Rapamycin Cost

Let me clear some things up for people considering rapamycin (generic sirolimus).  I am taking it and so are my dogs!!  (I have a very open-minded vet who trusts my judgement.)

Dr. Green, a very impressive individual, gave me my personal prescription for sirolimus.  I have a very good PPO (Blue Cross/Blue Shield).  I took it to CVS, the affiliated pharmacy, and got a great price of about $2.90/mg.  (Remember, you are only going to take about 3-6 mg/week.)  With a PPO you can probably do this also.  CVS wants to meter it to you with a month's worth of doses at a time, but that's just how they do things.  You still have access to the full quantity prescribed. 

With the prescription from my vet for my dogs, I was forced to take to the open sea.  Armed with only a prescription and no insurance, the picture is quite different, but you can still get a good price.  Cutting to the chase, I ended up at Walmart.  The prescription was for 90 mg - price $1440.  But wait! after presenting a coupon downloaded from GoodRX (that's right, just anonymously downloaded and printed) - price $396!!!!  As my vet remarked, that's a hell of a charge for not looking around first!  ($4.40/mg is better than taking a risk buying online, in my opinion.)  Costco is pretty close to that price.  At CVS/RiteAid, etc., you will pay vastly more.

You can't touch the original drug rapamune (Pfizer) unless you are wealthy or go to Canada.  The problem with the online pharmacies is that a lot of them are scams.  Just because they have a website doesn't mean anything.  At least check to see if they have a brick and mortar location.  Example: At one point I was excited by the online infomercials and wanted to take NMN instead of NR; however, when I looked up the reputations of the suppliers only one was unsullied, and on further investigation their brick and mortar location turned out to be a residential dwelling!

FYI, more than one company makes sirolimus.  From CVS the sirolimus was made by Greenstone, LLC, apparently a wholly owned subsidiary of Pfizer.

Hope that helps some people who are considering rapamycin but think it might be out of their reach.  If you know a doctor, great, but if you don't a visit to Dr. Green is worth the trip, and I live in CA!  (round trip less than $300)  Do your homework first and you will learn a great deal.

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    • Dennis
    • Retired USAF pilot, biochemist.
    • Dennis
    • 5 yrs ago
    • Reported - view

    Probably best to follow Dr. Green's advice and not take grapefruit juice since the evidence is weak of it helping and it complicates things.

    Like 1
      • Cynda
      • Cynda
      • 3 yrs ago
      • Reported - view

      Fred Cloud Well Fred you are right/correct about that.  I wrote to Dr. Green prior to  finding this forum....I was hoping he might be willing to work with me remotely for dosages, etc.  But I no longer think he could help (he was unwilling) and actually there are several people on this forum that I feel are just as qualified if not more so to help me learn more about Rapamycin.  Also learning so much from people like Peter Attia and Rhonda Patrick who have great podcasts.  Great to have knowledgeable people who don't charge $350 per visit and are willing to share what they know.   Thanks for asking.

      Like 1
    • Cynda Oh, thats good to hear. Yeah, the dosing is not super complicated so its easy to manage yourself and there is plenty of good support here, so I think you would be fine solo as most of us are. I am solo and have been taking it for 6 months and have had no issues.

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      • Cynda
      • Cynda
      • 3 yrs ago
      • Reported - view

      Fred Cloud Fred, if you don't mind my asking what have you experienced in 6 months and how much are you taking weekly? I am just starting 2 weeks into this and taking 5 mg weekly(with fresh grapefruit juice).  Too early to tell.  I, like others, wonder if Rap worked so well for Dr. Green due to his heart problems.  I am in great shape and feel good...my saying is "lifting weights is the panacea to life"....

      Like 1
    • Cynda Inflammation is way down in my body and overall I just feel better mentally and physically. Many people report feeling nothing, no effects or changes though. So don't expect anything. I take 4mg a week. No significant changes in bloodwork that I monitor monthly.

      Like
    • Cynda Wow - 5mg WITH grapefruit juice - that is a very high dose to start with.  Grapefruit juice effectively triples (approx) your dosage - so you're actually taking about 15mg a week - which is high to start with and not what many people take. In fact I don't know anyone who has taken that much on an ongoing basis before.  I hope you do regular blood work to check its impact on you.  

       I've been taking it for a year now and fluctuate between 6 and 10mg actual sirilimus (no grapefruit).  Also - there is data that suggests that females process sirolimus / rapamycin differently than males and don't need to take nearly as much (or for any given amount, seem to have a much higher blood level of rapamycin) - so that is something to be aware of also.  You can see that in this table below - if this link works:

      https://peterattiamd.com/wp-content/uploads/2021/02/ITP3-2048x773.png

      I highly recommend you listen to the recent Peter Attia interview with Richard Miller where they cover this issue:

      https://peterattiamd.com/richardmiller/

      https://podcastnotes.org/the-drive-with-dr-peter-attia/148-richard-miller-m-d-ph-d-the-gold-standard-for-testing-longevity-drugs-the-interventions-testing-program-the-drive-with-peter-attia/

      Looking at the rapamycin data from the 2009 ITP paper:

      The median extension—the age at which half the animals have died—

      • Increased by 13% in males and 20% in females 
      • Interestingly, when you give the same dose of rapamycin in chow, the blood levels in the females are three times higher than the males, but we don’t know why

      In total lifespan (aka P90 lifespan)—

      • The P90 lifespan extension was ~9% in males and ~14% in females
      • Note: This is NOT incremental lifespan extension, this is TOTAL lifespan
      • These numbers are “huge” says Peter
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      • Cynda
      • Cynda
      • 3 yrs ago
      • Reported - view

      Brin Chikovski Brin, thanks for your input.  I have heard the Peter Attia conversation with Miller.  I am aware that I probably should cut that back a bit ...say to 3 with juice. And yes I monitor my blood work.  It is very hard to say just what the correct dose is. But Peter Attia is taking 6 mg (he doesn't say if it with juice or not) and he is 47.  I on the other hand...am much older.  But I probably will cut back..  I can't find the article off hand but Mikhail Blagosklonny somewhere in his numerous reports indicated we are probably vastly under medicating with Rapamycin for longevity purposes. So I guess it's up to an individual's comfort level.  But I do so appreciate the time and energy to point this out and the information you included. This site is full of helpful and informative people like yourself.  

      Like
      • David H
      • David_Hanson
      • 3 yrs ago
      • Reported - view

      Cynda I was reading an article by Blagosklonny tonight.  He wrote "The higher the dose, the higher the anti-aging benefits, including cancer prevention and life extension."  "The optimal dose varies in different individuals due to the variability of potential side effects. Thus the optimal dose in a particular individual is determined by the emergence of side effects."  He views rapamycin as safe as it has been used by millions of people since 1999 - usually at higher doses some with reversible side effects.  An 18 year old tried to kill herself with 103mg and the only effect was an elevation of her total cholesterol.  I take 7mg on Sundays after eating 1 grapefruit.   One time I tried 8mg Rapamycin and I had a sore throat for 3 days but then it was gone.  I have been taking rapamycin for 10 months. 

      Like 2
      • Cynda
      • Cynda
      • 3 yrs ago
      • Reported - view

      David H Thanks David for the info.  That quote goes along with what I saw in an article.  May I ask since you have been taking for 10 months what results or not have you encountered ...?  Looks like you might have found your optimal dose. 

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      • David H
      • David_Hanson
      • 3 yrs ago
      • Reported - view

      Cynda I don't believe it is possible for me to tell what effects the rapamycin is having. (My age is 2 months short of 70  years old for reference).   Several reasons, I think:

      1. Per Dr. Blagosklonny, rapamycin is an anti-aging drug which he also writes that it "slows down time" or "slows aging".  It's benefits includes the myocardial infarction or stroke or cancer or pneumonia that didn't kill you in your 70's (or earlier).  I don't think I can ever tell if I avoided any of these physical problems.  Perhaps it's something that we have to take for granted like an Okinawa centenarian would as they lived their long life due mostly to their lifestyle  (since after the Americans brought in their western food at the end of WW2, they don't live so long now).

      2. Too many other factors - I started metformin in October 2019, tadalafil (5mg daily) in December 2020, and Acarbose in February 2020.  Also since I started the metformin, I started taking many supplements, 1/2 a bowl full, many of them herbal or mushroom powders.  And I changed my long term low fat high carb vegan diet to a more balanced (in carbs, protein, and healthy fats) vegan diet.  I don't eat foods that spike my blood glucose about 120 or 130 and if they do, I either stop eating them or I mix them with something else that stops the spiking.

      Other supplement additions I consider most important for this topic:

      - started taking NMN and Resveratrol daily - supposed to give me more energy

      - Istarted taking AKG daily - supposed to avoid frailty in older people and increase longevity.

      -I started drinking 2 cups of coffee in the morning (which makes me more alert)

      - I started 5 day FMD fasts most months in May 2020 which increases autophagy which I understand is part of what rapamycin does also

      - I eat 150gr of Natto daily which is high in spermidine which is also supposed to induce autophagy

      3. Here is a list of benefits for mice that were given rapamycin as described in a recent Peter Attia podcast with researcher, Dr. Richard Miller (with my comments concerning me):

      - Increased lifespan (how would I know?)
      - Fewer cancers (same as above - no one in my immediate family or my 4 grandparents or aunts or uncles have had cancer - a cousin had non fatal breast cancer)
      - Protection against cognitive decline (I had a TBI over 7 years ago and my mind has gotten better over the years even in the last year but I take multiple other supplements that are believed to help brain function - a cousin and uncle both died from/with dementia)
      - Improved cardiovascular function (I am not sure of the state of my cardiovascular function - my resting BP is 108/70 without BP meds and was the same before rapamycin - I do have a pacemaker because of genetic bradycardia which has me concerned about cardiac fibrosis - rapamycin is supposed to reduce cardiac fibrosis - my parents, grandparents, and aunts and uncles almost entirely died from some kind of cardio vascular disease)
      -Restoration of immune function - (I have not been doing my normal blood tests because of Covid 19.  Now that I have been fully vaccinated, I will get some data on my immune system soon.)
      -Improved renal function - (Before I started rapamycin, my eGFR was 96 which is like an average 30 year old so I don't believe that it will improve any further)
      - Improved oral health- (my dental hygienist and dentist have started praising me for my excellent gum health and they didn't used to do that)
      - Improved intestinal function - (no idea how I could tell)
      -Reduced gut dysbiosis - (same)
      -Preserved ovarian function - (obviously I don't have this - but a man in HK who does YouTube videos on longevity said that his wife had regular female cycles again after taking NMN for some months - it seems menopause was delayed?)

      4. Besides the increase cognition all joint pain has disappeared. For years, I had pain in my left hip and it is now gone.  Which of the changes that I have made (or something else) did this, I know not.

      Sorry for the length.  If you have found a way to determine the effectiveness of rapamycin in an individual please let me know.

      Like 2
    • JGC
    • Retired Professor of Physics
    • JGC
    • 5 yrs ago
    • Reported - view

    Rob,

    What is the name and address of your "open minded" vet? I have been looking for such a vet to administer the Oisin Biotechnology treatment (see https://www.oisinbio.com) that clears senescent cells from aging animals (and hopefully humans). All the vets I have contacted in the Seattle area about treating my two agility-champion Shetland Sheepdogs, 15 and 16 years old, are reluctant to cooperate.

    Like 1
  • Hello,

     

    I just received my Rapamycin, made by Profound Products, called RapaPro.  The bottle has 12 scored tablets in it with directions to take one quarter, one half , or one tablet per week(1.25 mg to 5 mg) as directed by your physician .  Trying just trying  to figure out now which dose to start with , for both myself and my pup!  No Rx required for this product .

    Like 1
      • Rob8311
      • Rob8311
      • 5 yrs ago
      • Reported - view

      angie4life You are rolling the dice to get this without a prescription.  Make sure they have an actual physical location.  Probably get their stuff from China - not necessarily bad, but not necessarily good either...  See above for dog dosage (read all as I was off by 10x at first).  I started at 3 mg 1x/week.  Now at 6mg where I expect to remain (per Dr. Green).  Just had one of my best blood tests ever.  Almost everything was in range and I am 67.

      Like 1
    • Rob8311 I am interested to know the results of your blood tests.  Which test in particular came out "best" than ever ?  

      In particular, look at "hematocrit" and "hemoglobin" and if you can compare with previous blood tests, see if they are lower now than before.  

      Rapamycin lowers hematocrit and hemoglobin.  (Hematocrit means the percent of your blood that is red blood cells... red blood cells carry hemoglobin, and hemoglobin carries OXYGEN... which is crucial for you to feel well.)

      The blood test you that you should get is "sirolimus level"...  You probably can get this test done in a hospital blood lab.   Take your dose (6 mgs) and test "sirolimus level" exactly 2 hours after your dose (which is the high point... transplant patients test at the low point...)   

      My opinion is that 6 mgs 1 time per week, as per Doctor Green, is too high, even for Dr. Green... You should not want to have your high point much higher than the range of the low point of transplant patients, which is 5 ng/ml to 20 ng/ml.

      In any case, I am just guessing... but I never guess wrong.   Take the "sirolimus level" blood test and I predict that you will find it is higher than the low point of transplant patients (ie, it will be higher than 20 ng/ml)

      Like
    • Ellis Toussier I think half-life of 62 hours plays a big part in side effects. Someone taking this daily will build up higher levels in their blood than someone taking weekly. 

      Like
    • Paul Beauchemin Hello Paul... I took THREE "sirolimus level" blood tests... the first was exactly 2 HOURS AFTER I took 5 mgs rapamycin.   The result was 40.09 ng/ml  and the range for transplant patients is 20 ng/ml - 5 ng/ml.  

      So it doesn't matter what the half life is, somebody taking it daily will build up higher levels than somebody taking it weekly, but in any case the levels of transplant patients is 20 ng/ml to 5 ng/ml.   I don't want to have my sirolimus levels much higher than theirs, not even for a day or two.

      So I took another "sirolimus level" blood test, exactly 5 DAYS after I drank 3 mgs. rapamycin.  My result was 1.51 ng/ml which means I probably started the 5 days about 25 ng/ml and ended 5 days at 1.51 ng/ml... Which to me, seems good enough for me, for a starting dose for me.   If after a few months I do not have a drop in red blood cells or in white blood cells, then maybe I would consider 5 mgs per week.

      And then I took a third "sirolimus level" blood test 10 DAYS AFTER I had taken 3 mgs, to see if it can still be detected in my blood.   If the half life is 62 hours, then from day 5 to day 10 is two half lifes... so I predicted my result would be 1.51 divided by half divided by half, or about 37.5   

      WRONG... the result was .70 ng/ml.   So the half life was in fact 5 days, not 2 and a half days.

      NOBODY KNOWS EXACTLY WHICH IS THE BEST DOSE.   We are all following Dr. Alan Green, or Bill Faloon.   But they are guessing too.  And there is no reason why their guess is better than yours, or than mine.   My guess is based on three blood test results, and a Complete Blood Count which says I have to raise my white blood cells before I raise to 5 mgs.

      So I consider that my 40 ng/ml is too high, and Dr. Green's 6 mgs is probably higher (after 2 hours) than 40, so it is even worse.  

      In any case, what we don't want is to have a drop in red blood cells, or a drop in white blood cells.  Dr. Green's blood tests as shown on his page show that he is "anemic"... He calls it "mild anemia" but I call it "dangerously low anemia" and so I think his 6 mgs per week is too much for him.  

      But I am not a doctor, so don't listen to me.

      Like 3
      • Van
      • Van
      • 4 yrs ago
      • Reported - view

      Ellis Toussier   Dr. Green is now taking 12 mg rapa a week.  One thing to remember:  the older you are, the stronger the TOR signal that has to be blocked, so it takes a higher dose to accomplish the same thing as when you are younger.  That is why it is critical that everyone should state there age.

      https://roguehealthandfitness.com/rapamycin-anti-aging-medicine-an-update-with-alan-s-green-m-d/

      See Question 2.

      Like 2
      • BobM
      • BobM
      • 4 yrs ago
      • Reported - view

      Mark Thimineur Ellis Toussier 

      Excellent post. Thanks for sharing your data. 

      Like
    • Van   With all due respect to Dr. Green... He is mistaken to take 12 mgs rapamycin per week.   If I got 40 ng/ml two hours after I drank 5 mgs of rapamycin, I guarantee that he is starting the week at way over 100 ng/ml, and the end of the 7 days he is probably too high also.   And... my blood test 10 days after 3 mgs rapamycin shows that it was still detectable 10 days after 3 mgs... I guarantee that after 12 mgs after 7 days will not only be detectable, it will be quite high... so when he adds another 12 mgs, he will start the 7 days with even higher than the first week he took 12 mgs, it is added to what was left.

      I have never read anywhere that Dr. Green has taken a "sirolimus level" blood test, so maybe he never has.   He has taken HbA1c, and "insulin" but he has never mentioned "sirolimus level"   So if he never has taken a sirolimus level, then I am more expert on rapamycin than he is, even if he is a doctor.

      And I am also more expert about human growth hormone, than Dr. Green, even if he is a doctor because he speaks with forked tongue about HGH.   I have taken a dose of HGH almost every day without fail since 1998, and I have sold it and received feedback from thousands of persons around the world, and not one single case of cancer or all the other diseases that Dr. Green mentions, never having taken a single dose of HGH in his life.   (Judging by his photograph, it would be of great benefit to him.)

      And I am also more expert about ANEMIA than Dr. Green, even if he is a doctor.   He says he has "mild anemia" and I say he doesn't have any idea how terrible is "mild anemia" (and his anemia is not "mild," it is quite serious.)  

      If you ask this self-made expert, don't do what Dr. Green does.   Do what I tell you to do:   Take a Complete Blood Count, and take 3 mgs every 5 or 6 or 7 days (take your pick) and after 20 doses, take a Complete Blood Count again, and then decide if you go up to 5 mgs.  or maybe suspend for a few months.  

      And if your Complete Blood Count shows that your red blood cells have dropped, or your white blood cells have dropped, then you have to put them back UP again before you continue with rapamycin.  

      Like 3
    • Ellis Toussier , I have a couple of comments. First, I think it unwise for you to slag Dr. Green. As you say, he is a physician and has years of medical training and a lifetime of experience in his profession, you...do not. He... has several years of experience prescribing rapamycin and other medications and following their blood-work... you...do not.

      Second, although I am far from an expert on this, peak levels of sirolimus seem to be unimportant in terms of side-effects. It's the trough levels that matter. If you have real evidence to the contrary (as opposed to opinion based on self-experimentation), please share it.

      Third, I went to Dr. Green's site. He lists his blood results as you stated.  (see photo). I fail to see any important change in his hemoglobin or hematocrit with rapamycin therapy over 18 months of rapamycin therapy. There was a brief , unimportant drop that has recovered. I cannot find any update that supports your assertions about desperation. If I missed it, please take a screenshot and post it.

      Fourth I am also a physician, and hemoglobin levels like Dr. Green's are incredibly common in older men... and likely are a result in natural declines in testosterone, systemic inflammation, Erythropoietin deficiency (related to renal function) as well as other factors. As a result, many propose age (as well as sex-related) normal values. The WHO definition for anemia is ,13g/dl in men (of any age)... and "unexplained anemia" in the elderly incredibly common. The age -related decline in androgen production can result in 1gm/dl drops in hgb. Thus, despite his age, Dr. Green's (normal) hemoglobin would be similar to 14gm/dl in a younger man. Normal. You may wish to review this article for more information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2586804/

      Lastly, I too think it's wise to have a  trough level checked (as I have done) and to do so after any dose change. That said, from the published studies, the actual risk of high levels with a once weekly dose of 5 mg is very low.... but not zero. I agree with Mikhail  Blagosklonny, that taking rapamcin, metformin, or other medications without medical supervision is unwise... but respect the individual decisions of those who decide otherwise. They run all of the risks and derive all of the benefits (if any).

      This area of therapy has many unknowns, is fraught with uncertainty and is often based on extrapolations from animal studies. As a result, we often must make decisions based on limited data... and recognize the potential for error. and the harm that can result.  Dogma has no place here.

      Arrogance is not an attractive attribute, and I encourage you to review the tone of your posts to see if this applies. I may have misinterpreted... as nuance is lost in text.

      Like 4
      • recortes
      • recortes
      • 4 yrs ago
      • Reported - view

      Ellis Toussier  in what form do you take HGH?. Is there a good way to take it in a non-inyectable form?.

      Like
    • recortes authentic human growth hormone MUST BE injectable, or else IT IS NOT REALLY AUTHENTIC HUMAN GROWTH HORMONE.   Human growth hormone is 191 amino acids long.  If you drink it, or spray it, or in a powder or gel, it is NOT human growth hormone.  

      Why do you want to take it in a non-injectable form ?   Are you SCARED of an "injection"?   IT DOES NOT HURT, FROM 1 TO 10, IT HURTS ZERO.   There is no good reason why you should be concerned that it is injectable.   In any case, if it is NOT injectable, you can be sure it is NOT authentic human growth hormone, it doesn't matter if a "doctor" recommends an amino acid or a spray or a gel, if Ellis Toussier says it is not authentic, it is not authentic.

      Look up my name "Ellis Toussier" on Google, and you will find many of my pages, and you will find how to write to me. If you write to me, please write to me FROM protonmail.com which is encrypted e-mail. My Hotmail was broken into in 2010, and the Bad Guys were reading my e-mail which caused me HUGE problems. So I only want to discuss growth hormone by encrypted e-mail.

      Like
    • Steve Roedde  

      First... I am not "slagging" Dr. Green.  I congratulate him for teaching us, including me, a lot about rapamycin.  However, even if he is a physician, I have taken three "sirolimus level" blood tests, and I don't see where he has taken one, and I don't see where he has shown a complete blood count, before and after.

      Second.  It does not matter if "anemia" is common among Old Men.  I am 74 years "old" so I am an Old Man too.   Being old does not make anemia acceptable.  Since he has anemia, he is suffering from a lack of oxygen in his body.  And since he is suffering from a lack of oxygen in his body, it is harming him in many ways, number one of which is it is killing neurons in his brain and all over his body.  It does not matter if anemia is incredibly common in older men, what matters is that it is extremely bad for his health, he will be senile or dead within ten years.   And now I shocked you, but I am only stating a fact.

      Most doctors (including you) don't care much about anemia because it does not "hurt" and because it is "incredibly common in older men."   And so, they leave it, they don't bother to fix it.  It can be fixed easily with erithropoyetin.   I am not a medical doctor, but I have taught hundreds or thousands of medical doctors about anemia and about erithropoyetin. 

      See my page: http://www.rajeun.net/hb.html

      I wrote that page almost 20 years ago.  So don't listen to me because I am not a doctor if you don't want to, but I know more about anemia than Dr. Green, and apparently more than you, so learn from me.  I know exactly what anemia does, I know exactly how Dr. Green must feel, (difficult to breath, easy to tire, forgetful, etc.)  and I know exactly how to fix it.

      I have helped hundreds of persons with anemia in my life, even if I am not a "medical doctor".    If I had been alive in the times of Hippocrates and Galen, I would have been regarded as a "doctor" not only because I would teach them about anemia, I would have also taught them about diabetes, about blood glucose, and about insulin.   

      I'm not bragging, I am just stating a fact.

      It does not matter what is the cause of his anemia.  What matters is what his anemia causes in his body.  Anemia causes other degenerative disease, because the bottom line is that it is a LACK OF OXYGEN.  And oxygen is essential to every cell in his body.

      For your information, MY hematocrit is about 53% and hemoglobin about 17+%.   And I have had it there, artificially if you wish, for more than 20 years.   I also have had nearly 200 sessions of hyperbaric oxygen, 100% oxygen at 1.7 atm for 60 to 90 minutes each session.   This means that I have about 40% more oxygen running through my body right now than Dr. Green.  And if I have any neurons that are damaged, I hope that my next hyperbaric oxygen session will help to recover it.

      Do you think I feel better than he does?   I guarantee, I not only FEEL better, I also am having LESS DAMAGE to neurons in my brain and all over my body than he is having.

      I agree that his anemia might be due to a decline in testosterone, but it doesn't matter what is the CAUSE.  What matters is that it exists, what it does.  It is causing damage in his body, and in his brain.  And 6 mgs rapamycin for four years has probably caused his red blood cell count to drop, because WE KNOW that this is one of the undesireable side effects of rapamycin.

      Dr. Green is proud that he has lost 10 pounds since he increased his dose to 12 mgs.   I say, that is a very bad sign.  He lost 10 pounds, a lot of it is muscle.  I am also an expert on sarcopenia.  (an "expert" is somebody who can talk to an audience about a single topic for 30 minutes, and nobody will get up because they are bored.) 

      He is evaporating.   I am sorry to be so blunt.

      I don't want the high levels of rapamycin, neither the high nor the trough levels to be as high or higher than transplant patients because WE KNOW that the effect on transplant patients is to lower the immune system.   

      So, I am shocked that Dr. Green DOUBLED HIS DOSE of rapamycin from 6 mgs which I KNOW is probably too high, (because I tested "sirolimus level" 2 hours after 5 mgs and the result was 40 ng/ml which is too high) he doubled it to 12 mgs.  

      It can only be that he is feeling very weak because of the lack of oxygen in his blood, and he is desperately seeking a solution.   (I wrote to him to help him... he never answered)

      You say that there was a brief, unimportant, drop of hemoglobin which has recovered.  It was not brief, and it was not unimportant.  His hematocrit dropped from 39% to 36%.   That was about a 10% LESS red blood cells.  His hemoglobin dropped to 12%, which is 25% LESS than what is average in a healthy 50 year old male.  

      So it was not unimportant, it was very important.  And it has not really recovered.   I want to see what a Complete Blood Count shows, in January 2020.  

      I will bet that his white blood cells are very low, too.  

      And that was with 6 mgs rapamycin every 7 days.  12 mgs will make it worse.   It doesn't matter if I am not a doctor, I know what I am saying.  

      The data shown on Dr. Green's page goes only to March, 2018.    We are in January, 2020 now.   Dr. Green increased his dose of rapamycin from 6 mgs to 12 mgs, now.   I will guess that his hematocrit has dropped from what it was in March, 2018, and this is why he doubled his dose.   I will bet that his hematocrit is 36% or less, and I will bet that he is suffering from a lack of oxygen.

      Excuse me, in spite of all Dr. Green's experience with rapamycin, he has never prescribed 12 mgs to any of his 350 patients.   So I will say point blank, he is mistaken to double his dose, and I will say that it is bad for him.   I am not a doctor, and he is a doctor, and you are a doctor, but he is mistaken.  And if you insist that he is right because he is a doctor and you are a doctor and I am not a doctor, then you are also mistaken.  And I think I am not mistaken.  

      It is a mistake to take 12 mgs of rapamycin, because it will lower his immune system, which is already low, and it will worsen his anemia, which is already very bad.

      Please excuse me if I sound arrogant, or if I seem to be boasting.  I wish I could help Dr. Green, but it is too late for me to help him.  He is a doctor, and I am not, and doctors don't listen to somebody who is not a doctor.

      So, better, I keep quiet.   Do what you like.  But don't follow Dr. Green with 12 mgs. per week because you will harm yourself.

      Like 3
      • Dennis
      • Retired USAF pilot, biochemist.
      • Dennis
      • 4 yrs ago
      • Reported - view

      Ellis Toussier Thanks much for the great info Ellis! Particularly useful for me since my GI doc called yesterday to let me know my hemoglobin was low at 12.9% (not on rapamycin anymore, positive cologuard test, likely need my second colonoscopy, age 75). Following Dr. Green and wanting to get back on a safe dose of rapamycin but not sure I want to order more from Wind Pharm. in India where I got my first two batches. 

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    • Dennis Just following along on the back and forth and thought my two cents might be useful for some people. It is not specific to your last entry but simply a way to enter.

      Longevity strategies and gambling have similar strategy. More insider info encourages larger  bets. The card counter in blackjack (personal experience) spends hours at a table waiting to identify the rare 6 deck shoe with a skewed distribution of high cards versus low. The vast majority of the time there is even distribution. Once identified, the skew becomes insider info and leads to greater probability of large wins with larger bets.


      We have so much insider information with rapamycin. Scientists all over the world working independently have conducted thousands of scientifically valid experiments on every conceivable disease. Sick patients with malignancy, heart stents, and kidney transplants have used the drug safely for decades. Pharmacokinetics of rapamycin are well known. Dosage of 0.12 mg/kg in average males (9mg) result in peak concentration of 45 ng/ml. Seven days later levels will be less than 2ng/ml. A 55kg teen liver transplant patient tried to OD taking 103mg (1.85mg/kg) and had level of 126ng/ml at 24 hrs and 15ng/ml at 7 days. It might be interesting for some people to report on a rapa levels but kinetics are known "insider info" already allowing us to basically know our levels without measurement.


      Now with this insider info normal people are placing their own personal bets on longevity benefits. By virtue of profession, some of us (Dr. Green, myself, etc) have more insider info in that we have treated patients and evaluated dose dependent safety and responses. I have personally done this before by making emperic observations on a certain method of intracranial neurostimulation leading to a U.S. Patent and sale of the method to a major biotech company. It seems with rapamycin, more insider information becomes public every week via rigorous scientific study. 


      My observations on this forum indicate most longevity gamblers are placing small bets with rapamycin and express fear of losing. Analysis of studies and emperic observations of patients coupled with personal experience suggest larger bets are likely necessary for longevity benefit.  The risk of losing appears acceptable as all adverse effects are reversable and serial labs and personal subjective (and objective) information provides further inside info to adjust bets accordingly. 


      It appears that Dr. Green feels comfortable adjusting his bet. I've also done that but chose a slight hedge by a cycling technique of higher (0.18mg/kg/wk) to lower (0.08mg/kg/wk) over specified time periods. I've completed one year of a lower cycle from higher (0.10 mg/kg/wk) to lower (0.04 mg/kg/wk). I've matched my regimen to about 50 other human beings whom I treat and another 10 family members and close friends. The higher regimen has been initiated in about 10 people aside from myself. Emperic observations and laboratory values indicate safety has been met in the lower cycle (stable blood counts, glucose, AIC, cholesterol) and that the higher dose levels in the cycle appears more beneficial (subjective observation). In addition, psychometric evaluation of mood and perception of physical function trends toward improvement moreso at the higher dose of this cycle. 


      At this point I choose to not place any bets with HGH as there is no clear insider info to make this any different than going "all in" with a pair of deuces. With rapamycin I think it is comparable to "all in" with a pair of queens or kings. As a physician and a longevity gambler, I don't see the point of blood doping. Risk of thrombotic events or cardiomyopathy makes it a possible "lose everything" scenario. Anyway, I'm not anywhere close to a point I need an oxygen carrying edge to win the Tour de France.


      We all have our own appetite for risk. Forums such as this can provide insider info to allow people to ajdust their own longevity bets accordingly. If each of us can be systematic in our dosing of rapamycin and careful in our observations, sharing of that info can lead to trend identification and improvement in "optimal" dose development. I'll be able to share info on the higher cycle dosing in 6-12 months. Wishing everyone good luck and good health.

      Like 10
      • Karl
      • Karl.1
      • 4 yrs ago
      • Reported - view

      Mark Thimineur great post. Appreciate the experienced, knowledgeable information.  Where are you getting your Rapamycin? Local pharmacy or online?  I am a fellow physician just starting down this road. Thanks.

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