Drug repurposing ⎮Spermidine and Rapamycin ⎮Meet Dr. Frank Lipman ⎮ Longevity Docs at ARDD ⎮New logo!

Your sneak peek into the world of Longevity Docs.

Sep 01, 2024

Hey Docs, back in NYC from Copenhagen where I met some of the leaders in longevity science and medicine at ARDD. I was honored to present the Longevity Docs ecosystem at the inaugural Longevity Medicine track, alongside other esteemed Docs: Dr. Andrea Maier and Dr. Evelyne Bischof.

This week in our newsletter:

Community
- Longevity Docs met at ARDD in Copenhagen
- Meet our Mastermind speaker: Dr. Frank Lipman
- New branding sneak peek

Buzz in the Chat:
- Super therapeutic testosterone in women
- Drug repurposing isn't receiving enough focus
- The bioavailability of compounded and generic rapamycin
Publications:
- Inflammation, Cholesterol, Lipoprotein(a), and 30-Year Cardiovascular Outcomes in Women
- Epigenetic patterns in long COVID
- Spermidine is essential for fasting-mediated autophagy and longevity.
Press: The Guardian view on aging: the science of longevity is advancing

So grateful for this amazing community!

Looking forward to seeing you all in New York, October 5th.

Happy Sunday!

David Luu

🚨 Longevity Docs News

👋 Longevity Docs at ARDD in Copenhagen

Community: new members

New members will be introduced in a separate newsletter. Stay tuned!

🎤 Dr. Frank Lipman will speak at the Longevity Docs Mastermind NYC on October 5-6

Dr Frank Lipman is a world renowned pioneer and innovator in integrative and functional medicine with more than 40 years of clinical experience, Dr. Lipman specializes in longevity medicine, crafting highly personalized health plans for optimal well-being, peak performance, and extended healthspans. He is a New York Times bestselling author of seven health-focused books, including The New Rules of Aging Well and How to Be Well, as well as the founder of the Eleven Eleven Wellness Center in NYC and advisor to a number of Health and Wellness Companies, including The Well and Hearty.

Book Early-Bird Ticket

🎨 New Logo

Here you go!

💬 Buzz in the Chat

Does anyone have experience or thoughts on mild supratherapeutic dosing with women’s T.

We have a variety of women who feel amazing at higher levels of T (normal range in Canada is 2-35 pmol/L) but often feel best at higher doses (50 - 70 pmol/L).
As a rule I consider myself a conservative prescriber, but I have a hard time telling women to come down from this dose when they often feel substantial more energy, better mood, improved metabolic effects at slightly higher doses.
I can’t find much for legitimate papers on this so any thoughts or anecdotal evidence would be greatly appreciated!
Dr Rebecca Glaser - breast surgeon and testosterone pellet advocate, uses super therapeutic testosterone in women. She advocates for 2-3 times the "normal" serum range in menopausal women with h/o breast cancer who take T + an AI. She's published several studies.
I have several women who feel better in that mildly supratherapeutic range. Counsel on potential side effects- voice, hair thinning, acne, clitoral enlargement as they are at higher risk. Monitor H/H. Work to find lowest possible therapeutic dose for symptoms. Sometimes changing formulation can help too. But I have several who have zero side effects with higher serum total testosterone levels

We finally submitted our paper comparing compounded rapamycin to commercially available (generic) tabs.

We also included a short review on rapa, for those interested: https://www.medrxiv.org/content/10.1101/2024.08.12.24311432v1
Which was more bioavailable, generic vs comds?
generic rapa gives blood levels about 3x higher than comppunded. So you make up for it by dosing compounded 3x the generic dose (so 15-18mg vs 6mg/wk). We did a few comparison tests on Rapamune vs generic (separate from this paper) and showed nearly identical levels. But we only tested the Dr Reedy generic brand. There is another brand out there (I think caremark or something) that looks very different than both Rapamune and Dr Reedy (which both have smooth, pyramid tablet shapes). But the cost of comppunded, even 3x-ing the dose, is less than generic
Much appreciate! Do you take Rapamycin?
yes. I currently take 15mg compounded once a week. I found 6mg of the generic was too strong for me (too many canker sores). I am relatively young and take so many other things, its hard to say what benefit I've had other than my right wrist tendonitis no longer bothers me
also, men "might" need higher doses than women to get benefits. we're not sure yet. this is based on data from the PEARL rapamycin RCT we completed where women seemed to have the most benefit across the board (increased lean tissue by DXA, improved QOL scores, etc..). but, we only tested 10mg compounded (so only about 3mg/wk generic) - so we suspect higher doses are needed to see results in men. even though there were no sex differences in our bioavailability study when it comes to blood levels (unlike mice where there are HUGE sex differences). sorry, I am jumping between multiple studies here...

Interesting article on whether ageing research is inflated and heading in the right direction. https://www.embopress.org/doi/full/10.1038/s44319-024-00226-2

I think most people in the field are "blind" to whats right under our noses: repurposed drugs. Majority of people are chasing the "shiny new molecule" (or intervention) that can be the next multi-billion blockbuster. But ignoring what is accessible TODAY
metformin and SGLT2 meds reduce dementia risk. Add to that recent papers on PDE5i, NRTIs, alpha blockers, (don't forget rapa!) - and you have a potential very potent cocktail of affordable drugs that can potentially eliminate dementia. But instead, billions have been wasted on trying to treat dementia (after neurons are probably too far gone), and almost nothing on prevention.
There are many potential therapies are being overlooked. I think term wasted is it fair. Brain health to me is a 4 prong process
1.⁠ ⁠Do the blood tests early from toxins, to GFAP to hormones and microbiome
2.⁠ ⁠⁠engage and promote the lifestyle change that have been shown to help and monitor the ones you can
3.⁠ ⁠⁠use these other meds and supplements that treat the results of neurodegenerative issues
4.⁠ ⁠⁠add in the specialty meds to target the patients who have that concern tau etc .
You need to do all these things not ignore the patients that already have it
Agree that drug repurposing isn't receiving enough focus. It does also worry me that new ageing research is happening in silo rather than building on decades of research on lifestyle behaviours and longevity.
There needs to be some intermediary between pharma/biotech and docs who understand repurposing and mechanisms of disease

🩺 Publications

Epigenetic patterns, accelerated biological aging, and enhanced epigenetic drift detected 6 months following COVID-19 infection: insights from a genome-wide DNA methylation study

Clinical Epigenetics - Recommended by Dr. Tom Rifai

Inflammation, Cholesterol, Lipoprotein(a), and 30-Year Cardiovascular Outcomes in Women

NEJM - Recommended by Dr. Giovanni Campanile

Bidirectional Effect of Long-Term Δ⁹-Tetrahydrocannabinol Treatment on mTOR Activity and Metabolome

ACS Pharmacology & Translational Science - Recommended by Dr. Giovanni Campanile

Plasmapheresis, Anti-ACE2 and Anti-FcγRII Monoclonal Antibodies: A Possible Treatment for Severe Cases of COVID-19

Drug Design, Development and Therapy - Recommended by Dr. Mona Ezzat Velinov

Spermidine is essential for fasting-mediated autophagy and longevity

Nature Cell Biology - Recommended by Dr. Woodson Merrel

The bioavailability of compounded and generic rapamycin in normative aging individuals: A retrospective study and review with clinical implications

Preprint - Recommended by Dr. Sajad Zalzala

🤝 Job Board

The Mayo Clinic Florida is seeking a highly reputable, forward-thinking, and innovative Medical Director to lead the newly established Longevity Department at Mayo Clinic, Florida.

🗓️ Events & conferences

👉 Longevity Docs Mastermind: NYC - October 5,6
RAAD Festival - Anaheim CA - September 5-8
Biomarkers of Aging Conference - November 1-2, Boston, MA
Peptide Therapy Certification - September 6-7, Orlando, FL
A4M Fest - December 13-15, Las Vegas
Cannes Longevity Festival: Cannes, France - June 25,27 2025

About Longevity Docs Mastermind

The Longevity Docs Mastermind is a physician-only event focused on precision and evidence-based longevity medicine. This is where the medical leaders of today shape the future of longevity.

New York City - October 5-6, 2024

Convene 101 Park Avenue, NYC

Book Your Ticket Now

Longevity Docs