Alan Green, MD has been using low-dose rapamycin in his clinical practice for years. We discuss the many potential health benefits and ways this compound can be used as a tool to support healthspan and prevent age-associated diseases.
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Show Notes:
01:57 Dr. Green tried rapamycin. It worked well on his symptoms from what turned out to be a congenital cardiomyopathy. It is best to treat diseases before irreversible structural damage, before you know you have the disease.
05:05 25% of people are ApoE4 positive. These people have most cases of dementia prior to age 80. It is a deterioration of the cerebral microvascular system. Rapamycin stops this deterioration and the development of dementia.
07:03 Insulin resistance makes you more prone to accelerated deterioration.
09:47 Pharmaceuticals do not treat end-stage disease. There is no money in keeping people healthy.
11:15 Rapamycin is anti-mTOR. mTOR is involved in all age-related diseases.
12:10 Ageing is the most misunderstood issue in all of medicine. Ageing is natural. Deterioration is optional.
15:50 Ageing promotes evolution, new genes.
19:35 A short lifespan promotes genetic innovation and variations. Evolution’s way to promote new gene variations is to eliminate those with old variations. The old needed to die to make room for and free up resources for the new.
24:40 Ageing is a programed genetic timebomb that goes off at a certain time. Traits can make sense in a broad biologic sense, but no for the individual.
30:00 Ageing is a process being promoted by genes.
30:50 mTOR in older animals is turned up and accelerates ageing. Turning down mTOR is helpful for a great number of age-related diseases and reducing the normal decline of ageing. Slowing mTOR with rapamycin slows ageing.
36:40 Using rapamycin to slow ageing is off label. It is only approved for transplant medicine once a day and to treat a few metastatic cancers. For anti-ageing rapamycin is taken once a week.
37:40 Transplant patients do not get the age/health benefits because the dosing of rapamycin is too high. mTOR1 provides the benefits. mTOR2 causes side effects. mTOR2 is completely resistant. mTOR1 is sensitive. The half life of rapamycin is 65 hours. If you take it every day, you build up blood levels. High levels of rapamycin outcompetes mTOR2.
40:18 Once a week dosing gives a high level at the beginning of the week to knock out mTOR1 and it was low enough at the end of the week to not interfere with mTOR2. It allows a functional level of mTOR2 and has the benefit of reducing mTOR1.
41:15 Reducing mTOR1 reduces the activity of the innate immune system, which goes by pattern recognition. Any altered molecule is seen as a bacterium and starts the inflammatory process.
42:45 Decreasing the innate immune system is good for stopping chronic inflammation and age-related diseases. However, the innate immune system is your first line of defense against bacterial or fungal infections. If you take azithromycin in the first few hours of a bacterial infection you are better in a few hours.
45:50 Coronary artery disease is triggered by oxidized LDL cholesterol. The innate immune system sees this as bacteria and begins an inflammatory process that builds up plaque and calcification with eventually occludes the arteries. Gingivitis has a different trigger, but the same chronic inflammatory mechanism.
48:30 A typical dose is 6 mg. It is less for a smaller healthy person. Canker sores in the first 3 to 6 months can be dose related, so start with a lower dose.
50:17 Rapamycin is good for sports performance because it is good for cardiac performance.
54:10 In young people mTOR is important for building strong muscle. Old people stay strong by maintaining the health of their muscles. Rapamycin helps maintain strength and quality of muscles.
55:30 Bodybuilders do not benefit from rapamycin. In animals, those with less musculature have a longer lifespan.
Dr. Green has been my rapamycin doc for almost 4 years. I’ve also interacted with him quite a bit when I find a study about aging or rapamycin and send it to him. He’s one of the best people I know at dissecting a study and finding its strengths and weaknesses (and I know some of the best aging researchers on the planet). He’s also a wonderfully caring physician. He was one of the first or the first physicians who added rapamycin to an anti-aging protocol. He also added PDE-5 inhibitors (Cialis, Viagara, etc.) to an anti-aging protocol years before the recent studies came out supporting that approach. I can’t say enough good things about him.