As of today, there’s zero evidence in non obese / non diabetics people. Nothing in animal models, no pathway, no epigenetic clock. Even in CKD I think they’re only looking at obese people. That alone tends to convince me that these drugs might not be great for non overweight people. I’ll wait until one GLP-1RA gets approved for an indication in non obese / non diabetic people (something like hypertension, heart failure, CKD, CAD, etc.). Or for evidence of life extension in animals.

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For what it’s worth, a friend of mine is microdosing 0.4mg of tirzepatide per day and wears a CGM. He also wore a CGM when taking Empagliflozin previously. He said his post meal glucose is much lower on Tirzepatide than on Empagliflozin.

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Same experience for me on semaglutide vs dapagliflozin. GLP-1RAs are way more potent. Too bad this comes at the cost of increased heart rate and lower HRV :sob:

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Even if not “overweight/obese” by BMI standards (the only standard used so far to judge obesity in GLP trials), I look at it more as potential health benefits of optimization of body fat and especially visceral fat. If my starting BMI is 25, but I cut my visceral fat down by 80% and raise my HR by 5, what’s the net result? I realize that’s probably a rhetorical question at this point, but I’d speculate a net benefit.

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I would also consider the individual feeling, that is the neurological feedback to a HR increase. It may cause no feeling of unease and that could be a sign that the increase is acceptable to the system.
I am aware that the reasoning is subjective and without scientific evidence (perhaps) but I value neurological feedbacks, if well interpreted without bias.

As a simplification, when having an elevated, much above average HR, many people do not feel relaxed and at ease.

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This paper may explain the intersubject variability: Dietary restriction impacts health and lifespan of genetically diverse mice

They found that:

Responses to DR vary across individuals, and the mechanisms underlying this variability remain largely unclear. Studies in mice and non-human primates have shown that the effects of DR are influenced by individual characteristics including sex, body size and composition, and genetics
There is a lack of knowledge regarding physiological markers that predict how individuals will respond to DR. Identification of such predictors could help to tailor DR to individual needs, serve as tools in the longitudinal evaluation of intervention success and elucidate the biological processes that mediate the effects of DR on lifespan.

As GLP-1RAs largely mimic calorie restriction, the same reasoning should apply. In the future a blood test might determine whether someone would benefit from them. In the meantime, I’d rely on “individual feeling” as suggested by @mccoy.

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Antoine, I didn’t know you were such a fine comedian! I laughed until I cried at your very funny commentary on the DR paper in the genetically diverse mice. Your joke has a very classic structure. First, you do the setup:

“This paper may explain the intersubject variability”, and then you deliver the punchline:

“They found that:” - and you quote from the study, and the funny reveal for us, that in fact they found nothing, are useless in generating an answer, and helplessly plead for studies from other researchers to find out the answer for them because it would be so helpful to have those answers and they list all the advantages of having such answers which they themselves don’t have and can’t supply.

That was a fantastic practical joke. When I read “they found that” I threw myself like a savage at the answer (“reveal”!), because it indeed would be fantastic to find out the explanation for intersubject variability, so I was completely taken in, and I rushed forward with great speed and excitement, and as I ran past toward the end line you pointed to, the great promise, you stuck your foot out, and I face-planted on the pavement to general laughter and merriment - the answer is “we don’t know, but maybe you - or someone - can find out for us, thank you!”. You really got me! Well played.

Of course I’m kidding. But joking aside, the answer can be boiled down to “it’s the genes”. There’s your variability. Not sure how actionable that is (apart for choosing your parents wisely), but the disentanglement of healthspan and lifespan could be useful in tuning out all the health gurus who promise that their health recommendations will prolong your life😂. With good genes, these interventions can be very helpful, although if you have bad genes, it sucks to be you - yet another confirmation for the most reliable and unbreakable rule in life “it is better to be lucky than to be good”.

This also is handy in explaining why health nuts are not overrepresented among the supercentannarians. I have always argued this simple evidence. If all these supposed life prolonging diet and exercise and wellness routines truly prolonged lifespan, you’d have the champions in these practices at the top of all those centennarian and supercentenarian lists. Instead, we have guys and gals (mostly gals) who are not particularly sophisticated wellness practitioners, they can’t tell us which of their practices were key, and all their lifestyles were all over the place, they were rarely paragons of diet and exercise ideals. Instead, their longevity had a strong family heritability component. Well, Sherlock, it sure seems like genes are the deep “secret” of extreme longevity, and the rest of us are whistling in the dark.

Until genetic engineering becomes an accessible intervention, we must focus on healthspan as best we can, and any individual variability in response to a health intervention is a matter of genetic luck.

January 2025, I will test my genetic luck in trying rapamycin to find out if it helps, harms or does nothing for this n=1 rat.

The same “test your luck” applies to everything else - how you respond to every drug, SGLT2i, GLP-1RA, statins, BP meds, exercise regimen, diet profile, supplements, meditation and psychological interventions, mood and happiness. Good luck, everyone!

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I feel that deep in my jeans :slight_smile:

I also see it in my N=2 experiments. My wife is female, she is less than 1 year younger and she is on the exact same set of protocols as I am. Yet she “beats” me in every metric related to health and epigenetics. She is now at #42 on the RO and I’m at #145 (out of over 3,600) after our 5th DNAm test in 4 years.

Over the past 4 years, I’ve come to accept 3 “realities”;

  1. genes matter
  2. managing health span is more important than the “wish” to increase lifespan
  3. genes matter

Should working towards increasing my healthspan lead to a longer lifespan, that would be acceptable to me.

I will become much more excited about the dream of increasing lifespan when I see even a few things that can actually “regenerate” certain biological functions. I have my wish list :slight_smile: One thing I am seeing is my PWV improving recently.

My motto is “Healthspan leads to Lifespan” and will be the tile of my book or the epitaph on my headstone, which ever comes first LoL!

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Have you read the paper and its comment?

It’s not a matter of “good” or “bad” genes. It’s possible that those who benefit the most from calorie restriction (and by extension GLP-1RAs?) are actually those with “bad” genes that would otherwise have a shorter lifespan. If that’s the case, then GLP-1RAs would be inefficient or even detrimental in those with “good” genes that are otherwise healthy. For instance, there was another study in mice showing that long-lived mice (with “good” genes) didn’t benefit from CR.

Don’t even get me started on GENES!

As a young girl, my dad taught me a useful life lesson
“dad, but that is not fair”
“life is not fair, you might as well get used to that now”

People ask me if my crazy healthy habits are so I can live to be 100… I say nope, it’s so I have a remote chance just to live as long as my peers!

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Yes, I read the paper. And you are wrong - that’s OK, I’ve studied CR for decades, so that’s my advantage. There is a lot of subtle stuff going on. CR is less effective or not effective, not in animals that have “better” genes, but in animals that are already somewhat optimised for longevity. As an example, it is speculated that the reason humans likely benefit little from CR, is because we as a species are already optimised for longevity, so CR doesn’t bring much to the table. It’s not that the genes of any particular human are good or bad that makes CR not effective in humans, it’s that the whole species is less suited to a CR intervention.

CR is a survival modality that was preserved evolutionarily to cope with food scarcity. The more a species was prone to encounter food scarcity, the more useful CR was, and the stronger its effects in that species. But conversely, the less energy scarcity a species had in its environment of operation, the less needed, and so the less developed was the CR response. Mice and rats are excellent models for CR. Mice live 3 years at best, even less with predation in the wild. And natural events in their environment - droughts, floods, fires, vegetation disease wiping out a food source etc., are a regular ocurrance to deal with. A bad year of drought or such is A FULL 30% of a mouse lifespan. If the mice were not able to survive food scarcity for a full 30% of their lifespan, they would die out as a species. So CR which allows them to survive with little food for a full 30% of their life is a very powerful evolutionary advantage. The worse the famine - the more extreme the CR - the longer they have to survive. That’s how you get mice on increasingly harsh CR live increasingly long by 30%, 40%, 50% and so on. They must survive worse and worse famines.

Contrast that with humans. First of all, humans as a species are very good at eating everything and finding food everywhere. For early humans in our evolutionary past, we were never in as harsh situations of food scarcity as species such as mice - we are more resourceful, eat more broadly omnivorously, can relocate and so on. A flood happens, or a disease wipes out the vegetation we live on, we are not in a disastrous situation like a mouse is. We can travel great distances, and we can bring down a mammoth. We don’t need CR as badly, so we never preserved as much of a response to it. Our ancestors would never find themselves in a situation of food scarcity - flood, fire, drought, disease - that lasts for 30% of our lifespan, for decades. So quite naturally, our response to food restriction, DR, CR is going to be mild, it will not give us a 40% lifespan extension, because in our evolution we at most had temporary food scarcity, so our response to CR, DR is equally small, temporary, fit for purpose, not for decades.

It is not because mice have bad genes and humans good genes that CR works great in mice and not much in humans. It is down to what the CR is good for in a given species from an evolutionary point of view.

Now back to mice. You referenced “long lived mice”:

“For instance, there was another study in mice showing that long-lived mice (with “good” genes) didn’t benefit from CR.”

Fundamentally, no. There are no “good” longevity genes - these are different mice with different genetic profile than lab mice. Same as you would not compare “good” human long-lived genes to “bad” short-lived mouse genes. But in mice it is more complicated, because they are the same species - still look at dogs, same species, but a terrier will live much longer than a great dane. With lab mice vs wild type mice it is even more complicated, because lab mice were selected for a variety of lifespan pressures compared to wild type. Apples and oranges. The CR experiments that you are referencing, were the Austed studies in wild type mice. There is a lot of background to understand the context. CR has a wide effect on an organism, such as a mouse. There is of course the more efficient use of energy. But there are many other effects, such as reorienting from reproduction to preservation - it makes sense not to have youngsters that need to be fed when there is a famine. Your energy output actually increases with CR in distinct ways, there is more movement and food seeking behavior, there is less need for sleep - makes sense for the animal to be able to forage more intensely and longer for scarce food. CR sharpens all the senses - makes sense to be able to find scarce food. And so on. It’s quite complicated to compare wild type mice for response to CR with laboratory mice with completely different genes that respond to lab conditions over generations, see below.

Here is the Austed et al study - it is very instructive:

"Summary

To investigate whether mice genetically unaltered by many generations of laboratory selection exhibit similar hormonal and demographic responses to caloric restriction (CR) as laboratory rodents, we performed CR on cohorts of genetically heterogeneous male mice which were grandoffspring of wild-caught ancestors. Although hormonal changes, specifically an increase in corticosterone and decrease in testosterone, mimicked those seen in laboratory-adapted rodents, we found no difference in mean longevity between ad libitum (AL) and CR dietary groups, although a maximum likelihood fitted Gompertz mortality model indicated a significantly shallower slope and higher intercept for the CR group. This result was due to higher mortality in CR animals early in life, but lower mortality late in life. A subset of animals may have exhibited the standard demographic response to CR in that the longest-lived 8.1% of our animals were all from the CR group. Despite the lack of a robust mean longevity difference between groups, we did note a strong anticancer effect of CR as seen in laboratory rodents. Three plausible interpretations of our results are the following: (1) animals not selected under laboratory conditions do not show the typical CR effect; (2) because wild-derived animals eat less when fed AL, our restriction regime was too severe to see the CR effect; or (3) there is genetic variation for the CR effect in wild populations; variants that respond to CR with extended life are inadvertently selected for under conditions of laboratory domestication."

And even in lab mice, the opposite is true for what you claim. It is the mice with “good” genes that live longer on CR, respond better to CR, than mice with bad genes. The mice which responded better to CR were superior genetically, because they could preserve weight with less food, had better immune systems to start with, and were more resilient to stress in general and the stress of CR.

Regarding drugs, yes, there are always arguments along the line of a drug of course prolonging the life of a sick individual (maybe due to bad genes), but not needed by a healthy individual (maybe one with good genes). But we are discussing who responds to a drug - who has genes that are “good” because they allow a good response to a drug, not whether the individual has good or bad genes in general. A sick person with “good” responsive genes to a drug, will live longer than an equally sick person who has “bad” gene responders to the same drug.

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You know it’s not because you’re behind a keyboard that you can talk like that. You can be nice!

I don’t think it was I had in mind. I had in mind this paper (The impact of short-lived controls on the interpretation of lifespan experiments and progress in geroscience – Through the lens of the “900-day rule” 2024) showing that long-lived strains don’t benefit much from CR:

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?? I don’t see where I was being rude in my reply, I am not in the habit of initiating hostile exchanges. You are jumping at shadows. I was being simply assertive, no more or less than you implying that I might not have read a paper I was commenting on. I could see that as rude, as I am not in the habit of commenting on stuff I don’t read - but I didn’t choose to see your remarkas as being rude, just asserting that my remarks are so wrong that it’s as if I have not read the paper. What else could you mean - I’m wrong (though it might not be seen as very nice to imply I was negligently wrong by not reading). Just assertive. I replied equally assertively that no, it is not I who was wrong, in my opinion, rather it is you who is wrong. Equally assertive. Nothing more. Just so there are no future misunderstanding, please always keep in mind that I am never an “@$$hole” unprovoked, I don’t shrink from a fight, but never initiate, so if you see something I wrote, it’s never an unprovoked attack, and interpret it as written in good faith - benefit of doubt. I extend my hand in friendship - all I care about, as I believe do you, is the passionate pursuit of the truth.

With that out of the way, OK, I see you were referring to a different paper. The Austad et al paper is the classic in the field of CR impact on differential genetic background impact of CR, so since you didn’t specify, I thought you meant this seminal paper in the field.

The paper you have referenced is the 900-day mouse rule paper by Kaeberlein et al, unfortunately, I don’t have access to the full paper - so I am not going to comment on it as I don’t comment on papers I have not read, but in general, from long experience with reading CR-related papers I’d be very cautious about reaching any conclusions such as “long lived mice don’t benefit from CR” - based on what data? I see ITP referenced as the gold standard, but that’s not it. If you look at specific studies, or studies in aggreggate, you may reach very different conclusions, since a ton of CR studies suffer from poor animal husbandry (Weidruch et. al). Unless you know the field of CR very well, I would be careful accepting some conclusion from a single set of graphs - I’ve seen too many flawed papers for that.

In any case, as the Austed et al. paper pointed out - looking for CR results in lab animals is very complicated, because of selection bias. Putting it all down to “longevity genes”, or “good” vs “bad” genes is simply wrong - different lifespans of lab mice in different strains are due to multiple factors, and any intervention might or might not fit with a given genetic profile.

As an example, see dwarf mice. Dwarf mice ALREADY LIVE SUBSTANTIALLY LONGER THAN normal mice. So, do they have “good genes”? Tricky question. And guess what - dwarf mice put on CR extend their lives even further. There you have an example of a strain of mice with according to you “good genes” that have their life extended by CR. So, as can be seen, long lived mice might or might not benefit from CR based on their strain. If you then have a bunch of CR experiments in long lived strains that don’t benefit from CR, guess what, you’ll reach the conclusion that long lived mice don’t benefit from CR - which is wrong, since it’s the strain that determines CR effects, and not just “good longevity genes”.

Extending the lifespan of long-lived mice

https://www.nature.com/articles/35106646

Quote:

Ames dwarf mice are mutant mice that live about 50% longer than their normal siblings1,2,3 because they carry a ‘longevity’ gene, Prop1 df, and in some phenotypic respects they resemble normal mice whose lifespan has been extended by restricted food intake2,4,5. Here we investigate whether these factors influence lifespan by similar or independent mechanisms, by deliberately reducing the number of calories consumed by Ames dwarf mice. We show that calorie restriction confers a further lifespan increase in the dwarfs, indicating that the two factors may act through different pathways.

Is the longer life of dwarf mice (hitting 1300 days or so) compared to wild-type mice long enough to qualify as “long-lived mice”? I would think so. Please note, that they did as favorable a comparison as possible by utilizing wild-type mice, that live roughly in line with the Kaeberlein 900 day rule - and these are normal mice, not some lab freaks selected for longevity, these are wild-type mice.

And yet, if you look at that graph, CR extends the lifespan of dwarf mice further. That right there shows you that the idea that somehow long-lived mice don’t benefit from CR is utter nonsense. It is highly strain specific. Which is what I said in my previous post when I said “these are different mice” - that was my point. Depending on the mouse strain, you will get a different effect of CR - not “good longevity” genes, because there are “good” genes that promote long life (like the dwarf mice), but that still benefit from CR, and “good” genes that are in other strains of long-lived mice that CR does nothing in. It’s all down to what “kind” of genes. In that sense, yes, it’s all down to the genes. Are we on the same page now? Again, all I seek is the truth.

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“Pardon my French” then. I apologize and I edited my message. I agree that all that matters is the pursuit of the truth. But I think the way you write doesn’t help in this endeavor to create a peaceful and respectful conversation (“Antoine, I didn’t know you were such a fine comedian! I laughed until I cried at your very funny commentary on the DR paper in the genetically diverse mice.” […] “And you are wrong - that’s OK”).

I asked “Have you read the paper and its comment?” because it was unclear from your answer whether you were commenting on my short comment on the paper (that was maybe wrong) or the underlying papers themselves. Actually, your opinion on these papers is still unclear to me: what do you conclude from them (“Dietary restriction impacts health and lifespan of genetically diverse mice” and “Dietary restriction interventions: lifespan benefits need resilience and are limited by immune compromise and genetics”)?

Thanks for the dwarf mice paper. Very interesting. So yes, it shows that some long-lived strains can still benefit from CR. But that wasn’t really the point of the conversation. My initial point and the start of this conversation (here: Experience with GLP-1s - #232 by adssx ) was just that I inferred from the DR paper that the response to GLP-1RAs was probably as individualized as the response to CR/DR/IF, based on genes (whether “good” or “bad”), and with, as of today, no way to predict it.

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Update on my friend taking Tirzepatide here. He just got a spike in heart rate and lowering of HRV so he has stopped taking it for now.

As for me, I’m still rolling with the Retatrutide. Hopefully my dose decrease manages this to a point I’m more comfortable with it. I am really liking the reduced appetite.

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At my highest weight, my resting heart rate (RHR) consistently ranged between 90 and 100 bpm. I have been using Tirzepatide, specifically in the form of Mounjaro, for nearly three years. Despite significant weight loss and a substantial increase in physical activity, I have not observed a reduction in RHR directly attributable to Mounjaro.

For approximately a year, I have also been taking Nebivolol to manage heart rate issues. This medication has effectively lowered my RHR without any noticeable side effects. Currently, my RHR is 58 bpm while on both Nebivolol and Tirzepatide.

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Are there ‘alternatives’ for individuals who have issues with GLP1s?

I have Crohn’s, and I tried Ozempic, and it predictably caused major issues with me, since it slowed down motility, which is kryptonite for me.

Actually, I am glad to know that Tirzepatide gives a resting heart rate spike.

I ordered some Tirzepatide from a vendor I have never used before. It arrived undiluted, with no filler.
10mg in a 10cc bottle. It sure didn’t look like very much. Some of it looked like it was deposited on the side of the bottle. In any case, I reconstituted it with bacteriostatic water and took a 2.5mg dose around 11 a.m. Yes, indeed, it spiked my resting heart rate from 58 to 80 bpm.
So, maybe I got the real deal. No other peptide has raised my resting heart rate so far.
I will check my HRV, but my experience is that too many things affect it.
None of my healthcare providers give a shite about it.

This was the first day, and I will closely monitor my resting heart rate for the next few days.

FYI: My BMI is ~22, and I am in good shape. I am trying to eliminate a couple of pounds of lower abdominal fat.

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Eli Lilly to test obesity medications as treatments for alcohol and drug addiction, CEO says

Company also wants to work toward over-the-counter access for weight loss drugs
“These medicines, we think and we’ve aimed to prove, can be useful for other things we don’t think about connected to weight. These are often called anti-hedonics, so they are reducing that desire cycle,” said Ricks, speaking at an event hosted by The Economic Club of Washington D.C. “Next year, you’ll see Lilly start large studies in alcohol abuse and nicotine use, even in drug abuse.”

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Yes you did get the “real deal” :slight_smile:

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