Research and videos
Rapamycin (sirolimus): the research and Kevin's videos
Is rapamycin worth trying for APOE4 carriers, and how do people get it prescribed and monitored?
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This page has no results from Phoenix members yet. It shows what published research says, and what Kevin and the experts say in his videos.
See what Phoenix members have measuredIs rapamycin worth trying for APOE4 carriers, and how do people get it prescribed and monitored?
Too early to say: rapamycin extends lifespan and protects the brain in mice, including APOE4 mice, but there is no human trial showing it prevents memory loss. A small 2025 human pilot found no change in thinking, and the drug can raise blood fats and sugar. Doctors who use it call it speculative and monitor patients closely; it is not something to try on your own.
What the research says
Grade DAPOE4-specific evidence: limited
Too early to say: rapamycin protects the brain in animal studies, including APOE4 mice, but human evidence for memory or dementia is missing, and it can raise blood fats and sugar.
Key studies
Gonzales 2025, Commun MedGrade B
10 people with MCI or early dementia, 8 weeks, no control group: rapamycin was not found in spinal fluid, thinking did not change, and spinal-fluid p-tau181, GFAP and NfL rose.
Read on PubMed (opens in a new tab)Moel 2025, Aging (PEARL trial)
48-week placebo-controlled trial in healthy adults: weekly low-dose rapamycin looked relatively safe; small gains in lean mass and well-being, no change in the main outcome.
Read on PubMed (opens in a new tab)Lin 2020, Neurobiol Dis
Animal or lab study
Animal study: in mice carrying human APOE4, rapamycin restored brain blood flow and reduced amyloid; not seen in APOE3 mice.
Read on PubMed (opens in a new tab)
2 more key studies
Harrison 2009, Nature
Animal or lab study
Animal study: rapamycin started late in life extended lifespan in genetically diverse mice.
Read on PubMed (opens in a new tab)Kasiske 2008, Am J TransplantGrade A
In kidney-transplant patients on mTOR inhibitors, triglycerides and cholesterol rose.
Read on PubMed (opens in a new tab)
What Kevin and experts say
1 passage for, 1 against, 8 with a caution, 1 also discussed
Now showing: Dr. Grant Fraser · 20:16
Open on YouTube (opens in a new tab)For1 passage
A clinic reported no dementia among carriers on it; uncontrolled report.
“he did not have a single one of those patients with APOE4s over an average period of time that he cared for them at five years get mild cognitive impairment”
Dr. Grant Fraser, Board-certified anti-aging and family medicine physician, APOE4 carrier
Against1 passage
Dr. Fraser: compounded capsules absorb only about a third as well as coated tablets.
Dr. Grant Fraser
Watch the Short on YouTube (opens in a new tab)
With a caution8 passages
Animal results are strong; human proof is still missing.
“we've seen in a number of animal models that it actually reverses those changes. I don't think that we find that in humans.”
Dr. Grant Fraser, Board-certified anti-aging and family medicine physician, APOE4 carrier
Daily rapamycin can worsen insulin and lipids; it is cycled instead.
“if you take [rapamycin] on a daily basis and you don't cycle it does end up inhibiting mtorc2 which is not good”
Dr. Grant Fraser, Board-certified anti-aging and family medicine physician, APOE4 carrier
Rapamycin for brain health is speculative; safety comes first.
“this is a speculative therapy and I think the biggest thing with any speculative therapy is that it's safe”
Dr. Grant Fraser, Board-certified anti-aging and family medicine physician, APOE4 carrier
Do not self-prescribe rapamycin; use a monitoring doctor.
“I think the main message is to do not do that on your own right since you need a lot of blood test”
Dr. Kevin Tran, Founder of The Phoenix Community, Doctor of Pharmacy, APOE4/4 carrier
The good results may come from the whole program, not one drug.
“I think that combination of things probably led to the outcomes. I'm not sure it was just the [rapamycin].”
Dr. Grant Fraser, Board-certified anti-aging and family medicine physician, APOE4 carrier
Rapamycin may not suit advanced disease; it could even harm.
“certainly somebody that already has significant Alzheimer's pathology, I'm not at all convinced. There's some data that looks a little concerning that could actually make things worse.”
Dr. Grant Fraser, Board-certified anti-aging and family medicine physician, APOE4 carrier
A physician times rapamycin by genotype; 4/4 earliest.
Dr. Grant Fraser
Watch the Short on YouTube (opens in a new tab)
Rapamycin needs monitoring; the guest hasn't seen metabolic harm.
Dr. Grant Fraser
Watch the Short on YouTube (opens in a new tab)
Also discussed1 passage
He reads rising blood markers on rapamycin as clearance; untested idea.
“people go oh my goodness we're making it worse and I don't think so I think what we're doing is we're enhancing clearance”
Dr. Grant Fraser, Board-certified anti-aging and family medicine physician, APOE4 carrier
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