Rapamycin and shingles, is there a connection

I have a question about the effects of rapamycin and whether it may play a part in my attack of shingles. I am 53 and have been self experimenting with 6mg a day augmented with grapefruit juice for 6 months. This is the first attack of shingles I had had and I wonder if I am inhibiting my immune system too much. I also take an anti TNF drug for a rheumatological condition. Any thoughts much appreciated? 

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    • Marcus
    • Marcus_Asaro
    • 1 yr ago
    • Reported - view

    If I'm reading your post the right way it does look like you are taking immunosuppressive doses, which is not good if you are looking for therapeutic/longevity results. For example, the Mayo Clinic lists Sirolimus (Rapamycin) to prevent kidney rejection, to be dosed at 2 mg a day for adults, after an initial first dose of 6 mg. Others are put on 5 mg a day after an initial large dose. 

    Grapefruit is compounding the problem by increasing one's serum level to ~350%, according to Cohen et al. "Phase I Studies of Sirolimus Alone or in Combination with Pharmacokinetic Modulators in Advanced Cancer Patients " (2012). 

    In the PEARL trial the cohorts are taking either 5mg once a week or 10mg once a week of rapamycin, for one year. That's a far cry from your 6mg per day. 

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      • Dr Sian Klerk
      • Doctor and self experimenter
      • Dr_Sian_McIver
      • 1 yr ago
      • Reported - view

      Marcus Asaro Marcus thank you for replying and also for pointing out my mistake. It’s 6mg per week not per day. I would still value your opinion on whether this with anti TNF is immunosuppressing me too much 

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      • Marcus
      • Marcus_Asaro
      • 1 yr ago
      • Reported - view

      Dr Sian Klerk I do not know if your TNF inhibitor is causing shingles but if it's for a condition you should probably continue taking it. Perhaps your outbreak is a one-time thing? You can try to periodically go off/on rapamycin and see if there is a correlation with shingles. 

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      • Dr Sian Klerk
      • Doctor and self experimenter
      • Dr_Sian_McIver
      • 1 yr ago
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      Marcus Asaro Thanks Marcus, yes I'm back on it now and will also try to get the shingles jab in about a years time. I'm not too worried about the shingles if I can get a vaccine but I am worried that getting it may be an indication of a suppressed immunity 

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  • Together with grapefruit the effective dose can go up to around 21 mg = 6 mg * 3.5 (grapefruit effect on effective dose). So it is very high dose and can probably create different side effects.

    On this post you can see some common longevity dose regimes out there.
    https://twitter.com/KristerKauppi/status/1565994098250637314

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      • Dr Sian Klerk
      • Doctor and self experimenter
      • Dr_Sian_McIver
      • 1 yr ago
      • Reported - view

      Krister Kauppi Thanks for this Krister, it is really helpful and I used the link. I realise I am now taking quite a large dose of 4-6mg weekly with grapefruit (the twitter data had this does without the augmentation) alongside the anti TNF drug. I take the anti TNF for a painful seronegative arthritis in my back and I now find that my back pain is much improved on this combination. When I dropped the rapper during the shingles attack my back got worse and its now taken a few weeks back on it to get control again. So I have quite a dilemma on my hands. I think from an immune perspective I am in uncharted territory and I worry about an increased risk of cancer long term but from a well being perspective this is really helping. There is also the fact that if I've got a better treated rheumatological condition that may also be geroprotective. My biggest long term goal is to avoid expressing my ApoE4 gene!

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