The mTOR Sabbatical — Rapamycin + Acarbose Protocol
The evidence-based longevity protocol centred on pulsed mTOR inhibition via weekly rapamycin. Modelled on protocols used by longevity physicians including Peter Attia. Combines rapamycin's mTORC1 inhibition with complementary autophagy support (spermidine) and NAD+ restoration (NMN). Requires physician prescription and monitoring.
Daily Schedule
Timing and dosage for each step
Monday 08:00 AM
5 mg
Once weekly rapamycin. Take with a small amount of fat (improves absorption). Note the day — same day each week, every week.
Daily 08:00 AM
500 mg
NMN 500mg daily. Rapamycin's mTOR inhibition reduces NAD+ consumption — NMN maintains NAD+ levels throughout the week.
Daily 08:00 AM
1 mg
Spermidine 1mg daily (from supplement or wheat germ). Synergistic autophagy induction via independent mTOR-independent pathway.
Protocol Overview
The mTOR Sabbatical protocol centres on pulsed pharmacological mTOR inhibition — the most evidence-backed single pharmacological intervention for lifespan extension across multiple organisms.
The weekly pulse strategy (5mg once weekly) achieves mTORC1 inhibition during and for several days after dosing, while allowing mTORC2 recovery in the intervening days. This preserves the longevity benefits of mTOR inhibition while avoiding the continuous immunosuppression of transplant-dose protocols.
The Evidence Basis
The Interventions Testing Programme (ITP) found rapamycin + acarbose produced 28% median lifespan extension in genetically heterogeneous mice — among the strongest results in mammalian longevity research. The combination appears to work via additive mechanisms: rapamycin inhibits mTORC1 directly; acarbose reduces postprandial glucose and insulin, blunting nutrient-sensing activation of mTOR.
⚠️ Physician Requirement
Rapamycin is a prescription medication. This protocol requires:
- Initial blood panel: fasting glucose, HbA1c, lipid panel, CBC, metabolic panel
- Prescription from a longevity-focused physician
- Regular monitoring: trough rapamycin levels (target 3–8 ng/ml), lipid panel quarterly
- Dental assessment: mouth sores are the most common side effect
Starting Protocol
Months 1–2: 1mg/week — assess tolerance
Months 3–4: 3mg/week — standard low dose
Months 5+: 5mg/week — standard longevity dose
Advanced (physician-guided): Up to 10mg/week
What to Monitor
- Rapamycin trough level (24h post-dose): target 3–8 ng/ml
- Fasting glucose and HbA1c: quarterly
- Lipid panel (LDL, triglycerides): quarterly — rapamycin can elevate triglycerides
- Immune function: Any unusual infections warrant dose reduction
- Wound healing: Pause 2–3 weeks before elective surgery
Supporting Interventions
- Metformin 500mg (with physician guidance): additive AMPK/mTOR pathway effects
- Acarbose 25–50mg with largest meal: blunts postprandial mTOR activation
- Resistance training 3x/week: preserves muscle during mTOR inhibition
- High protein intake (1.6–2g/kg): counteracts potential lean mass effects
Disclaimer
Rapamycin is a prescription immunosuppressant. Off-label use for longevity carries risks. This protocol is for educational purposes only and must be implemented under physician supervision.