Longevity in a pill? Why older people are taking this immunosuppressant

Can a pill extend your life?

Anti-aging enthusiasts are embracing the promise they believe exists in the immune-suppressing drug rapamycin, a generic medication that has never been tested for boosting longevity in people. But animal studies have convinced even some doctors that it’s a path to a longer, healthier life.

As The New York Times reported, “On podcasts, social feeds and forums devoted to anti-aging, rapamycin is hailed as the ‘gold standard’ for life extension. Longevity influencers Dr. Peter Attia and Bryan Johnson are believers, both saying they’ve taken rapamycin for years, and touting research to their millions of followers that shows the drug can extend the life spans of mice by over 20%.”

While noting some claims of benefit by those using the drug off-label, the article also reports: “While users are optimistic and the evidence that rapamycin can increase longevity in animals is promising, the research in humans is thin and long-term side effects are uncertain. In the few studies in which rapamycin has been compared to a placebo, tangible benefits are hard to come by.”

What is rapamycin?

The Washington Post reported earlier this year that rapamycin “was collected by a scientific expedition in the 1960s from the soil of Easter Island, also known as Rapa Nui, one of the most remote inhabited places on earth. The FDA approved it in 1999 to help transplant patients tolerate their new organs. But scientists kept exploring how the drug worked and ultimately set the field of longevity medicine abuzz.”

In testing in 2006, it extended the life of yeast in a study at the University of Washington. The researchers wrote that “cellular responses to nutrients are mediated through broadly conserved nutrient-sensing pathways that can extend life span when signaling through these pathways is reduced.” Studies in yeast, worms and flies all suggested the drug does that.

It’s believed that the drug inhibits a biological pathway called the mTOR complex, which boosts cellular health by decreasing inflammation and helping autophagy, the process that clears junk from cells. A study in Nature said the mTOR complex is likely vital to a number of biological processes, including “cell growth, cell survival, immunity, autophagy and metabolism.”

As the Times reported, a study in mice by researchers working at multiple institutions helped the rodents live about 12% longer.

While typically suppressing the immune system, it’s believed that it provides a greater antibody response for things like vaccines, as well as reducing inflammation. But suppressing the immune system also can make one more susceptible to infection, some experts warn.

There are different opinions, though, on that as well, when it comes to rapamycin. Wrote Mikhail V. Blagosklonny, of the Cell Stress Biology Department at the Roswell Park Cancer Institute in Buffalo, New York, in an opinion piece in Aging : “If rapamycin had been labeled an immunomodulator and anti-inflammatory drug instead, it would sound much more appealing now. At anti-aging doses, rapamycin ‘eliminates hyperimmunity rather than suppresses immunity’ or, more figuratively, it ‘rejuvenates immunity.’”

Most human studies, however, have been small and while some people thought they felt better, there were potential side effects, including a “slight increase in the marker for insulin resistance,” per the Times. More common side effects include mouth sores and nausea. It could raise cholesterol, too.

No substitute for healthy living

As a result of the mixed findings, many doctors believe that risks outweigh potential benefits, which have not yet been well-proven by studies in humans, though some studies are ongoing.

“Let’s see, taking something that’s risky, that’s going to have no benefits?” Andrew Dillin, an aging specialist and professor of molecular and cell biology at University of California Berkeley, told the Times. “I’ll pass.”

Eric Verdin, 66, CEO of the Buck Institute on Aging, admits that he takes rapamycin, but he also said he wouldn’t recommend it to everyone as a cure for aging. Rather, he noted, exercise and a healthy diet are crucial to aging well, per the Post.

“People going on it, using it as a substitute for a healthy lifestyle, is a bridge too far for me,” he said, telling the Post that he’s doing what he can to “maximize my longevity.” But he said that while he’s taking the drug, “I haven’t felt any difference one way or the other.”