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New Rapamycin Study- up to 60% increase in mouse lifespan- Anyone Experimenting With This?

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#841 Engadin

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Posted 10 September 2020 - 11:30 AM

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F U L L   T I T L E :   Rapamycin may suppress muscle aging and prevent sarcopenia

 

 

 

 

S O U R C E :   MedicalXpress

 

O P E N   A C C E S S   P R I M A L   S O U R C E :   Nature Communications   (The neuromuscular junction is a focal point of mTORC1 signaling in sarcopenia)

 

 

 

 

 

 

muscleagings.jpg

 

Muscle size decreases at high age and is preserved by rapamycin treatment (from left to right: mouse muscle cross sections from adult, old and rapamycin treated old mice). Credit: University of Basel, Biozentrum

 

 

 

With life expectancy increasing, age-related diseases are also on the rise, including sarcopenia, the loss of muscle mass due to aging. Researchers from the University of Basel's Biozentrum have demonstrated that a well-known drug can delay the progression of age-related muscle weakness.

 

Even during peak years, human muscles begin to shrink and become less strong. Unfortunately, this is a natural part of aging. For some people, the decline in muscle mass and function is excessive. This condition, called sarcopenia, affects every second or third person over 80, reducing mobility, autonomy and quality of life.
 
The causes of sarcopenia are diverse, ranging from altered muscle metabolism to changes in the nerves supplying muscles. Researchers led by Professor Markus Rüegg have now discovered that mTORC1 also contributes to sarcopenia and its suppression with the well-known drug rapamycin slows age-related muscle wasting.
 
 
Rapamycin preserves muscle function
 
"Contrary to our expectations, the long-term mTORC1 suppression with rapamycin is overwhelmingly beneficial for skeletal muscle aging in mice, preserving muscle size and strength," says Daniel Ham, first author of the study. "Neuromuscular junctions, the sites where neurons contact muscle fibers to control their contraction, deteriorate during aging. Stable neuromuscular junctions are paramount to maintaining healthy muscles during aging and rapamycin effectively stabilizes them." The researchers also demonstrate that permanently activating mTORC1 in skeletal muscle accelerates muscle aging.
 
 
Molecular signature of sarcopenia
 
In collaboration with Professor Mihaela Zavolan's team, the scientists identified a molecular signature of sarcopenia, with mTORC1 as the key player. To help the scientific community further investigate how gene expression in skeletal muscle changes during aging or in response to rapamycin treatment, they developed the user-friendly web application, SarcoAtlas, which is supported by sciCORE, the Center for Scientific Computing at the University of Basel.
 
There is currently no effective pharmacological therapy to treat sarcopenia. This study suggests the possibility of slowing down age-related muscle wasting with treatments that suppress mTORC1 and thereby extend the autonomy and life quality of elderly people.
 
 
 
 
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#842 Guest

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Posted 10 September 2020 - 07:52 PM

It should be noted, that the mice in this study received the human equivalent of roughly - 40 mg of Rapamycin - every day.


At that dose, every day (considerably more than organ transplant patients take for immuno-supression), it might preserve muscle loss in old age - but is unlikely to yield much life-extension benefits for regular people.


A strategy like CRON, targeting MTORC1, but not inhibiting MTORC2, might be better for muscle preservation for people that don't live in cages and need to rely on their immune system.

Edited by Guest, 10 September 2020 - 07:53 PM.

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#843 Researchgrounded

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Posted 19 September 2020 - 09:23 AM

Rapamycin, acarbose, metformin, etc. Q&A today at 3pm by Dr. Richard Miller ( prominent UM aging researcher deeply involved in the ITP).

 

This may be of interest.  For example one question posed to him involves a patient taking 20 mg of rapamycin every week( this is about 4x the more common dose discussed in these forums) with great labs and feeling great...

This was based on an N=1 at https://twitter.com/agingdoc1

 

Can such case reports be the basis of targeted translational research, and what are the prospects as he sees it from a funding and regulatory vantagepoint?

 

Upvote & downvote the questions posed, and/or ask your own questions for today's Zoom call.

 

For details and to ask questions see:

 

https://www.reddit.c...web2x&context=3

for 3pm EST today.  See you there.


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#844 judge

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Posted 20 September 2020 - 04:21 AM

Quick update, still taking rapamycin 5 gms a week.  blood sugar had become unstable, started doing 1000 mg berberine and 1000 mg cinnamon twice day and now blood sugar is stable.  Did have some minor basel cell skin cancer spots that started to grow a bit, So stopped rapamycin for 2 weeks and started using natural alkaloid skin cream treatment, cancer subsided, back on rapamycin  :)

 

not to change the subject, anyone have experience with alpha-ketoglutarate (AKG), in the news lately and it has histroy with muscle builders, any here?  :D

 

Thanks!



#845 Researchgrounded

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Posted 20 September 2020 - 10:12 AM

Your dose of rapamycin is very modest - skeptical that this is the source. What is your height and weight ( BMI ) and diet?

Have seen much, much higher rapamycin weekly doses with improvements in glucose.

#846 smithx

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Posted 21 September 2020 - 12:55 AM

What do we think of 25mg once a month, as Blagosklonny I think was suggesting? I did 15mg once and had no observed ill effects but have not tried 25mg yet.



#847 judge

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Posted 21 September 2020 - 01:47 AM

Did he or someone he knew take 25 mg for a long time?



#848 PAMPAGUY

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Posted 21 September 2020 - 02:06 PM

I have taken up the 30 mg at one time.  No side effects that I could tell.  Took 30 days off for next dose.  Only did 2 doses.  Noticed no difference, and I am 74. Using a 1/2 life calculator, you could really take another dose after 15 days, but my thinking was the residual effect of the rapamycin sticks around for awhile in mouse studies.  I use 80 hours 1/2 life for Rapa.  Believe most of the other studies (62 hours) have been done on sick people taking other drugs.  There has been a study on healthy men where the 1/2 life was 82 hours.      https://pubmed.ncbi.....gov/11034258/  Dr.  Blagosklonny's thinking on the "Chronic Spike" in Rapamycin is that it get's past the blood/brain barrier into the brain where real change happens.  There was a rat study where they got the Chronic Spike and reset there weight point.  Don't know why Dr. B takes 10 mg weekly instead of the larger dose.  Something to think about.


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#849 judge

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Posted 21 September 2020 - 04:56 PM

I am pretty sure its getting to my brain, I get a mild headache for a few hours after i take it.  I am sure I will build up to higher doses as I age.


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#850 Valijon

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Posted 22 September 2020 - 12:55 AM

I take 2g Berberine per day. 2G vitamin C, 2000ui D3, 300mg NR, Cant remember how much transresveratrol. Currcummin, and a ton of omegas 3 from flax seed ,5 from shark liver, 7 from seaweed? Just started AKG at whatever dose is on the bottle. I avoid much sun most days, plenty of sleep and water. Was on 2mg of Rapamycin for a few months. Then my supplier dropped it...

Im 44 and a powerlifter. I try to eat healthy, lean chicken, salads, rice. Foods without high inflammation. All my values are good. Ive increased well-being, more energy. Id attribute that to the NR. At my age, I cant say what works super well and what doesn't. I called Dr. Green. He said for mid 40s, he prescribes 2 to 3mg per week of Rapamycin. Had muscle pain going from 1mg to 2mg at first but, it subsided. For me, Rapamycin really knocked down some other chronic pain the first day or two after ingestion.
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#851 judge

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Posted 22 September 2020 - 02:40 AM

I take 2g Berberine per day. 2G vitamin C, 2000ui D3, 300mg NR, Cant remember how much transresveratrol. Currcummin, and a ton of omegas 3 from flax seed ,5 from shark liver, 7 from seaweed? Just started AKG at whatever dose is on the bottle. I avoid much sun most days, plenty of sleep and water. Was on 2mg of Rapamycin for a few months. Then my supplier dropped it...

Im 44 and a powerlifter. I try to eat healthy, lean chicken, salads, rice. Foods without high inflammation. All my values are good. Ive increased well-being, more energy. Id attribute that to the NR. At my age, I cant say what works super well and what doesn't. I called Dr. Green. He said for mid 40s, he prescribes 2 to 3mg per week of Rapamycin. Had muscle pain going from 1mg to 2mg at first but, it subsided. For me, Rapamycin really knocked down some other chronic pain the first day or two after ingestion.

IMPRESSIVE!    Surprised you don't do B vitamins.  Thanks for the post!



#852 Valijon

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Posted 22 September 2020 - 10:12 PM

I do, theres much more that I take but, I only wanted to touch on what I felt was very related to anti-aging. Horsetail, pomegranate, folic acid, vitamins A and C. Stopped taking K2 when I read about the clotting from the coronavirus.

For the virus I have Ivermectin, another antiparasite med, and of course Zinc Picolinate.

If I feel any muscle cramping I take calcium or magnesium malate.

The list goes on and on. I have things for mucus buildup, kidneys, liver, and more.

#853 smithx

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Posted 25 September 2020 - 03:08 AM

I have taken up the 30 mg at one time.... There was a rat study where they got the Chronic Spike and reset there weight point.  Don't know why Dr. B takes 10 mg weekly instead of the larger dose.  Something to think about.

 

Pampaguy: did you notice any weight loss or a change in weight?
 



#854 Researchgrounded

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Posted 27 September 2020 - 10:15 AM

This was posted on Twitter by @agingdoc1 in an attempt to elevate the discussion around rapamycin ( https://bit.ly/2ECA7Vj ).  On Twitter, after reading each portion you keep clicking on the content to read the next part of the discussion (there is a word limit, so the post was broken up into a series of parts sequentially stacked).  Should this be useful it has been also compiled (with a few edits here and there) below into one post.  I hope you find it valuable:

 

####

 

The following is for educational purposes only, and not medical advice.

 

@Blagosklonny is a pioneer in rapamycin research and was the first to propose it has the potential to extend life based on its mechanism of action; this prediction was subsequently confirmed in model organisms including but not limited to Saccharomyces (yeast), C elegans (nematode worms), Drosophila (fruit flies), and mice.

Rapamycin, also called sirolimus, has been used off-label (for non-FDA indications) for theorized healthspan and/or lifespan by such celebrities as @PeterAttiaMD and as you can see Dr. Blagosklonny practices what he preaches in these videos showing 10 mg/week: https://bit.ly/349jlpM

 

The discussion that follows puts this in some respects very modest dose in perspective and provides a framework for thinking about dosing (more or less – in the 10-30 mg rapamycin range).

 

Some background follows in this stacked thread:

 

In the ITP for 42 PPM, male mice sirolimus concentration=23 ng/mL (23% median LE, 8% max) & for females 80 ng/mL (26% median LE, 11% max) https://bit.ly/335VZBM

 

In one study (mostly males, mean 79.6 kg ~175#) subject Cmax ~23ng /mL with 10 mg of sirolimus (+/- ~7 ng/mL).  Cmax varies substantially by person & setting, so measuring and monitoring Cmax & Cmin is far more accurate https://bit.ly/3mW8uIk

 

So, 42 PPM in mice ~10-35 mg of rapamycin for the average 79.6 kg pt (0.125 mg/kg to 0.44 mg/kg). 

 

While the ITP mice mostly sustained the concentrations by daily dosing, in persons Cmax is achieved within 1-2 hrs & washed out to a trough corresponding to its half life (~65 hrs in this study; 55-85 in others).  So the AUC and sustained dose duration are substantially higher/longer in the mice though the implications of these differences and the validity of any extrapolations represent unknowns that are matters of both great speculation (https://bit.ly/2GgBt8x) and ongoing investigation.

 

Everything is a tradeoff – of knowns/unknowns, and risks/benefits.  For example, a higher dose would achieve a higher Cmax and also a higher AUC and a more sustained dose above a given concentration threshold.  Higher doses also have associated greater potential risks, side-effects, and imply less frequent dosing to allow sirolimus wash-outs to diminish potential side effects ( excess mTORC2 inhibition sequela, excess immunomodulation, etc.):

 

There is nothing magic about weekly dosing, it can be higher doses taken less frequently – but the implications of such tradeoffs are mostly black boxes.  In 2020, long-term transplant rejection prophylaxis therapeutic drug levels are 12-20 ng/mL and 5-15 ng/mL for lymphangioleiomyomatosis. 

 

E.g., if someone takes 20 mg per week instead, sirolimus concentration >= the 10 mg dosing level for one full half-life (longer) as it gets eliminated, but OTOH at 7 days the Cmin trough would be higher too.

 

The frequency of 20 mg can be reduced or the risk of higher trough levels accepted. 

 

Case report: N=1 of a ~120-130# patient definitely taking sirolimus 20 mg/wk, every week, with no problems & perfect biomarkers but less washout (e.g. less dose or frequency) has>risk, so YMMV. 

 

@Agingdoc1 was created in 2020 in part to increase geroscience awareness and elevate geroscience discussions. 

 

 

### ( end quote from the threaded tweets)

 

Attached Files


Edited by Researchgrounded, 27 September 2020 - 02:14 PM.

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#855 PAMPAGUY

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Posted 27 September 2020 - 02:30 PM

Yes, I follow Dr. B on Twitter.  Thanks for post.  I would like emphasize that dosing is a very individual thing.  Yes, you get the most longevity benefit by taking the highest tolerable dose without side effects.  Over the last 3 1/2 years, I have taken all doses from 1 mg to 30 mg.  I currently take 7 mg.  Tried higher doses to 15 mg. weekly, but got mouth sores.  Work up to a higher dose until you get side effects then back off.  So this is where I am at my age of 74 yo.  Normally, Tor signal is strongest the older you get, and as such takes a higher dose of rapa is needed to inhibit it.  I am one of those people that has a lower Tor signal for my age.  I cannot take more than 7 mg. weekly at this moment without getting side effects.  I also believe that the 1/2 life of Sirolimus is closer to 80 than 60.  Many of the 1/2 life studies were done on sick people with many other drugs in there bodies.  62 hours is too low in my opinion in order to calculate wash out periods, (trough)  before next dose.    In this study of healthy male volunteers the 1/2 life was 82 hours.    Most people taking rapa for longevity purposes are healthy.   https://pubmed.ncbi....h.gov/11034258/



#856 Researchgrounded

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Posted 27 September 2020 - 04:48 PM

Everyone is different.  And every medication has risks.  Due to inter-individual variation half life can only be accurately determined by obtaining  Cmax (peak) and Cmin(trough) at least several times under the same setting including dietary composition or fasting.  The variance is great from patient to patient, and to some degree meal to meal, for example with fat and natural/supplemental CYP3A4 inhibitors increasing absorption.

 

Interestingly, it was reported that the healthy middle-aged case report who takes sirolimus 20 mg weekly with no problems only developed temporary mouth sores in the very beginning during the first 1-2 months of treatment while still taking under 6 mg per week.  No mouth sores since at 20 mg weekly!

 

This does not imply that this is a "good" or "safe" dose for this individual or anyone else. But it is interesting that the mouth sores were transient from the beginning of therapy, and they did not re-appear with gradual weekly titration to substantially higher doses.


Edited by Researchgrounded, 27 September 2020 - 06:48 PM.


#857 aribadabar

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Posted 27 September 2020 - 09:24 PM

This was posted on Twitter by @agingdoc1 in an attempt to elevate the discussion around rapamycin ( https://bit.ly/2ECA7Vj ).  On Twitter, after reading each portion you keep clicking on the content to read the next part of the discussion (there is a word limit, so the post was broken up into a series of parts sequentially stacked).  Should this be useful it has been also compiled (with a few edits here and there) below into one post.  I hope you find it valuable:

 

####

 

The following is for educational purposes only, and not medical advice.

 

@Blagosklonny is a pioneer in rapamycin research and was the first to propose it has the potential to extend life based on its mechanism of action; this prediction was subsequently confirmed in model organisms including but not limited to Saccharomyces (yeast), C elegans (nematode worms), Drosophila (fruit flies), and mice.

Rapamycin, also called sirolimus, has been used off-label (for non-FDA indications) for theorized healthspan and/or lifespan by such celebrities as @PeterAttiaMD and as you can see Dr. Blagosklonny practices what he preaches in these videos showing 10 mg/week: https://bit.ly/349jlpM

 

The discussion that follows puts this in some respects very modest dose in perspective and provides a framework for thinking about dosing (more or less – in the 10-30 mg rapamycin range).

 

Some background follows in this stacked thread:

 

In the ITP for 42 PPM, male mice sirolimus concentration=23 ng/mL (23% median LE, 8% max) & for females 80 ng/mL (26% median LE, 11% max) https://bit.ly/335VZBM

 

In one study (mostly males, mean 79.6 kg ~175#) subject Cmax ~23ng /mL with 10 mg of sirolimus (+/- ~7 ng/mL).  Cmax varies substantially by person & setting, so measuring and monitoring Cmax & Cmin is far more accurate https://bit.ly/3mW8uIk

 

So, 42 PPM in mice ~10-35 mg of rapamycin for the average 79.6 kg pt (0.125 mg/kg to 0.44 mg/kg). 

 

While the ITP mice mostly sustained the concentrations by daily dosing, in persons Cmax is achieved within 1-2 hrs & washed out to a trough corresponding to its half life (~65 hrs in this study; 55-85 in others).  So the AUC and sustained dose duration are substantially higher/longer in the mice though the implications of these differences and the validity of any extrapolations represent unknowns that are matters of both great speculation (https://bit.ly/2GgBt8x) and ongoing investigation.

 

Everything is a tradeoff – of knowns/unknowns, and risks/benefits.  For example, a higher dose would achieve a higher Cmax and also a higher AUC and a more sustained dose above a given concentration threshold.  Higher doses also have associated greater potential risks, side-effects, and imply less frequent dosing to allow sirolimus wash-outs to diminish potential side effects ( excess mTORC2 inhibition sequela, excess immunomodulation, etc.):

 

There is nothing magic about weekly dosing, it can be higher doses taken less frequently – but the implications of such tradeoffs are mostly black boxes.  In 2020, long-term transplant rejection prophylaxis therapeutic drug levels are 12-20 ng/mL and 5-15 ng/mL for lymphangioleiomyomatosis. 

 

E.g., if someone takes 20 mg per week instead, sirolimus concentration >= the 10 mg dosing level for one full half-life (longer) as it gets eliminated, but OTOH at 7 days the Cmin trough would be higher too.

 

The frequency of 20 mg can be reduced or the risk of higher trough levels accepted. 

 

Case report: N=1 of a ~120-130# patient definitely taking sirolimus 20 mg/wk, every week, with no problems & perfect biomarkers but less washout (e.g. less dose or frequency) has>risk, so YMMV. 

 

@Agingdoc1 was created in 2020 in part to increase geroscience awareness and elevate geroscience discussions. 

 

 

### ( end quote from the threaded tweets)

 

Allow me to introduce: https://threadreader...1776203778.html for easier readability :)
 


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#858 Researchgrounded

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Posted 27 September 2020 - 11:51 PM

Very nice! Is the URL you provided permanent?  Good to have it since the Twitter thread may grow.



#859 aribadabar

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Posted 28 September 2020 - 02:29 AM

Very nice! Is the URL you provided permanent?  Good to have it since the Twitter thread may grow.

 

According to the FAQ, it is but may require a "refresh" to include the new replies since its generation.
 



#860 Researchgrounded

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Posted 28 September 2020 - 06:54 PM

Thanks.  Looks like its already updated.



#861 Engadin

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Posted 29 September 2020 - 05:23 PM

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Rapamycin maintains NAD+/NADH redox homeostasis in muscle cells

 

 

 

 

 

 

O P E N   A C C E S S   S O U R C E :   AgING

 

 

 

 

 

 

Abstract
 
Rapamycin delays multiple age-related conditions and extends lifespan in organisms ranging from yeast to mice. However, the mechanisms by which rapamycin influences longevity are incompletely understood. The objective of this study was to investigate the effect of rapamycin on NAD+/NADH redox balance. We report that the NAD+/NADH ratio of C2C12 myoblasts or differentiated myotubes significantly decreases over time in culture, and that rapamycin prevents this effect. Despite lowering the NADH available to support ATP generation, rapamycin increases ATP availability, consistent with lowering energetic demand. Although rapamycin did not change the NAD+/NADH ratio or steady-state ATP concentration in the livers, kidneys, or muscles of young mice, optical redox imaging revealed that rapamycin caused a substantial decline in the NADH content and an increase in the optical redox ratio (a surrogate of NAD+/NADH redox ratio) in muscles from aged mice. Collectively, these data suggest that rapamycin favors a more oxidized NAD+/NADH ratio in aged muscle, which may influence metabolism and the activity of NAD+-dependent enzymes. This study provides new insight into the mechanisms by which rapamycin might influence the aging process to improve health and longevity among the aging population.
 
 
Introduction
 
It is estimated that the fraction of the global population over the age of 60 years will reach 20% in the near future, and health-care costs will rise correspondingly [1]. Thus, there is a growing recognition that solutions must be found to keep people healthy longer. Aging is a complex and multifaceted process. Nevertheless, research has demonstrated that health and longevity can be extended by calorie restriction [2], medications such as metformin [3], rapamycin [4], ibuprofen [5], resveratrol [6], spermidine [7], and supplementation of nicotinamide adenine dinucleotide (NAD+) [8], exposure to young blood [9], transfer of extracellular vesicles containing nicotinamide phosphoribosyltransferase [10], or elimination of senescent cells [11]. More recently, Fahy et al. reported that epigenetic aging can be reversed in human cells in vivo using a cocktail of drugs that was designed to promote regeneration of the thymus [12]. Collectively, these observations raise hopes that intervention in human aging may be possible.
 
Rapamycin and its analogs are clinically approved drugs that prevent solid organ allograft rejection and are used in the treatment of certain cancers. Rapamycin is an inhibitor of mechanistic target of rapamycin (mTOR), which has wide-ranging effects on growth and metabolism across tissues. Rapamycin extends maximal lifespan in model organisms ranging from yeast to mice, and a few studies suggest that rapamycin may also promote healthy aging in humans [4, 13, 14]. In addition to promoting survival, rapamycin is also protective in several mouse models of chronic disease [1, 15], and suppresses geroconversion which is a conversion from reversible cell cycle arrest to irreversible senescence [16]. Despite extensive studies, it remains unclear how exactly rapamycin affects longevity and diseases.
 
Maintaining NAD+ redox balance is necessary for optimum cellular health and may be compromised over the course of natural aging. NAD+, which is interconverted between its oxidized (NAD+) and reduced (NADH) forms, is an endogenous coenzyme and co-substrate that has key roles in diverse cellular and physiologic processes including energy metabolism and signaling through enzymes such as poly ADP-ribose polymerases (PARPs) and sirtuins. The NAD+/NADH ratio in a given cellular compartment represents the redox state, which is influenced by, and in turn regulates, metabolic activity [12]. A decrease in the NAD+/NADH ratio, reduced cellular NAD+ level, and increased NADH have all been observed during aging [17–19]. However, the effect of rapamycin on the NAD+/NADH redox state has not been thoroughly investigated.
 
The cell has two major routes to re-oxidize NADH to NAD+, the mitochondrial electron transport chain and lactate dehydrogenase (with subsequent export of lactate). In the absence of a functional electron transport chain, cultured cells are completely dependent on a source of exogenous oxidizing equivalents (typically pyruvate) to oxidize NADH and maintain growth [20, 21]. Under conditions of high cell density due to long-term culture or high seeding density, the release of lactic acid produced via aerobic glycolysis, which is necessary to dispose of excess reducing equivalents, acidifies the culture media. High lactate and low extracellular pH may feed back to inhibit the lactate dehydrogenase reaction, preventing cells from regenerating NAD+ from NADH and thus resulting in a reduced redox ratio, similar to that observed in aged tissues in vivo [18, 22–24]. Interestingly, rapamycin has been shown to decrease lactate production in cultured cells, raising the possibility that it can also shift NAD redox balance [25].
 
In the present study, we employ multiple methods, including the optical redox imaging techniques pioneered by Chance et al. [26–29], to investigate the effects of rapamycin on NAD+/NADH redox status in cultured cells, and in old and young mice in order to gain a more complete understanding of the mechanisms by which rapamycin may influence mammalian physiology.
 
 
Results
 
NAD+/NADH ratios were decreased in C2C12 myoblasts cultured at high density
 
The concentrations of NAD+ and NADH and the size of the total NAD (NAD+ + NADH) pool in C2C12 myoblasts increased over time in culture (72 h compared to 24 h) (Figure 1A). Comparison of 72 h cultures at two different seeding densities showed that NAD+, NADH, and total NAD were also increased with cell density (Figure 1A). In addition, NAD+/NADH ratio of C2C12 myoblasts decreased with the extension of culture time or high seeding density (Figure 1B, 1C). A decrease in NAD+/NADH ratio was recapitulated by culturing C2C12 myoblasts under low pH, high lactate, or in conditioned medium from cells plated at high density for 48 h (Figure 1D). Thus, lactic acid buildup in the medium likely contributed to the redox shift observed over time in cell cultures.
 
 
 
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Figure 1. NAD+/NADH ratios in long-term cultured C2C12 myoblasts. (A) NAD+, NADH, and total NAD concentrations of C2C12 myoblasts (2×105 cells/well and 4×105 cells/well) cultured for 24 and 72 h, respectively. *, P < 0.05 for comparison of NAD+ concentrations between cells cultured for 24 h and 72 h; #, P < 0.05 for comparison of NADH concentrations between cells cultured for 24 h and 72 h. &, P < 0.05 for comparison of total NAD+ concentrations between cells cultured for 24 h and 72 h. (B) NAD+/NADH ratio of C2C12 myoblasts (2×105 cells/well) cultured for 24 and 72 h; *, P < 0.05 versus cells cultured for 24 h group. © NAD+/NADH ratio of C2C12 myoblasts (4×105 cells/well) cultured for 24 and 72 h; *, P < 0.05 versus cells cultured for 24 h group. (D) NAD+/NADH ratio of C2C12 myoblasts (2×105 cells/well), which were cultured for 24 h, and then treated by lactate (10 mM), pH6 medium, and 48 h medium (collected from C2C12 myoblasts which were cultured at 4×105 cells/well for 48 h) for 24 h, respectively. *, P < 0.05 versus control group (Con, receiving no treatment). All data shown as mean ± SEM. Statistical tests were done by the Student's t test.
 
 
Rapamycin restored NAD+/NADH ratio in long-term cultured C2C12 myoblasts
 
We cultured C2C12 myoblasts for 24-72 h and then subjected them to 24 h rapamycin treatment. Although the NAD+/NADH ratio of freshly plated C2C12 myoblasts (2×105 cells/well, cultured for 24 h) was not significantly changed by 24 h rapamycin treatment (data not shown), rapamycin significantly increased the NAD+/NADH ratio and decreased NADH concentration of C2C12 myoblasts cultured for either 48 h or 72 h (Figure 2A, 2B). Similarly, rapamycin significantly increased the NAD+/NADH ratio (Figure 2C) and decreased NADH concentration (Figure 2D) in C2C12 myoblasts that had been cultured longer and differentiated into myotubes (P < 0.05). Therefore, rapamycin significantly affected NADH and NAD+/NADH ratio but not NAD+ (despite an uptrend in the differentiated myotubes) in C2C12 myoblasts cultured longer than 24 h.
 
 
 
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Figure 2. Effect of rapamycin on NAD+/NADH ratio of longer-term cultured C2C12 myoblasts and myotubes. (A) NAD+/NADH ratio of C2C12 myoblasts (2×105 cells/well) cultured for 48 h and 72 h, then were treated by rapamycin (100 nM) for 24 h, respectively. *, P < 0.05 comparing control (cultured for 48 h followed by 24 h vehicle treatment) versus cells treated by rapamycin for 24 h group by Student’s t test. # P < 0.05 comparing control (cultured for 72 h followed by 24 h vehicle treatment) versus cells treated by rapamycin for 24 h group. (B) NAD+ and NADH concentration of C2C12 myoblasts. *, P < 0.05 control versus cells cultured for 48 h and then treated by rapamycin. #, P < 0.05 control versus cells cultured for 72 h and then treated by rapamycin. © NAD+/NADH ratio of C2C12 myotubes treated by rapamycin (100 nM) for 24 h. *, P < 0.05 control versus rapamycin-treated groups. (D) NAD+ and NADH concentrations of C2C12 myotubes treated by rapamycin (100 nM) for 24 h. *, P < 0.05 versus rapamycin-treated groups.
 
 
 
Effect of rapamycin on ATP concentration in C2C12 myoblasts and myotubes
 
Since decreased lactic acid production could indicate decreased glycolysis, and we and others previously showed that rapamycin can decrease mitochondrial respiration [30], these results suggested the possibility that rapamycin might be creating an energy deficit. However, rapamycin also inhibits many energy-consuming processes, making the net effect on energy balance unclear. We observed a significant increase in ATP concentration in rapamycin-treated C2C12 myoblasts (Figure 3A) and C2C12 myotubes (Figure 3B) (P < 0.05). Thus, rapamycin has a net ATP-sparing effect, despite reducing flux through pathways of energy production.
 
 
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Figure 3. Effect of rapamycin on ATP concentration in C2C12 myoblasts and myotubes. (A) ATP concentration of C2C12 myoblasts, which were cultured for 48 h, then treated by rapamycin (100 nM) for 24 h. (B) ATP concentration of C2C12 myotubes, which were cultured for 6 d, then treated by rapamycin (100 nM) for 24 h. *, P < 0.05 control versus rapamycin-treated groups by Student’s t test.
 
 
 
Rapamycin did not change NAD+/NADH ratio and ATP concentration in kidney, liver, and muscle tissues of young mice
 
As shown in Figure 4A, 4B, rapamycin treatment did not significantly change the concentrations of NAD+ and NADH, or the NAD+/NADH ratio in kidney, liver, and muscle of young mice (2 months old). In addition, rapamycin treatment did not result in significant differences in ATP content in kidney, muscle, and liver (Figure 4C).
 
 
Attached File  Clipboard04.jpg   87.17KB   0 downloads
 
Figure 4. NAD redox status and bioenergetics in kidney, liver, and muscle tissues of young mice. (A) NAD+ and NADH concentrations, (B) NAD+/NADH ratio, and © ATP concentration in liver, kidney, and muscle tissues of young mice.
 
 
 
Rapamycin induced a more oxidized state in old mouse muscle
 
We also employed optical redox imaging techniques to detect rapamycin’s effects on the NAD+/NADH redox status. Optical redox imaging measures the endogenous fluorescence intensities of NADH and Fp, which represents oxidized flavoproteins containing flavin adenine dinucleotide [26–29]. The optical redox ratio Fp/(NADH + Fp) reflects the mitochondrial redox state, and there is a linear correlation between optical redox ratio Fp/(NADH + Fp) and biochemically-determined redox ratio NAD+/(NADH + NAD+) [31, 32]. Thus, the optical redox ratio can be used as a surrogate indicator of NAD+/NADH redox state. Optical redox imaging has been widely applied to metabolic studies at both the cellular and tissue level [33–35]. Compared to extraction and biochemical determination of NAD+ and NADH, optical redox imaging directly shows NADH concentration and its spatial distribution of a tissue specimen with high resolution and can be used even when tissue is very limited.
 
Figure 5 shows that optical redox imaging can be used to detect the redox shift induced by 24 h 100 nM rapamycin in cultured undifferentiated live C2C12 myoblasts. Figure 5A displays typical Fp, NADH, and optical redox ratio images of control and rapamycin-treated C2C12 myoblasts, showing unchanged Fp signals (indicated by similar colors), decreased NADH (indicated by dark blue color for the majority of the cells) and increased optical redox ratio on average. Quantitative analysis (n = 4) revealed that 24 h 100 nM rapamycin treatment did not significantly change Fp level, but lowered NADH level in C2C12 by 36% (P < 0.01), resulting in an uptrend of the optical redox ratio Fp/(NADH+Fp) (P = 0.09) (Figure 5B). These results are consistent with rapamycin effects on C2C12 myoblasts obtained with biochemical analysis of NADH and the redox ratio (Figure 2).
 
 
Attached File  Clipboard05.jpg   86.86KB   0 downloads
 
 
Figure 5. Optical redox imaging of live C2C12 myoblasts. (A) Typical redox images of control or rapamycin-treated cells, where the color bars in Fp or NADH images represent the intensities of the signals in arbitary unit and that for Fp/(NADH+Fp) represents the redox ratio ranging from 0 to 1; (B) Quantification of the redox imaging results (unpaired 2-tailed Student’s t test assuming unequal variance), n = 4. **, P < 0.01. All data shown as mean ± SEM.
 
 
 
 
 
 
.../...
 
 
 
 
 
 
 
 
 
 
.

 


Edited by Engadin, 29 September 2020 - 05:28 PM.

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#862 Researchgrounded

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Posted 29 September 2020 - 11:06 PM

Nice addition to the rapamycin in the muscle literature.  This and related themes (rapamycin and sarcopenia) was just recently discussed at https://www.reddit.c...m/r/longevity/  ( https://www.reddit.c...meostasis_in/).

 

Thanks to aribadabar, at the top of @agingdoc1 profile on Twitter, there are now two long rapamycin-themed threads (old one now longer, and the new one on mTORC2 inhibition potential implications on dosing considerations) here https://bit.ly/3iaO76l 

(https://twitter.com/...951422976?s=20 )

It referred to:

1) https://threadreader...1095433217.html and 

2) https://threadreader...1776203778.html

 

As for implications in humans time will tell but most reassuring is in rodents rapamycin appears in most setting to help rather than harm, which was the original concern.


Edited by Researchgrounded, 29 September 2020 - 11:32 PM.

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#863 FrankT.Hippo

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Posted 16 October 2020 - 01:42 AM

Hello,

 

I have been taking rapamycin for a mitochondrial disorder (complex I & III). I can say that I am 95% confident that it is having a substantive positive effect. I have increased energy, mental clarity, and stamina. I have cycled on and off since march 2017 and when I am on I rebound and when off I regress.

 

2mg /week, skip every other two week. 

 

40 years old, 180 lbs.  Movement disorder, physical and mental fatigue, exercise intolerance, executive function issues, headaches, insomnia, minor sensory-neural hearing loss, etc.

 

Supplements: CoQ10 800mg/day, MitoQ 5mg/ every other day, creatine 5g/day, Curcumin 1000mg/day when cycling of rapmycin, vitamin D/C/B complex, DHA 1000/day (when I can afford it), & cerebral folate (for deficiency diagnosed by spinal tap).

 

The only major issue is that it depresses my immune system and I am susceptible to infections when on (from warts on my hands to colds).

 

 Anyways, I need a resupply. I was wondering if someone has advice regarding a reliable vendor.

 

Thanks upfront for the time. 

 

I haven't been following this threat for a while, but I wanted to give an update in case anyone was interested in this data point: 

 

 

 

I have a poorly characterized mitochondrial disorder ("disorder of mitochondrial respiratory chain complexes"). I was in bad shape in January 2017 when I came across this thread and came into contact with Jaris.

 

Soon after, I started low doses of rapamycin. My condition has since stabilized and I am substantially more functional. 

 

 

I was even able to travel a bit, something I have not been able to do for a decade. 

 

 

I was taking Sirolimus prior, however that had terrible side effects. I have since switched over to Everolimus*, which I find much more tolerable. 

 

 

Of note, I have had to increase doses to achieve the same effect, but I am still at relatively low doses (5 mg / once every three weeks). 

 

 

 

I am going to try to boost the dose up to 10mg. I will let you know how that works. 

 

*Note, Everolimus is Glenmark brand from India.

 

Attached Files


Edited by FrankT.Hippo, 16 October 2020 - 01:57 AM.

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#864 rodentman

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Posted 16 October 2020 - 04:22 AM

 

I haven't been following this threat for a while, but I wanted to give an update in case anyone was interested in this data point: 

 

 

 

I have a poorly characterized mitochondrial disorder ("disorder of mitochondrial respiratory chain complexes"). I was in bad shape in January 2017 when I came across this thread and came into contact with Jaris.

 

Soon after, I started low doses of rapamycin. My condition has since stabilized and I am substantially more functional. 

 

 

I was even able to travel a bit, something I have not been able to do for a decade. 

 

 

I was taking Sirolimus prior, however that had terrible side effects. I have since switched over to Everolimus*, which I find much more tolerable. 

 

 

Of note, I have had to increase doses to achieve the same effect, but I am still at relatively low doses (5 mg / once every three weeks). 

 

 

 

I am going to try to boost the dose up to 10mg. I will let you know how that works. 

 

*Note, Everolimus is Glenmark brand from India.

 

 

Glad it's helping you.   Do you know what caused your condition?  Was it sudden or gradual onset?   Do/Did you have other symptoms that are seemingly unrelated to mitochondrial disorder?



#865 PAMPAGUY

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Posted 16 October 2020 - 07:47 AM

Check out this site if concerned about cost of Sirolimus or Everolimus.              https://forum.age-re.../rapamycin-cost



#866 judge

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Posted 16 October 2020 - 04:29 PM

 

I haven't been following this threat for a while, but I wanted to give an update in case anyone was interested in this data point: 

 

 

 

I have a poorly characterized mitochondrial disorder ("disorder of mitochondrial respiratory chain complexes"). I was in bad shape in January 2017 when I came across this thread and came into contact with Jaris.

 

Soon after, I started low doses of rapamycin. My condition has since stabilized and I am substantially more functional. 

 

 

I was even able to travel a bit, something I have not been able to do for a decade. 

 

 

I was taking Sirolimus prior, however that had terrible side effects. I have since switched over to Everolimus*, which I find much more tolerable. 

 

 

Of note, I have had to increase doses to achieve the same effect, but I am still at relatively low doses (5 mg / once every three weeks). 

 

 

 

I am going to try to boost the dose up to 10mg. I will let you know how that works. 

 

*Note, Everolimus is Glenmark brand from India.

 

Very good info thanks!  I did not know about Everolimus,

  Found this:

In comparison to sirolimus, everolimus has higher bioavailability, a shorter terminal half-life, different blood metabolite patterns, the potential to antagonize the negative effects of calcineurin inhibitors on neuronal and kidney cell metabolism (which sirolimus enhances), the ability to stimulate mitochondrial oxidation (which sirolimus inhibits), and to reduce vascular inflammation to a greater extent. A head-to-head, randomized trial comparing the safety and tolerability of these two mTOR inhibitors in solid organ transplant recipients is merited.

https://www.ncbi.nlm...les/PMC6053318/

 

Anyone here think of any advantages of life extension with Everolimus?   Does this statement mean Everolimus is better or worse for kidneys compared to Sirolimus????

 

 



#867 FrankT.Hippo

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Posted 16 October 2020 - 05:54 PM

 

Anyone here think of any advantages of life extension with Everolimus?   Does this statement mean Everolimus is better or worse for kidneys compared to Sirolimus????

 

Thank you for the reply. I will ask my mitochondrial specialist next week.

 

 

 

The case studies I have seen in context to mitochondrial disorders have used Everolimus e.g.,

 

 

 

"After obtaining Institutional Review Board approval and parental consent, the patients were started on everolimus 4.5 mg/m2/day, given by mouth or gastrostomy tube. Serum everolimus levels were measured by gas phase liquid chromatography/mass spectrometry, targeting a trough level of 5–10 ng/mL. The drug was withheld for grade 3–4 toxicities, and then resumed at a lower dose."

 

https://onlinelibrar...002/acn3.50846 

 

 

 

 

"Following the preclinical evidence, four MELAS patients were treated with everolimus, a rapamycin analogue, following kidney transplant [31]. Primary fibroblasts derived from these patients showed improved mitochondrial morphology, membrane potential and replicative capacity. Blood markers showed reduced oxidative damage but no decrease of heteroplasmy levels. In another study, two children, one affected by MELAS and one by Leigh disease, have been treated with everolimus [32]. The Leigh syndrome patient was a girl carrying a homozygous missense mutation in NDUFS4 and started treatment (2-4 gr/day) at 23 months of age. Six months after starting the treatment, improvement by brain MRI consisted of reduction of the bilateral signal hyperintensity in thalami and brainstem. After 19 months of treatment, she was walking independently with a slightly ataxic gait, she spoke in sentences, and she no longer required tracheostomy and gastrostomy. MRI did not improve further, but the clinical scales continued to improve up to 47 months. In contrast, the MELAS patient was a boy, who started the treatment at 69 months, did not show any improvement in the brain MRI and continued to deteriorate until he passed away at 79 months of age. An open-label phase 2a study to evaluate the safety, tolerability and clinical activity of ABI-009 (the rapalogue Nab-sirolimus) in Patients with genetically confirmed Leigh or Leigh-like Syndrome is currently ongoing but not yet recruiting (NCT03747328). Overall, the available data support the idea that rapamycin may be effective in several mitochondrial disorders. Both mouse and human studies suggest that the specific gene affected or genderspecific effects should be carefully evaluated. It is currently unknown whether the immunosuppressive effect of mTORC1 inhibitors can be detrimental for mitochondrial patients in the long term.”

 

 

https://onlinelibrar...1111/joim.13046

 

Moreover, for whatever reason, I can tolerate the Everolimus much better. With sirolimus I am usually bedridden for a week while dosing: no energy, flu-like, weak, headaches, etc..-- but then I recover and in the following couple of weeks I feel improved relative to my baseline. I would compare the feeling to what I imagine chemotherapy to feel like. However, I will look into it. 


Edited by FrankT.Hippo, 16 October 2020 - 05:55 PM.


#868 FrankT.Hippo

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Posted 16 October 2020 - 06:13 PM

Glad it's helping you.   Do you know what caused your condition?  Was it sudden or gradual onset?   Do/Did you have other symptoms that are seemingly unrelated to mitochondrial disorder?

 

I have had significant problems since my early 20s but they gradually got worse.

I had a muscle biopsy and other testing (showing complex I & III dysfunction, etc.), in my early 30s, which led to a clinical diagnosis of "probable mitochondrial disease".

After, a couple of variants were identified; this changed the diagnosis to "mitochondrial disease".

However, since, the variants have been classified as VUS and there is uncertainty whether I have a "mitochondrial disease" proper (in the typical mendelian-disease sense).

So, now I am back to disorder of mitochondrial functioning, which could be secondary. So I don't presently know the ultimate (genetic) cause.

The symptoms are so varied for mito disorders it is hard to say whether some symptoms are atypical. But there is both a central nervous aspect and a remainder of the body aspect. 



#869 judge

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Posted 16 October 2020 - 06:55 PM

 

Thank you for the reply. I will ask my mitochondrial specialist next week.

 

 

 

The case studies I have seen in context to mitochondrial disorders have used Everolimus e.g.,

 

 

 

"After obtaining Institutional Review Board approval and parental consent, the patients were started on everolimus 4.5 mg/m2/day, given by mouth or gastrostomy tube. Serum everolimus levels were measured by gas phase liquid chromatography/mass spectrometry, targeting a trough level of 5–10 ng/mL. The drug was withheld for grade 3–4 toxicities, and then resumed at a lower dose."

 

https://onlinelibrar...002/acn3.50846 

 

 

 

 

"Following the preclinical evidence, four MELAS patients were treated with everolimus, a rapamycin analogue, following kidney transplant [31]. Primary fibroblasts derived from these patients showed improved mitochondrial morphology, membrane potential and replicative capacity. Blood markers showed reduced oxidative damage but no decrease of heteroplasmy levels. In another study, two children, one affected by MELAS and one by Leigh disease, have been treated with everolimus [32]. The Leigh syndrome patient was a girl carrying a homozygous missense mutation in NDUFS4 and started treatment (2-4 gr/day) at 23 months of age. Six months after starting the treatment, improvement by brain MRI consisted of reduction of the bilateral signal hyperintensity in thalami and brainstem. After 19 months of treatment, she was walking independently with a slightly ataxic gait, she spoke in sentences, and she no longer required tracheostomy and gastrostomy. MRI did not improve further, but the clinical scales continued to improve up to 47 months. In contrast, the MELAS patient was a boy, who started the treatment at 69 months, did not show any improvement in the brain MRI and continued to deteriorate until he passed away at 79 months of age. An open-label phase 2a study to evaluate the safety, tolerability and clinical activity of ABI-009 (the rapalogue Nab-sirolimus) in Patients with genetically confirmed Leigh or Leigh-like Syndrome is currently ongoing but not yet recruiting (NCT03747328). Overall, the available data support the idea that rapamycin may be effective in several mitochondrial disorders. Both mouse and human studies suggest that the specific gene affected or genderspecific effects should be carefully evaluated. It is currently unknown whether the immunosuppressive effect of mTORC1 inhibitors can be detrimental for mitochondrial patients in the long term.”

 

 

https://onlinelibrar...1111/joim.13046

 

Moreover, for whatever reason, I can tolerate the Everolimus much better. With sirolimus I am usually bedridden for a week while dosing: no energy, flu-like, weak, headaches, etc..-- but then I recover and in the following couple of weeks I feel improved relative to my baseline. I would compare the feeling to what I imagine chemotherapy to feel like. However, I will look into it. 

 

 

Does baking soda therapy help lower the lactic acid build up in MELA patients?  It does in us regular folks  :)
 



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#870 Starchild

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Posted 22 October 2020 - 02:59 AM

Does baking soda therapy help lower the lactic acid build up in MELA patients?  It does in us regular folks  :)
 

 

Hi, can you please tell us more about your baking soda protocol? I'm on 500mgx2/day Metformin, 6mg Rapa weekly. My blood CO2 went down below the normal range recently. My hematocrit also went up as high as 52.7, indicating acidosis and hypoxia. I started taking B complex vitamins after watching the video below (was supplementing with B12 already). Also ordered baking soda, but haven't been using regularly as I wasn't sure if it'd work. Thanks! 







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