None at all… the ankle edema I had… appears to be from my high rapamycin doses… 36 - 38 ng/mL. Once my dose reduced after 7 months… the edema went away completely.
That said some people (a few in the study) get ankle edema for a few months… then it goes away.
Link: https://www.nytimes.com/2022/08/18/health/minoxidil-hair-loss-pills.html
A new NY Times article on the topic of hair:
(as a side note, minoxidil tablets are available from many of the companies on the list of reliable online pharmacies, for very little money - i.e. $1 for a strip of 10 tablets of 5mg, which would need to be broken up to deliver the much lower dose used in the study). The doctor is quoted as now giving patients “effective doses of one-fortieth of a pill and began routinely prescribing the drug. That first patient still takes it.”
But there is a cheap treatment, he and other dermatologists say, costing pennies a day, that restores hair in many patients. It is minoxidil, an old and well-known hair-loss treatment drug used in a very different way. Rather than being applied directly to the scalp, it is being prescribed in very low-dose pills.
Although a growing group of dermatologists is offering low-dose minoxidil pills, the treatment remains relatively unknown to most patients and many doctors. It has not been approved by the Food and Drug Administration for this purpose and so is prescribed off-label — a common practice in dermatology.
At a meeting in Miami in 2015, Dr. Sinclair reported that low doses of minoxidil prompted hair growth in 100 successive women.
He published those results in 2017, noting that rigorous studies were needed, in which some patients would be randomly assigned to take minoxidil and others a sugar pill. But that has not happened. He says he has now treated more than 10,000 patients.
Recently, a rising number of hair-loss dermatologists have been giving the low-dose pills to patients with male and female pattern hair loss, a normal occurrence with age.
nytimes.com – 18 Aug 22
Dermatologists who specialize in hair loss say that the key ingredient in a topical treatment worked even better when taken orally at a low dose.
The research papers that have been published on this is below:
Background
Minoxidil and spironolactone are oral antihypertensives known to stimulate hair growth.
Objective
To report on a case series of women with pattern hair loss (PHL) treated with once daily minoxidil 0.25 mg and spironolactone 25 mg.
Methods
Women newly diagnosed with a Sinclair stage 2–5 PHL were scored for hair shedding and hair density before and after 12 months of treatment with oral minoxidil 0.25 mg and spironolactone 25 mg.
Results
A total of 100 women were included in this observational pilot study. Mean age was 48.44 years (range 18–80). Mean hair loss severity at baseline was Sinclair 2.79 (range 2–5). Mean hair shedding score at baseline was 4.82. Mean duration of diagnosis was 6.5 years (range 0.5–30). Mean reduction in hair loss severity score was 0.85 at 6 months and 1.3 at 12 months. Mean reduction in hair shedding score was 2.3 at 6 months and 2.6 at 12 months. Mean change in blood pressure was −4.52 mmHg systolic and −6.48 mmHg diastolic. Side effects were seen in eight women but were generally mild. No patients developed hyperkalemia or any other blood test abnormality. Six of these women continued treatment, and two women who developed urticaria discontinued treatment.
Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone
https://onlinelibrary.wiley.com/doi/10.1111/ijd.13838
Conclusion
Oral minoxidil was found to be an effective and well-tolerated treatment alternative for healthy patients having difficulty with topical formulations.
Blood pressure - systolic a bit lower too about 10 points from 137 to 127… A good thing.
