Alan Green on Rapamycin Master Series | Lessons learned from over 1200 patients

Thanks for sharing this! Vince took 3-4mg of Rapamycin 3-4 days in a row and got different side effects. My guess is that this dose regime was way too tough for him and it’s also a dose regime very few people use. So I would not listen so much on what Vince says about Rapamycin because of this.

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I don’t myself understand the rationale for this sort of dosing scheme.

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I agree. That dosing schedule goes against all of the common thinking regarding Rapamycin. It’s way too heavy!

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It seems a shame nobody is mining his patient data (with their permission of course). He says he has 60 APOE4 homozygotes on rapa! Or is there an effort to publish some of this data?

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I agree… Would seeem to be the best data available. I know he worked with Matt kaeberlein in the rapamycin users survey, but haven’t heard of any other collaborations.

Thanks for sharing, being on 5yrs on Rapa, what have you concluded? Did your biomarkers improve? Have you ever tried a daily low dose?

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Thanks for posting the interview. His HVR is 117! (from his iPhone screen so I am assuming it is genuine). He looks decent for his age, has good skin, good teeth, and is mentally astute. He does have a bit of trembling in his hands. He dismissed Rapa but he is pushing his Four Herb Synergy thingy (Curcumin, Boswellia, Sensoril™ Ashwagandha, and Ginger) and wants to start a consulting business with his knowledge. At least, at his age, he is very motivated.

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I just read this about Vince. I’m surprised. When I interviewed Vince in June he mentioned that he kept getting gum infections with rapamycin so he quit. He didn’t mention such an aggressive dosing. I guess he figured he needed a huge dose to make a difference at his age but I speculate.

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My lipids went up which is not unusual. But my primary improvement was a 80-90% reducing in hand pain from arthritis. I’d tried a rheumotoligists recommendation of Voltarin, which is a topical form of vioxx which was banned. But only R weekly saw improvements. Daily R? I know some can tolerate it without seriously impacting mTor2 but i never found a need as weekly dosing worked well. It’s really mostly about throttling down sterile inflammation.

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I don’t remember if I asked this before but how did you lipids change more specifically. Can you give pre and post values on that?

Yes, but diabetics on Metformin age slower than the rest of us!

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Yeah, read a couple of papers a while ago, people on Metformin are seeing lower rates of all cause mortality.

what medications were you on or tried prior your success with rapamycin?

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There was a problem with the Metformin/All-Cause Mortality study in that whenever someone on Metformin’s diabetes got worse and needed an extra drug to control their diabetes, they were dropped from the study. Therefore it’s only looking at the “healthiest” diabetics on Metformin whose diabetes never got worse. I believe that when you add back in the diabetics who were dropped you get more realistic results in that the diabetics on Metformin (and other drugs) had higher all-cause mortality than the normal population not on Metformin.

It’s all in how you cherry pick the data.

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Sorry, no they escalated as Dr. GREEN notes they would on his site, RapamycinTherapy.com. My endocrinologist, a young fellow widely respected, Dr. MEDHAVI Jogi, noted it and started me on a low dose of Pravastatin which easily normalized it… over maintained that dose for over 4 years with no issues.

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I am an internist and have been taking Rapamycin for about 18 months. I have also noticed a significant increase in the frequency and duration of URIs (Upper Respiratory Infections). I have taken 3 courses of doxycycline since I started (compared with no use of antibiotics for about 20 years). I have decreased my dose from 6 mg/week to 2 mg/week. However, I do not feel like I have as much energy on the lower dose (when I do not have a significant URI). I also stop the Rapamycin when I get an infection. The problem I am having is that I was feeling so great initially on the 6 mg. Has anyone on this forum had any documented opportunistic infections such as Cryptococcus, CMV, zoster, parvovirus B-19, polyomavirus, mucormycos, etc?

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Another way to think about this data is that for some patients metformin works very well. But not all patients. All of this is confounded patient behavior: “I’m on metformin so I can eat my nightly cake and ice cream without any worry” (e.g., my father, RIP).

Yes, I have noticed an increase in respiratory infections as well. I have one right now. I skip my Rapamycin doses and take antibiotics when this happens. It’s annoying when you are exposed to a lot of URIs through living in a city or working in a clinic/hospital. Too many bacterium floating around these days.

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@cpk & @DeStrider Thanks for sharing this. One thing I’m wondering a bit about is the use of antibiotics and how that can impact the immune system long term. I myself don’t use antibiotics. I think last time I took it was probably 25 years ago or something like that. So here in Sweden we only use it in special more severe cases because one problems with antibiotics as I have understood it is that the bacteria gets antibiotic resistance by time and by that the antibiotics will not work as efficient as it first did. Any thoughts on that?

Here is a text from Swedish health care page:

What are antibiotics?
Antibiotics are a type of medicine used in infections to remove bacteria or prevent them from multiplying.

Are there different types of antibiotics?
Yes, there are many different types of antibiotics. They can also be called antibiotic classes. Antibiotics are usually divided into narrow-spectrum and broad-spectrum antibiotics. A narrow-spectrum antibiotic only helps against certain types of bacteria, while broad-spectrum antibiotics can fight many more types of bacteria.

Are penicillin and antibiotics the same thing?
In everyday speech, antibiotics are often called penicillin, but this is only one of the many types that exist. Penicillin belongs to the type of narrow-spectrum antibiotics and is also slightly less harmful to the body’s own bacterial flora (normal flora).

Why don’t we treat all infections with broad-spectrum antibiotics?
In Sweden, we have a long-standing tradition of using penicillin primarily for respiratory tract infections. This has certainly contributed to us being in a fairly good position in terms of antibiotic resistance, compared to the rest of the world.
In the rest of the world, broad-spectrum antibiotics are often used, which affect the normal flora to a much greater extent.

Do antibiotics help against colds and flu?
No, colds with coughs, runny noses and sore throats are caused by viruses. Antibiotics do not help at all against viruses.

Are there infections with bacteria that do not need to be treated with antibiotics?
Yes, some infections heal just as quickly without antibiotics even though they are caused by bacteria. An example of this is most ear infections in children and other upper respiratory tract infections, such as coughs, runny noses and sore throats.

I want to get well as quickly as possible when I’m sick. Can antibiotics make me get better faster?
Yes, in the case of certain infections, you can get well a little faster with antibiotics, even if the infection is harmless and in most cases heals by itself. Examples of this are strep throat and lower urinary tract infection in women who are not pregnant. Against these infections, antibiotics are often given to relieve the symptoms and contribute to a faster recovery. But in many cases the duration of the illness is only shortened by a few days.

What is resistance?
Resistance means resilience. Bacteria can become resistant to antibiotics, and then the medicine against the bacteria no longer helps.

How are antibiotic use and resistance related?
The more antibiotics we use, the more resistant bacteria we get. The bacteria that survive the antibiotic get the opportunity to grow and spread when other bacteria have been knocked out.

If I have received a lot of antibiotics in my life, could I have become resistant to antibiotics?
No, a patient receiving antibiotics cannot become resistant, but the bacteria can. But the risk of becoming a carrier of resistant bacteria increases when you use antibiotics. If you then get sick from these bacteria, the infection can be more difficult to treat.

Can antibiotics do harm?
Yes, in several ways. Overuse of antibiotics increases the risk of becoming a carrier of resistant bacteria in, for example, the intestine. Antibiotics also disrupt the normal, friendly bacterial flora in the gut, on the skin, in the abdomen and in the throat. This can make you more susceptible to more infections. Many also get side effects from antibiotics, such as diarrhoea, skin rashes and fungal infections in the genital area.

I have a cold and will be traveling away in a week. Can I get antibiotics just to be safe so the disease doesn’t get worse?
Antibiotics do not help with colds. You won’t get well any faster. However, you risk getting diarrhea, increased risk of resistant bacteria and increased susceptibility to new infections.

When I was abroad, I received antibiotics for a severe cold. Why can’t I get it in Sweden?
In Sweden, we do not treat colds with antibiotics at all. In the past, for example, long-term troublesome coughs were treated with antibiotics in Sweden as well. Research has shown that this does not speed recovery.

Source: Frågor och svar om antibiotika - 1177

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Yes - broadly speaking, its a huge issue globally. I think the biggest issue in the US (from what I’ve heard, I’ve not researched this) is likely the excessive use by farmers in the US with their livestock:

Antimicrobial resistance is increasing globally due to increased prescription and dispensing of antibiotic drugs in developing countries.[20] Estimates are that 700,000 to several million deaths result per year and continues to pose a major public health threat worldwide.[21][22][23] Each year in the United States, at least 2.8 million people become infected with bacteria that are resistant to antibiotics and at least 35,000 people die and US$55 billion is spent on increased health care costs and lost productivity.[24][25] According to World Health Organization (WHO) estimates, 350 million deaths could be caused by AMR by 2050.[26] By then, the yearly death toll will be 10 million, according to a United Nations report.[27]


Farmers typically use antibiotics in animal feed to improve growth rates and prevent infections. However, this is illogical as antibiotics are used to treat infections and not prevent infections. 80% of antibiotic use in the U.S. is for agricultural purposes and about 70% of these are medically important.[72] Overusing antibiotics gives the bacteria time to adapt leaving higher doses or even stronger antibiotics needed to combat the infection. Though antibiotics for growth promotion were banned throughout the EU in 2006, 40 countries worldwide still use antibiotics to promote growth.[73]

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