I am not so sure about that. GLP1’s are pretty good at reducing LDL/ApoB as well.
@Deane I forgot all about this risk, so I’m glad you brought it up.
My eye doc has seen it happen…
I’ve assumed the people having this happen are on higher doses. Is that what you’ve seen?
I’m on a small dose and I assume this means I am getting limited health benefits from it, but also limited negative effects.
As a member of team R&D I would definitely leave out GLP1s. There are far better ways of controlling lipids and better ones are on the way. Pcsk-9 inhibitors soon becoming oral and cheaper… I think GLP1s will blow in our faces as a disaster in 10-20 years; individuals with reduced capacity for willpower, with sarcopenia and breaking bones at younger age. Almost as bad an idea as the fat free high sugar advice of the 80s. GLP1s should be considered treatment for obese individuals without willpower, not a longevity drug for the well.
At any rate I don’t think anyone in this forum stops at rapa and dapa and use AI to personalise further with supplements.
Mine are 30+ and they stave off autoimmune flares and keep me young with clean arteries and no cancer. If you have an autoimmune condition already I would recommend reading below. It kept changing over 2-3 years…
Supplement protocol Feb 2026
Empty stomach supplements:
I drink:
70ml symprove probiotic
First 400ml of water with:
lemon juice and coarse grey sea salt (guerende france - low plastic high mineral) and 4 drops of lions mane tincture (microdose)
Then
Probiotic💩 kefir dissolved in
400ml of water with:
5g collagen peptide 2 (u-perform uk) (5 tabs) fortigel🦿
1g MSM powder doctors best USA optimsm for toxins👶.
Spermidine 3mg LB autophagy 
Zinc 12.5mg
Thiamin 25mg
Plasmalogens 500mcg 1 tab myelin bricks: NeuroREGAIN is the validated Japanese alternative used in the “Scallop-derived” clinical trials for cognitive decline. Synergistic with lion’s mane and semax. During work days
Magnesium ultimate8 (LB UK) 67mg elemental.
Glycine/NAC 500mg+500mg (LB UK) for autoimmune and antioxidant Glutathione precursor:brain:
Special interventions:
Next, I inject peptides if planned as below on empty stomach.
I meditate for 5 minutes with deep breathing early in the day. I watch the sunrise if I can.
Then I spend 15 mins of vagus nerve stimulation with Nurosym device.
Then I stand 5 mins in total for full body red light therapy:fire: with neck, upper body, lower body stretches following that. I also stain with Methylene Blue (USP liquid UK Hospital) my solar keratosis prior to PDT with RLT. I drink 20mg MB 60 mins prior to RLT for 5 mins for 10 days alt days every 2.5 months, 4 weeks after completion of my 5 week course of Ss-31 . This is followed by the next cycle of Ss-31 as MB doesn’t need a functional washout period like Ss-31.
After exercise supplements:
350ml water with 5g creatine monohydrate (creapure) with 3g taurine powder🏋️♀️ and 20g whey protein after exercise
Breakfast supplements:
Selenium 100-200mcg for heart and immune taken as 2x brazil nuts twice a week!
Vitamin C liposomal ( swiss bioenergetics UK) 250mg with zinc bisglycinate 4mg and Selenium 17mcg and copper 0.25mg.
Or better 3 kiwis which also help digest protein with catalidins.
Vit d3/k2 1 tab (healthspan.co.uk) 4000iu in total in summer and winter for autoimmune with 20 min uvb exposure if the sun is out.
Urolithin A 500mg as mitosurge with Coenzyme Q10 150mg and Riboflavin B2 20mg (LB UK) for Mitophagy
Boron 3-6mg to increase testosterone from prune juice.
Diacerein (verboril non prescription in greece pharmacy) 50mg for joints and autoimmune Il1beta inhibitor dyes urine yellow, activates bowels due to rhein metabolite.
Asthaxanthin (weightworld UK) 18mg:heart:
Omega 3 600mg total dha+epa (healthspan.co.uk) 3tabs or bare biology 2000mg 1 teaspoon
Undenatured Collagen UC-2 (healthspan.co.uk UK)40mg 1tab🦿
Olive leaf extract (time health uk) 450mg, providing 175mg oleuropein and 20mg hydroxytyrosol.
Geranylgeraniol & Ubiquinol - GG-Gold® 1 tablet 100mg Ubiquinol and 50mg Active Trans-Geranylgeraniol: (Time Health UK) For statin related myopathy prevention. Once finished and on repatha, Change to
Ubiquinol 100mg with 6mg vit E alphaTE and 1.1mg vit B1 healthspan.co.uk⛽️
Pyrroloquinoline Quinone 20mg (Hellenia UK) mitochondrial biogenesis.
Lunch supplements:
Methylated Vit b complex high strength UK 1tab
LipoNAD complete 1tab 250mg (renuebyscience.com USA) 5 days a week.
Alpha GPC (high bioavailability Choline) 650mg x1 (LB UK) to supplement eggs,salmon and once weekly lamb liver (350mg in 100g) RDA 500mg but no toxicity upto 3g on work days only
Dapagliflozin 10mg (prescription UK) SGLT-2 inhibitor to pass glucose in urine for heart failure rather than diabetes. stopped lipoberberine with this.
Ezetimibe 10mg
I avoid screen after 8pm.
I go to bed at 9.30pm:brain:
evening supplements:
Before dinner 1 hour if needed Physillium 5g in 250ml water for constipation.
Evening supps split into 2 time points 6pm with dinner:
Optiturmeric 1tab healthspan.co.uk
LipoHyaluronic acid (renuebyscience.com USA) 150mg🦿
LipoPEA (Renuebyscience.com USA) 250mg (600mg otherwise if not liposomal)
L-ergothioneine 25mg (mind nutrition) : Mitochondrial shield antioxidant. cardio-protective insurance that works on the OCTN1 transporter, independent of your glutathione/NAC stack
Urolithin A 500mg as mitosurge with Coenzyme Q10 150mg and Riboflavin B2 20mg (LB UK) for Mitophagy
8pm before bed:
250ml water with kefir and 1g optiMSM (Doctors best USA):
Glycine/NAC (LB UK) 500mg+500mg:brain:
Lithium orotate 5mg with food. good kings college evidence for mental health and sleep. (Swanson USA)
Apigenin (LB) cd38 inhibitor anti-inflammatory natural increase in nad 100mg🔥
Magnesium glycinate (LB UK) 225mg elemental (double during fever)
Atorvastatin (prescription UK) 20mg at night.
Plasmalogens 500mcg 1 tab work only
Then I spend 15 mins of vagus nerve stimulation with Nurosym device.
Acute Infection supplements:
- vitamin c/d/k2/zinc increase and lipoquercetin 3x daily (Renuebyscience.com USA) all high dose if viral infection.
Autoimmune flare up supplements
- KPV peptide in freezer. 330mcg at night 30 days
- Rapamycin: 2mg/1mg alt days for trough of 3.2 autoimmune indication not longevity. prednisolone as rescue reducing dose
- Bpc157 500mcg and tb500 500mcg twice daily. 5 days on 2 days off to protect skin from prednisolone.
- Ss-31 5mg am support heart. 4 weeks on 5 weeks off.
- Increase vit d3 k2 to 10000 iu
- Stop high dose vit c, high dose zinc, liposomal nad boosters nmn/nr/Tregonelline/nad total 250mg mix,vitamin b complex, spermidine, lions mane tincture not to stimulate immune system.
- thymalin 200mcg 5 days on 2 days off 6 weeks 3x2mg vials.
- glandokort 2 tabs am to start when pred tapers to 5mg total 60 tabs adrenal recovery.
- anemo 3 (vladonix, bonomarlot, ventfort) for bone marrow recovery with rapamycin every 3 months or based on neutrophils with bonomarlot. Once flare over crp<1.
- Bonomarlot 2 tabs bd 7 days. If neutropenia or lymphopenia while on rapamycin.
Cycling Supplements:
1.Fisetin👶 oral liposomal 750mg for 3 days every month for 6 months as senolytic every 3 years (Mayo clinic protocol). With nothing else and intermittent fasting on those days for maximum autophagy which should be periodic only to avoid potential negation of positive aspects of evolutionarily conserved mechanism. Also risk of autoimmune flare from inflammation caused by intense senolysis.
-
Methylene blue 20mg followed 60 minutes later by RLT for 7 days alt day every 2 months ; 4 weeks after finishing Ss-31 course to avoid excessive mitochondrial oxidative stress.
-
Cyclical Peptides
I inject peptides as needed, in small physiological doses, and in a cyclical fashion to biohack the highly sophisticated cellular signalling. This must be done with caution without arresting body’s own signaling pathways over long periods.
These are tailored for me with safety consideration for my autoimmune myocarditis history:
Safe peptides:
1.SS-31 peptide subcut:
5mg a day am for 4 weeks every 9 weeks . 1 week before next cycle start methylene blue 20mg alternate day for 7 days 30 mins before RLT. This peptide stops oxidative stress at mitochondrial level therefore makes possible all other mitochondrial interventions such as nmn, redlight, exercise etc. Shown to help kidneys, brain (dementia prevention), heart, macular degeneration, muscle strength. Take nad complete with this x1.
2. Mots-c (alternating with ss-31 or together. ) for new mitochondria generation via AMPK signaling
3. semax nasal spray once both nostrils 2x day for 25 days every 6 months from bioregulator uk for brain and bdnf last course taken November 2025
4. Bonomarlot for bone marrow stimulation for neutropenia. 2 tabs twice daily 15 days Khavinson peptides. Test improvement in neutrophil count.
6. thymalin peptide: For T-Regs / Thymus. producing a healthy, balanced T-cell/T-reg population.
Relatively safe peptides:
- Bpc157 500mcg:fire:
twice daily peptide subcut for repair of injured tendons and osteoarthritis inflammation. The principle activity of this is increase in vegf, growth and a:ti-inflammatory in combination. 15 day courses over 3 weeks as needed for injuries. Potential angiogenic activation of autoimmune. - Cardiogen peptide 1mg a day subcut for 20 days twice a year for heart .
- KPV for autoimmune calming keep in freezer start if relapse.
Unsafe peptides in autoimmune previously taken safely that I might consider again:
- GHK cu
- Epithalon/ Pinealon Pinealon or Epithalon peptide for brain Longevity every 6 months 2mg a day total 20mg over 10 days🧠
- TB-500 possible autoimmune flare as hormonal trigger
🔥 actions for inflammation: 28
actions for brain: 19
actions for heart: 16
actions for energy: 13
actions for joints: 11
actions for muscles: 9
actions for longevity: 8
actions for sleep: 6
actions for bowels: 4
actions for bones: 3
actions for hormones: 3
actions for infections: 2
Total: 122 actions.
Made up of:
Supplements: 41
Peptides: 15
Lifestyle/Interventions: 11
Prescription/Rescue Meds: 5
Total Interventions: 72
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They didn’t in the past 20 years but keep moving the goalpost. The only major side effect they cause is seething in people like you.
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People like me? You mean doctors with with 30 years Hospital medicine practice with publications, working in one of the top 5 medical schools in the world? Yeah what do we now…
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On the internet everyone is a doctor.
Yeah what do we now…
We look at the pyramid of evidence and observe that expert opinions, particulary those of who can’t be verified as such, rank at the very bottom.
I once again reiterate that we have 20 years of clinical use of GLP1 in diabetics as well as many more years of animal research before that. If any rare or long term side effect was possible, it would have occured already and we’d be seeing the signals in case reports and observational trials.
How many decades or centuries will need to pass before people like you admit that you were wrong?
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I am not doubting you are a practicing published doctor. I am not. I can say though you are a highly unusual doctor, perhaps singular and unique. Your stack looks like nothing any doctor I know, or any I’ve heard of - and I’ve been on various longevity message boards since time immemorial, including email lists - never heard of a doctor with a stack this extensive and this packed with marginal supplements. Including peptides. With this little evidence behind the vast majority of all this. Doctors in my experience tend to be far more cautious, selective and too busy (unless retired) to adhere to such an intricate, elaborate protocol and scheduling. Again, I don’t doubt your claims, but I personally am utterly flabbergasted at this stack - this level of complication and rube goldberg effect stacking makes me dizzy just reading through it, and I’ve been an avid explorer of this space since the early 80’s. How on this green earth you hope to harmonize all these is something my poor imagination completely fails at - but I guess that’s my limitation.
Btw., I am not on any glp1-ra, and have my own suspicions about them, but I certainly don’t think there’s a “disaster” hiding there. My suspicions are rather pedestrian centered around doubts about their effectiveness as life extension agents, but I’ll await the results of the animal studies under way.
What can I say, your stack is quite shocking (to me), but hey, we all do the best we know how to. Good luck!
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I think the indiscriminate use of GLP1s could be a problem for sure.
But to say that it will be the equivalent of fat free high sugar advice is a stretch.
It is fairly easy to get sarcopenia and some bone loss of you don’t work on things with GLP1s but bone loss is becoming more fixable as time goes on.
And so many pros, just try to avoid sarcopenia and most will come out way ahead.
I have to agree. That is quite the list of supplements for anyone, let alone a practicing doctor. I am semi retired with 20% of that list and still feel overwhelmed at times.
I also was offended but not surprised by the use of willpower among the obese, as if that explains the problem adequately.
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Thanks Cronos, I am well aware of my profession’s scepticism of anything that hasn’t been evidenced by double blind RCT on humans, but trust someone who’s been at the coal face of medicine for a long time, it is far from safe or ideal. At the individual level, statistics are just that. The stuff you consider marginal have synergistic and additive properties when combined, particularly when cycled and timed correctly with the right lifestyle. When personalised, as I have mine over several years, it does look crazy complicated but eventually takes very little time and effort. No one should be taking the same stack regularly because it works for someone else.
I don’t care if I look young or what my methylation clock says but I have the lipids, glucose, coronary and carotid arteries, dexa scan and performance of a 20 year old at 57. That doesn’t come without some risk and alot of research after 20 years of autoimmune myocarditis courtesy of flu vaccine and a stressful life.
We should remember that every study is conducted usually on a single molecule with everything else being equal. Expecting our highly evolved physiology to accept that as sufficient for a longevity impact is naive at best.
A study combining rapa and dapa and glp1 is welcome but you can already see people asking why not also lipid lowering agent and how to mitigate risks with other supplements. I think we intuitively sense it’s not enough, it’s not personalised, many won’t benefit so others do. To a point where why would we even try.
The answer is simple; be brave and personalise with a good AI. If you have a medical background read the papers and sense check it before you apply, otherwise, consult someone who can do it for you. Pay for it if you must. It’s far cheaper than what waits in hospital.
I am not sure why suggesting willpower and diet being related is offensive. Don’t we all agree that some stress and consequently abstinence is one of the pillars of longevity? Japanese tradition of eating until 80% full, pushing exercise to high intensity interval training, enduring ice cold baths … these are all willpower increasing, for which interestingly we have a brain domain that is more developed in the autopsies of centenarians. So I am convinced GLP1s are sabotaging one route to longevity while promising a seemingly simpler mechanistic one.
When it comes to circumventing sarcopenia from using GLP1s by exercising and focusing on protein, there’s an interesting fact about willpower; if you don’t practice it you get worse at it. So I don’t expect a general population (on which these studies are planned) having suddenly the luxury of not exercising willpower on what they eat, will suddenly find the willpower to exercise more and eat what they don’t fancy with the little appetite they’ve got left.
I appreciate this is all speculative but I don’t buy the temptation of a 25% weight loss in 18 months if 30% of that weight comes off muscle and bone.
We all know where the problem lies with obesity, its the food industry praying on the stressed, the poor and yes also those with reduced willpower.
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I’m a much simpler man than you (i.e. not much medical knowledge) but have come to exactly same conclusion about GLP1’s. They are very bad other than for morbidly obese people that have no other way of losing weight (and have tried everything else). I needed to lose about 35lbs and jumped on the GLP1 wagon about eighteen months ago. I managed to lose 25lbs but a lot of it was actually muscle (maybe even bone) loss as my strength plummeted to about 50% of original. My muscles were visibly smaller and i was lethargic to the point of not wanting to go out of the house. anyway, my recovery journey has been slow but I’m almost whole again thanks to HGH and Maraviroc. So, for me I don’t care if I became a whale I’ll never go near GLP1’s again. In my layman terms there is very few things more adverse to longevity than to lose muscle, bone and strength especially at an advanced age 50+.given how hard it is to maintain or gain it back.
So, my rule number one is trying to preserve as much muscle and bone as possible and try to be as strong as possible for as long as possible and then do/try other things for longevity.
People who take GLPs need to eat enough protein AND follow even a basic resistance training program. If you lost too much weight too fast, then your dose was probably too high and/or you ramped it up too fast. Demonizing the entire class of meds doesn’t exactly seem fair when so many people who know what they’re doing are able to completely prevent loss of lean muscle and strength.
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As @Virilius stated they’ve been around for 20 years. In that time we have seen enough data to generally know the side effects, pitfalls and how to avoid them. Incredible amounts of data pointing to these being longevity medicines outside of just weight loss. Given all of that data I think GLP1s are the perfect candidate for longevity studies.
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Well the problem with me was twofold. I couldn’t do either. No exercise as I was lethargic, almost bedridden and I did eat protein but not a lot because I couldn’t eat even if I wanted to (appetite suppression) but generally speaking I did eat a 12OZ steak daily (or equivalent chicken breast, salmon etc) . Having said that not everyone has same negative side effects. I have a niece that was way overweight and she has been losing a lot of weight with no negative effects to think of, and she barely exercises at all. She’s lost about 100lbs and needs another 70 or so. I guess like many other drugs GLP! effect differently different people. For me it doesn’t seem like a good idea. There is plenty other meds that do relatively same (i.e. metformin and SGLt2) albeit at a slower pace (than GLP1) with no noticeable negative effects so I’d rather stick with those.
The fact they have been around for 20 years doesn’t mean they have been used for the same purpose and at same doses. I think it is in the last five years or so that they have been used and abused and yes you are right there is a lot of data but the data itself says that you do lose muscle with it even if you exercise and eat protein (at least data I looked at). Perhaps you lose less but still you do lose muscle, and many people say you lose muscle with other diets also but that was not my experience at all. I lost once over 40lbs on mainly protein (no carbs and fats) but did not lose any muscle and my motivation and strength both increased a lot.
One positive thing I have to admit I did get from the GLP1 is the fact that it reduces visceral fat (fat surrounding internal organs) as I used to have hard time sleeping on my right side (pre glp1) and now I have no problem at all doing it. So not arguing or totally discounting the benefits but the lethargy part was what I hated the most.
I am a bariatric surgeon and the abhorrent way that most doctors and others in medicine treat obese people is offensive to me. Plenty of studies on this that I feel comfortable calling this a fact. And it effects outcome as people fear their medical interactions and avoid them. GLP1s have given doctors a tool and has dramatically changed the interactions between patients and the health care system. Millions of people are now going to their doctor wanting to lose weight and become healthier. And surprise, they get their blood pressure and cholesterol checked and treated more often. Patients generally afraid of medications learn how valuable they can be.
Humans are fallible. Annoyingly so. Even you admit that your medical issue is/was somewhat affected by stress which some people would dismiss as your own fault - lack of self awareness or discipline. All in your head or something to that effect.
The fact is that no one is perfect and we all lack willpower at some level. Blaming obesity on a lack of willpower is a common refrain. Carry that over to anyone addicted to anything. None of us should throw stones and none of us know what damaged lives other people have lived. Or what metabolic problems an individual might have.
The flip side of this is a deprivation tendency. Call in Puritanical or use almost any religion. Many people find emotional strength in deprivation or pain. Can be not healthy just the same. As you know, the majority view is that your stack borders on obsessive. Certainly, the majority of your colleagues. I’m genuinely curious if you share your stack with them. Also curious your specialty because, as I can attest, that can shape our world view.
Appreciate the discussion. You will likely never convince me that sarcopenia will overcome obesity as a medical problem because of GLP1s. I also think that someone on it to lose a stubborn 10 pounds is not going to become sarcopenic. Nor is someone using it for longevity purposes. But I am willing to debate.
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@DavidCary
That was perfectly said. Thank you for sharing your professional insight.
Speaking of how the obese are treated, I think The Pitt did an excellent job highlighting a story about a morbidly obese man in the last two episodes. It was so well done and showed the shame, empathy, and challenges. I think you’d enjoy watching.
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I saw that too. There are at least 3 cases this season that would have benefitted from the use of GLP1s. The burden of metabolic diseases is really high on the US medical system when you think about how 4 or 5 days in the hospital cost you 100k, because you have to recover from ketoacidosis and you don’t have health insurance .
My read on this is that you were very likely on too high of a dose. Some people (especially non-diabetic non-obese) are extremely sensitive to these meds and only need a very small dose to achieve substantial weight loss while minimizing side effects.
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Had the same thought.
To some extent, everyone feels some fatigue with calorie restriction. But if it becomes too aggressive…
I can tell you with surgery, most people are bouncing off the walls at 600 kcals per day. Ketosis overwhelms the lack of calories. But with some people, they have sign fatigue.
If a patient was on GLP1 with sign fatigue. I would cut the dose or stop it.
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Coverage in one of world’s top journals:
“The vision of PROSPR is to build the train tracks” for these large clinical studies, which are needed to gain the OK from regulators, says Andrew Brack, the ARPA-H manager of the program. “The longevity landscape will look substantially different in 5 years in large part because of the PROSPR program,” he predicts.
PROSPR is also targeting the regulatory pathway. The drug approval process at the U.S. Food and Drug Administration (FDA) and other regulators is typically set up to assess treatments for a specific disease, not a natural process such as aging. In the past, researchers hoping to launch a clinical trial of a potential intervention have been “forced to treat an age-related disease rather than aging itself,” Brack says. For instance, a trial of metformin proposed by Barzilai and colleagues 10 years ago would have measured whether the drug delays the onset of several chronic illnesses such as dementia, cancer, and heart disease. (The trial never started because of a lack of funds.)
The goal, Brack says, is “to demonstrate a pathway to approval.”
Barzilai says PROSPR shows that the aging field has reached a watershed. “We are at the stage when we can realize the promise” of decades of basic research.
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