It may be of interest, that in a previous pilot trial, lower circulating blood levels of rapa in marmosets resulted in marekedly less mTOR inhibition:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400395/

This trial also collected data of liver tissue and adipose tissue of marmosets. Only individuals with a high circulating levels of rapa got mTor suppression in liver/fat tissue. Those monkey with blood through levels of 1.93–2.43ng/mL did not achieve notable mTor effects outside of blood cells.

7 Likes

That’s all good, but I think it would be more valuable to find out what happens in human adipose tissue regarding mTOR inhibition for someone taking Rapamycin. Then we could correlate blood levels with tissue levels.

If tissue levels of mTOR inhibition aren’t high enough, then dosage levels are probably too low.

2 Likes

Sure, I agree - someone needs to test that in humans.

I was more reasoning about previous posts claiming significant mTor inihibition even at lower doses/blood levels in humans (as in the Mannick papers). As outlined these are based on blood cells, while the mice studies used adipose tissue. And the pilot trials in marmosets demonstrated, that lower through levels of rapa in blood inhibit mTor in blood cells - but they do not achieve mTor inhibition in liver and adipose tissue.

3 Likes

This kind of confirms my belief that the recommended 6mg/week dose is pointless. Anything below 20-30mg as a single dose won’t sufficiently spread through tissue and it is an open question whether taking such a high dose weekly or biweekly has the same longevity effect as taking it five times a week.

1 Like

Well; the recommendations were never based on clinical outcomes or reliable markers of clinical outcomes. Peter Attia for example explicitly states that he got no real idea if it’s doing anything impactful and is going by the strategy of minimizing side effects.

It’s just a strong possibility, that dosing to minimize side effects equals dosing to minimize actual effects.

3 Likes

I tend to think that the path towards optimizing the benefits of rapamycin in terms of lifespan and healthspan is through rigorous testing and carefully increasing doses to higher levels. Exactly what “higher levels” means, is still an open question. Perhaps its time to reopen discussions around this topic: Ideas on Protocols for Testing Higher Rapamycin Doses

5 Likes

Put me in for the unpopular “lower is better” camp for rapamycin dosing. After taking between 3 and 5 mg every week for about 1.5 years. I stopped, mainly due to consecutive increases (over 6 months) in apoB numbers and fasting blood glucose, which couldn’t be explained by changes in diet or exercise regimen (those 2 stayed the same). So it looks like my “intermittent” dosing had become somewhat chronic over time.

After a 6-month break, I re-started back with 2mg, and got a very strong immune response, akin to taking a flu/COVID shot: low-grade fever, nausea, fatigue, gastrointestinal distress. These symptoms lasted a full 10 days. To me, this indicates that my dosage is enough.

I plan to take 1-2mg every 2 weeks in the future, just to make sure my dosage is truly intermittent. I believe that at least in my case that more is not necessarily better, and I might get 80% of the benefits on 25% of the “adequate” dosage, akin to how statins work. I’ve also always believed that some side effects like canker sores, elevated blood sugar, etc are signs my dosage is too high.

4 Likes

I’m in your camp bud. I took 6 mg for 1 year and a 1/2. And had excellent biological markers.

I started increasing my dosage up to…
30 mg, and 7 months later it was a shit show from my biological markers stand point.

I’m back on at 4 to 8 mg. Going on 1 1/2 years. And all my bological markers look great again.

My next biological markers results should be back within the week – GlycanAge and TruMe.

I cringe every time I see somebody on this site… pushing for higher and higher. Blogsklonny did that, but he also has major cancer. Matt Kaeberlein, who knows all the research, also wasn’t sold on higher is better. He doses at 8mg weekly. Just say’in.

8 Likes

Same here:

  • 2-3 mg + GFJ - excellent immune response to usual events like colds/flu (+substantial reduction in autoimmune conditions); blood glucose in the normal range.

  • 4-5 mg + GFJ - huge volatility of blood glucose and fasting glucose in the prediabetic range, plus one case of tooth root inflammation with subsequent surgical root tip resection (might be just a coincidence, but I never had something like this before).

Unfortunately, I am not able to test blood levels of rapa in Germany. :frowning:

3 Likes

Wow, that is frustrating- why is that? Clearly they must be testing in and many thousands or organ transplant recipients around the country?

1 Like

Sneak peak
… got my GlycanAge results on body inflammation. My 66 year-old body is measuring at 44 years old, meaning a 22 years difference, which is about the life extension years… rate you’re supposed to get from constant rapamycin use in life extension.

Very positive about my 8 to 12 mg weekly dose coming from 4 mg zydus with fresh 5 ounces Red GFJ at dosing.

12 Likes

Awesome results @Agetron

I’m right there with you with the 4 mg + GFJ weekly! Let’s live longer and set a great example for everyone else.

4 Likes

That’s the dose I use every 2 weeks. Maybe I shouldn’t watch my lipids and blood sugar so closely, but I’m sticking with this for a while.

3 Likes

I’m not sure what you’re asking here. If you’re wondering what doses of rapamycin are needed to inhibit mTOR2 and how much acarbose is needed to partially prevent that, that’s going to be very individual. In case of rapamycin it depends just as much on the frequency than the dose.

I would say it’s very strong. As far as rapamycin increasing glucose in ways that are independent of mTORC2 such as by damaging beta cells, I strongly doubt that’s what we are seeing in people that take rapamycin weekly and notice increased blood glucose. The reason why is because most of these people are healthy with healthy beta cells and their blood glucose improves again in a matter of weeks after stopping the rapamycin. If it were caused by damage to beta cells I doubt it would recover nearly that fast if at all. Another reason why I think this is the case is because organ transplant patients will get a lot more mTORC2 inhibition than the people taking weekly doses for longevity, yet they don’t seem to be getting type II diabetes left and right due to beta cell destruction. That said, it’s good to keep in mind that high doses might have negative effects on the beta cells.

4 Likes

Apparently not: the lifespan cohort was started at age 7, and 15% is median:
https://spotify.localizer.co/uploads/default/original/3X/0/d/0d28cb6151909debfc25b88e36fe5750846d1757.jpeg

1 Like

That would be the case if it only increased median. They don’t have data on maximum yet; obviously animals that outlive all the controls because of rapa would still contribute to increased median LS, but would not be animals that would otherwise have died prematurely.

Different researchers calculate it differently: traditionally it’s the average LS of the longest-lived 10% of the group, or it’s the first death of the longest-lived 10%. More recently a more complicated, less intuitve, but more robust test (Wang-Allison II) has been used.

1 Like

Now my biggest concern about Rapamycin is that the doses may be too low to attain the same effect.

See:

2 Likes

Yes, they seem to be two different marmoset studies / groups and not the same across the paper and the new study published at the meeting.

Only if you just assume without evidence that lower dosing would be useful in humans. They did a pilot study to identify a dose that inhibited mTOR and was sufficient to stimulate autophagy, but didn’t lead to hyperlipidemia or glucose dysregulation in most animals. They tested five doses ranging from 0.01-1.0 mg/kg/day and found:

The higher doses of 0.2–0.4 mg/day (roughly 0.5–1.0mg/kg/day) resulted in a measureable and reproducible decrease in phospho-rpS6 indicating downregulation of mTORC1 in marmoset PBMCs as expected. In tissues, the phosphorylation of rpS6 appeared to be suppressed by the treatment of RAPA. However, the two obese subjects (with relatively low circulating RAPA concentrations) showed no decrease in phosphor-rpS6 in PBMCs at 2 weeks of dosing and had ratios that overlapped that of the controls in liver and adipose tissue taken at 14 months. These results indicate that consideration may have to be given to altered concentrations of RAPA dosing in obese subjects, including humans.
Testing Efficacy of Administration of the Antiaging Drug Rapamycin in a Nonhuman Primate, the Common Marmoset | The Journals of Gerontology: Series A | Oxford Academic

So 1 mg/kg wasn’t enough for the obese subjects — and since this was the top dose they tested, it’s possible that a higher dose would have been better even in the normal-weight animals.

Here’s the critical point:

Circulating trough rapamycin levels (mean = 5.2ng/mL; 1.93–10.73 ng/mL) achieved at roughly 1.0 mg/kg/day was comparable to those reported in studies of rodents and within the therapeutic range for humans. …The trough levels observed in both the short-term and the long-term studies that were achieved at the dose of 0.4 mg/day (roughly 1.0 mg/kg/day) were comparable with those reported in studies of C57BL/6 mice being fed a diet containing e-RAPA at a concentration of 14 ppm. Zhang and colleagues (4) report blood concentrations averaging 3–4 ng/mL and Fok and colleagues (5) report a range of 2.0–10 ng/mL. Harrison and colleagues (1) and Miller and colleagues (18), in contrast, report significantly higher circulating concentrations in the genetically heterogeneous UM-HET3 mice used in the NIA Intervention Testing Program.

By comparison, the marmoset blood concentrations averaged 5.2ng/mL with a range from 1.93 to 10.73 ng/mL. The among-subject variance in trough blood concentrations, as evidence by coefficient of variation, was similar in marmosets receiving 0.40 mg/day and humans receiving 4–5mg/day (11)—marmoset c.v. = 0.667, human c.v. = 0.673–0.778.

And in this lifespan study, per Salomon’s interview with @RapAdmin , the trough levels were even higher:

In our previous pilot study, we showed that the delivery of a dose similar to this produced trough concentrations (24 hr since last treatment) of rapamycin of ∼5 ng/ml (Tardif et al., 2015). This previous report also details the pharmacokinetics Here, with approximately double the number of animals, the average trough concentration of rapamycin for all animals 24 hr after dosing was 6.4 ± 1.0 ng/ml

we found that rapamycin concentrations in male marmosets were significantly higher than those in females (Figure 2). Rapamycin concentrations in the blood averaged 8.4 ± 1.7 ng/ml for male marmosets and 4.4 ± 0.6 ng/ml for female marmosets.

IMO, this puts all gymnastics around half-life to one side: these animals, similar to the mice in nearly all LS studies, were dosed every day and never had plasma levels below 6.4 ± 1.0 ng/mL. This seems to put weekly dosing out the window for an effect size in this range.

Exactly. Conversely, if they had used the kinds of doses most people here use and it had failed (as the dose-ranging study suggests it would have), you would be left wondering if it meant the dose was too low or if rapa just doesn’t work in primates — including hairless primates.

4 Likes

From the ITP. The 20 months until death, 3 months only, and 1 month on 1 month off groups all achieved similar lifespan increases. This suggests that all 3 strategies, including pulsed dosing, is effective if done at a high dose.

Genetically heterogeneous male and female mice, from the four‐way UM‐HET3 cross, were given food containing Rapa at 42 ppm from 20 months of age at each of the three test sites. One group of cages (“Rapa 20”) received this dose for the rest of their lives. A second group (“Rapa cycles”) received Rapa for 1‐month period interrupted by 1 month periods without drug. The third group (“Rapa 20–23”) received Rapa for the 3‐month period starting at age 20 months, but not thereafter. Kaplan–Meier plots are shown in Figure ​Figure1,1, and summary statistics, pooled across sites, are collected in Table ​Table1.1. In male mice, all three dosage schedules led to a similar increase in median lifespan (9%–11%), and all three produced a significant result by the log‐rank test.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7681050/

4 Likes