I am a healthy sixty-one-year-old man. Addressing my health, fitness, and longevity has been a priority for me for at least fifteen years. I do all of the basics of diet, exercise, sleep and supplements, but I wanted more.
In this article, I describe rapamycin and why many people have started taking it. I will explain, with my doctor’s consent, why I started and stopped taking the “anti-aging” drug rapamycin, all within four weeks.
Rapamycin is also known by its prescribed name, sirolimus, and Rapamune.
In 1964, Georges Nógrády wanted to understand why the inhabitants of Easter Island did not get tetanus when their environment suggested that they should. He decided to gather soil samples from around the island and study them. (1)
Nógrády was not successful in answering the question about tetanus, but he did provide soil samples to a company that later became part of Pfizer. These researchers discovered a novel antifungal compound that had interesting properties. Subsequently, the compound, rapamycin, has been studied extensively. Rapamycin was found to have anti-fungal, immunosuppressive and anti-tumor capabilities.
Currently, rapamycin is an FDA approved “on label” prescription drug for treating certain types of cancers as well as preventing organ rejection.
In addition, rapamycin received attention for potential anti-aging effects. By 2006, an extensive body of work from several independent studies, including studies from yeast to mammals, all pointed to rapamycin as having an anti-aging effect or at least slowing down the aging process. No significant side effects were identified, which is quite remarkable. (2)
There is plenty to be excited about related to rapamycin. One mouse study that was extrapolated to humans suggests that rapamycin could extend the life of humans for six and a half years. Influencers such as Peter Attia, MD are currently taking the drug “off label” for its anti-aging potential. Attia said that rapamycin, “hands down [is] the most important and exciting and promising neuroprotective molecule.” (3)
I take my health seriously. My exercise consists of multiple low-intensity, zone-two, cardiovascular workouts to address aerobic fitness along with at least one high-intensity, zone-five, cardiovascular workout to address anaerobic fitness that is commonly assessed by VO2 max. I also lift heavy weights three days a week. In addition to exercise, I manage my diet by limiting sugar to a high degree and consistently consuming at least 120 grams of protein a day. I haven’t consumed any alcohol in four years. My goal for sleep, as measured by the Oura ring, is seven hours per night. I was previously taking metformin, atorvastatin, testosterone cypionate and a handful of supplements to be as metabolically and hormonally healthy as possible.
Even considering everything I do, the promise of what rapamycin might be able to do was too much for me to ignore. I discussed the possibility of taking the drug with my concierge doctor. After doing his own research, he agreed to prescribe sirolimus to me. The dose for the anti-aging effect isn’t clear because comprehensive studies in humans have not been completed, but is far lower than the on-label dose. For the anti-aging effect, most people dose weekly from between three and ten mg. We decided on a dose of 4 mg once weekly for me. There is no known toxic dose for sirolimus so I felt good about that.
Sirolimus is not expensive. The cash price is about $40 per month, which I paid out of pocket.
After one week on the 4 mg dose, my only side effect was an occasional pain in my right lower abdominal area which is a normal side effect. It was only after the second week of taking sirolimus that I associated the pain with the drug. If this was the only effect I would have been fine. However, I also started losing weight. After four weeks I had lost 5% of my body weight. I also started having trouble sleeping. My normal seven hours of sleep was deteriorating to six hours or less. Additionally, I was losing libido. After four weeks, my doctor and I agreed to stop the sirolimus protocol.
After a couple of weeks being off of sirolimus my weight stabilized but did not return to normal, which I thought was strange. When I was prescribed sirolimus, my doctor and I also made adjustments to my metformin and atorvastatin doses. Each went up. I went from 1000 mg of metformin to 1500 mg. We also raised my atorvastatin from 20 mg daily to 40 mg daily.
I began to wonder if one of these other changes was responsible for my weight loss. We reduced those doses back to the original levels and there was still no change in my weight. Digging deeper, I realized that my newly fulfilled metformin prescription was not time-released whereas the original, baseline drug was time released. When we took the non-time-released metformin out of my diet, my weight finally began to rebound. So it might not have been the sirolimus that was responsible for my weight loss.
In retrospect, there were actually two mistakes made with the introduction of sirolimus. Everything else should have been kept the same. The other mistake that we might have made was starting my sirolimus dosing with the end or target dose. Some people start with a low dose and over the course of many weeks gradually increase to their target dose.
When my body returns to baseline levels I will consider re-taking sirolimus starting with a much lower dose, like 0.5 mg or 1 mg per week, and very gradually increasing the dose, without making other changes, to avoid any other surprises.
Certainly this experiment would not have been possible without access to an interested and available physician and the medication at a reasonable price. Hopefully my experience with rapamycin can help other people who have this luxury have a smoother introduction to the drug than I have had.
Written by Greg Damian: I am a 61-year-old author, motivational speaker, health and fitness disruptor and a coach. My book, Abs at 60: The Four Steps to Look and Feel Younger at Any Age was recently released on Amazon. My mission is to assist men over 50 to overcome perceived limits of their age to look and feel younger. I do this by applying my four step DOLR(TM) system that is described in the book. Each chapter of the book has a set of questions to answer. You can download a free workbook that includes all of these questions at www.absat60.com
References
- https://www.bio-rad-antibodies.com/blog/history-of-rapamycin.html
- Powers T. The origin story of rapamycin: systemic bias in biomedical research and cold war politics. Mol Biol Cell. 2022 Nov 1;33(13):pe7. doi: 10.1091/mbc.E22-08-0377. PMID: 36228182; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634974/
- https://www.youtube.com/watch?v=7s7d7WNT1Ek&t=4079s
Written by Greg Damian.
Why using Immunosuppressants if there’s no medical indication?
That class of drugs is known for some serious side effects.
The reason here is extensively documented over the last 20 years. Google is your friend
Hi Pip. People using rapamycin are using it off label and are on a dosing schedule very different from it’s on label use. Do your research, talk with your doctor and decide what is best for you.
Greg
I have not personally taken metformin but gastrointestinal complaints including abdominal pain are common side effects of metformin which often resolve when the body adjusts to it’s introduction or when a higher dose its taken so does your functional medicine think that is likely the cause? Have you listened to the recent episode on Peter Attia’s podcast on sirolimus? He/the other scientists stated that the most common side effects of off label sirolimus in the weekly or biweekly dosing was 15% of patients having mouth sores.
Hi Greg,
Thank you for sharing your experience. The mist-steps you made with dosing are common. In the rush to get on board with new medications/protocols people often try to jump right to the final/full dose. This almost always leads to a problem.
As an integrative medicine/oncology doc, I have been routinely prescribing rapamycin (sirolimus), metformin, statins, LDN and other off-label medications as part of cancer fighting protocols along side standard of care protocols. And more so now in the last few years purely for their anti-aging effects as the data has been emerging and become more compelling. Experience with these indicates a start low and go slow strategy as the best approach, and working with someone with experience with these medications helps avoid side effects.
Dr. Fabio (drfabio.com)
I am in a longevity study by Zen – Healthspan. They are charging me $360 4 times a year. I was told to take 5 mg. once a week. I got headaches then so I reduced it to 4 mg. once a week. Still got headaches but less severe. So I reduced it to 3 mg. once a week and the headaches disappeared. I’ve been on it for about 9 months now. I know that rapamycin is far less expensive at my pharmacy than what I am paying but my primary care doctor is afraid to prescribe it. I live in south Florida. Do you work there or know of any doctors there who would prescribe it to me and follow me with blood tests to monitor me.
I have heart disease. I am a 73 year old female. I read in the National Library of Medicine that rapamycin had reversed heart disease in mice so that is my motivation for taking it although living longer is certainly appealing too. Does one 3 mg. dose per week have any therapeutic value?
I
I have previously taken rapamycin/sirolimus and my prescription was MUCH more expensive. I’ve looked for it on several sites and all were around $250/month. Can you tell me where you purchased yours?
Hi Samantha, if you could find a doctor who would prescribe it, it’s very inexpensive at pharmacies. However, my primary care doctor is too afraid to prescribe it. I get a months worth of pills a month from Zen – Healthspan in a FDA approved longevity study. I am charged $360 4 times a year which is considerably less than you are paying. Their telephone number is 650-563-3696. The study also covers your blood work at Lab Corp.
a question for greg damian:
what was your rapamycin dosing regimen? my understanding is that you should be taking it only once a week; 2mg to 6mg each dose. i’m considering starting this; probably 2mg/week for the 1st few weeks, then increasing a bit. not sure if i want to do 6mg/week.
thanks!
doug s.
I have been taking Rapamycin (Sirolimus) 5mg/ wk about 15 weeks and my wife for about 9 weeks. We are both 73 years old.
Both my wife and I recently got severe respiratory infections. Mine was on March 1st, and my wife got sick on April 8, requiring three days of hospitalization. She was diagnosed to have infections with Hemophilus influenza and Mycoplasma. My infection was less severe but did take me to the emergency room. I also had Mycoplasma.
That is why we searched the net to see if Rapamycin is associated with infections. We found the attached article which mentions the issue but not conclusively. I will be interested in other peoples’ experience with Rapamycin and respiratory infections.
Regards
” Here we describe 2 cases of infant patients with KHE and KMP who were scheduled to receive sirolimus on a long-term basis. However, both patients developed paroxysmal cough and tachypnea shortly after the onset of sirolimus treatment and succumbed to infection thereafter. This report reveals a potential risk of infection in sirolimus-treated infant patients. The fatal complication highlights the importance of antibiotic prophylaxis and serum sirolimus level monitoring to ensure the safe use of sirolimus in the treatment of infant patients with KHE.” (Use text to search source).
Also see https://www.sciencedirect.com/science/article/abs/pii/S1090379816300253
On the other hand it could have been just coincidence. Hard to tell, Ask on rapamycin.news forum.