March 18, 2025 • 42 mins
Would you like to live 10, 15, or even 20 years longer just by taking a weekly pill? Join us as we dive into the buzzworthy world of rapamycin, a drug lauded by researchers as potentially the most powerful anti-aging treatment ever discovered.
Dr. Rhee shares his personal journey of considering rapamycin, offering an in-depth look at its history, how it works by inhibiting the mTOR pathway, and its promising results in extending lifespan in lab animals. Beyond just living longer, these animals stayed healthier, showing delays in age-related diseases including cancer. He also discusses the current evidence in human studies, potential benefits, and noteworthy side effects like mouth sores and metabolic changes.
Addressing the risks and practicalities of dosing, prescribing, and costs, Dr. Rhee reflects on why he is rapamycin-curious and the steps he might take if he began using it.
Whether you're new to the topic or deeply curious about longevity science, this episode provides a comprehensive overview of rapamycin's potential to help us stay youthful longer.
#Longevity #AntiAging #Rapamycin #HealthAndWellness #Biohacking #HealthyLiving #FitnessJourney #AgingGracefully #HealthyLifestyle #CrossFitLife #BotoxAndBurpees #health #movement
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Sam Rhee (00:04):
Hello and welcome to Botox and Burpees.
I'm Sam Rhee, your host,board-certified plastic surgeon,
crossfit coach, who lovesexploring where health, beauty
and fitness intersect.
Thanks for tuning in.
Today I want to talk aboutsomething that's been generating
a lot of buzz in the longevityand anti-aging world drug called
rapamycin.
Some researchers have evencalled rapamycin potentially the
(00:27):
most powerful anti-aging drugever discovered.
Now that's a huge claim, solet's dig into what that really
means.
Now, if you're watching onyoutube, you can actually see
I'm holding up rapamycin, whichlooks pretty ordinary actually
it's just some small white pills.
I had a physician prescribe itfor me because I actually have
(00:47):
been considering startingrapamycin myself, but I haven't
started it yet.
But after one of my colleaguesstarted rapamycin about six
months ago and told me about themedication, I did a quick
Google search and it's lookedgreat so far at first glance.
But a couple of weeks ago, whenI got the medication before I
was about to start it, Irealized I really didn't know
(01:08):
what this medication was allabout and it was something that
I was going to have to take fora long time to help me live
longer.
So before I actually decided tostart, I wanted to actually
research this medication, whichI did, and now I'm going to
share what I found with you, mypodcast audience.
All of us are looking to stayyoung, and it's obvious that
(01:28):
it's very important to almostall of us.
What's so funny is, when Ifirst brought the medication
home, my spouse saw it and askedme what it was, and when I said
it was an anti-aging drug, sheimmediately said what, you're
going to take a longevity drugand you aren't going to give any
to me.
So what, You're going to take alongevity drug and you aren't
going to give any to me.
So what, you're going to wantme to die early and then you'll
just keep living.
And I had to say whoa, whoa,whoa, let's take a step back
(01:49):
here, sheesh.
So in this episode I'll be doinga deep dive into what rapamycin
is and why people think itmight help us live longer.
I'll cover a bit of thebackstory of how it was
discovered and first used inmedicine, how scientists first
found it could extend lifespanin lab animals and the mechanism
behind how it works in ourcells.
(02:09):
I'll also go over the evidencefor its longevity benefits, what
studies in animals and humanshave shown so far and the
reasons to be skeptical,including potential risks and
side effects.
I'll talk through why I'mconsidering it as a part of my
own health journey, but alsowhat my reservations are risks
and side effects.
I'll talk through why I'mconsidering it as a part of my
own health journey, but alsowhat my reservations are, and by
(02:31):
the end we'll recap the keypoints.
Basically, is rapamycin a truelongevity silver bullet or just
another far out chancyexperimental elixir?
But remember, as always, thispodcast is not a substitute for
professional medical advice,diagnosis or treatment.
This shows for informationalpurposes only.
Treatment and results may varybased on circumstances,
situation and medical judgment.
After appropriate discussion,always seek the advice of your
(02:52):
qualified health provider withany questions you may have
regarding medical care and neverdisregard professional medical
advice or delay seeking advicebecause of something in the show
.
And, to emphasize this point,don't decide what to do with
rapamycin for yourself until yousee your own physician.
Okay, so whether you've neverheard of rapamycin or you've
already gone down the internetrabbit hole on it, we'll keep
(03:15):
this conversation approachablejust as if we were chatting over
a post-workout fit aid.
See what I did there About thisintriguing drug that might help
us stay youthful.
So let's start with thebackground on rapamycin.
What exactly is it?
Rapamycin, also known by thebrand name sirolimus, is a drug
that has been around for a fewdecades.
(03:36):
Back in the 1960s and 70s,researchers were exploring the
soil on Easter Island theisland's local name is Rapa Nui,
which is where the namerapamycin comes from and they
discovered a new compoundproduced by bacteria in that
soil.
And by 1972, scientists hadisolated this compound from the
soil and named it rapamycin,initially noting it had
(03:59):
antifungal properties.
So at first scientists thoughtit might be a useful antifungal
medication.
However, as they studiedrapamycin, more scientists
thought it might be a usefulantifungal medication.
However, as they studiedrapamycin more, they found it
had some other remarkableeffects.
It turned out rapamycin couldsuppress the immune system In
medical terms, animmunosuppressant.
This made it extremely usefulfor a completely different
(04:20):
purpose, which is preventingorgan transplant rejection.
In organ transplant patients,you want to dampen the immune
system to a certain degree so itdoesn't attack the newly
transplanted organ, andrapamycin was found to be
effective for this, and the FDAapproved it in 1999 for use in
kidney transplant patients, andsince then it's been given to
(04:41):
millions of transplant patientsto protect their organs.
It's also been used indrug-eluting coronary stents, to
prevent those stents fromgetting clogged and for a rare
lung disease.
But the main thing to know isthat rapamycin has been a legit
medicine for years, typicallygiven daily to suppress immunity
, just enough to help transplantpatients.
Now why are we even talkingabout this transplant drug in
(05:03):
the context of longevity?
Now, why are we even talkingabout this transplant drug in
the context of longevity?
The link became apparent whenscientists unraveled how
rapamycin works at the cellularlevel.
Rapamycin's big trick is thatit inhibits a protein in our
cells called mTOR.
That stands for mechanistictarget of rapamycin.
Yes, this protein is literallynamed after rapamycin, because
(05:24):
rapamycin was key to discoveringit.
Mtor as a protein is basicallya master controller for cell
growth and metabolism.
You can think of mTOR as acentral nutrient sensor.
It gauges if cells have enoughnutrients like amino acids,
growth factors, energy, anddecides if the cell should grow,
divide or instead hunker downand do maintenance.
(05:46):
When nutrients are plentiful,mtor is active and it promotes
cell growth and proliferation.
When nutrients are scarce, likeif you're fasting, mtor
activity drops and the cellshifts into maintenance mode,
which includes things likeautophagy, which is a cellular
cleanup, recycling process.
Rapamycin turns down mTORactivity, essentially mimicking
(06:10):
a low nutrient signal and byinhibiting the mTOR pathway,
rapamycin causes cells to act asif they're in a
calorie-restricted or low-energystate.
So why does that matter foraging?
Well, you may know that decadesof research have shown that
caloric restriction, where youeat significantly fewer calories
while still getting nutrients,can extend lifespan in many
(06:34):
organisms.
One reason is that it enhancesautophagy and reduces cellular
growth signals, which seems toslow down aging processes.
Mtor is a key player in thatwhole story.
So scientists theorized if weuse rapamycin to inhibit mTOR,
could we get similar longevitybenefits without actually
cutting calories?
(06:54):
It's like a fastingimpersonator at the cellular
signaling level and, sure enough, when researchers started
testing rapamycin in various laborganisms, the results were
striking.
Rapamycin consistently extendedlifespan in every species tested
.
Yeast, worms, fruit flies andmice all lived longer when given
(07:16):
rapamycin.
This is a big deal.
There are a lot of compoundsthat might extend life in a worm
but do nothing in a mouse, forexample, and rapamycin is one of
the few that seems to work inmany different species,
suggesting it hits a fundamentalaging mechanism.
In fact, rapamycin was thefirst drug proven to extend
(07:36):
lifespan in a mammal mice in arigorous, excellently
constructed study, and thatopened the floodgates of
excitement that maybe, justmaybe, rapamycin could have an
anti-aging effect in humans too.
So to sum up the background,rapamycin was discovered on an
exotic island, became a drug tohelp transplant patients by
(07:58):
suppressing immunity, and in theprocess of studying it, we
learned that it targets anaging-related pathway called
mTOR, and in lab animals,turning down mTOR with rapamycin
makes them live longer,presumably by triggering
cellular housecleaning,autophagy and dialing back some
of the age-acceleratingprocesses.
It went from an obscurecompound to a potential
(08:20):
longevity superstar in the eyesof scientists, which is quite
the winding road for thismedication.
So what are the evidence forlongevity benefits?
It's one thing to have a theorythat a drug might slow aging,
but it's another to show actualdata that it does.
So what do we know so far aboutrapamycin's impact on lifespan
(08:42):
and healthspan?
Healthspan meaning healthyyears of life.
The strongest evidence comefrom animal studies.
The landmark study that everyonecites was published in Nature
in 2009.
In that study, rapamycin wasfed to middle-aged mice.
The mice were equivalent toabout 60 years.
The mice were equivalent toabout 60-year-old humans in age,
(09:02):
and it still extended theirlives.
This was remarkable because itsuggested that it's never too
late to start.
Even starting rapamycin at alater life phase, the mice lived
longer.
How much longer?
Well, the rapamycin-treatedmice saw about a 9% increase in
lifespan for males and 14% forfemales on average.
(09:24):
Now that might not sound huge,but think of it this way that's
like giving a 60-year-old persona drug, and they end up living
significantly longer than theyotherwise would have.
The mice lived about six monthslonger than their non-treated
counterparts, and six months fora mouse that usually lives
three years at most in captivityis roughly equivalent to 15 to
20 extra years of life for ahuman, whose average life
(09:47):
expectancy is currently around75 to 80 years.
So in mouse terms, the lifeextending benefit of rapamycin
was quite significant, and since2009, there have been many
follow-up studies on mice.
Consistently, rapamycin extendsmedian lifespan, which is the
age by which half the populationhas died, and often maximum
(10:08):
lifespan as well, pushing theoldest age that some mice reach.
And depending on the strain ofmice, dosage and timing, the
effects vary, but increases of10 to 30 percent in lifespan are
commonly reported.
And not only do the mice livelonger, but they often stay
healthier longer.
Delayed onset of cancers,improved heart function in aged
(10:30):
mice.
One study even showed thatbrief treatments with rapamycin
in early adulthood could havelasting positive effects on
lifespan.
The evidence has been sooverwhelming that one scientist
said rapamycin is the universalanti-aging drug in animals,
extending life in all animalstested, from yeast to mammals.
(10:50):
It's hard to overstate howunusual that is in anti-aging
research.
So what about higher animalslike primates?
We don't have conclusivelifespan studies in primates yet
.
Those take a long time.
But there have been trials inmarmoset monkeys and currently
in pet dogs, like the dog agingproject which I mentioned in a
previous podcast, to see ifrapamycin can improve health
(11:11):
span.
Some preliminary results inmonkeys showed rapamycin was
well tolerated and affected someaging biomarkers, but it's too
early to say if it extends theirlives.
The dog studies are ongoing andso we will stay tuned on that
front.
It's being taken very seriously.
So moving on to human studies,the big question is is there any
evidence in humans thatrapamycin could positively
(11:33):
affect our aging or health?
We obviously don't have adefinitive give rapamycin to
people and see if they livelonger study yet, because those
will take decades and a lot offunding.
But we do have some intriguingearly findings.
One key area researchers havestudied is the immune system of
older adults and as we age, ourimmune system tends to decline,
(11:56):
which is why vaccines don't tendto work as well in the elderly
and infections can hit harder.
Rapamycin's immune effects arecomplex.
It suppresses some immunefunctions but paradoxically, it
might boost immune function incertain contexts by reducing
chronic inflammation andrejuvenating immune cells, so to
speak.
In 2014, a controlled trial wasdone where people over 65 were
(12:20):
given a rapamycin analog, whichis a drug similar to rapamycin
or a placebo, for several weeks.
Then they all got a flu vaccine.
The group that had taken therapamycin-like drug had about a
20% better response to the fluvaccine than the placebo group.
In other words, their immunesystems reacted more vigorously,
producing more antibodies.
That was a big hint thatrapamycin was kind of dialing
(12:44):
back the immune aging and makingthe immune system behave more
youthfully.
That same study also notedchanges in immune cell markers
consistent with improved immunecell function.
Building on that, another studypublished in 2018 tested a
combination of rapamycin-relateddrugs in older adults and found
that something even morestriking.
The people who took the drugcombo had fewer infections over
(13:07):
the year compared to those whotook placebo.
To put numbers on it, in thattrial, the treated group had 1.5
infections per year on average,versus 2.4 infections per year
in the placebo group in thefollow-up period, which is a
significant reduction in illness.
They also confirmed theimproved response to vaccines in
this study.
So not only laboratory markersbut actual health outcomes the
(13:31):
catching of fewer colds orinfections were better in the
rapamycin group, and that's apretty encouraging sign that
rapamycin is doing somethingbeneficial in the aging immune
system.
Beyond the immune system, wedon't yet have clinical trials
showing, say, improved lifespanor clear-cut prevention of
diseases due to rapamycin.
These studies are justbeginning.
There are also studies beingplanned or started for seeing if
(13:54):
rapamycin can help withAlzheimer's disease, heart aging
and other conditions.
But what we do have right nowis a growing crowd of
self-experimenters andphysicians who are trying
rapamycin for longevity andtracking results.
There was a recent survey,published in 2023, that
collected data from 333individuals who were taking
rapamycin off-label for healthand longevity reasons, and the
(14:18):
results were interesting.
The people generally reportedpositive effects, with many
saying they felt healthier onrapamycin.
In fact, a large portion agreedwith healthier on rapamycin.
In fact, a large portion agreedwith the statement rapamycin
had anti-aging properties andthat their health had improved
since starting it.
They noted things like feelingmore energetic, improvements in
mood and better physical health.
Now, this is all self-reportedand not a controlled trial, so
(14:41):
take it with a grain of salt,but it shows why enthusiasm is
high.
A lot of users are convincedit's helping them.
Let's talk about the earlyadopters and longevity
enthusiasts In the biohackingcommunity.
Rapamycin has become a hot topicover the past few years.
Big names have publicly talkedabout it.
Dr Peter Attia, a well-knownphysician focused on longevity,
(15:03):
has discussed rapamycin atlength.
He actually classifiesrapamycin as one of the most
promising longevityinterventions, as opposed to
others that he thinks areoverhyped.
He has mentioned that hepersonally has used rapamycin,
albeit cautiously, and heexplores the science on his
podcast.
Then you have techentrepreneurs like Brian Johnson
(15:24):
, who's famous for spendingmillions on anti-aging
experiments on himself.
He for a time includedrapamycin in his routine as well
.
He for a time includedrapamycin in his routine as well
.
He was taking rapamycin foralmost five years as part of his
ultra-quantifiedself-experiment.
And a number of other doctors,such as Dr Alan Green, dr Matt
(15:47):
Kaberlin, have been vocal aboutrapamycin, some actively taking
it, some prescribing it, some asresearchers.
And all of this attention hasled to rapamycin sometimes being
dubbed the fountain of youth ina pill in media headlines.
Now we should all be cautiouswhen it comes to fountain of
youth claims, because there's alot of hype.
But the reason rapamycin standsout is that it actually has
(16:11):
more serious science behind itthan most supposed anti-aging
supplements.
It's multiple studies acrossspecies and some human data
hinting at benefits.
So, in summary, the evidencefor rapamycin as a longevity
drug is compelling but stillincomplete.
In animals it absolutelyextends life robustly.
(16:32):
In humans it seems to improvesome aging-related functions
such as immune performance, andanecdotal reports are positive.
That makes it very promising.
But it's not a done deal, whichis a perfect segue into our next
part of our discussion theskepticism and the risks.
It almost sounds too good to betrue.
Right, an existing inexpensivedrug that could help us live
(16:55):
longer and healthier.
Sign me up.
But as a physician and as arational human, I have to
emphasize we are not 100% surerapamycin will actually extend
human lifespan or evenhealthspan in the long run.
All the excitement is based onindirect evidence.
We are not the same as mice orworms and we live much longer
(17:18):
lives.
It's possible that what worksto extend a mouse life may not
have a big effect on a person's80 old lifespan, or it could
even have unforeseenconsequences.
The truth is, we won't know forsure until we have more data,
and that could take many years.
There's a lack of law.
There is a lack of largelong-term clinical data proving
rapamycin users live longer orhealthier.
(17:40):
Scientists like to say mice arenot men, meaning promising
results in animals don'tguarantee the same in humans,
and because of this, manyexperts urge caution.
For example, you won't find theFDA or mainstream guidelines
telling everyone to go takerapamycin to slow aging.
Far from it, in fact.
The FDA currently doesn't evenconsider aging itself to be a
(18:01):
disease, so you can't market adrug for aging.
So let's talk about the risksand side effects, because
rapamycin is not a benign gummyvitamin.
It's a potent drug.
The very thing that makesrapamycin useful its ability to
modulate the immune system andcell growth can also produce
side effects.
Transplant patients who takerapamycin daily.
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Known side effects includethings such as elevated
cholesterol, antriglycerides,mouth ulcers, slowed wound
healing, rash or acne edema,swelling and, of course,
increased risk of infections dueto immune suppression.
The doses and scheduleslongevity users take are usually
much lower, so we don't see allthose heavy side effects
commonly, but some do carry over.
One of the most common sideeffects, even on low once-weekly
(18:47):
dosing, is mouth sores, alsoknown as aphthous ulcers or
canker sores.
These are usually small soreson the tongue or inside the
mouth that can be annoyinglypainful.
They're not dangerous, butdefinitely a nuisance.
Usually they go away on theirown and they can be managed by
adjusting the dose or taking abreak, and in the survey of
rapamycin users I mentioned, theonly side effect that stood out
(19:07):
statistically were the mouthsores.
Another potential issue aremetabolic effects.
Rapamycin can cause a slightinsulin resistance, meaning it
might raise your blood sugar orreduce how effectively your body
handles carbohydrates.
Why?
Because mTOR is involved inmetabolism and rapamycin, by
inhibiting mTOR, can interferewith some of the insulin
(19:29):
signaling pathways.
So, in simple terms, somepeople on rapamycin can see
their fasting blood glucoselevel creep up or their glucose
tolerance worsen.
There's also often a slightincrease in blood lipids,
cholesterol and triglycerides inpatients on rapamycin, so you
could be trading a possiblelong-term benefit for a mild hit
on your metabolic health in theshort term.
(19:49):
Now, interestingly, in micethese side effects, like higher
blood sugar, are actuallyassociated with longevity, but
in a person you obviously don'twant to induce diabetes or other
issues related to increasedblood sugar.
In practice, many doctorsprescribing rapamycin for
longevity will monitor thesemarkers and, if needed, adjust
(20:10):
diet or add something likemetformin, which is another drug
to counteract any blood sugarrise.
But it is a factor to be awareof.
And now there's the big elephantin the room immune suppression.
Rapamycin's whole job intransplant patients is to dampen
the immune system so it doesn'treject a new organ.
When intermittently used at lowdoses, rapamycin seems to
(20:32):
actually enhance some aspects ofimmune function, like we saw
with vaccines.
But it's a fine line.
Too much rapamycin or toofrequent dosing and you could
absolutely increase your risk ofinfections.
There are anecdotal reports ofrapamycin getting things like
zoster or shingles or slowerrecovery from viral illnesses
which could be due to the drug.
Brian Johnson, who I mentionedearlier, actually stopped taking
(20:56):
rapamycin after he experiencedrepeated infections that he and
his doctors felt might be linkedto rapamycin.
He decided the risk wasn'tworth it for him, and that's a
cautionary tale.
If your immune system gets abit too suppressed, you might
start catching every cold thatgoes around or have minor
infections more often.
(21:17):
That risk likely varies personto person.
Some people on low-doserapamycin report no issues with
infections at all, but othersmight.
Another risk that's beendiscussed is effects on
fertility or hormone-sensitivepathways.
Is effects on fertility orhormone-sensitive pathways?
Rapamycin can inhibit a lot ofcell growth signals, so there
(21:38):
are concerns about, for example,in animal studies, high doses
of rapamycin can reduce spermfunction or ovarian function,
which makes sense since it slowscell growth.
This might not be an issue atlow doses, but if a young person
who is still planning on afamily, it's still something to
consider.
We just don't have data onfertility impact in humans at
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the doses used for longevity.
Similarly, because mTOR isimportant for wound healing and
muscle building, takingrapamycin might slow your wound
healing a bit, and some peoplehave noted that if they get
injured or have surgery, theypause the rapamycin treatment to
allow full healing, which seemsprudent.
Given all these unknowns andside effects, many doctors take
(22:20):
a cautious stance.
For example, dr Andrew Huberman, a neuroscientist who talks a
lot about health optimization,said publicly that, while
rapamycin is intriguing, as faras I know he's not taking it for
longevity right now because ofthe side effect profile and the
lack of long-term data.
His view, which I respect, isthat it's a drug that can be
taken relatively safely, but ithas enough possible downsides
(22:44):
that he'd rather wait until weknow more or until he has a
clearer reason to use it, andthat's a totally valid approach.
In essence, the skepticismboils down to promising but
unproven, and the risks are youmight be causing some harm in
the short term for a benefitthat isn't guaranteed.
(23:04):
If someone is otherwise healthy, do you really want them to
mess with their pathways with adrug without certainty that it
helps?
That's the debate.
Some people are comfortablewith that risk-reward ratio and
others want to see more evidencefirst.
We should also remember thateveryone is different.
A dose that might be fine forme might cause my friend to be
(23:26):
lousy or get sick, depending ongenetics, diet or other medical
issues.
This isn't a one-size-fits-all.
What about dosing and costconsiderations?
Let's say someone, after doingtheir research and consulting a
doctor, is interested in tryingrapamycin for potential
longevity benefits.
How do people actually take itin this context and what is the
cost and what does it involvelogistically?
(23:48):
These are obviously commonpractical questions.
Let's start with dosing.
Dosing for longevity obviouslyis not the same as dosing for
organ transplant.
In transplant medicine,rapamycin might be given every
day at 2-5 mg per day, or evensometimes after a higher initial
loading dose.
That daily regimen is whattends to cause more side effects
(24:10):
and immune suppression Forlongevity.
Nearly all experts and usersfavor an intermittent dosing
schedule, most commonly once aweek.
A typical dose is in theballpark of 5 to 6 milligrams
weekly and some people willstart lower, like 1 to 2
(24:31):
milligrams weekly, and thenincrease.
Others might go higher if theytolerate it.
There are folks out theretaking 10 milligrams once a week
, for example, but surveys havefound that most are using five
to six milligrams weekly, whichis the sweet spot that people
settle on.
The reason for once weeklydosing is to get a periodic
knockdown of the mTOR pathway totrigger the good effects, but
(24:53):
then to allow the mTOR pathwayto come back to normal in
between doses.
This intermittent approachseems to minimize side effects
while still providing benefit.
In fact, one paper noted thatthis weekly schedule is
generally well-tolerated withminimal issues aside from rare
mouth sores.
It does depend on the individual, however.
For example, one of mycolleagues who has been taking
(25:14):
rapamycin for six monthsadjusted his dose to seven
milligrams every 10 days becausehe was having a lot of GI upset
.
So a higher dose, spaced outlonger, seemed to work better
for him and he still gets thosemouth sores, but he says that's
not a big deal for him.
There is an ongoing debateabout best dosing strategy 10
days, two weeks.
Others have experimented withrapamycin vacations, taking it
(25:35):
for a few months, then pausing.
Since we don't have definitivedata, people are basically
experimenting based on animalstudies and theory.
We do know from mice thathigher doses tend to produce
bigger lifespan gains up to apoint, but of course higher
doses risk more side effects.
So it's a balancing act.
One more thing on dosingbecause rapamycin has a long
(26:00):
half-life, around two to threedays, in humans, it's mostly out
of your system by the next dose, but not entirely.
That's why some choose, say,once every 10 days, like my
colleague, to be extra surethere's no continuous
accumulation of drug.
Again, these fine details arestill being worked out.
If I were to start it, it seemsreasonable to start at a
once-a-week schedule to keep itsimple, unless there's a reason
to adjust.
(26:21):
What about getting aprescription?
Rapamycin is a prescriptiondrug and you can't just buy it
as a supplement at GNC.
So how are people obtaining itfor off-label use?
Well, there are a few ways.
There are an increasing numberof doctors in the field of
longevity medicine orintegrative medicine who will
prescribe rapamycin off-labelfor patients who want to use it
for healthspan, and one reviewmentioned there were more than
(26:42):
20 medical practices in the USthat were already prescribing
rapamycin as an anti-agingtreatment.
There are also telemedicineservices and longevity clinics
that specifically cater to this.
You can do a consultation andif you're an appropriate
candidate, they might prescribeit.
Additionally, because rapamycinis an FDA-approved medication,
any licensed physician canprescribe it off-label if they
(27:05):
judge it's appropriate.
Some patients have had lucktalking to their regular medical
doctors by presenting research,especially if they're older or
have some condition that itmight benefit.
For example, if a patient had ahistory of cancer, their doctor
might be more open to it, givenrapamycin's anti-cancer
possible benefits.
Then there's the gray marketroute.
Some people order rapamycinfrom international pharmacies
(27:28):
since generics are made incountries such as India, or even
online.
I don't recommend going aroundprescribing practices without a
doctor's oversight, but it doeshappen, and one survey found
about 20% of rapamycin userswere taking it without physician
supervision, essentiallyself-medicating.
That just shows you how eagersome people are to get their
(27:49):
hands on it.
But of course, ideally oneshould do it with medical
guidance, because you need thatmonitoring for safety.
What about cost?
So here's a pleasant surpriseit's not very expensive.
It's a generic drug.
The brand name Rapamune can bepricey, but the generic
Sirolimus is relativelyaffordable.
Pricing can vary but the costfor a typical weekly dose is
(28:13):
usually about $5-10 a week.
Some compounding pharmacies inthe US might charge a bit more
or if you go through a longevityclinic, it might be marked up,
but compared to many othermedications or supplements, it's
not a budget breaker.
One thing to watch out for ifyou're working with a clinic
that provides a whole package ofanti-aging services, they might
(28:35):
bundle the cost or charge apremium.
But since rapamycin itself is ageneric, you do have the option
to shop around.
What about regulatoryconsiderations?
As I mentioned, rapamycin forlongevity is an off-label use.
That means it's legally allowed, but it's not an FDA-recognized
indication.
(28:56):
As I mentioned, the FDA is notevaluating rapamycin for aging
because aging isn't classifiedas a disease and there's no
company that would spend themoney to get that indication
anyway because the drug isoff-patent.
Practically, it means you can'tjust go into your regular
pharmacy and say I wantrapamycin for aging and get a
prescription.
It means we don't have officialdosing guidelines and it's all
(29:19):
community driven In terms ofaccessibility because it's
prescription only.
The main hurdle is just findinga doctor or service willing to
prescribe it.
And now my own personalreflection.
I want to shift gears a littlebit, talk about my own personal
take, why I'm even consideringtaking rapamycin for myself and
how I would approach it.
I'll admit, the whole idea oflongevity and extending one's
(29:42):
healthy years fascinates me.
As a medical professional andon a personal level, I've
dedicated my career to plasticsurgery and wellness, helping
people not only look better butfeel better.
And as a CrossFit coach andsomeone involved in fitness, our
goal is to be able to functionat the highest level for as long
as possible.
(30:02):
I mean, who wouldn't want to bethat 80-year-old who's still
crushing it in the gym orplaying with their grandkids
without getting winded?
So rapamycin caught my attentionbecause it's one of the first
interventions that has shownreal promise in actually slowing
markers of aging, not justmasking them, unlike Botox,
which is a great drug, but justworks on the wrinkles on the
(30:23):
surface, or even exercise, whichis fantastic for health but has
its limits.
Trust me, I feel that at a 5 amclass.
Rapamycin works at a cellularlevel on a pathway we know is
tied to aging, and that'sprofound.
It is amazing that we might beable to influence the biology of
aging with a simple pill.
(30:43):
So why would anyone considertaking rapamycin?
I think the biggest reasonwould be prevention.
I'm 55 years old and I certainlytry to optimize my life to a
reasonable degree.
I try to do all the healthyrecommended lifestyle things
exercise regularly, keep my dietrelatively clean.
I wish I could manage my stressbetter and get more sleep, but
(31:04):
I'm still working on that.
I don't have any major healthissues and I want to keep it
that way for as long as I can.
So if rapamycin could even adda few extra healthy years, keep
me healthier into my 70s, 80s orlonger, that's something I
think anyone would be interestedin, especially if rapamycin can
reduce the risk of big killerssuch as cancer, heart disease or
(31:26):
neurodegenerative diseases.
In animal studies, rapamycin hasbeen shown to delay the onset
of cancers and other age-relateddiseases.
For example, in the studies,rapamycin has been shown to
delay the onset of cancers andother age-related diseases.
For example, in the studies,all mice got the same diseases
as they got old, but the ones onrapamycin got them later and
sometimes less severely.
This suggests that rapamycinisn't just making them live
(31:47):
longer in a frail state, it'sactually extending their health
span and I find that reallyappealing state.
It's actually extending theirhealth span and I find that
really appealing.
Our goal isn't to live to 120if those extra years are
bedridden.
Our goal is to compress theperiod of decline and stay
vibrant for longer, andrapamycin theoretically could
help achieve that by slowingdown the accumulation of
(32:07):
cellular damage.
Also, I have to mention, as aplastic surgeon, I'm curious if
rapamycin would have anynoticeable effects on things
such as skin aging.
There's some evidence that itmight improve skin quality.
There have been some smallstudies of topical rapamycin on
aging skin.
Now I wouldn't bank on afountain of youth for appearance
specifically, but you mightthink if it keeps you healthy,
(32:28):
it would also reflect on theoutside as well.
And anecdotally my colleaguehas mentioned, not only do their
skin quality appear clearer,but their hair appears to be
thicker and their bald spotappears to be shrinking.
I don't know if that's a realeffect or placebo, but that
would be great to have thoseside effects too.
What are my concerns?
Number one is safety.
(32:48):
I'm wary of any long-termunknown effects.
If I start taking rapamycin inmy 50s and take it for decades,
what might happen that wehaven't predicted?
Could it be a rare side effectthat only shows up after 10
years of use?
We just don't have longtimelines and data yet.
Now for transplant patients yes,some of them have been on it
(33:09):
for long term, but they oftentake high doses.
But they take high doses andthey have other medical
conditions in play.
I'm also concerned about themetabolic side effects.
The last thing I want to do isinduce prediabetes in myself by
taking a drug.
That would be counterproductive, so I'd have to monitor my
blood sugar closely.
That would be counterproductive, so I'd have to monitor my
blood sugar closely and if I sawa trend upward, I might have to
(33:30):
adjust my dose or even takeanother drug such as metformin.
I'm not terribly worried aboutday-to-day minor infections
because I'm generally healthy,but if I started catching
unusual infections or hadtrouble recovering from a flu,
that would be a red flag and Imight stop the drug if that
happened.
Health always comes first.
Longevity hacking comes second.
(33:51):
I'm not going to risk seriousillness now for potential
benefit later.
And one other issue that wedon't have time to get into
greater detail is whetherrapamycin could negatively
affect muscle mass and athleticperformance.
After all, rapamycin inhibitsmTOR, and mTOR is a key driver
of muscle protein synthesis.
Some worry that it could impairmuscle gains or even accelerate
(34:14):
muscle loss.
Now, right now, the availablehuman data does not show a
dramatic loss of muscle inpeople taking low intermittent
doses.
Plus, there's anecdotalevidence of individuals who
still maintain or can increasetheir muscle mass while on a
once-weekly regimen.
But this theoretical risk stillexists, especially someone
taking a higher or daily dosethat inhibits the mTOR pathway
(34:36):
more strongly.
So for bodybuilders or athleteswho rely heavily on maximizing
muscle protein synthesis, it maybe prudent to proceed carefully
, monitor strength and bodycomposition and possibly adjust
dosing if signs point todiminished muscle gains.
And I can already see a lot ofpeople at my gym mentally
crossing rapamycin off theirlist just with this issue,
(34:58):
because they don't want to losetheir gains, bro.
So how do I plan to approach it?
I haven't started it yet.
I am rapamycin curious.
I'll continue to talk to mydoctor, who has experience with
rapamycin in patients, and eventhough I'm a physician myself, I
value getting other experts'opinions, especially those
prescribing it.
There are longevity clinics outthere.
(35:20):
I might speak to some of myother local colleagues in
geriatric medicine orendocrinology, and these
discussions will help me weighmy personal risk factors and
establish a baseline.
Before I start, I would get abaseline of various health
metrics blood work, including acomplete blood count, metabolic
panel, glucose, liver, kidneyfunction, lipids, inflammatory
(35:42):
markers, possibly a HbA1c, whichis a three-month average of a
blood sugar level marker,possibly even immune function
tests or an epigenetic age test.
I might also establish myexercise performance as a
qualitative baseline.
Maybe I'll do FRAN, which is apopular CrossFit workout, before
(36:02):
I start and then retest myselfin six months.
I think the strategy is startlow, go slow.
I would probably start at alower dose, maybe two milligrams
weekly for a while and thenincrease to five milligrams
weekly if I felt that I wasobserving, and then I might
increase to five milligramsweekly after observing.
(36:25):
If there were any possibleeffects.
I would want to recheck myblood work, maybe effects.
I would want to recheck myblood work after several months
to see if anything's changed.
Maybe my cholesterol spiked ormy blood sugar had increased.
If my blood sugar went up, I'dconsider adding metformin or
adjusting my diet.
And if my white blood cellcount dropped significantly.
(36:46):
That would certainly concern meabout immune suppression.
I would want to continue all ofmy healthy habits.
If anything, I might tightenthem up even more to support my
body.
For example, rapamycin'sbenefits might depend on good
nutrition and not overeating,and maybe it might work best
with synergy, and it might evenwork best in synergy with things
(37:07):
such as exercise.
There is some thought thatexercise and rapamycin are
complementary in improvinghealth span.
I'd also want to avoid anyimmunosuppressive things.
I certainly wouldn't want to beon rapamycin and another
immune-suppressing drug, such asprednisone, simultaneously, and
it would be interesting torepeat an epigenetic age marker
(37:30):
to see if there's any change intrajectory after starting
rapamycin.
Although these are experimental, they might give me some
insight.
I think the big thing is tokeep expectations realistic.
I don't expect to feel 20 yearsyounger overnight or anything
dramatic.
In fact, if rapamycin isworking, I might not feel
anything at all.
It might just be quietlycleaning up my cells in the
(37:51):
background and the payoff mightbe invisible in the short term,
where no news is actually goodnews, and I'm just essentially
betting my future on it.
And if I keep thoseexpectations, I think I would be
okay.
With that mindset, I wouldprobably commit to taking
rapamycin for a year or two andthen reevaluate.
One advantage is, if you do stoprapamycin, its effects, both
(38:13):
good or bad, will wear off.
You can always restart it later.
It's not permanent.
Some people do cycle it, as Imentioned, a year on, a few
months off.
We don't know if that's abetter approach or not, but it
is something some people aredoing.
Emotionally and psychologically, it's interesting to take a
drug that can potentially slowaging.
It almost feels sci-fi.
I'd be lying if I said I wasn'tat least a little bit excited
(38:36):
by that idea.
But I check myself by sayingall right, this is still
experimental and I have aresponsibility to do it in an
informed way and share honestlyabout it.
In summary, I'm drawn to itbecause of its strong science
backing and possibility ofextending my healthy years.
I am cautious for the unknownsand I don't necessarily need it
(38:57):
right now.
It's just a choice topotentially enhance my future
health.
If I proceed, I would want todo it in a careful, monitored
way, almost like enrollingyourself in an experiment where
n equals one, which is myself,and I would hope to share those
insights in a future podcast ifpossible.
So we've covered a lot, solet's zoom out, recap some of
(39:19):
the key takeaways.
Rapamycin is a drug with areally unique pedigree,
discovered on Easter Island,used in transplant patients and
now repurposed in the labs ofaging researchers.
It inhibits the mTOR pathway,telling cells to slow down
growth and rev up maintenancemode, like autophagy, and in
study after study with organismsfrom yeast to mice, it's
(39:41):
extended lifespan.
That makes it one of the mostpromising potential anti-aging
therapies we know of.
That makes it one of the mostpromising potential anti-aging
therapies we know of.
Early human trials have notshown people living longer yet,
but show some improvement inimmune function and other health
markers, and many earlyadopters claim it's helping them
feel healthier.
But it's not a proven fountainof youth for humans.
(40:04):
At this point it's an excitinghypothesis backed by strong
animal data and some suggestivehuman data, but it's not
definitive.
There are trade-offs andpotential downsides mouth sores,
metabolic changes, lack ofmuscle growth.
It's a real drug that deservesrespect In terms of dosing and
cost.
(40:24):
A lot of people are taking fivemilligrams once weekly, which
tends to be well-tolerated.
The cost is on the order oftens of dollars a month, which
is quite reasonable, but sinceit's off-label, you'll need to
find a willing provider to getit.
From my perspective, I thinkit's promising enough that it's
on my radar to possibly use formyself, and I hope that this
(40:46):
discussion has been helpful andinformative.
In conclusion, I just want toemphasize that no longevity
approach works in isolation.
It's not a magic pill thatmeans you can ignore all the
other basics.
You'll still need to exercise,which is the burpees part of
this podcast Eat well, sleep,reduce stress, have social
connections and so on.
Those are the foundations, andif rapamycin works, it would be
(41:08):
icing on the cake, but if itdoesn't pan out, those
foundational healthy habits willstill carry you far.
I'm really curious to hear yourthoughts on rapamycin.
Have you heard about it before?
Would you consider taking adrug to potentially slow aging,
or is that a line you wouldn'twant to cross?
Maybe some of you have eventried rapamycin and if so, I'd
like to know about yourexperiences.
(41:29):
Please feel free to reach out.
Instagram handle is at Botoxand Burpees podcast or our
YouTube channel Any comments orquestions.
This is a rapidly evolvingfield.
I'm sure there will be newstudies and findings coming out
very rapidly.
Until next time, take care ofyour body.
Take care of your health Untilnext time.
Take care of your body, takecare of your health and, as
(41:50):
always, keep chasing that bestversion of yourself, whether
it's a better skincare routine,hitting that PR in a gym or,
maybe, someday, a little pillthat will keep you younger at
heart.
Stay healthy and see you nextepisode.
Thank you.
Hello and welcome to Botox and Burpees.
I'm Sam Rhee, your host,board-certified plastic surgeon,
crossfit coach, who lovesexploring where health, beauty
and fitness intersect.
Thanks for tuning in.
Today I want to talk aboutsomething that's been generating
a lot of buzz in the longevityand anti-aging world drug called
rapamycin.
Some researchers have evencalled rapamycin potentially the
(00:27):
most powerful anti-aging drugever discovered.
Now that's a huge claim, solet's dig into what that really
means.
Now, if you're watching onyoutube, you can actually see
I'm holding up rapamycin, whichlooks pretty ordinary actually
it's just some small white pills.
I had a physician prescribe itfor me because I actually have
(00:47):
been considering startingrapamycin myself, but I haven't
started it yet.
But after one of my colleaguesstarted rapamycin about six
months ago and told me about themedication, I did a quick
Google search and it's lookedgreat so far at first glance.
But a couple of weeks ago, whenI got the medication before I
was about to start it, Irealized I really didn't know
(01:08):
what this medication was allabout and it was something that
I was going to have to take fora long time to help me live
longer.
So before I actually decided tostart, I wanted to actually
research this medication, whichI did, and now I'm going to
share what I found with you, mypodcast audience.
All of us are looking to stayyoung, and it's obvious that
(01:28):
it's very important to almostall of us.
What's so funny is, when Ifirst brought the medication
home, my spouse saw it and askedme what it was, and when I said
it was an anti-aging drug, sheimmediately said what, you're
going to take a longevity drugand you aren't going to give any
to me.
So what, You're going to take alongevity drug and you aren't
going to give any to me.
So what, you're going to wantme to die early and then you'll
just keep living.
And I had to say whoa, whoa,whoa, let's take a step back
(01:49):
here, sheesh.
So in this episode I'll be doinga deep dive into what rapamycin
is and why people think itmight help us live longer.
I'll cover a bit of thebackstory of how it was
discovered and first used inmedicine, how scientists first
found it could extend lifespanin lab animals and the mechanism
behind how it works in ourcells.
(02:09):
I'll also go over the evidencefor its longevity benefits, what
studies in animals and humanshave shown so far and the
reasons to be skeptical,including potential risks and
side effects.
I'll talk through why I'mconsidering it as a part of my
own health journey, but alsowhat my reservations are risks
and side effects.
I'll talk through why I'mconsidering it as a part of my
own health journey, but alsowhat my reservations are, and by
(02:31):
the end we'll recap the keypoints.
Basically, is rapamycin a truelongevity silver bullet or just
another far out chancyexperimental elixir?
But remember, as always, thispodcast is not a substitute for
professional medical advice,diagnosis or treatment.
This shows for informationalpurposes only.
Treatment and results may varybased on circumstances,
situation and medical judgment.
After appropriate discussion,always seek the advice of your
(02:52):
qualified health provider withany questions you may have
regarding medical care and neverdisregard professional medical
advice or delay seeking advicebecause of something in the show
.
And, to emphasize this point,don't decide what to do with
rapamycin for yourself until yousee your own physician.
Okay, so whether you've neverheard of rapamycin or you've
already gone down the internetrabbit hole on it, we'll keep
(03:15):
this conversation approachablejust as if we were chatting over
a post-workout fit aid.
See what I did there About thisintriguing drug that might help
us stay youthful.
So let's start with thebackground on rapamycin.
What exactly is it?
Rapamycin, also known by thebrand name sirolimus, is a drug
that has been around for a fewdecades.
(03:36):
Back in the 1960s and 70s,researchers were exploring the
soil on Easter Island theisland's local name is Rapa Nui,
which is where the namerapamycin comes from and they
discovered a new compoundproduced by bacteria in that
soil.
And by 1972, scientists hadisolated this compound from the
soil and named it rapamycin,initially noting it had
(03:59):
antifungal properties.
So at first scientists thoughtit might be a useful antifungal
medication.
However, as they studiedrapamycin, more scientists
thought it might be a usefulantifungal medication.
However, as they studiedrapamycin more, they found it
had some other remarkableeffects.
It turned out rapamycin couldsuppress the immune system In
medical terms, animmunosuppressant.
This made it extremely usefulfor a completely different
(04:20):
purpose, which is preventingorgan transplant rejection.
In organ transplant patients,you want to dampen the immune
system to a certain degree so itdoesn't attack the newly
transplanted organ, andrapamycin was found to be
effective for this, and the FDAapproved it in 1999 for use in
kidney transplant patients, andsince then it's been given to
(04:41):
millions of transplant patientsto protect their organs.
It's also been used indrug-eluting coronary stents, to
prevent those stents fromgetting clogged and for a rare
lung disease.
But the main thing to know isthat rapamycin has been a legit
medicine for years, typicallygiven daily to suppress immunity
, just enough to help transplantpatients.
Now why are we even talkingabout this transplant drug in
(05:03):
the context of longevity?
Now, why are we even talkingabout this transplant drug in
the context of longevity?
The link became apparent whenscientists unraveled how
rapamycin works at the cellularlevel.
Rapamycin's big trick is thatit inhibits a protein in our
cells called mTOR.
That stands for mechanistictarget of rapamycin.
Yes, this protein is literallynamed after rapamycin, because
(05:24):
rapamycin was key to discoveringit.
Mtor as a protein is basicallya master controller for cell
growth and metabolism.
You can think of mTOR as acentral nutrient sensor.
It gauges if cells have enoughnutrients like amino acids,
growth factors, energy, anddecides if the cell should grow,
divide or instead hunker downand do maintenance.
(05:46):
When nutrients are plentiful,mtor is active and it promotes
cell growth and proliferation.
When nutrients are scarce, likeif you're fasting, mtor
activity drops and the cellshifts into maintenance mode,
which includes things likeautophagy, which is a cellular
cleanup, recycling process.
Rapamycin turns down mTORactivity, essentially mimicking
(06:10):
a low nutrient signal and byinhibiting the mTOR pathway,
rapamycin causes cells to act asif they're in a
calorie-restricted or low-energystate.
So why does that matter foraging?
Well, you may know that decadesof research have shown that
caloric restriction, where youeat significantly fewer calories
while still getting nutrients,can extend lifespan in many
(06:34):
organisms.
One reason is that it enhancesautophagy and reduces cellular
growth signals, which seems toslow down aging processes.
Mtor is a key player in thatwhole story.
So scientists theorized if weuse rapamycin to inhibit mTOR,
could we get similar longevitybenefits without actually
cutting calories?
(06:54):
It's like a fastingimpersonator at the cellular
signaling level and, sure enough, when researchers started
testing rapamycin in various laborganisms, the results were
striking.
Rapamycin consistently extendedlifespan in every species tested
.
Yeast, worms, fruit flies andmice all lived longer when given
(07:16):
rapamycin.
This is a big deal.
There are a lot of compoundsthat might extend life in a worm
but do nothing in a mouse, forexample, and rapamycin is one of
the few that seems to work inmany different species,
suggesting it hits a fundamentalaging mechanism.
In fact, rapamycin was thefirst drug proven to extend
(07:36):
lifespan in a mammal mice in arigorous, excellently
constructed study, and thatopened the floodgates of
excitement that maybe, justmaybe, rapamycin could have an
anti-aging effect in humans too.
So to sum up the background,rapamycin was discovered on an
exotic island, became a drug tohelp transplant patients by
(07:58):
suppressing immunity, and in theprocess of studying it, we
learned that it targets anaging-related pathway called
mTOR, and in lab animals,turning down mTOR with rapamycin
makes them live longer,presumably by triggering
cellular housecleaning,autophagy and dialing back some
of the age-acceleratingprocesses.
It went from an obscurecompound to a potential
(08:20):
longevity superstar in the eyesof scientists, which is quite
the winding road for thismedication.
So what are the evidence forlongevity benefits?
It's one thing to have a theorythat a drug might slow aging,
but it's another to show actualdata that it does.
So what do we know so far aboutrapamycin's impact on lifespan
(08:42):
and healthspan?
Healthspan meaning healthyyears of life.
The strongest evidence comefrom animal studies.
The landmark study that everyonecites was published in Nature
in 2009.
In that study, rapamycin wasfed to middle-aged mice.
The mice were equivalent toabout 60 years.
The mice were equivalent toabout 60-year-old humans in age,
(09:02):
and it still extended theirlives.
This was remarkable because itsuggested that it's never too
late to start.
Even starting rapamycin at alater life phase, the mice lived
longer.
How much longer?
Well, the rapamycin-treatedmice saw about a 9% increase in
lifespan for males and 14% forfemales on average.
(09:24):
Now that might not sound huge,but think of it this way that's
like giving a 60-year-old persona drug, and they end up living
significantly longer than theyotherwise would have.
The mice lived about six monthslonger than their non-treated
counterparts, and six months fora mouse that usually lives
three years at most in captivityis roughly equivalent to 15 to
20 extra years of life for ahuman, whose average life
(09:47):
expectancy is currently around75 to 80 years.
So in mouse terms, the lifeextending benefit of rapamycin
was quite significant, and since2009, there have been many
follow-up studies on mice.
Consistently, rapamycin extendsmedian lifespan, which is the
age by which half the populationhas died, and often maximum
(10:08):
lifespan as well, pushing theoldest age that some mice reach.
And depending on the strain ofmice, dosage and timing, the
effects vary, but increases of10 to 30 percent in lifespan are
commonly reported.
And not only do the mice livelonger, but they often stay
healthier longer.
Delayed onset of cancers,improved heart function in aged
(10:30):
mice.
One study even showed thatbrief treatments with rapamycin
in early adulthood could havelasting positive effects on
lifespan.
The evidence has been sooverwhelming that one scientist
said rapamycin is the universalanti-aging drug in animals,
extending life in all animalstested, from yeast to mammals.
(10:50):
It's hard to overstate howunusual that is in anti-aging
research.
So what about higher animalslike primates?
We don't have conclusivelifespan studies in primates yet
.
Those take a long time.
But there have been trials inmarmoset monkeys and currently
in pet dogs, like the dog agingproject which I mentioned in a
previous podcast, to see ifrapamycin can improve health
(11:11):
span.
Some preliminary results inmonkeys showed rapamycin was
well tolerated and affected someaging biomarkers, but it's too
early to say if it extends theirlives.
The dog studies are ongoing andso we will stay tuned on that
front.
It's being taken very seriously.
So moving on to human studies,the big question is is there any
evidence in humans thatrapamycin could positively
(11:33):
affect our aging or health?
We obviously don't have adefinitive give rapamycin to
people and see if they livelonger study yet, because those
will take decades and a lot offunding.
But we do have some intriguingearly findings.
One key area researchers havestudied is the immune system of
older adults and as we age, ourimmune system tends to decline,
(11:56):
which is why vaccines don't tendto work as well in the elderly
and infections can hit harder.
Rapamycin's immune effects arecomplex.
It suppresses some immunefunctions but paradoxically, it
might boost immune function incertain contexts by reducing
chronic inflammation andrejuvenating immune cells, so to
speak.
In 2014, a controlled trial wasdone where people over 65 were
(12:20):
given a rapamycin analog, whichis a drug similar to rapamycin
or a placebo, for several weeks.
Then they all got a flu vaccine.
The group that had taken therapamycin-like drug had about a
20% better response to the fluvaccine than the placebo group.
In other words, their immunesystems reacted more vigorously,
producing more antibodies.
That was a big hint thatrapamycin was kind of dialing
(12:44):
back the immune aging and makingthe immune system behave more
youthfully.
That same study also notedchanges in immune cell markers
consistent with improved immunecell function.
Building on that, another studypublished in 2018 tested a
combination of rapamycin-relateddrugs in older adults and found
that something even morestriking.
The people who took the drugcombo had fewer infections over
(13:07):
the year compared to those whotook placebo.
To put numbers on it, in thattrial, the treated group had 1.5
infections per year on average,versus 2.4 infections per year
in the placebo group in thefollow-up period, which is a
significant reduction in illness.
They also confirmed theimproved response to vaccines in
this study.
So not only laboratory markersbut actual health outcomes the
(13:31):
catching of fewer colds orinfections were better in the
rapamycin group, and that's apretty encouraging sign that
rapamycin is doing somethingbeneficial in the aging immune
system.
Beyond the immune system, wedon't yet have clinical trials
showing, say, improved lifespanor clear-cut prevention of
diseases due to rapamycin.
These studies are justbeginning.
There are also studies beingplanned or started for seeing if
(13:54):
rapamycin can help withAlzheimer's disease, heart aging
and other conditions.
But what we do have right nowis a growing crowd of
self-experimenters andphysicians who are trying
rapamycin for longevity andtracking results.
There was a recent survey,published in 2023, that
collected data from 333individuals who were taking
rapamycin off-label for healthand longevity reasons, and the
(14:18):
results were interesting.
The people generally reportedpositive effects, with many
saying they felt healthier onrapamycin.
In fact, a large portion agreedwith healthier on rapamycin.
In fact, a large portion agreedwith the statement rapamycin
had anti-aging properties andthat their health had improved
since starting it.
They noted things like feelingmore energetic, improvements in
mood and better physical health.
Now, this is all self-reportedand not a controlled trial, so
(14:41):
take it with a grain of salt,but it shows why enthusiasm is
high.
A lot of users are convincedit's helping them.
Let's talk about the earlyadopters and longevity
enthusiasts In the biohackingcommunity.
Rapamycin has become a hot topicover the past few years.
Big names have publicly talkedabout it.
Dr Peter Attia, a well-knownphysician focused on longevity,
(15:03):
has discussed rapamycin atlength.
He actually classifiesrapamycin as one of the most
promising longevityinterventions, as opposed to
others that he thinks areoverhyped.
He has mentioned that hepersonally has used rapamycin,
albeit cautiously, and heexplores the science on his
podcast.
Then you have techentrepreneurs like Brian Johnson
(15:24):
, who's famous for spendingmillions on anti-aging
experiments on himself.
He for a time includedrapamycin in his routine as well
.
He for a time includedrapamycin in his routine as well
.
He was taking rapamycin foralmost five years as part of his
ultra-quantifiedself-experiment.
And a number of other doctors,such as Dr Alan Green, dr Matt
(15:47):
Kaberlin, have been vocal aboutrapamycin, some actively taking
it, some prescribing it, some asresearchers.
And all of this attention hasled to rapamycin sometimes being
dubbed the fountain of youth ina pill in media headlines.
Now we should all be cautiouswhen it comes to fountain of
youth claims, because there's alot of hype.
But the reason rapamycin standsout is that it actually has
(16:11):
more serious science behind itthan most supposed anti-aging
supplements.
It's multiple studies acrossspecies and some human data
hinting at benefits.
So, in summary, the evidencefor rapamycin as a longevity
drug is compelling but stillincomplete.
In animals it absolutelyextends life robustly.
(16:32):
In humans it seems to improvesome aging-related functions
such as immune performance, andanecdotal reports are positive.
That makes it very promising.
But it's not a done deal, whichis a perfect segue into our next
part of our discussion theskepticism and the risks.
It almost sounds too good to betrue.
Right, an existing inexpensivedrug that could help us live
(16:55):
longer and healthier.
Sign me up.
But as a physician and as arational human, I have to
emphasize we are not 100% surerapamycin will actually extend
human lifespan or evenhealthspan in the long run.
All the excitement is based onindirect evidence.
We are not the same as mice orworms and we live much longer
(17:18):
lives.
It's possible that what worksto extend a mouse life may not
have a big effect on a person's80 old lifespan, or it could
even have unforeseenconsequences.
The truth is, we won't know forsure until we have more data,
and that could take many years.
There's a lack of law.
There is a lack of largelong-term clinical data proving
rapamycin users live longer orhealthier.
(17:40):
Scientists like to say mice arenot men, meaning promising
results in animals don'tguarantee the same in humans,
and because of this, manyexperts urge caution.
For example, you won't find theFDA or mainstream guidelines
telling everyone to go takerapamycin to slow aging.
Far from it, in fact.
The FDA currently doesn't evenconsider aging itself to be a
(18:01):
disease, so you can't market adrug for aging.
So let's talk about the risksand side effects, because
rapamycin is not a benign gummyvitamin.
It's a potent drug.
The very thing that makesrapamycin useful its ability to
modulate the immune system andcell growth can also produce
side effects.
Transplant patients who takerapamycin daily.
(18:23):
Known side effects includethings such as elevated
cholesterol, antriglycerides,mouth ulcers, slowed wound
healing, rash or acne edema,swelling and, of course,
increased risk of infections dueto immune suppression.
The doses and scheduleslongevity users take are usually
much lower, so we don't see allthose heavy side effects
commonly, but some do carry over.
One of the most common sideeffects, even on low once-weekly
(18:47):
dosing, is mouth sores, alsoknown as aphthous ulcers or
canker sores.
These are usually small soreson the tongue or inside the
mouth that can be annoyinglypainful.
They're not dangerous, butdefinitely a nuisance.
Usually they go away on theirown and they can be managed by
adjusting the dose or taking abreak, and in the survey of
rapamycin users I mentioned, theonly side effect that stood out
(19:07):
statistically were the mouthsores.
Another potential issue aremetabolic effects.
Rapamycin can cause a slightinsulin resistance, meaning it
might raise your blood sugar orreduce how effectively your body
handles carbohydrates.
Why?
Because mTOR is involved inmetabolism and rapamycin, by
inhibiting mTOR, can interferewith some of the insulin
(19:29):
signaling pathways.
So, in simple terms, somepeople on rapamycin can see
their fasting blood glucoselevel creep up or their glucose
tolerance worsen.
There's also often a slightincrease in blood lipids,
cholesterol and triglycerides inpatients on rapamycin, so you
could be trading a possiblelong-term benefit for a mild hit
on your metabolic health in theshort term.
(19:49):
Now, interestingly, in micethese side effects, like higher
blood sugar, are actuallyassociated with longevity, but
in a person you obviously don'twant to induce diabetes or other
issues related to increasedblood sugar.
In practice, many doctorsprescribing rapamycin for
longevity will monitor thesemarkers and, if needed, adjust
(20:10):
diet or add something likemetformin, which is another drug
to counteract any blood sugarrise.
But it is a factor to be awareof.
And now there's the big elephantin the room immune suppression.
Rapamycin's whole job intransplant patients is to dampen
the immune system so it doesn'treject a new organ.
When intermittently used at lowdoses, rapamycin seems to
(20:32):
actually enhance some aspects ofimmune function, like we saw
with vaccines.
But it's a fine line.
Too much rapamycin or toofrequent dosing and you could
absolutely increase your risk ofinfections.
There are anecdotal reports ofrapamycin getting things like
zoster or shingles or slowerrecovery from viral illnesses
which could be due to the drug.
Brian Johnson, who I mentionedearlier, actually stopped taking
(20:56):
rapamycin after he experiencedrepeated infections that he and
his doctors felt might be linkedto rapamycin.
He decided the risk wasn'tworth it for him, and that's a
cautionary tale.
If your immune system gets abit too suppressed, you might
start catching every cold thatgoes around or have minor
infections more often.
(21:17):
That risk likely varies personto person.
Some people on low-doserapamycin report no issues with
infections at all, but othersmight.
Another risk that's beendiscussed is effects on
fertility or hormone-sensitivepathways.
Is effects on fertility orhormone-sensitive pathways?
Rapamycin can inhibit a lot ofcell growth signals, so there
(21:38):
are concerns about, for example,in animal studies, high doses
of rapamycin can reduce spermfunction or ovarian function,
which makes sense since it slowscell growth.
This might not be an issue atlow doses, but if a young person
who is still planning on afamily, it's still something to
consider.
We just don't have data onfertility impact in humans at
(21:59):
the doses used for longevity.
Similarly, because mTOR isimportant for wound healing and
muscle building, takingrapamycin might slow your wound
healing a bit, and some peoplehave noted that if they get
injured or have surgery, theypause the rapamycin treatment to
allow full healing, which seemsprudent.
Given all these unknowns andside effects, many doctors take
(22:20):
a cautious stance.
For example, dr Andrew Huberman, a neuroscientist who talks a
lot about health optimization,said publicly that, while
rapamycin is intriguing, as faras I know he's not taking it for
longevity right now because ofthe side effect profile and the
lack of long-term data.
His view, which I respect, isthat it's a drug that can be
taken relatively safely, but ithas enough possible downsides
(22:44):
that he'd rather wait until weknow more or until he has a
clearer reason to use it, andthat's a totally valid approach.
In essence, the skepticismboils down to promising but
unproven, and the risks are youmight be causing some harm in
the short term for a benefitthat isn't guaranteed.
(23:04):
If someone is otherwise healthy, do you really want them to
mess with their pathways with adrug without certainty that it
helps?
That's the debate.
Some people are comfortablewith that risk-reward ratio and
others want to see more evidencefirst.
We should also remember thateveryone is different.
A dose that might be fine forme might cause my friend to be
(23:26):
lousy or get sick, depending ongenetics, diet or other medical
issues.
This isn't a one-size-fits-all.
What about dosing and costconsiderations?
Let's say someone, after doingtheir research and consulting a
doctor, is interested in tryingrapamycin for potential
longevity benefits.
How do people actually take itin this context and what is the
cost and what does it involvelogistically?
(23:48):
These are obviously commonpractical questions.
Let's start with dosing.
Dosing for longevity obviouslyis not the same as dosing for
organ transplant.
In transplant medicine,rapamycin might be given every
day at 2-5 mg per day, or evensometimes after a higher initial
loading dose.
That daily regimen is whattends to cause more side effects
(24:10):
and immune suppression Forlongevity.
Nearly all experts and usersfavor an intermittent dosing
schedule, most commonly once aweek.
A typical dose is in theballpark of 5 to 6 milligrams
weekly and some people willstart lower, like 1 to 2
(24:31):
milligrams weekly, and thenincrease.
Others might go higher if theytolerate it.
There are folks out theretaking 10 milligrams once a week
, for example, but surveys havefound that most are using five
to six milligrams weekly, whichis the sweet spot that people
settle on.
The reason for once weeklydosing is to get a periodic
knockdown of the mTOR pathway totrigger the good effects, but
(24:53):
then to allow the mTOR pathwayto come back to normal in
between doses.
This intermittent approachseems to minimize side effects
while still providing benefit.
In fact, one paper noted thatthis weekly schedule is
generally well-tolerated withminimal issues aside from rare
mouth sores.
It does depend on the individual, however.
For example, one of mycolleagues who has been taking
(25:14):
rapamycin for six monthsadjusted his dose to seven
milligrams every 10 days becausehe was having a lot of GI upset
.
So a higher dose, spaced outlonger, seemed to work better
for him and he still gets thosemouth sores, but he says that's
not a big deal for him.
There is an ongoing debateabout best dosing strategy 10
days, two weeks.
Others have experimented withrapamycin vacations, taking it
(25:35):
for a few months, then pausing.
Since we don't have definitivedata, people are basically
experimenting based on animalstudies and theory.
We do know from mice thathigher doses tend to produce
bigger lifespan gains up to apoint, but of course higher
doses risk more side effects.
So it's a balancing act.
One more thing on dosingbecause rapamycin has a long
(26:00):
half-life, around two to threedays, in humans, it's mostly out
of your system by the next dose, but not entirely.
That's why some choose, say,once every 10 days, like my
colleague, to be extra surethere's no continuous
accumulation of drug.
Again, these fine details arestill being worked out.
If I were to start it, it seemsreasonable to start at a
once-a-week schedule to keep itsimple, unless there's a reason
to adjust.
(26:21):
What about getting aprescription?
Rapamycin is a prescriptiondrug and you can't just buy it
as a supplement at GNC.
So how are people obtaining itfor off-label use?
Well, there are a few ways.
There are an increasing numberof doctors in the field of
longevity medicine orintegrative medicine who will
prescribe rapamycin off-labelfor patients who want to use it
for healthspan, and one reviewmentioned there were more than
(26:42):
20 medical practices in the USthat were already prescribing
rapamycin as an anti-agingtreatment.
There are also telemedicineservices and longevity clinics
that specifically cater to this.
You can do a consultation andif you're an appropriate
candidate, they might prescribeit.
Additionally, because rapamycinis an FDA-approved medication,
any licensed physician canprescribe it off-label if they
(27:05):
judge it's appropriate.
Some patients have had lucktalking to their regular medical
doctors by presenting research,especially if they're older or
have some condition that itmight benefit.
For example, if a patient had ahistory of cancer, their doctor
might be more open to it, givenrapamycin's anti-cancer
possible benefits.
Then there's the gray marketroute.
Some people order rapamycinfrom international pharmacies
(27:28):
since generics are made incountries such as India, or even
online.
I don't recommend going aroundprescribing practices without a
doctor's oversight, but it doeshappen, and one survey found
about 20% of rapamycin userswere taking it without physician
supervision, essentiallyself-medicating.
That just shows you how eagersome people are to get their
(27:49):
hands on it.
But of course, ideally oneshould do it with medical
guidance, because you need thatmonitoring for safety.
What about cost?
So here's a pleasant surpriseit's not very expensive.
It's a generic drug.
The brand name Rapamune can bepricey, but the generic
Sirolimus is relativelyaffordable.
Pricing can vary but the costfor a typical weekly dose is
(28:13):
usually about $5-10 a week.
Some compounding pharmacies inthe US might charge a bit more
or if you go through a longevityclinic, it might be marked up,
but compared to many othermedications or supplements, it's
not a budget breaker.
One thing to watch out for ifyou're working with a clinic
that provides a whole package ofanti-aging services, they might
(28:35):
bundle the cost or charge apremium.
But since rapamycin itself is ageneric, you do have the option
to shop around.
What about regulatoryconsiderations?
As I mentioned, rapamycin forlongevity is an off-label use.
That means it's legally allowed, but it's not an FDA-recognized
indication.
(28:56):
As I mentioned, the FDA is notevaluating rapamycin for aging
because aging isn't classifiedas a disease and there's no
company that would spend themoney to get that indication
anyway because the drug isoff-patent.
Practically, it means you can'tjust go into your regular
pharmacy and say I wantrapamycin for aging and get a
prescription.
It means we don't have officialdosing guidelines and it's all
(29:19):
community driven In terms ofaccessibility because it's
prescription only.
The main hurdle is just findinga doctor or service willing to
prescribe it.
And now my own personalreflection.
I want to shift gears a littlebit, talk about my own personal
take, why I'm even consideringtaking rapamycin for myself and
how I would approach it.
I'll admit, the whole idea oflongevity and extending one's
(29:42):
healthy years fascinates me.
As a medical professional andon a personal level, I've
dedicated my career to plasticsurgery and wellness, helping
people not only look better butfeel better.
And as a CrossFit coach andsomeone involved in fitness, our
goal is to be able to functionat the highest level for as long
as possible.
(30:02):
I mean, who wouldn't want to bethat 80-year-old who's still
crushing it in the gym orplaying with their grandkids
without getting winded?
So rapamycin caught my attentionbecause it's one of the first
interventions that has shownreal promise in actually slowing
markers of aging, not justmasking them, unlike Botox,
which is a great drug, but justworks on the wrinkles on the
(30:23):
surface, or even exercise, whichis fantastic for health but has
its limits.
Trust me, I feel that at a 5 amclass.
Rapamycin works at a cellularlevel on a pathway we know is
tied to aging, and that'sprofound.
It is amazing that we might beable to influence the biology of
aging with a simple pill.
(30:43):
So why would anyone considertaking rapamycin?
I think the biggest reasonwould be prevention.
I'm 55 years old and I certainlytry to optimize my life to a
reasonable degree.
I try to do all the healthyrecommended lifestyle things
exercise regularly, keep my dietrelatively clean.
I wish I could manage my stressbetter and get more sleep, but
(31:04):
I'm still working on that.
I don't have any major healthissues and I want to keep it
that way for as long as I can.
So if rapamycin could even adda few extra healthy years, keep
me healthier into my 70s, 80s orlonger, that's something I
think anyone would be interestedin, especially if rapamycin can
reduce the risk of big killerssuch as cancer, heart disease or
(31:26):
neurodegenerative diseases.
In animal studies, rapamycin hasbeen shown to delay the onset
of cancers and other age-relateddiseases.
For example, in the studies,rapamycin has been shown to
delay the onset of cancers andother age-related diseases.
For example, in the studies,all mice got the same diseases
as they got old, but the ones onrapamycin got them later and
sometimes less severely.
This suggests that rapamycinisn't just making them live
(31:47):
longer in a frail state, it'sactually extending their health
span and I find that reallyappealing state.
It's actually extending theirhealth span and I find that
really appealing.
Our goal isn't to live to 120if those extra years are
bedridden.
Our goal is to compress theperiod of decline and stay
vibrant for longer, andrapamycin theoretically could
help achieve that by slowingdown the accumulation of
(32:07):
cellular damage.
Also, I have to mention, as aplastic surgeon, I'm curious if
rapamycin would have anynoticeable effects on things
such as skin aging.
There's some evidence that itmight improve skin quality.
There have been some smallstudies of topical rapamycin on
aging skin.
Now I wouldn't bank on afountain of youth for appearance
specifically, but you mightthink if it keeps you healthy,
(32:28):
it would also reflect on theoutside as well.
And anecdotally my colleaguehas mentioned, not only do their
skin quality appear clearer,but their hair appears to be
thicker and their bald spotappears to be shrinking.
I don't know if that's a realeffect or placebo, but that
would be great to have thoseside effects too.
What are my concerns?
Number one is safety.
(32:48):
I'm wary of any long-termunknown effects.
If I start taking rapamycin inmy 50s and take it for decades,
what might happen that wehaven't predicted?
Could it be a rare side effectthat only shows up after 10
years of use?
We just don't have longtimelines and data yet.
Now for transplant patients yes,some of them have been on it
(33:09):
for long term, but they oftentake high doses.
But they take high doses andthey have other medical
conditions in play.
I'm also concerned about themetabolic side effects.
The last thing I want to do isinduce prediabetes in myself by
taking a drug.
That would be counterproductive, so I'd have to monitor my
blood sugar closely.
That would be counterproductive, so I'd have to monitor my
blood sugar closely and if I sawa trend upward, I might have to
(33:30):
adjust my dose or even takeanother drug such as metformin.
I'm not terribly worried aboutday-to-day minor infections
because I'm generally healthy,but if I started catching
unusual infections or hadtrouble recovering from a flu,
that would be a red flag and Imight stop the drug if that
happened.
Health always comes first.
Longevity hacking comes second.
(33:51):
I'm not going to risk seriousillness now for potential
benefit later.
And one other issue that wedon't have time to get into
greater detail is whetherrapamycin could negatively
affect muscle mass and athleticperformance.
After all, rapamycin inhibitsmTOR, and mTOR is a key driver
of muscle protein synthesis.
Some worry that it could impairmuscle gains or even accelerate
(34:14):
muscle loss.
Now, right now, the availablehuman data does not show a
dramatic loss of muscle inpeople taking low intermittent
doses.
Plus, there's anecdotalevidence of individuals who
still maintain or can increasetheir muscle mass while on a
once-weekly regimen.
But this theoretical risk stillexists, especially someone
taking a higher or daily dosethat inhibits the mTOR pathway
(34:36):
more strongly.
So for bodybuilders or athleteswho rely heavily on maximizing
muscle protein synthesis, it maybe prudent to proceed carefully
, monitor strength and bodycomposition and possibly adjust
dosing if signs point todiminished muscle gains.
And I can already see a lot ofpeople at my gym mentally
crossing rapamycin off theirlist just with this issue,
(34:58):
because they don't want to losetheir gains, bro.
So how do I plan to approach it?
I haven't started it yet.
I am rapamycin curious.
I'll continue to talk to mydoctor, who has experience with
rapamycin in patients, and eventhough I'm a physician myself, I
value getting other experts'opinions, especially those
prescribing it.
There are longevity clinics outthere.
(35:20):
I might speak to some of myother local colleagues in
geriatric medicine orendocrinology, and these
discussions will help me weighmy personal risk factors and
establish a baseline.
Before I start, I would get abaseline of various health
metrics blood work, including acomplete blood count, metabolic
panel, glucose, liver, kidneyfunction, lipids, inflammatory
(35:42):
markers, possibly a HbA1c, whichis a three-month average of a
blood sugar level marker,possibly even immune function
tests or an epigenetic age test.
I might also establish myexercise performance as a
qualitative baseline.
Maybe I'll do FRAN, which is apopular CrossFit workout, before
(36:02):
I start and then retest myselfin six months.
I think the strategy is startlow, go slow.
I would probably start at alower dose, maybe two milligrams
weekly for a while and thenincrease to five milligrams
weekly if I felt that I wasobserving, and then I might
increase to five milligramsweekly after observing.
(36:25):
If there were any possibleeffects.
I would want to recheck myblood work, maybe effects.
I would want to recheck myblood work after several months
to see if anything's changed.
Maybe my cholesterol spiked ormy blood sugar had increased.
If my blood sugar went up, I'dconsider adding metformin or
adjusting my diet.
And if my white blood cellcount dropped significantly.
(36:46):
That would certainly concern meabout immune suppression.
I would want to continue all ofmy healthy habits.
If anything, I might tightenthem up even more to support my
body.
For example, rapamycin'sbenefits might depend on good
nutrition and not overeating,and maybe it might work best
with synergy, and it might evenwork best in synergy with things
(37:07):
such as exercise.
There is some thought thatexercise and rapamycin are
complementary in improvinghealth span.
I'd also want to avoid anyimmunosuppressive things.
I certainly wouldn't want to beon rapamycin and another
immune-suppressing drug, such asprednisone, simultaneously, and
it would be interesting torepeat an epigenetic age marker
(37:30):
to see if there's any change intrajectory after starting
rapamycin.
Although these are experimental, they might give me some
insight.
I think the big thing is tokeep expectations realistic.
I don't expect to feel 20 yearsyounger overnight or anything
dramatic.
In fact, if rapamycin isworking, I might not feel
anything at all.
It might just be quietlycleaning up my cells in the
(37:51):
background and the payoff mightbe invisible in the short term,
where no news is actually goodnews, and I'm just essentially
betting my future on it.
And if I keep thoseexpectations, I think I would be
okay.
With that mindset, I wouldprobably commit to taking
rapamycin for a year or two andthen reevaluate.
One advantage is, if you do stoprapamycin, its effects, both
(38:13):
good or bad, will wear off.
You can always restart it later.
It's not permanent.
Some people do cycle it, as Imentioned, a year on, a few
months off.
We don't know if that's abetter approach or not, but it
is something some people aredoing.
Emotionally and psychologically, it's interesting to take a
drug that can potentially slowaging.
It almost feels sci-fi.
I'd be lying if I said I wasn'tat least a little bit excited
(38:36):
by that idea.
But I check myself by sayingall right, this is still
experimental and I have aresponsibility to do it in an
informed way and share honestlyabout it.
In summary, I'm drawn to itbecause of its strong science
backing and possibility ofextending my healthy years.
I am cautious for the unknownsand I don't necessarily need it
(38:57):
right now.
It's just a choice topotentially enhance my future
health.
If I proceed, I would want todo it in a careful, monitored
way, almost like enrollingyourself in an experiment where
n equals one, which is myself,and I would hope to share those
insights in a future podcast ifpossible.
So we've covered a lot, solet's zoom out, recap some of
(39:19):
the key takeaways.
Rapamycin is a drug with areally unique pedigree,
discovered on Easter Island,used in transplant patients and
now repurposed in the labs ofaging researchers.
It inhibits the mTOR pathway,telling cells to slow down
growth and rev up maintenancemode, like autophagy, and in
study after study with organismsfrom yeast to mice, it's
(39:41):
extended lifespan.
That makes it one of the mostpromising potential anti-aging
therapies we know of.
That makes it one of the mostpromising potential anti-aging
therapies we know of.
Early human trials have notshown people living longer yet,
but show some improvement inimmune function and other health
markers, and many earlyadopters claim it's helping them
feel healthier.
But it's not a proven fountainof youth for humans.
(40:04):
At this point it's an excitinghypothesis backed by strong
animal data and some suggestivehuman data, but it's not
definitive.
There are trade-offs andpotential downsides mouth sores,
metabolic changes, lack ofmuscle growth.
It's a real drug that deservesrespect In terms of dosing and
cost.
(40:24):
A lot of people are taking fivemilligrams once weekly, which
tends to be well-tolerated.
The cost is on the order oftens of dollars a month, which
is quite reasonable, but sinceit's off-label, you'll need to
find a willing provider to getit.
From my perspective, I thinkit's promising enough that it's
on my radar to possibly use formyself, and I hope that this
(40:46):
discussion has been helpful andinformative.
In conclusion, I just want toemphasize that no longevity
approach works in isolation.
It's not a magic pill thatmeans you can ignore all the
other basics.
You'll still need to exercise,which is the burpees part of
this podcast Eat well, sleep,reduce stress, have social
connections and so on.
Those are the foundations, andif rapamycin works, it would be
(41:08):
icing on the cake, but if itdoesn't pan out, those
foundational healthy habits willstill carry you far.
I'm really curious to hear yourthoughts on rapamycin.
Have you heard about it before?
Would you consider taking adrug to potentially slow aging,
or is that a line you wouldn'twant to cross?
Maybe some of you have eventried rapamycin and if so, I'd
like to know about yourexperiences.
(41:29):
Please feel free to reach out.
Instagram handle is at Botoxand Burpees podcast or our
YouTube channel Any comments orquestions.
This is a rapidly evolvingfield.
I'm sure there will be newstudies and findings coming out
very rapidly.
Until next time, take care ofyour body.
Take care of your health Untilnext time.
Take care of your body, takecare of your health and, as
(41:50):
always, keep chasing that bestversion of yourself, whether
it's a better skincare routine,hitting that PR in a gym or,
maybe, someday, a little pillthat will keep you younger at
heart.
Stay healthy and see you nextepisode.
Thank you.
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Dateline NBC
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