4/22/25

Rapamycin: The Worst Longevity Idea Ever Conceived?

In this episode, Matt delivers a detailed rebuttal to a widely circulated essay by Chris Masterjohn titled “The Worst Longevity Idea Ever Conceived,” which criticizes the use of rapamycin in aging and longevity. Matt systematically deconstructs the claims made in the essay, identifying multiple factual inaccuracies, misleading statements, and omissions. Drawing on decades of published literature and his own research, he aims to correct the record for listeners who may have been confused or alarmed by the essay’s conclusions.

Matt begins by highlighting where the essay goes wrong on fundamental points—including false assertions that rapamycin only impairs healthspan despite extending lifespan. He reviews multiple studies in mice showing that rapamycin improves health across various tissues including heart, immune system, kidneys, and even periodontal health, while also extending lifespan. He also points out where Masterjohn cherry-picks data and relies on outdated or irrelevant studies, including extrapolating side effects seen in organ transplant patients—who take much higher daily doses—to healthy individuals taking once-weekly doses off-label.

A major theme throughout the episode is the importance of dosing and context. Matt explains why high-dose, chronic rapamycin use is not the same as the once-weekly, lower-dose protocols used by many in the longevity space. He addresses common concerns about side effects like glucose impairment, testicular degeneration, and oral inflammation, showing how many of these either lack support in human data or have been overblown in animal models. He also critiques Masterjohn’s conflation of physiological analogies (e.g., “drilling a hole in your mouth equals brain damage”) as fearmongering rather than science.

The episode also discusses clinical and observational data in humans, including findings from the PEARL trial, Everolimus vaccine response studies, and self-reported outcomes from over 300 off-label rapamycin users. So far, these suggest that rapamycin is generally well tolerated, with canker sores being the most common side effect. Matt also shares updates on emerging clinical trials exploring rapamycin’s effects on immune function, periodontal disease, and other age-related conditions.

Matt concludes with a broader warning about misinformation in the longevity space and encourages listeners to prioritize scientific rigor over sensationalism. He invites Dr. Masterjohn to have an open, fact-based conversation on the podcast and emphasizes that good science requires honest dialogue, not ideological takedowns. This episode is essential listening for anyone navigating conflicting views on rapamycin and longevity interventions.

References:

Rapamycin increases lifespan and inhibits spontaneous tumorigenesis in inbred female mice

Rapamycin Extends Life and Health in C57BL/6 Mice

Chronic inhibition of mammalian target of rapamycin by rapamycin modulates cognitive and non-cognitive components of behavior throughout lifespan in mice

Lifelong rapamycin administration ameliorates age-dependent cognitive deficits by reducing IL-1beta and enhancing NMDA signaling

Short-term low-dose mTORC1 inhibition in aged rats counter-regulates age-related gene changes and blocks age-related kidney pathology

Rapamycin attenuates age-associated changes in tibialis anterior tendon viscoelastic properties

Transient rapamycin treatment can increase lifespan and healthspan in middle-aged mice

Effect of caloric restriction and rapamycin on ovarian aging in mice

Rapamycin added to diet in late mid-life delays age-related hearing loss in UMHET4 mice

Previous

The Hidden Health Toll Of Grief (and the 4 Tasks that Actually Work). | Emma Payne

Next

Siim Land: Biohacking Longevity, Health Span Truths & Cutting Through the Hype