Rapamycin: A Promising Game-Changer for Longevity Enthusiasts

Highlights

• Some physicians are prescribing rapamycin — an FDA-approved drug for organ transplant recipients — for off-label purposes as an anti-aging treatment.
• Despite research showing rapamycin extends lifespan in yeast, flies, worms, and mice, its promise as a longevity drug in humans remains controversial among experts.
• High-profile rapamycin users like Bryan Johnson and Peter Attia have promoted its purported benefits.

Rapamycin, a Food and Drug Administration (FDA)-approved drug to prevent organ rejection in transplant patients, has gained notoriety thanks to researchers and celebrity doctors. They have proposed using the drug for its purported anti-aging properties, citing animal studies showing it extends lifespan. These longevity researchers and doctors contend that rapamycin may be a game-changer in the quest to ward off age-related diseases.

Thus, rapamycin has gone mainstream as an anti-aging treatment. Even so, there is no evidence that it extends human lifespan.

Some Aged Individuals Are Willing to Experiment with Rapamycin

Some aged individuals use rapamycin to maintain their health as they enter their later years. Similar to guinea pigs or mice in a lab, they are experimenting with rapamycin’s unproven effects. Along those lines, some are ordering a year’s supply at a time for about $200 from vendors in far-off locations like India.

“If I was younger, I would hold off,” says David Sandler, a 77-year-old retired accountant who lives in New Jersey. “But at this age, I’m making myself part of the experiment,” he says in the Washington Post.

Rapamycin Modulates a Cell Nutrient Sensing System to Optimize Cellular Function

As for its mechanism of action, rapamycin is thought to mimic the effect of calorie restriction, one of the most reliable ways to prolong lifespan in non-human animals. It does so by suppressing a cellular molecule called mTOR (mechanistic target of rapamycin) that is important for nutrient sensing. Through its inhibition of mTOR, rapamycin modifies a nutrient sensing cellular communication system that gives cells directions to grow when the body has enough food or to slow down when nutrients are scarce. In this way, rapamycin can tamp down signals for growth, which allows cells to clear accumulated junk and debris and facilitates more efficient cellular function.

Despite all of the attention rapamycin has gained for possible anti-aging effects, it is unlikely that the FDA will ever approve it for anti-aging purposes. For one thing, although some researchers believe aging fits within the World Health Organization’s criteria for designation as a disease, the FDA does not consider aging to be a disease. For this reason, there is no reason for the FDA to approve a drug that may treat aging. Furthermore, rapamycin’s generic status gives little incentive to run a multitude of human trials testing it on age-related conditions.

As such, entrepreneurs and doctors are starting to market rapamycin outside of the scope of its regulatory label, believing it to be a potentially life-extending drug hiding in plain sight. Furthermore, more than 20 medical practices within the US prescribe rapamycin to treat symptoms of aging, according to the Washington Post. Also, telehealth companies, services that provide healthcare via phone or video calling, are bringing rapamycin to thousands of aged patients.

Rapamycin prices range widely, but some vendors offer a typical dose for around $10 a week. Along those lines, Dr. Alan Green, a physician in Little Neck, New York, says he has treated nearly 1,500 patients with rapamycin since 2017 and calls it “the most important drug in the history of medicine.”

No One Knows the Optimal Human Dose

At the same time, controversy regarding the drug’s safety and efficacy have mounted. With initial enthusiasm for rapamycin stemming from its longevity benefits in multiple species, doctors caution that no one knows the optimal dose for humans. Some physicians and researchers believe, though, that if taken intermittently and in low doses — five milligrams a week — rapamycin may increase human lifespan the way it has done in animals. All the same, taking certain higher doses of rapamycin may lead to reproductive complications and make the body more susceptible to infections.

“Mice may be a little different from humans when it comes to drug tolerance, diseases, and reactions,” says Dr. Elena Volpi, a professor and aging researcher at the University of Texas Health Science Center at San Antonio.

Furthermore, according to Stanford’s Dr. Andrew Huberman, “It is a drug that I think can be taken safely under certain conditions but has enough of a side effect profile that I’m not interested in taking it for the sake of increasing lifespan at this time.”

In contrast, a doctor in Los Angeles, Brad Rosen, says he believes in the potential longevity benefits from rapamycin. Enough so that he has given it a try.

“At 60, I don’t have the luxury of expecting studies to be completed that can validate the benefits of a longevity drug prior to my own steeper decline,” says Rosen. Notably, Rosen has also prescribed rapamycin to around 250 of his patients.

Rapamycin Was Discovered in Bacteria on the Remote Location of Easter Island

Rapamycin was discovered in 1972 during a scientific expedition to the remote location of Easter Island — also called Rapa Nui. It was isolated from bacteria in soil samples and approved by the FDA in 1999 to help organ transplant patients avoid tissue rejection complications.

Regarding its discovery, celebrity podcaster, author, and longevity doctor Peter Attia says, “It was uncanny. This exotic molecule, found only on an isolated scrap of land in the middle of the ocean, acts almost like a switch that inhibits a very specific cellular mechanism that exists in nearly everything that lives.” He adds, “This fact still blows my mind every time I think about it.”

As for human data on rapamycin, a survey of 333 people who used rapamycin for anti-aging purposes reported a better overall quality of life. Compared to a group that did not take rapamycin, the only side effect was a higher incidence of mouth sores.

“I would say that rapamycin is the current best-in-class for a longevity drug that we have,” says Dr. Matt Kaeberlein, a professor at the University of Washington. He has researched rapamycin for over two decades and credits rapamycin’s anti-inflammatory properties with alleviating his chronic shoulder pain.

The longevity guru Bryan Johnson has also joined the ranks of high-profile rapamycin users. He has included rapamycin in his Blueprint protocol, designed to reverse the aging process.

A Long Wait to Find Whether Rapamycin Extends Human Lifespan

While some experts warn that no one knows the optimal rapamycin dose for humans and whether it even extends lifespan in humans, the drug is gaining popularity against aging. However, due to its generic drug status giving low incentive for human trials, we will likely not find out anytime soon whether its purported anti-aging benefits are real.