Peter Attia· MD
Not until we get our study completed (and it has not yet started).
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The headline is broadly defensible, but the qualifications matter. Effect sizes vary by population, the strongest claims rest on shorter trials, and credible voices push back on how it's typically framed.
Not until we get our study completed (and it has not yet started).
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The "high risk" framing here is the right call. I've had three patients ask about rapa this month and none of them grasped the immunosuppression tradeoff until I walked them through it.
The PEARL trial framing in the dossier is the clearest writeup I've seen for a non-specialist. Worth linking from the AMA pages too.
I'm on 6mg/week, year two. Tracking IL-6, fasting glucose, lipids. Happy to share the spreadsheet if Whalespan wants longitudinal user data.
The dosing variance across the advocate camp is staggering. 3mg, 5mg, 8mg, biweekly, weekly… brief is right that "monitor or specialist only" is the responsible read.
very few of my patients are taking it I would say if I don't think 10% of our patients are taking rapy and um the the reason for that quite simply is um you know unless a patient is willing to go down the rabbit hole with me on understanding this and and sort of you know understanding the risks and probabilities and the uncertainty
very few of my patients are taking it I would say if I don't think 10% of our patients are taking rapamycin and um the the reason for that quite simply is um you know unless a patient is willing to go down the rabbit hole with me on understanding this and and sort of you know understanding the risks and probabilities and the uncertainty
I mean that that's sort of why I think there's a bit of a a disconnect in my willingness to have been taking this drug um for the past 6 years uh and my my hesitation in just sort of giving it to to anybody who walks in the door
I I again I fewer than 10% of our patients take rapamy because my view is unless you're willing to have a very lengthy discussion about the pros the the risks, the uncertainties, and I don't give people an answer that says, "Oh, this is this stuff's amazing." My answer is, "I don't know." Uh, here's how I think about it probabilistically. Uh, here are the trade-offs.
There are people who are very critical of my use of rapamy in in patients for geroprotective reasons. There are people who might think I'm crazy for giving people SGLT2 inhibitors who don't have diabetes.
My answer is I don't know. Uh, here's how I think about it probabilistically. Uh, here are the tradeoffs.
Rapamycin extends median and maximum lifespan in mice across multiple lab strains and dosing protocols.
Rapamycin will extend human lifespan by 5+ years at standard weekly dosing.
Weekly rapamycin dosing in healthy adults shows favorable safety and immune markers in early observational data.
Chronic low-dose rapamycin imposes an immune trade-off that outweighs the longevity hypothesis for most healthy adults.
mTORC1 inhibition is the mechanistic backbone for rapamycin's healthspan effects in mammals.
The PEARL trial showed an acceptable 48-week safety profile in healthy adults on weekly rapamycin.