Does anyone know if it is ok to continue supplements when on Rapamycin? Or do I need to stop any of these: turmeric - it says even if not taken at the same time with Rapamycin, it inhibits absorption of Rapamycin, bioflavonoids (ritin, quercetin) and berberine increase absorption of Rapamycin. I also take CoQ10, Ginkgo biloba and metformin.
So I guess I am here talking to myself. Took Rapamycin yesterday after blood test, for the first time, started with 2 g, planning to take it on Tuesdays. By the evening observed 10-15 mg/dL higher that usual blood sugar base ( I wear CGM). Same observation today. Which means there is some effect from Rapamycin, and that it didn’t get blocked by Turmeric(Curcumin). The main reason I started Rapamycin is to lower A1c and feel more energy. So far getting opposite effect regarding A1c, but I hope it is temporarily, or I need reduce to 1 mg. The most strange thing is if I try exercise to lower blood sugar to my normal base, it goes up instead of down.
Hi Emma! This is Brandon from the Clinical Team. That’s a great question, so thank you for reaching out!
Rapamycin can interact with some supplements because it is metabolized through something called the CYP3A4 enzyme system and a transport protein called P‑glycoprotein (P‑gp). Anything that strongly inhibits or induces these pathways can change rapamycin levels in your body, which is why you are seeing warnings about turmeric and bioflavonoids.
As I mentioned, Rapamycin is mainly broken down by the liver enzyme CYP3A4 and transported by P‑gp in the gut and liver.​ So, substances that inhibit CYP3A4 or P‑gp can raise rapamycin levels (higher side‑effect risk), and those that induce them can lower levels (less effect).​ In fact, this is the same pathway involved with drugs like certain antifungals, macrolide antibiotics, some seizure meds, and grapefruit.
Turmeric / curcumin can inhibit P‑gp and may modestly inhibit CYP3A4 in lab and small human studies, which could increase absorption and blood levels of drugs handled by those systems.​ At typical dietary or moderate supplement doses, the effect is probably small, but very high or enhanced‑absorption curcumin (especially with piperine/black pepper) may have a more noticeable impact.
So, you do not necessarily have to stop turmeric, but it is wise to avoid mega‑doses or products heavily boosted with black pepper. Also, try to keep your dose consistent so our clinical team can have a stable “background” when judging your dose and potential side effects.
As for the Bioflavonoids (rutin, quercetin) and berberine:
Quercetin can inhibit P‑gp and some CYP enzymes, and berberine can inhibit CYP3A4 and P‑gp in vitro; both might increase rapamycin exposure in theory, similar to a mild grapefruit‑like effect.​ Human data specifically combining these with rapamycin are limited, so any effect size is uncertain.
These are not absolute “never use” supplements, but, a good rule(s) of thumb here is to use them only if there is a clear reason (e.g., lipids, blood sugar, mast‑cell/allergy issues), to let us know what you are taking (or adding to your supplement stack), and watch for increased side effects (mouth ulcers, infections, delayed wound healing, unusual fatigue) after starting or changing the dose, and report these promptly.
Finally, for CoQ10, Ginkgo, and metformin:
CoQ10 is not known to meaningfully affect CYP3A4/P‑gp; this is generally considered safe with rapamycin from a drug‑interaction standpoint.
Ginkgo biloba: mild effects on some CYP enzymes have been reported, but its main concern with rapamycin is bleeding risk if you are also on aspirin, anticoagulants, or other blood thinners—not specific rapamycin level changes.​
Metformin: cleared mostly by the kidneys and does not use CYP3A4; it does not appear to increase or decrease rapamycin levels in a major way, though both affect metabolism and mitochondria, so we would watch kidney function and overall tolerance (all lab markers, which are included as part of your rapamycin subscription with Healthspan).
I hope this helps!
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Hello again, Emma! It makes sense to feel discouraged when your first dose doesn’t match what you were hoping to see on your CGM. The pattern you are noticing (slightly higher glucose and a paradoxical rise with exercise) is not unusual in the short term with rapamycin, and it does not mean it’s “blocked” by turmeric or that you’ve already failed the experiment! Rest assured 
What rapamycin does to blood sugar:
- Rapamycin works mainly by inhibiting mTOR, which affects how cells handle nutrients and insulin; in the short term, this can make muscles and the liver a bit less sensitive to insulin, so glucose may run higher for a while.​
- Of course, this is not what we are seeking here, but just to illustrate that in transplant patients on daily, higher‑dose sirolimus, this insulin‑resistance effect is strong enough that new‑onset diabetes and higher A1c are well documented.​
- With low, intermittent doses (like 1–6 mg once weekly) used for longevity, human data are much more limited, but small studies and case series show:
- Mild, often transient increases in fasting glucose or post‑meal spikes in some people.
- No consistent long‑term A1c improvement purely from rapamycin itself; when A1c does improve, it is usually because of weight loss, diet, or added drugs (like metformin or GLP‑1s) rather than rapamycin alone.​
So, your experience of a 10–15 mg/dL bump after the first 2 mg dose actually fits the known biology. While we certainly respect everyone’s unique situation, tolerance to various medications, and the acceptance of conservative approaches (“low and slow”), we often advise that, in most cases, <3mg/week is often subtherapeutic. Weight-based dosing typically confirms this stance of .075mg/kg of bodyweight.
Why exercise might be spiking your CGM right now:
- When you exercise, your body releases adrenaline and cortisol, which tell the liver to put more glucose into the blood; normally, muscles then soak that up efficiently.​
- If rapamycin temporarily blunts muscle insulin signaling, the “extra” glucose can show up as a higher CGM reading during or just after exercise, especially with intense or interval‑type activity.​
- This doesn’t mean exercise is bad—it’s still beneficial—but it does explain why your usual pattern (exercise → lower glucose) is temporarily flipped.
What (I think) this means for A1c and your goals:
- Right now, there is no strong human evidence that low‑dose, once‑weekly rapamycin by itself lowers A1c; the signal is closer to “neutral to slightly worse” in the short term, with possible indirect benefits if it helps weight, inflammation, or activity level over time.​
- If your primary goal is A1c reduction and more day‑to‑day energy, the better‑supported tools are still:
- Diet pattern (especially carb quality and timing).
- Exercise that you can tolerate regularly.
- Medications like metformin, SGLT2 inhibitors, or GLP‑1 agonists, when appropriate.​
Rapamycin is more of a longevity / immune‑modulating add‑on, not a proven A1c drug.
A few thoughts of how to proceed:
- Don’t judge the whole experiment from one dose.
- It is common to see noise in the first week or two as your body adjusts.
- Tracking CGM, fasting glucose, and how you feel over several weeks gives a much clearer picture.
- As I said, its perfectly fine to consider a gentler starting dose or schedule.
- Dropping from 2 mg to 1 mg once weekly, or even every 10–14 days at first, is a reasonable discussion if you are very glucose‑sensitive or already close to diabetes.​
- Adjust exercise expectations short‑term.
- Know that a temporary rise with exercise does not mean it’s harmful; over the long term, regular movement still improves insulin sensitivity.
- You might favor moderate, steady‑state activity (walking, light cycling) over very intense intervals right after dosing until you see how your body behaves.
- Discuss the overall strategy for A1c with our team!.
- If A1c lowering is the top priority, it may be a good idea to schedule some time with us so we can best support you and your health goals!
Hope to talk soon!