Usage of semaglutide with rapamycin

[drsteve7777]

Continuing the discussion from Intermittent (oral) semaglutide use in healthy individuals?:

here are some answers:

1. I feel that those with rapamycin lose more weight and have better skin elasticity and they tend to have more energy
2. the weight loss is more significant with the semaglutide and especially with the brown and white fat Semaglutide definitely stops the appetite 4 hours after the first injection but they both help with brain protection, liver health, and overall health
3. I only do the semaglutide once a week for the significant weight loss I administer the injection once a week and have them take their rapamycin weekly usually the same day the side effects since we start out low are minimal and after the first or second week I do not have patients with nausea the fatigue ness is still there for a while as they convert from sugar to fat energy
4. The protocol is my secret sauce but we start out really low and build up fast most do not get to the 1 mg dose The average is 15 lbs a month for women and 20 lbs a month for men

[shc]

This is nice to hear!

1. Good!
2. What do you mean w.r.t brown and white fat? You mean more white fat is converted to brown fat, etc.?
3. Gotcha
4. I recently started oral semaglutide 3mg daily and after a week, the fatigue was overwhelming. So I’ve stopped for a few days. However, I still notice significant appetite suppression. These make me feel that I don’t need to hurry in ramping up the dose. I’m in fact considering doing an ON OFF protocol – where I’m ON it till I start noticing any fatigue or side effects, and then I get OFF it till I notice my previous appetite picking back up. This seems nicer on the pocket. Once 3mg seems to stop having noticeable effects, I’ll move to 7mg.

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5. Have you also experimented with senolytics such as dasatinib and quercetin in your practice, especially along with semaglutide and rapamycin? I find this interesting because these senolytics are shown to reduce senescence especially in the adipose tissue. I took some before starting my course of semaglutide.

6. Have you ever stopped semaglutide in your patients after they reached their target weight? If so, does the use of rapamycin also affect the amount of weight regained? I ask because there’s a popular view that rapamycin can help with resetting weight set points, even though I have had trouble finding explanations for the mechanism by which rapa would do so.

[drsteve7777]

2. sorry the semaglutide burns both fats so the visceral fat melts also as well as the fat in the liver
   4 we found that after the second or third injection the fatigue goes away it takes the body a while to convert from sugar energy to fat energy then as the weight goes down the energy increases The feeling of fatigue goes away if you stay on it continuously even though at first you feel so tired
   5 yes I use dasatinib with quercetin as well as with fisetin
   6 once patients get to their target weight or “set point” they stop the injection and no weight gain I lost my weight and have not been on it for seven months no change in weight and I eat what I want though my brain has changed so I do not eat as much and avoid seed oil fats I am on rapamycin but my office manager lost his 45 lbs and has not been on the injection for 7 months also and has not lost one pound or gained one pound and he is not on rapamycin

[shc]

That’s impressive. Good stuff!

[Pestodude]

Do you ever prescribe oral Semaglutide or only injections?

[drsteve7777]

only injections once a week SQ small amounts it does last a week and sometimes 2 weeks before appetite comes back but once at set point the appetite does not come back

[shc]

Even though I generally practice keto I’ve made sure to be on a much higher protein (by ratio) diet while on semaglutide, along with doing some regular resistance exercise. My guess is that this will help better with maintaining (or I hope, even building) muscle mass while losing weight and fat.

Just curious if you have you also suggested particular diets to patients and noticed anything interesting w.r.t fat lost, set points, etc.?

[drsteve7777]

I recommend basically a Mediterranean diet mainly the proteins avoid all seed oils and the carbs are limited by themselves due to low intake. A continuous glucometer is used if weight loss slows down to help figure out what they are eating. I do not see muscle wasting except for fat coming out of the muscle but using a combination of different peptides like CJC and others keeps the muscle tone up Once they get to their set point (usually they stop losing weight for a while and then maintain that weight after stopping the injections) they tend to stay at their set point weight and do not return to the same amount of food because their brain has changed as well as now insulin sensitive.

[shc]

So what’s your take on intermittent fasting / time-restricted eating v.s. calorie restriction?

I imagine that on semaglutide most people are already restricting calories because of feeling so full. Are there any additional benefits you believe that occur due to IF/TRE?

[drsteve7777]

You are right most people are restricting their diets and after they stop it seems to continue with calorie restriction. I recommended intermittent fasting before I started this new program so I recommended to people after they stop the injections to continue intermittent fasting whether an8/16 fast or water fast two or three times a month. It is hard to know if added benefits but I think it would. I need to start doing calorie counts on patients who finish the program to see what % they now eat versus prior. I am recommending other senolytics and 20% of the patients on the injection are taking metformin in addition.

[Babster]

So, I just started taking Semaglutide in addition to my Sirolimus/Metformin. I’ve been really struggling with my knee and trying to get weight off, I work out, my baker’s cyst flares, I can barely do anything and I need to get the weight off as I may need a knee replacement soon. Mine is an early journey with Semaglutide but something interesting has happened. When I had my gallbladder removed years ago, I developed Bile Acid Malabsorption/BAD and had to take Cholestyramine before I can go ANYWHERE in the morning. Since starting the Semaglutide, I’m no longer having the BAD issue. I don’t know if it will last but it’s very interesting as to how Semaglutide must be impacting the liver and bile? Thus far, I haven’t had any weird side effects. I am definitely not hungry and I used to want a glass of wine at night and I have no desire for that, so that’s a plus too. My protocol is .25 x4 weeks, then .50 x 4 weeks. I’ll update as I go but thus far, positive impact!