Update on Brad Stanfield's Rapamycin Clinical Study in NZ

I’m somewhat astonished that people on that forum did not realize that rapamycin blocks mTOR whose name is literally Target Of Rapamycin.

No mTOR =>

  • no or reduced skeletal muscle protein synthesis
  • no or reduced connective tissue and tendon protein synthesis (collagen)

Obviously complete blockages are only achieved at high concentration but lower concentrations will be enough to blunt the effects which is why people taking rapamycin in that study did get an effect but blunted compared to placebo.

The good news is that rapacymin enhance the effect of endurance training though.

That’s why I only take rapamycin during my deload/assimilation/rest weeks and I don’t do any strength training while my rapamycin level are above 2 or 3 ng/ml.

I asked Gemini pro to give me the reference studies from reputable authors (i.e. Keith Baar for tendons) on that topic.


The molecular regulation of both muscle and connective tissue (tendon) relies heavily on the mechanistic Target of Rapamycin Complex 1 (mTORC1) signaling pathway. Research by leading figures in musculoskeletal physiology has demonstrated that rapamycin—a potent and specific mTORC1 inhibitor—significantly blunts the synthetic response of these tissues to primary stimuli like exercise and growth factors.

1. Skeletal Muscle Protein Synthesis (MPS)

In skeletal muscle, mTORC1 is the primary “hub” for integrating mechanical and nutritional signals to initiate translation. Foundational human studies by Blake B. Rasmussen and Micah J. Drummond have established that rapamycin administration effectively “blocks” the expected rise in protein synthesis following resistance exercise.

  • Human In Vivo Evidence: In a seminal study, Drummond et al. (2009) demonstrated that when humans were given rapamycin (12 mg) prior to a bout of resistance exercise, the typical 50–100% increase in mixed muscle protein synthesis was almost entirely abolished. The study showed that rapamycin specifically blocked the phosphorylation of downstream targets like S6K1 and the formation of the eIF4F complex, which are critical for initiating protein translation (Drummond et al., 2009).
  • Blood Flow Restriction (BFR): Further research by Gundermann et al. (2014) (also from the Rasmussen group) showed that the stimulatory effect of BFR exercise on muscle protein synthesis is also inhibited by rapamycin, confirming that the mTORC1-dependent synthetic block applies across various exercise modalities (Gundermann et al., 2014).

2. Connective Tissue and Tendon Protein Synthesis

While less studied than muscle, connective tissue synthesis—specifically collagen production in tendons—is also highly sensitive to mTORC1 inhibition. Key work from Keith Baar, a leading authority in functional connective tissue biology, has utilized human-engineered ligament models to quantify these effects.

  • Inhibition of Collagen Synthesis: Research by El Essawy and Baar (2023) demonstrated that rapamycin treatment in engineered human ligaments decreased procollagen synthesis by 55% and total collagen content by 36% (El Essawy & Baar, 2023). Crucially, the study found that while growth factors like IGF-1 normally stimulate collagen production, these increases are blocked by rapamycin, indicating that the anabolic response of tendon fibroblasts is predominantly mTORC1-mediated (El Essawy & Baar, 2023).
  • Fibrosis and Tenocytes: Complementary research by Zheng et al. (2018) found that rapamycin significantly reduces collagen synthesis in human tenocytes and fibroblasts. By activating autophagy and inhibiting the mTOR signaling pathway, rapamycin was shown to suppress the excessive extracellular matrix (ECM) production typically seen in peritendinous fibrosis (Zheng et al., 2018).

Mechanistic Summary Table

Tissue Type Key Reputable Authors Primary Finding Reference
Skeletal Muscle Drummond, M. J. & Rasmussen, B. B. Rapamycin blocks the contraction-induced increase in human MPS. (Drummond et al., 2009)
Tendon / Ligament El Essawy, E. S. & Baar, K. Rapamycin decreases procollagen synthesis by 55% in human ligaments. (El Essawy & Baar, 2023)
Fibroblasts Zheng, W. & Fan, C. Rapamycin reduces collagen synthesis and ECM production in tenocytes. (Zheng et al., 2018)

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References

Drummond, M. J., Fry, C. S., Glynn, E. L., Dreyer, H. C., Dhanani, S., Timmerman, K. L., Volpi, E., & Rasmussen, B. B. (2009). Rapamycin administration in humans blocks the contraction-induced increase in skeletal muscle protein synthesis. The Journal of Physiology , 587 (7), 1535–1546. https://doi.org/10.1113/jphysiol.2008.163816 Cited by: 598

El Essawy, E. S., & Baar, K. (2023). Rapamycin insensitive regulation of engineered ligament structure and function by IGF-1. Journal of Applied Physiology, 135(4), 833–839. https://doi.org/10.1152/japplphysiol.00593.2022 Cited by: 7

Gundermann, D. M., Walker, D. K., Reidy, P. T., Borack, M. S., Dickinson, J. M., Volpi, E., & Rasmussen, B. B. (2014). Activation of mTORC1 signaling and protein synthesis in human muscle following blood flow restriction exercise is inhibited by rapamycin. American Journal of Physiology-Endocrinology and Metabolism, 306(10), E1198-E1204. https://doi.org/10.1152/ajpendo.00600.2013 Cited by: 181

Zheng, W., Qian, Y., Chen, S., Ruan, H., & Fan, C. (2018). Rapamycin Protects Against Peritendinous Fibrosis Through Activation of Autophagy. Frontiers in Pharmacology, 9. https://doi.org/10.3389/fphar.2018.00402 Cited by: 52

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Can you remind us what the Human equivalent dose is for the marmoset study?

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" perhaps closer to 30mg [of rapamycin] every day or two equivalent in humans, per Adam Salmon interview ]"

from here: Breaking: 15% Healthy Lifespan improvement via Rapamycin seen in Marmosets

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That’s a lot! It makes me wonder if 9-10 mg every week is enough. :frowning:

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Its a balance… risk and reward…

as I said in that initial report on Adam Salmon’s announcement:

This new marmoset study suggests that a higher dose may be required for humans to get the same level of benefit, but with higher doses of rapamycin we tend to see higher rates of side effects (diarrhea, gastro-issues, etc.) and if higher doses are taking on a regular basis you typically get some level of immune suppression, and potentially some lipid and blood sugar disregulation; all of which tend to increase health risks in humans. So this may be the key challenge for human translation of this research, how to get higher levels of rapamycin into the blood system, while minimizing the undesirable side effects and risks.

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I tend to agree with this. The long-term effects seem to be positive for skeleton and muscle while short term may be slightly detrimental especially if you are looking to build muscle. Looking at it in a more pragmatic way, I think RAPA will help the natural composition and muscle while not being beneficial if you want to artificially get bigger, if it makes sense at all.

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I’m really curious the rationale here. This study was of old, untrained, people using an Exercycle and seeing how many times they can stand out of a chair. Looking at your profile photo, presumably you’re just a bit more active and capable than that :wink: And both groups did make gains - but the placebo group gained more. (Plus, as we both know, this is the “noob gain” phase when you start any exercise program. It’s pretty different to what happens 6+ month later.)

IMO, unless you’re bodybuilding and need maximum gains, I don’t think this study is a strong deterrent. And if you were bodybuilding, common sense would have told you that mTOR inhibition would be suboptimal. We’ve always known that there’s somewhat of a conflict when it comes to maximising performance and longevity. You can probably maximise lifespan by calorie restriction, but you end up sarcopenic, or you can maximise muscle grown which comes with its own downsides. Or, you can find a sensible middle ground, which is what I hope to do.

I don’t quite get the logic here. Rapa might blunt the muscle protein synthesis, but it doesn’t negate all the benefits of exercise - the connective tissue strength, metabolic adaptations, the anaerobic capacity, stimulation of blood vessel formation, better nitric oxide etc. And even in this study, the people on Rapa still gained - just not as much as the placebo. So it’s not like lifting while on Rapa is harmful. It might just be slightly less beneficial than if you weren’t taking it.

I commend Brad for running the study. But IMO, the biggest problem is simply the short duration. When you start any new exercise program a lot of weird stuff happens. First of all, many people don’t make gains at all, because their body is just struggling to adapt to the new stimulus. So getting a 60 year old first-time lifter to squat the empty bar is going to make them mega sore, and they won’t gain much muscle. So the first few weeks typically actually have very few gains. Then, once you hit adaptation, you get a very rapid increase in session-to-session performance, and they can basically add weight to the bar every week. But that soon (couple months) starts to level off. That’s where the real magic happens IMO. At this point you need more myonuclei, more satellite cells, and you get lots of adaptations in the myocytes themselves - glycogen storage, they get better at glycolysis, they develop more pH buffer capacity, the mitochondria fuse together and become more efficient etc etc. Sadly, this short-term study is really only looking at the first part of the noob gains. I know that’s not Brad’s fault, but it is a limitation for our interpretation and whether it’s relevant to our own situations.

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