My CGM data while on Rapamycin

[Barnabas]

@Beth

you can’t go back and look at specific times and exact levels with the freestyle libre 3

If you go to LibreView.com and create an account, you can see some nice reports and even download CSV spreadsheets with granular data.

[Beth]

THANK YOU! I was googling and watched videos but never found this… appreciate it!

[ng0rge]

@Beth

I have questions about spiking and what is acceptable for good heart health

For some very good info on blood sugar spikes and CGMs, see my post (and thread) here:
https://spotify.localizer.co/t/good-energy-new-book-by-casey-means-metabolic-health-mitochondria-and-cgms/14530/8?u=ng0rge

It says - If you just want to hear Casey Means’ insight on CGMs (useful) go to the Huberman podcast above and listen to the segment from 2:19:30 - 2:33.

And here’s the link to the YouTube podcast to watch those 13 minutes.

https://www.youtube.com/watch?v=8qaBpM73NSk&list=PL_v7HcCd-Od9povq_lcxMV_iXZ_waSK0y

[Beth]

I just watched and that was very interesting!

I wish they showed concrete examples when discussing this because I’m still not sure how my numbers fit in here, or any other conversations. I hear them say, it’s ok to spike if you come down quickly… but if spike too high (what number is that?) and you come down quickly, it’s a crash and that is bad…

[John_Hemming]

There is a threshold for the spike at around 8/140 which means a different metabolic pathway is being used.

[SilentWatcher]

@wrap-a-mice-in

Also, re: the survey on this forum showing only ~10% of people reported glucose dysregulation

As mentioned by @Angel_Myers, CGMs from Abbott and Dexcom can be inaccurate in the lower range of 80-120 mg/dL. You can use a conventional blood glucose monitor to confirm this.

Additionally, I recommend looking into lithium supplementation.

Correcting lipid/glucose side-effect

I have reduced my intake of rapamycin to once every 2 or 3 weeks to stabilize the negative glucose effect. Currently, I view this glucose intolerance as part of the therapeutic effects of the starvation-mimicking drug rapamycin (Once again on rapamycin-induced insulin resistance and longevity: despite of or owing to; Mikhail V. Blagosklonny). There are some studies that point out that “combination of lithium with rapamycin canceled the latter’s effects on lipid metabolism” (A triple drug combination targeting components of the nutrient-sensing network maximizes longevity). In my n=1 experiment, adding lithium orotate substantially stabilized the glucose side effect (take 1mg daily and 2-3mg on rapa-days).

[RapamycinCurious]

@Correcting lipid/glucose side-effect

There are some studies that point out that “combination of lithium with rapamycin canceled the latter’s effects on lipid metabolism”

There is a study that finds that — in fruit flies.

[John_Hemming]

@RapamycinCurious

There is a study that finds that — in fruit flies.

Which is why I think we need a bit more of a focus on multiple N=1 biohacking.

[Beth]

John, are you saying that after 140 is when I should worry? I wasn’t sure what 8/140 meant (the ‘8’)

I guess I need to consider taking a higher dose of metformin or perhaps consider adding acarbose that seems to be very popular here.

[Barnabas]

I was confused at first too, but I think 8 is in different units. 140 would be mg/dL. 8 would be mmol/L.

[wrap-a-mice-in]

Last week’s 3mg was uneventful. I took it friday night before sleeping so I’d be in a fasted state before and after the dose.

This friday, I forgot and took it saturday afternoon after lunch. I waited until my BG was stable ~3 hours after the meal and took 4mg. After about 45 minutes I noticed my BG rose about 25 mg/dL and I had to exercise it off. When I sat back down it went up slightly again before stabilizing.

I think this is more evidence that taking rapamycin immediately shuts down or lowers insulin production in me and I should avoid taking it while not fasted.

First week, took 2mg 30 min after a meal → big spike
Third week, took 3mg in a fasted state and didn’t eat for 8 hours after dosage → no spikes while I slept
Fourth week, took 4mg 3 hours after a meal → small spike

[John_Hemming]

The strict conversion is 8 mmol/L or 144 mg/dL, but people tend to think of thresholds of 10 mg/dL.

Ideally, however, your body would keep glucose levels below the point at which I think the inositol pathway gets engaged. A quick google search did not find a good reference for this. If people want one I will put some time in. I probably recorded the reference when I found this useful bit of information.

[Neo]

@John_Hemming

this. If people want one I will put some time in. I probably recorded the reference when I found this useful bit of information.

Yes, that would be very valuable John!

[John_Hemming]

This comes from starting with the Polyol pathway and Chris MasterJohn has written about this here:

323: Why Should Postprandial Glucose Be Kept Under 140 mg/dL?

When blood glucose rises above 140 mg/dL, this is the approximate point at which it spills into the polyol pathway at a greater-than-normal rate, which represents a suboptimal state of metabolism that is likely to hurt antioxidant status and compromise detoxification pathways as well as the recycling of vitamin K and folate. It must be kept in mind that a healthy person will adapt to glycemic loads they consume regularly. Thus, a one-time spike above 140 mg/dL should never be used to conclude anything whatsoever. Only repeated spikes above this level with repeated consumption of the same glycemic load over several days to several weeks should be used as a cause for concern.

This may be better as well

So polyol pathway is why glucose should always be kept under 140?

​ Quote Question: Why should postprandial blood glucose be kept under 140 milligrams per deciliter? Short Answer: When blood glucose rises above 140 mg/dL, this is the approximate point at which it spills into the polyol pathway at a greater-than-normal rate, which represents a suboptimal state of metabolism that is likely to hurt antioxidant status and compromise detoxification pathways as well as the recycling of vitamin K and folate. It must be kept in mind that a healthy person will adapt to glycemic loads they consume regularly. Thus, a one-time spike above 140 mg/dL should never be used to conclude anything whatsoever. Only repeated spikes above this level with repeated consumption of the same glycemic load over several days to several weeks should be used as a cause for concern. is it also bc glucose is converted to fructose in the pathway? ​

[Karl92651]

Glucose will increase with stress, and rapamycin seems to simulate stress in the body. I wonder if the increase is similar to the increase you see with stress. When diabetics are stressed, it is difficult to control their glucose. Any non-diabetics out there using a continuous glucose monitor and taking rapamycin?

[Beth]

That would be me. I’ve had a couple conversations with my doc this week because my cgm is showing my rapa is causing very abnormal spiking… I’m prone to it anyway and take metformin, but it’s nuts since rapa (it’s what it was before starting metformin)

[Beth]

This is very helpful, thank you!
After texting my doc my cgm data showing my spike going over 200, we just talked and he suggested instead of taking metformin twice during the day that I experiment with taking it before bed. I didn’t understand why but he explained when taken before bed, it can help affect cortisol in the morning. Doing that might help me self regulate all day. I don’t really understand it nor do I need to, but I’ll give it a shot. If this doesn’t work, we will then see how I tolerate acarbose (he said gi effects are likely). Thoughts?

[Karl92651]

Are your spikes only with meals? Do you take rapamycin once per week, and if so, are your glucose levels more difficult to control for the days immediately following taking rapamycin? How high are your spikes, and do they correlate with high-carbohydrate meals? Do you know your HbA1c?

[Karl92651]

If Metformin is often added to Rapamycin to control blood sugars and Rapamycin is taken once per week, is anyone pulsing Metformin? I think pulsing Metformin would decrease the problems with exercise but still give control while the Rapamycin serum levels are elevated (assuming the elevation is from the Rapamycin). Do most non-diabetics see problematic elevations in their blood sugars with continuous glucose monitors while taking Rapamycin? I am assuming problematic would be peaks above 180 or 200.

[wrap-a-mice-in]

In Matt Kaeberlein’s latest video he says on the first couple days days following his dose, his blood glucose does a “jumpy” pattern which matches mine and other peoples’ experience here. He also said by the 3rd day it settles down again which matches my timeline exactly.

Answering Questions on RAPAMYCIN (Gold Standard Longevity Intervention) | 47 - AMA #4