#21

Thanks for the warm welcome, Dr. Fraser. I appreciate the advice; I have to keep reminding myself to keep the DDx broad especially when a pts course/data doesn’t totally fit with the putative diagnosis.

I was unaware of Mark Houston, but I’ll look into him. Thanks!

Most of the material on this site/in this space has been a personal hobby of mine for the past couple years. For now, I’m focused on becoming the best physician I can be within mainstream medicine, but I’m always interested in other viewpoints/ideas that are well-reasoned and backed by evidence, which is why I really enjoy this site. Basically wherever the data goes, I’ll follow :slight_smile:

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#22

Excellent to hear back from you. It is a different mindset to have informed patients who recognize the uncertainty and risk/benefit - often in individuals with no disease.

As physicians we are focused on waiting for well defined disease and then using an evidence based approach to treat it - which as an EM and FP physician, I do well - but it is more elegant, albeit less spectacular to preempt disease.

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#23

Ah sorry for the misunderstanding, I appreciate the support!

#24

No worries! And certainly no apology necessary!

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#25

Hi, this is Prabhakar from India, age 22. I have been taking rapamycin for the last two years because I want to go “all in,” because why not stare back at the abyss? I started with 6 mg of rapamycin weekly initially, two years ago when I was 20. I got some mouth ulcers, but when I took it continuously for around three months, my mouth ulcers and other side effects were gone. Now, I try to cycle it: three months on and one month off. Recently, I also upped my dosage of rapamycin to 15 mg weekly. I have been following a strict diet with lots of vegetables and fruits and taking good care of my body by exercising regularly, six times a week, one hour daily, and sleeping eight hours. My supplement list is as follows: 15 mg rapamycin weekly, 6000 IU vitamin D weekly, 4 mg creatine daily, 500 mg metformin daily after meals to restrict glucose spikes, two spoons of olive oil after every meal, soy protein for protein deficiency in Indian meals, and 1500 mg EPA/DHA combined fish oil daily. I have a family history of cancer. My father died at 41 due to cancer, my grandmother died from cancer at 63, and my aunt has cancer at 38 but is hopefully recovering. This is the reason for me to go “all in.” Here is my latest biomarker report and interpretation from Grok3. My LDL-C is 116 due to hyperlipidemia caused by rapamycin, my CPK is way out of range due to poor excercise recovery, and my eosinophils are too high due to rapamycin immunomodulation. what do you all think @DeStrider @RapAdmin @DrFraser :: blood biomarker report 22012025 - Google Docs

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#26

It sounds like you are off to a good start. My primary concern is your lipids. You may want to add Bempedoic Acid and Ezetemibe. They should be inexpensive in India.

Next, I would consider adding B12 and Magnesium as most people are deficient in these two. B12 especially since you are taking daily metformin.

What types of cancer run in your family? You may want to target interventions for those that run in your family. For instance, getting a colonoscopy if colon cancer runs in the family or PSA tests if you have a history of prostate cancer. Etc…

Also starting Rapamycin in your early 20s seems too young. It may negatively affect your development. 25 is the minimum age IMHO and probably better to wait until 30-35. The biggest benefits of Rapamycin are increased autophagy and prevention of senescence which primarily occurs as you get older.

I do 17.5 mg (5 mg + GFJ) of Rapamycin every two weeks, but I’m almost 50. 15 mg every week seems a bit too much too often. I can understand how the loss of your father can motivate you to try and prevent cancer!

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#27

First thing – I’m not certain that any 22 year old is going to have any benefit from Rapamycin (for longevity).

Second thing, unless you weigh 300 kgs, the dosing is going to leave you with continuous mTORC1 and C2 inhibition which is not a good thing. This is a dose done weekly that I’d not recommend to anyone, unless blood levels were monitored and we saw that your 50 hour level was ~3 ng/mL. My experience however, is that it would be a very rare non-absorber of rapamycin who would require this, and I’d want data to support this.

The CK elevation is something that can happen if you worked out hard in the prior 48-72 hours, but if not, this is another red flag. The goal of longevity medicine is to improve outcomes, not accidentally cause significant adverse effects.

If one is worried about malignancy - then at an appropriate age, get a yearly MRI of body/head/neck - it won’t cost much in India. In general, I don’t recommend this before age 40 years, but if early family history, then possibly in the 30’s. If there is something that is truly familial, then screen appropriately for that in the least invasive and risky manner.

As I’ve not personally evaluated you or your situation (and I can’t as I’m not licensed in India) - I’d recommend some serious contemplation on the risk/benefit and if you choose to continue, certainly get some advice from a physician familiar with rapamycin, but overall, if you continue, scale down the doses unless you have data supporting this dosing.

If you continually have a high CK, you will risk ongoing irreversible kidney injury. But this might be worth a recheck if you worked out hard and had very sore muscles at the time of the draw.

Not meant to be medical advice, but just my observations and thoughts on this.

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#28

If your lipids are elevated, perhaps you want to reconsider the practice of adding several spoonfuls of olive oil each day, especially considering there is already plenty of fat in typical beyond-yummy Indian meals. I say this not knowing your particular diet.

I also think your dosing is too extreme. I don’t know anyone who doses like that each week, and this is not even mentioning your age.

You are very tuned into health at your very young age, so if you make a few tweaks, you’ll probably have excellent long term outcomes. Great job on your mission!