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1

Rapamycin and endurance performance

Hi Peter, I am a Physician, 58 y o, a competitive long distance triathlete and I started taking 6 mg/week Rapamycin 8 weeks ago. My Hb has moved from16.3 g/dl (before taking it) to 14.9 g/dl (also, my resting heart rate baseline has gone from 52,3 to 53.7). This should lead to a reduced performance in the next triathlon competition, don't you think? Do I have to choose between being competitive and taking Rapamycin?

3

liver function, AST/ALT

my AST/ALT levels are low (25/20), but the ratio is >1. reading literature, low levels indicate liver health, but a >1 ratio indicates possible alcohol liver damage (yes, I drink alcohol moderately). any cause for concern?

1

Mounjaro and body comp

My endocrinologist put me on Mounjaro for chronic obesity 10 months ago. I went from 258.8 to 197.4lbs, weight loss continues but very slowly. I am losing fat much faster than muscle, now at 24% fat, 27.3% muscle (not dexa though) and my resting heart rate ranges from 58-64. I am 71. The success is due to 3-5 sessions of weight training per week, and LOTS of protein powder (50-100 gms daily) with HMB. Why don’t doctors INSIST on weight training and protein supplementation? Trying to eat lean meat or eggs in Mounjaro

5

ApoB Testing

Which test results are more useful for ApoB lowering intervention decisions - blood drawn while fasted for 8 - 12 hours or post prandial if the results over several trials are significantly different, say 20 - 30 mg/dL ?

3

Limitations with aneurysmal ascending aorta

I suffer from hypertension which I keep in check using Losartan ~ under 120/80. It was discovered that I had an aneurysmal ascending aorta after a coronary calcium scan, score of 10, aorta 42mm. A subsequent electrocardiogram confirmed aneurysm and size. I am an avid cyclist and my typical ride due to the terrain I ride has my heart rate mostly in zones 4 & 5. I also like to lift weights. I have been given conflicting guidance on whether or not I should limit my physical exertion and to what extent with the aneurysm. What are your thoughts?