Challenge my drug stack, be ruthless but honest

[Karel1]

A warning about side effects of finasteride on BBC.com :
Finasteride: Hair loss drug was 'biggest mistake of my life'

[Agetron]

From the article: “It’s just a little pill. You take it and don’t really think about what it can do to you,” he says. "Every day I beat myself up saying like ‘You had a perfect life, you didn’t have to risk something over hair’.
"It was vain of me…but when you get insecure you do stupid things.
“If I were made aware of what it can do I never would have took it.”

And, maybe this is true - just like some people on rapamycin have horrible physiological responses.

On the other hand - I too started the little blue pill for hair loss at at 33 years or so - I will be 67 years in a few months, so about 34 years of constant use. Still have my hair - but also a very - very small prostate and possible cholesterol clearing from research-- coronary calcium score of zero - heart of someone under 35 years. No libido or ED issues - at 67 years. I read - that whatever age you are - that percent of the male population has ED issues at 40 years 40% – at 50 years 50% - I guess 67% - lol.

The point is many have benefited from this medication in many ways - and some have seen no effect - and some have bad effects. That’s how your physiology reacts to material introduced into the body. In most cases - stop the medication and the side effects vanish - like with rapamycin. Could be other issues. Or, maybe not.

[Virilius]

Personal anecdotes on trash media are not even listed on the pyramide of evidence.
Google “reddit X ruined my life” for any substance X known to man and you will find a horror story.
Depression, ED, low libido and various other conditions do naturally occur in men over the age of 20 at ever-increasing rates. As the FDA stated, there is no evidence that finasteride causes any permanent or prolonged side effects after cessation despite a decade of the PFS Foundations attempts to sue Merck.
Or perhaps I am just invincible because I am triple-vaccinated, take finasteride, statins, tirzeptatide etc. and haven’t even died once.

[Agetron]

Antoine - not sure if this is helpful. But while checking benefits of estradiol from my last blood test, I came across this information - about Parkinson’s Disease.

Estrogens appear to have a protective effect on neurodegenerative disorders characterized by major cognitive dysfunctions, including Parkinson’s disease and Alzheimer’s disease.

Link: The Role of Estrogen in Men’s Health

[RapAdmin]

@Virilius

Personal anecdotes on trash media are not even listed on the pyramide of evidence.

Yes - keep in mind the pyramid of evidence:

[Karel1]

Dear @RapAdmin,

I would be very pleased if all n=1 “trials” and reactions would be excluded from this forum and we as forum participants would be limited to contributions that have either a sound theoretical basis and/or a sound experimental basis. And of course test results or info about diseases or adverse effects that participants are willing to share.

[RapAdmin]

That would take far more moderation time than I’m willing to devote here. Ultimately all of our experiences here are n=1, and while they hold minimal value from a scientific standpoint perhaps over time they can provide some sort of signal that can be investigated by our researcher friends, which is when the real value is derived.

[adssx]

You’re right I think some papers showed neuroprotective effects of 17b-estradiol in animal models of PD. But I don’t know if that’s also the case for 17a-estradiol. I’ll have to do more research on that

[Virilius]

Finasteride VS The BBC, why finasteride may soon be banned

What a surprise, the guy mentioned in the BBC article had a reddit account where he mentioned taking finasteride again (despite allegedly suffering from PFS from taking finasteride over a year ago), was very active on the minoxidil side-effects subreddit and is also an anti-vaxxer.

[Bicep]

BBC are the culprit. They would have paid no attention to the guy if they weren’t looking for a way to do a hit piece on it. Probably could have picked a better guy too.

[Powe]

Was your lp(a) high pre statin? My lp(a) doubled slowly over time when I started a statin. I had always been told I had great lipid numbers, but my cholesterol began to increase from a pretty steady 165 up to my age of mid 60s. Once cholesterol got to 200 with estimated LDL about 130 my doctor recommended a statin. I tried diet to no avail. And requested a coronary artery calcium scan. After a lengthy Covid delay, I tested and I thought I would have a great score. I also requested a more accurate test of APOB and of lp(a) to establish a baseline. Then I started a statin and identified the rise in lp(a). I also had my genome decoded by Nebula Genomics and they calculated propensity risk scores for many diseases and conditions using parameters estimated by recent publications. I discovered I have a very high propensity risk score for cardiovascular disease and stroke—having a predicted risk greater than 95% of their sample and in a few cases 99%. Whatever is going on in my body is not due just to lipids — otherwise I would not have had so much arterial calcification after only a few years of inadequate lipids. (If Nebula were still in existence I’d recommend testing with them if only to get the propensity risk scores which can provide some hints about mechanisms.) I recently dropped the statin and added a PSK9 inhibitor (Praluent 75). My lp(a) which had hit the 95th percentile, has been more than cut in half. And my APOB and LDL (APOB more highly predictive of risk than LDL) is in the mid 50’s. Unfortunately the numeric values of lp(a) vary by lab — they aren’t standardized. And all you get from a lab is the identification of the value at the 95th percentile. So hard to say if I have achieved a healthy value of lp(a) or even what percentile it is. (My current age is 77.) I’d be interested in hearing more about your lipid protocol—your rationale and your experience.

[DeStrider]

Here’s my stack. Challenge it! Be ruthless but honest. Tell me why I should drop something or if there’s something I should add! Thanks in advance for the help.

(I’m always trying to improve)

Medications:
Rapamycin 3 mg + GFJ + EVOO weekly (unless sick or injured)
Metformin XR 500 mg at night
Empagliflozin 12.5 mg in the morning
Dutasteride 0.5 mg at night
Galantamine 4 mg at night
Brillo EZ 1 tab at night
Atorvastatin 5 mg at night
Telmisartan 20-40 mg in the morning (discontinued due to low BP)

Coffee 1 (2 cups)
Creatine Monohydrate 5 g
Glycine 5 g
Collagen Peptides 11 g
TMG 1 g

Coffee 2 (2 cups)
Magnesium Citrate (210 mg)
Taurine 6g
Whey protein 25 g (going to switch to plant-based)

Night Decaf sugar-free Tea (chamomile or berry)
2 g citrulline
5 g glycine

EVOO shot in the morning
Crushed black pepper
Turmeric powder
1 g of NMN
Hyaluronic acid (500 mg)

Supplements Morning
5000-10000 IUs Vitamin D3
NAC 2 g
Vitamin B12 2000 mcg methylcobalamin
Horbaach Prostate Support
Zinc 50 mg Mon Wed Fri
CoQ10 100 mg
Super B Complex Mon and Thurs
Lithium Orotate 5 mg
Lutein and Zeaxanthin 20 mg 4 mg

Supplements Night
Ultra Omega 3 fish oil (NOW) 500 mg 2X daily
Vitamin C 1 g
Astaxanthin 24 mg
NAC 2 g
Lithium Orotate 5 mg
MK-7 Vitamin K2 100 mcg
Glucosamine Chondroitin 1.8 g
Turmeric 800 mg
Magtein (Magnesium Threonate) 50 mg
Spermidine 500 mg
Centrum Silver Mon Wed Fri
Boron 5 mg
DHEA 25 mg (added after blood work)
Dihydro Berberine 100 mg

[Virilius]

Glycine 5 g

In the evening?

[DeStrider]

I take Glycine 2X a day. 5 g in the morning and 5 g in the evening.

[Viracocha]

With so much glycine + the glycine in the collagen, diet, etc and so much vit C, aren’t you worried of a kidney stone?

[DeStrider]

Glycine helps prevent kidney stones; it doesn’t cause them, AFAIK. As for vitamin C, 1 g daily is enough to cause kidney stones, but I believe the risk is a real concern at 2 g or more daily.

[desertshores]

I am not about to criticize anyone’s stack unless I spot something very dangerous. We are all on our own self-discovery to find the things that work best for us. We have noted from many posts that things that work for one person don’t work for another.
I am always trying to keep my stack as small as reasonably possible without missing out on a major intervention.

Old men (84), like old cars, generally have a lot of things that need fixing.
This is my current list of supplements and drugs that I have chosen for my personal needs and not a recommendation for anyone else, especially younger people.

I have eliminated many supplements I have taken in the past to reduce the list to a manageable number.

You may wonder why metformin is not on my list. I took metformin for decades, and I am a believer in its efficacy. Unfortunately, I reached an age where my gut no longer tolerates it, even in timed-release form. Statins? I just feel better when I am not taking them, and I have been taking substitutes that keep my lipids in order.

These are the supplements/drugs that I am currently taking.
As you can see, it is heavily weighted towards cognitive benefits. Losing one’s mind is an old person’s worst nightmare.

These are the supplements that I have been taking on a regular basis:

CoQ10 Cardiovascular health
Vitamin D3 Cardiovascular and immune health
Vitamin K2 (MK7) Cardiovascular health, preventing arterial calcification.
Lithium orotate Cognitive health, life extension
Magnesium L-threonate Cognitive function and sleep.
Alpha GPC Choline: Cognitive enhancement
Bacopa monnieri Cognitive function, stress reduction, memory support
Ginkgo Biloba Cognitive function, circulation, brain health
Phosphatidylserine Cognitive function, stress reduction
Creatine Cognitive function, creatine has neuroprotective effects. Prevention of muscle loss. Creatine may help regulate blood sugar levels.
Galantamine Cognitive function By increasing acetylcholine levels, it can help enhance memory, attention, and the ability to perform daily activities.
L-citruline Nitric oxide production, improve circulation, reduces blood pressure
Boswellia serrata Boswellia serrata exhibits a broad spectrum of therapeutic benefits, particularly in managing chronic inflammatory conditions and supporting joint health. Reduces hsCRP

Drugs:
Metoprolol Helps lower blood pressure, reducing the risk of stroke, heart attack, and kidney problems.
Telmisartan Lowers blood pressure, improves heart function, reduces the risk of stroke, improves insulin sensitivity, and improves the function of blood vessel linings.
Dutasteride Reduces symptoms of BPH and possibly reduces the risk of developing prostate cancer
Tamsulosin Improves urine flow
Tadalafil Tadalafil helps relieve symptoms of BPH. Tadalafil is approved for treating pulmonary arterial hypertension by relaxing the blood vessels in the lungs, which improves blood flow and reduces the strain on the heart, thus improving exercise capacity and quality of life. PDE5 inhibitors like tadalafil may promote autophagy. PDE5 inhibitors have been shown to protect against cognitive decline and support brain health, potentially influencing aging-related cognitive decline. Preclinical studies have suggested that PDE5 inhibition may improve mitochondrial function, leading to better cellular energy production. PDE5 inhibitors, such as tadalafil, may have anti-inflammatory effects, which could contribute to improved healthspan and longevity.

bempedoic acid/ezetimibe (combo pill) Enhanced LDL cholesterol reduction. Greater reduction in LDL cholesterol than either drug alone. Lower risk of new-onset diabetes compared to statins.

My life extension supplements/drugs (unproven as yet)
Rapamycin ~15-20 mg effective dose weekly.
Lithium Orotate 10mg daily
Melatonin 10 - 1000 mg. nightly.
Tadalifil 5 mg daily

[LukeMV]

@DeStrider Looks good to me. If anything, there may be some things on there that might not be doing a whole lot but since you’re a bit older than me, you probably want to throw the kitchen sink at your health. I would too.

@desertshores Looks like a great stack

[Bicep]

It looks good and you’re obviously all in. The only thing I notice is that you’re taking a small boatload of D, small on the k2 (no k1?), no A and no E, though there could be small amounts in the multi. Pretty sure it was Masterjohn that says to take fat soluble vitamins in excess in the correct ratio. There is a cleanup crew to get the excess vitamin D out of the way and it will indiscriminately reduce A, E and K. He also thinks K2 mk4 is the main one even though the mk7 can be converted. And Lustgarten says K1 is a big deal even though it may not seem like it. If you eat like a goat (lots of green leaves) you may be ok anyway. I’m not.
For my D I use the life extension one with iodine and all the k’s.

Obviously YMMV,

[SilentWatcher]

@DeStrider

2 g citrulline

Dear @DeStrider, thank you posting that… 1-2 years ago you attracted my attention to citrulline. With time I noticed, that you need at least 3-6g a day, in order to notice any effect on NO.

Why 2 g citrulline is too low (Schwedhelm 2008):
• 2 g citrulline → only +20–25% arginine (too low for NO increase)
• 3 g citrulline → +35–40% arginine (crosses NO activation threshold >30%)

2 g = not enough NO → tadalafil has nothing to extend synergetically
3 g = enough NO → tadalafil + NO = full synergetic effect.

That’s why 3 g citrulline works synergistically with tadalafil, but 2 g often feels like nothing. Up2you