sudiki
#1
So relatively new to the site and am ramping up to 8mg/wk. I will take my 7mg tomorrow. (I dose on sunday). No side effects so far. I notice there is a lot of talk about A1C and how rapamycin seems to cause elevated blood sugar/A1C. I came across this today on another site about A1C and bood sugar. (I only copied the two below). I of course was very interested in the 2nd bullet. Could rapamycin use be giving a false high reading?
An artificially high A1c test result can be caused by any of the following factors:
- Certain types of anemia, including iron-deficiency anemia
- Drugs that suppress your immune system
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After taking between 10 and 14 mg equivalent of Rapamycin a week (3-4 mg + GFJ), my HBA1C went up to 5.7 from 4.9. After taking 500 mg Metformin daily and one month of Akkermansia probiotics and Polyphenols ,my HBA1C came back down to 4.9. Iām happy with this result.
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Its interesting how they state thisā¦ āartificially highā could mean that its just higher than it would be if you werenāt taking these drugs, or it could be meaning ādistorts the result, so what you see is not the true resultā. I think my interpretation, with respect to rapamycin, is the former, not the later.
Rapamycin, when dosed frequently, and at higher levels, tends to result in higher blood glucose levels for some significant portion of people it seems from the research Iāve seen. I would not ignore that higher level.
See this paper:
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I am with @RapAdmin on this.
We know Rapamycin drives up average glucose levels which is measured by HbA1c. I donāt think there is any evidence that it causes test errors.
The glucose levels are high in reality. This is actually not good and to be avoided where possible. As with many things, however, there is a balance.
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Jay
#5
Sudiki, I agree with RapAdminās interpretation. However, you could use a glucose meter to check 1 hour and 2 hours after meals for a while to see if your actual blood glucose is higher than it should be when using Rapamycin.
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I agree with others - there is not a mechanism for a āfalse high readingā - it is instead a real elevation. It is pretty common and varies individual to individual. My. Personal HbA1C went from 4.7 to 5.5% with adding Rapa 8 mg q8days, which is my regimen.
Lipids also may go up a bit. This is why we measure.
Irrespective of whether a diabetic or not, I see a high rate of individuals on the board also being on SGLT2-i, Acarbose, GLP1/GIP agonists, and/or Metformin.
Some of these agents also have the advantage of likely slowing cognitive decline, possibly due to improving insulin sensitivity in the brain. Irrespective - if doing a general longevity protocol, it would be common to be on medications that will blunt/reverse this anticipated effect.
In general, best way to track these things is through a continuous glucose monitor to see in real time impacts of behavior and interventions on glucose. Iād generally think that after 3 weeks of your final dose, would be a good time to look at your glucose to get an idea of what the effect will be, and then talk with your doctor about ways to mitigate any increase, generally with a strategy that has benefits of improving longevity and improving insulin sensitivity in the brain.
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I wore a CGM last April and posted the results here:
There is one subtlety about HbA1c in that there are two ways of measuring it either just ketoamine or aldimine and ketoamine glycated haemoglobin.
sudiki
#8
Thanks to all for responses so far. Iāll see if I can find the article again and try to find out what was meant by āartifically high.ā Iām not ignoring all the data about blood sugar/A1C elevations; but I found the info. interesting and wanted to see what the consenses is. Not that it matters but FWIW: I made a typo in my original post, I did my 8mg dose today, not 7mg. No side effects that I can tell so far on my ramping up to 8mg/wk.
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If the red blood cells lived longer or shorter on average, that would āartificiallyā change the meaning of the HbA1c (vs a change in the average blood sugar levels). Is there any mechanism for rapamycin or anything else we do for longevity impacting the turnover of red blood cells?
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The average RBC survives around 100 days. But the HbA1C isnāt really going to massively change if your RBCās survive 90 vs. 110 days. I believe Rapamycin only makes a difference on RBC production - such that you are likely to decrease your hemoglobin level a little. This is actually a good thing for a lot of people - and works synergistically with men who are needing Testosterone replacement, where we worry about Hb increasing.
I donāt know of any information that RBC survival is impacted by Rapamycin. There are individuals who destroy their RBCās more rapidly, and Iāve not seen any literature indicating that the HbA1C isnāt accurate in those individuals - however, the impact would be over what period of time you have the average - which should match the days the average RBC survives.
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sudiki
#11
well if my A1C/blood sugar goes up like most people seem do; thereās not a whole lot I can do about it other than maybe take a low dose metformin? My last labs in Jan my A1C was 5.4. I excercise 5-6 days a week for a min of 1 hr ea. day. (I swim laps, 4.5 miles on treadmill and the rowing machine on different days and do a few different nautalis machines each day) and I watch carbs (but donāt completely avoid them).
Some of us are taking acarbose and / or an SGLT2 inhibitor like Canagliflozin or Empagliflozin.
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Even though I take Metformin, I would recommend an SGLT2I like empagliflozin for HBA1C control. If it can keep your HBA1C at normal levels, thereās no need for Metformin. Iāll be taking a low dose empagliflozin starting this summer.
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I receive no hbA1c benefit from my sglt2 inhibitor (Farxinga). I donāt know why. Akkermansia is the only thing that made a big impact for me.
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PBJ
#15
Just a thought. Should we keep our dosages low enough not to have a significant impact on blood sugar without ancillary medications? Raised blood sugars seem to come from mitigation of mTORC2 which we are trying to avoid.
Bicep
#16
Thatās kind of where I am at this point. I still use acarbose with meals that have carbs because it is supposed to boost mtor2. Only other way to boost it is fasting. I also use metformin some for a day or two after Rapa dose.
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sudiki
#17
is a day or two enough? if sugar only rises for a day or two I wouldnāt think thatās really that harmful. I would be more worried if it was continously high. (I dose 8mg once per week)
sudiki
#18
I didnāt want to take the common TR treatment meds so my Urologist suggested Clomi. He said it was very safe and hardly any side effects. I take 25 mg daily (he initially prescibed 50mg but I wanted to see what a 1/2 pill did) My testosterone went from high 100ās to 480ās on 25mg. After I got my results and told him I was only doing 25mg, He said stay on the 25mg! 
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This is a common treatment, as is HCG, if your body has the ability to build testosterone. Currently, I will try this in those <55 years with other lab values looking likely to have this be successful - but the success rates go way down in the mid 50ās. Not that it never works. With Clomid, there are a significant number of people who get side effects - but also a significant number who donāt. HCG is the stand in if you donāt tolerate clomid and you can build Testosterone.
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sudiki
#20
Iām 65 and started Clomi a little over a yr ago. My Urologist said there were few side effects and I havenāt seen any since I started. My labs are normally very good. (CMP, CMP, PSA, Tsetosterone, Vit B, Mg) My Mg was critically low due to long term PPI use and started giving me heart issues. Mg Supplements wouldnāt bring it up so I stopped the PPI. You would think your Gastro would tell you about Mg and PPI useā¦but Nooooo. I had to figure it out on-lineā¦sigh. My PCM says he wishes his Labs looked like mine. 
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