In 2006, I published an article that aging is not caused by free radicals nor by any kind of molecule damage but instead is a quasi-program driven in part by mTOR (Target of Rapamycin). By sheer luck, mTOR inhibitors – Sirolimus (rapamycin) and Everolimus – were clinically available. As I summarized in 2006: “…all diseases of aging from osteoporosis to Alzheimer’s may be treated with rapamycin. Finally, rapamycin will be most useful as anti-aging drug to slow down senescence and to prevent diseases.” That article has detailed how treatment can be initiated. And importantly it stated that “As an anti-aging drug, rapamycin will prevent diseases rather than cure complications of diseases. Rapamycin will prevent [organ] damage but not to reverse [organ] damage. It might control diabetes and obesity but not diabetic gangrene and stroke. It might slow or prevent macular degeneration but will unlikely cure blindness. Rapamycin will not repair broken bones but might prevent osteoporosis.”

Thirteen years later, in Rapamycin for longevity I continued that “rapamycin will be most effective when administered at the pre-disease, or even pre-pre-disease stages of age-related diseases. … anti-aging drugs are most effective before overt diseases cause organ damage and loss of function. Rapamycin and everolimus are more effective for preventing cancer than treating it. They may also be useful for treating osteoporosis, though not a broken hip after an osteoporotic fracture. [They] may slow atherosclerosis, thereby preventing myocardial infarction, but they are unlikely to help reverse an infarction.” In particular, Carosi et al. suggested that mTOR inhibitors could be useful in Alzheimer disease, but only in the earliest stages.

As I suggested “self-medication (even by physicians themselves) should be avoided and strongly discouraged. Instead, we need anti-aging clinics that implement the entire anti-aging recipe, including a complementary low carbohydrate diet and life style changes. Blood levels of rapamycin should be measured, as the rapamycin concentration in blood varies greatly among individuals taking the same dose. Doses of rapamycin should be tailored: personalized dosing and schedules. There is no shortage of potential patients who unfortunately already employ self-medication with rapamycin, but there is a shortage of physicians to treat them. Fortunately, a prototype clinic already functions in the USA, demonstrating that it is feasible from a regulatory standpoint (https://rapamycintherapy.com).” Still the time is now but the sooner, the better. Or as a song goes: “Better late than never but never late is better”