Peter Attia· MD
do we know where the selectivity of rapamycin is i mean is it more selective in hepatocytes is it more selective in adipose tissue i mean i i don't know of any good studies that have really carefully looked at this
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Direct evidence is thin. The claim is plausible and aligns with adjacent findings, but there isn't yet a body of high-quality work that would let us call it well-supported on its own terms.
do we know where the selectivity of rapamycin is i mean is it more selective in hepatocytes is it more selective in adipose tissue i mean i i don't know of any good studies that have really carefully looked at this
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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.
I'm not convinced at this point that the idea that that all of the benefits are due to M torque 1 inhibition and all of the side effects are due to mtor 2 inhibition I'm not sure how how accurate that model is it's a model that still needs to be studied.
I do think we have to ask how relevant that activity is to the potentially beneficient effects of rapy and you know and a lot of the drive to find rapy that don't do that comes from my work right and so to some extent um I am saying hey look is that oversold I think that is a potential you know argument to make.
I think the point is we just really don't have a good understanding of how rap Ain or fasting or other drugs that hit mtor are affecting all of the things that are Downstream of of mtor
whether these would happen in people what happen in people taking it every other day every fifth day whether they are beneficial or harmful or a mixture I really don't know
I don't know enough to say many of our slow aging mice actually uh mtor complex one function is down in all of them but mtor complex 2 is often up
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.