoted me $150 for the “longevity” therapy, she flagged that they had raised their rates and that new patient consults were $300 (I do not know if this extends to in person consults-presumably its the same or more). I told the receptionist of my conversations with the Dr and she said she would need to investigate.
Unwilling to leave this diligence to her, I decided to forward the prior correspondence to the general practice e-mail and cc-ed the Dr, asking for clarity given the discrepancy. Dr Warren responded that as he had quoted before the practice manager had increased rates (or as I infer-since he quoted w/out consulting her), I was told I would only need to pay $150.
Dr. Bird-from the list I provided at any rate-seems like your best option re the sub $200 price point unfortunately.
If having a doctor’s supervision is important to you I would not dally too long trying to find someone. Inflation is most definitely real. If my experience is anything to go by, either the good doctor wildly underquoted or they just raised their rates 100%!
That seems very enticing if the pricing includes a comprehensive (and semi-regular) consultation process.
For my part, I’m only doing this for the supervision/guidance/medical advice rather than prescription itself. IndiaMart prices can not be beat, esp if willing to buy in bulk and negotiate. My pharma contact also seems like an honest person given interactions over past 6 months.
Don’t believe Push is available for those of us outside the US anyway given its primarily a script service…