In-person Meetups, The Rapamycin Debate, and Lessons from Forward Health
Your sneak peek into the world of Longevity Docs.
Hey Docs, this week, I’m trying a new format:
Bringing back the Members' Intro
A deep dive into the buzz in the chat: Rapamycin
Highlighting 3 peer-reviewed publications: outcomes and limitations
Insights one key current news in our field
This week:
Community
New Members
Launching Meetups in SF, LA, Vegas, and NYC
Buzz in the chat: The Rapamycin Debate
Research:
Caloric restriction and inflammation
Effects of testosterone and metformin on the GlycanAge index
NR on airway inflammation in COPD
In the News
What Longevity clinics can learn from Forward Health's closure
Happy Sunday!
Dr. David Luu
👋 Community
Members' Intro
Launching Meetups: connecting physicians worldwide
We couldn’t resist the demand—in-person Longevity Docs Meetups are here! Starting in the U.S., and soon expanding to Europe and Asia, these private members meetups will connect, inspire, and grow our community. Stay tuned!
If you are a doc and like to join contact Meriem: meriem@longevitydocs.org
💬 Buzz in the Chat
The Rapamycin Debate
The discussion around Rapamycin was one of the most active and polarizing topics in the chat, reflecting its prominence in the field of longevity medicine. Here's a detailed breakdown of the key points raised:
1. Mixed Efficacy and Safety Perceptions
Advocates highlighted:
Rapamycin’s proven ability to extend lifespan in animal studies.
Its role in targeting the mTOR pathway, which is crucial in aging and cellular senescence.
Potential benefits in reducing inflammation and immune dysregulation, especially in older populations with chronic conditions.
Skeptics raised concerns:
Reports of adverse effects like increased infections, lipid abnormalities, glucose intolerance, and fatigue.
Conflicting human data, with some studies showing limited benefits in healthy individuals.
2. Bryan Johnson’s Publicized Discontinuation
Bryan Johnson’s decision to stop rapamycin due to side effects (e.g., infections, lipid profile disruptions) sparked controversy.
Many members criticized the media influence of high-profile figures like Johnson, arguing that his experience might discourage appropriate rapamycin use in suitable candidates.
Others pointed out the lack of standardized dosing protocols, which may contribute to variability in outcomes.
3. Alternatives and Comparisons
Members debated whether metformin and GLP-1 agonists (e.g., semaglutide) are better alternatives for broader populations.
Metformin: Stronger clinical data supporting its safety and potential as a longevity intervention.
GLP-1 Agonists: Praised for additional benefits in weight management and metabolic health, making them complementary or preferable in certain cases.
4. Biomarker Insights
The group emphasized the importance of using biomarkers like CRP, ESR, and lipid panels to monitor rapamycin’s effects.
There was interest in multiomic analyses to better understand how rapamycin impacts aging at a molecular level, especially compared to other interventions.
5. Use Cases in Clinical Practice
Physicians discussed rapamycin’s suitability for:
Older patients with chronic inflammation or immune dysfunction.
Those with metabolic overactivation (e.g., excessive mTOR signaling).
Some advocated for cycling rapamycin use, aligning with the concept of periodic fasting or hormesis.
6. Future Directions and Research Needs
Members agreed on the need for:
Larger, randomized controlled trials to clarify the clinical effects of rapamycin in humans.
Standardized protocols for dosing, monitoring, and patient selection.
Further exploration of combining rapamycin with other therapies like metformin or GLP-1 agonists.
Consensus
While rapamycin holds significant promise, its clinical use remains contentious due to side effects, conflicting data, and the lack of robust human trials. The chat underscored the need for personalized approaches, careful patient selection, and ongoing research to unlock rapamycin’s full potential in longevity medicine.
🩺 Publications
Calorie Restriction as a New Treatment of Inflammatory Diseases
Calorie restriction (CR) shows anti-inflammatory effects and potential to improve metabolic health, but limitations include insufficient data on optimal protocols, fasting intervals, and individual variability. While animal studies highlight benefits, rigorous human research is needed to assess safety, efficacy, and long-term impacts, making CR a promising yet unproven tool for managing inflammatory diseases.
Adv. Nutr. - Recommended by Dr. Tom Rifai
Effects of testosterone and metformin on the GlycanAge index of biological age and the composition of the IgG glycome
Testosterone therapy significantly impacts IgG glycosylation patterns, suggesting its potential in assessing biological age and health, while metformin showed no significant effects on glycosylation. However, further research is necessary to unveil the functional significance of these glycosylation changes and explore the broader implications of IgG glycosylation as a biomarker and effector of the aging process.
Geroscience - Recommended by Dr. Amy Killen
Effect of nicotinamide riboside on airway inflammation in COPD: a randomized, placebo-controlled trial
A randomized, placebo-controlled trial showed that nicotinamide riboside (NR) supplementation in COPD patients reduced airway inflammation (IL-8 levels decreased by ~52-63%) and increased NAD+ levels in whole blood. Exploratory analyses suggested NR may upregulate genomic integrity pathways and reduce epigenetic aging, though clinical outcomes and immune mechanisms remain unclear. Despite small sample size and study limitations, NR was safe and well tolerated, warranting larger trials to confirm its potential as a COPD treatment.
Nature Aging - Recommended by Dr. David Luu
🌐 In the News
What Longevity clinics can learn from Forward Health's closure
Unsustainable spending: Forward Health’s rapid loss of $650 million in funding in 8 years highlights the risks of scaling without sustainable revenue streams, especially in personalized healthcare.
Cost of quality care: providing personalized care requires significant investments in providers time, licensing, insurance, and ongoing education, making it essential to build viable financial models.
Challenges of scaling: delivering detailed, personalized care is difficult to scale in models reliant on high-touch services.
Hybrid models could work: combining retail testing hubs with expert telemedicine might offer a way forward, but high urban costs and licensing challenges complicate implementation.
Subscription models for stability: subscription and program-based care models create predictable revenue while offering patients consistent, long-term support.
Tiered care options: offering both high-end concierge care and affordable subscription tiers can attract diverse demographics, though profitability at lower tiers requires careful planning.
Franchising opportunities: franchising in suburban or global markets could be a viable growth strategy, though maintaining quality standards remains a challenge.
The marketing problem: traditional marketing often yields low returns for high costs. A shared marketing platform for longevity practices could allow for collaboration and cost-sharing.
Technology as a solution: telemedicine and AI diagnostics could reduce costs and improve care, but integrating these tools into a sustainable business model is complex.
Filling the Gaps: Forward Health’s closure reveals opportunities for longevity practices, including:
Providing value-based care with measurable outcomes.
Expanding into untapped markets.
Offering integrated services through subscription tiers.
Collaborating on marketing and education to build trust.
Key Takeaway
Forward Health’s challenges provide valuable lessons. Longevity practices can thrive by building sustainable revenue models, using technology wisely, and balancing personalized care with scalability.
🗓️ Events & conferences
Longevity Docs Cannes: Cannes, France - June 24-26, 2025
Tech for Longevity - November 20, Paris
Longevity Summit - December 3-4, Novato
Roundtable of Longevity Clinics - December 6-7, Novato
A4M Fest - December 13-15, Las Vegas
Founders Longevity Forum - Singapore, February 27-28, 2025
The Longevity Med Summit - Lisbon, May 6-8, 2025