Morning everyone!

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. This week I’m excited to talk about an “outside the box” drug that I’ve been studying for years. It’s probably the most effective life extension drug ever discovered: RAPAMYCIN.  

Rapamycin is a hot topic now at Anti-Aging conferences all over the world, and if you’ve done a lot of anti-aging studying yourself, my guess is that you already know something about it. I’m at the point where I’ve been studying it so much that I’m comfortable using it in certain cases. In this Note, I will share what it is, how to take it, where to get it, how to dose it, and things to look out for (like anything else!). 

Let’s dive in. 


The Story of Rapamycin 


Rapamycin is a compound that’s produced by a strain of bacteria discovered on Easter Island in 1964. Easter Island is one of those very remote islands in the Pacific. If you google it, you’ll see that this is where those big head stone carvings are. It’s a fascinating place. 

A team of researchers from Canada went there searching for compounds that could cure different kinds of fungus. They took all these soil samples and ended up discovering what they labeled Rapamycin, which turns out to be a really good antifungal. They also discovered that it had this incredibly potent immunosuppressive activity. 

As they kept studying it, it was finally approved by the FDA as an organ transplant rejection drug in 1999. That’s what it is most famous for. They’ve been using it in that capacity for years. For example, if a patient has a kidney transplant (the most common organ transplant), for the most part, their body won’t reject it if they’re taking Rapamycin in high daily doses. 

A lot of times we will have one medicine that can be repurposed for another illness or malady. In fact, most of the medicines we have available to us, we use for more than one reason. So as they kept studying Rapamycin they found more uses for it. It was found to have great anticancer properties. The National Cancer Institute found that it worked differently than most anticancer drugs. It wasn’t like chemotherapy. They use Rapamycin for several types of solid cancer tumors. 

They also found that it had a great effect in cardiac procedures, especially placing cardiac stents. When you’re having blockage, they used to open the coronary arteries and it could close back again after 3-6 months. But, they found that if they coated the stents with Rapmycin, it would prevent closure. Cardiologists love Rapamycin for this reason. It’s been used safely for decades. 


Rapamycin and Anti-Aging 


To understand how Rapamycin works as an anti-aging drug, you have to understand a couple key concepts.  

  • mTOR 
  • autophagy 

mTOR stands for mechanistic target of Rapamycin. This is an enzyme that regulates the signaling pathway that monitors the availability of nutrients in every cell of the body. When nutrients are available (i.e. food for your cells and energy) this mTOR pathway turns on cellular metabolism. What that means is it activates growth and proliferation. So, when nutrients aren’t available (i.e. a fasting state) mTOR is inhibited. That inhibition enables the body to perform cellular repair and regeneration. This is called autophagy. It’s almost like a detox. It’s when the cells remove the damaged proteins. Remember, stresses like heat, acidity, and free radicals cause proteins to be misfolded. These misfolded proteins are non functional. 

It’s really a process of detoxification, waste removal, and recycling. It’s essential to renew all cells. This is done when we’re not eating. That’s so important! I go back all the time to the IMPORTANCE OF FASTING.  

Rapamycin binds to the enzyme called mTOR and allows autophagy to proceed, even if you’re eating. It mimics calorie restriction. That’s how it works. Since the 1924 mice studies, we’ve known that calorie restriction is really the only life extension tool that we’ve definitively proven.  

For 99% of human life, people ate within a 4 hour window. We were hunter gatherers. There was no real evidence of the age-related diseases we see today, I.e., metabolic syndrome, heart disease, all these different types of cancer, diabetes, obesity, and dementia. 

Calorie restriction and intermittent fasting was the norm for everyday life, and as a result, people were much healthier! I think if our ancestors saw how unhealthy and unfit we are today, they would be shocked and horrified.  

There have been lots of animal studies that have shown the health benefits and life extension of Rapamycin. It’s an FDA approved drug that’s been used off label for years. I know big time medical people that have been taking it for years. It’s legal to do this for different maladies, with consent. 

Note: there are both human and dog trials undergoing right now. Who knows how long it will take for Rapamycin to be approved for life extension and other things we will repurpose it for. 


Dosing Rapamycin 


For anti-aging it’s a once a week low dose. The reason dosing is important is because with higher daily doses (like we use for organ transplants and cancer treatment protocols) it acts as an immunosuppressant. 

In a low weekly dose, it helps to increase your immune system. In my opinion, It really should be called an immune modulator, rather than an immunosuppressant. 

Rapamycin has being studied for: 

  • Obesity 
  • Cardiovascular Disease
  • Alzheimer’s Disease 
  • Parkinson’s 
  • Cancer (already approved for certain types of cancer)
  • Multiple Sclerosis (MS)
  • Rheumatoid Arthritis 
  • Lupus
  • Osteoporosis 
  • Hearing Loss
  • Periodontal Disease
  • Macular Degeneration

It’s even being used topically for many aging conditions of the skin and psoriasis. Remember, it’s an immune modulator. 


Side Effects


Like with anything, if you take too much Rapamycin it could do harm. I have seen some mouth ulcers at higher doses in people getting organ transplants. You probably have to watch out for hypoglycemia, because it helps improve glycemic control. You also have to watch out for anemia. People on Rapamycin should monitor their blood work and have a regular medical follow up. 

I wouldn’t use Rapamycin in people under 30 years of age, because young people need mTOR.  They’re growing! Older people don’t need as much mTOR. They need to suppress it because they need autophagy. Note: Autophagy is very important as you age. 

I prescribe Rapamycin primarily to physicians who come in asking for it and so far, everyone tolerates it great, feels better, and hurts less. My guess is that they will age better.  


Closing Soap Box


Rapamycin may be one of the most important scientific discoveries of our times, but it’s not going to work if you’re out there smoking, eating junk food, not exercising, and stressed out all the time. What I’ve found out as a practicing family physician for 36 years is that unless you get to the ROOT CAUSE of emotional trauma and stress, nothing is going to work for your health. Emotional stability is vital for overall health.  

With that said, educate yourself on Rapamycin. It’s off label and needs regular monitoring. The dose matters! And surprisingly, it’s relatively affordable. I’ll end with a quote from a physician who writes frequently in the journal AGING: “Not taking rapamycin may be as dangerous as smoking.” 

That’s a bold statement, but think about that. Do your own research. At the very least, practice intermittent fasting. 

Till next week.