#41

The USPSTF guidelines are for primary prevention. IF you already have vascular disease, then it is secondary prevention and the guidelines for most people favor taking daily 75-81 mg of aspirin.

2 Likes
#42

Creatine in that mix?

I have mine with taurine in my coffee in the morning. Then, another scoop in a small coffee before I work out in the evening. :wink:

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#43

Rapamycin absorption/clearance variability is honestly shocking. We’re currently testing 12mg rapamycin weekly for me based on 50 hour levels of 10mg at 1.8ng/mL. (I’m guessing your 100 hour levels were right around 3)

This is a pretty compelling case that suggests everyone should measure their levels to verify they’re getting the dose they expect.

6 Likes
#44

I was using 300mg of aspirin 3 days a week with fish oil for inflammation with subjective success but I got acid reflux eventually so that experiment has ended. I’m not convince about SPMs from supplements or fish oil / aspirin anymore anyway after the talk by OmegaQuant.

#45

Have you considered just taking a nitrate medication instead? Eg nitroglycerin or isosorbide mononitrate.

#46

Thank you for sharing your protocol. May I ask the reasoning you do 12 mg of Rapamycin every two weeks as opposed to 6 mg weekly?

1 Like
#47

Blood level monitored results is the reasoning. 6 mg would be a waste for me, I’d have around 24 hours maximum of levels >3.0 ng/mL. I’m at least finding safety with <=30% of the time being >3.0 ng/mL and then 70% of the time being below this as the rapamycin continues to be metabolized.

On my rationale for doing every 14 day dosing - it is theoretic that having higher peak values (due to the big dose) there may be more effect, especially in areas hard to get into, such as brain. So for me, I get a 100 hour level, for my patients on weekly dosing get a 50 hour level to assess if dose should go up or down.

Very difficult to know with insufficient data efficacy, but am focusing on safety, and it seems thus far to be safe to dose how I’m suggesting - but naturally seek independent physician advice on this.

4 Likes
#48

Creatine and caffeine in the evening with no sleep disruption? Amazing. I used to be able to sleep after coffee and hard workouts and while the plane was taking off, but that was when I was chronically sleep deprived.

Now I have go fully native to get good sleep:

  • no coffee at all; green tea before noon (but caffeine is on my hit list)
  • turn off all lights in the house at sunset
  • don’t eat anything after 7pm; small dinners
  • no supplements at night
  • TV, computer, phone off after 8pm
  • HRV biofeedback and Pulsetto at 8pm
  • read in bed for 30 minutes with dim red light
  • no sleep aids unless I get up at 2am +- to pee (only if I feel alert; happens less and less)

It’s worth it to improve 5.5 hours to 7.5 hours per night on average. But I miss my old life.

6 Likes
#49

A post was merged into an existing topic: Rapamycin bioavailability webinar (generic vs compounded)

#50

What supplement do you take at 2 am that helps you get back to sleep?

1 Like
#51

@JeffW i take 10mg of melatonin if I get up at 1-2am. If I get up at 3am or later on a morning spin day I just get up. If I’m worked up (totally not sleepy), I’ll read for 45 minutes and then take another 10mg.

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#52

Hi Jules, I think restarting the statin is very sensible. End of the day, you’ve had 3 heart attacks and your LDL-C is 120. That’s not a good place to be. The evidence says that you want that LDL-C pretty much as low as possible.

I totally understand the feeling of natural vs pharmaceutical. However, the principle of red yeast rice (RYR) is that the active ingredient is… a statin. Most red yeast rice supplements sold nowadays have that compound removed, because it’s a prescription drug so can’t be sold as a supplement in most countries. Thus, most RYR supplements are pointless. Additionally, if your supplement does contain the statin compound, you have no idea the dose, the purity, the storage/handling history of the product. You’re trusting the manufacturer. On the other hand, the 5mg Crestor contains exactly 5mg of Rosuvastatin, and the entire process is validated from start to finish. Lastly, the drug has been through extensive testing, before and after FDA approval. Supplements are almost always less tested, studies usually sponsored by manufacturers etc etc.

Basically, I think you’re way better off with the statin. IMO, you would ideally get that LDL-C below 70.

4 Likes
#53

Dr. Fraser,

Would you be willing to share your rationale for the 12 mg of Methylene blue twice daily?

#54

I presuming you asking not why do I take methylene blue at all, but why take it twice daily?

I find it helps my mental sharpness and energy, but it’s half life is 5-6 hours. So if I’m in my practice, which is lower stress, I just take an AM dose, if I’m in the ER, I take one at 6am then a second one around 1p as the effects do wane a bit.

4 Likes
#55

Thanks for the reply. I’d also like to know why you take it in general and could you share the brand you use?

#56

As this substance improves mitochondrial efficiency, it makes a difference to mental energy and getting through very busy days, with lots of stress and keeping a solid mental focus and energy.

It also has a role in ADHD, long covid, chronic fatigue, etc.

I’ve been using this one Nutricel Blue Boost 12 mg. Amazon.com: Methylene Blue (USP Grade) Pharma Grade Supplements, Capsule Form, with Added Vitamin C Ester for Enhanced Absorption, Brain Supplement with Brain Fuel, Memory, Focus, Clarity, Cognitive, Energy : Health & Household

Many of my patients use compounded and they are available in many strengths and price points.

I’ve been happy with the OTC one I can get on Amazon.

2 Likes
#57

MB seems to make me briefly hypertensive. Probably goes with those reports of higher RHR.

#58

Thank you for this information.

#59

I notice Low Dose Naltrexone (LDN) is not on your list? You ever consider taking this for reducing inflammation? If not, what medicines/supplements you recommend to reduce inflammation?

#60

The reason why it isn’t on the list yet, is that the evidence for mild improvement in function when AD is already established seems mildly promising, but for prevention of getting AD, I’m not seeing convincing evidence. It makes sense, but I’ll need to see more data come forward on this. I certainly have patients on LDN, but not for this indication (yet).

1 Like