I’m a Biohacker, But I Don’t Trust These Longevity Drugs

Key wellness / longevity strategies discussed (with what to do)

• Use a “frosting, not the cake” approach

  • Prioritize fundamentals first: sleep, movement/exercise, proper nutrition, and vascular health (plus basic supplements/lifestyle).
  • Treat longevity drugs as optional pathway tweaks, not replacements.

• Understand aging as multiple root causes

  • There are “about a dozen known causes of aging.”
  • Pharmaceuticals are discussed as repurposed “scalpels”: drugs made for other diseases that may impact aging-related pathways.

• Be selective with common drugs

  • The speaker argues several popular “longevity” drugs have poor risk/benefit for most people.

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“No” list (drugs the presenter says not to use for most people)

Metformin

• Main concern: blunts exercise benefits
  • A trial in older adults doing resistance training found muscle gains were better without metformin (CT-confirmed).
• Mechanism concern: may blunt mTOR-related growth/repair needed from training.
• Safety/downsides:
  • GI side effects (diarrhea/farting).
  • B12 deficiency risk that can persist for years after stopping → requires ongoing B12 support if used.
• Recommendation context:
  • Could be appropriate for people with type 2 diabetes (harm reduction), but not as a default longevity pill.

Rapamycin / “rapamyi(n)” (systemic/internal use)

• Concern: human evidence and dosing uncertainty; mouse lifespan data doesn’t translate cleanly.
• Mechanism concern: mTOR has two arms; rapamycin affects both at different times/doses, raising risk of unwanted effects.
• Side-effect examples:
  • mouth ulcers, impaired wound healing
  • elevated lipids, insulin resistance
  • immune system changes
• Recent human trial mentioned:
  • A 2025 placebo-controlled study where outcomes weren’t confirmed (e.g., visceral fat didn’t change).

Statins

• Main claim: poor harm-reduction ratio for low-risk, generally healthy people.
  • Very small average benefit versus widespread side effects.
• Side-effect concern:
  • muscle symptoms are a leading reason for discontinuation.
  • statins may lower CoQ10 in muscle/mitochondria; the speaker personally supplements CoQ10.
• Framing argument:
  • lowering cholesterol numbers alone isn’t the same as improving mortality risk for most people.

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“Yes” list (drugs the presenter suggests considering—primarily at low/targeted dosing)

The speaker repeatedly emphasizes micro-dosing/off-label and “research-based” dosing, and notes not being a physician.

Tadalafil (Tadalapil / “Cialis”) ~5 mg nightly

• Rationale: PDE5 inhibitor → improves blood flow / endothelial function via nitric-oxide–driven vasodilation.
• Longevity framing:
  • improved vascular signaling may help protect against cardiac/cognitive decline pathways
  • also presented as a “keep endothelial dysfunction from getting worse” strategy
• Safety caveat (implied): avoid if on nitrate drugs or with low blood pressure concerns.

SGL2 inhibitors (e.g., Jardiance / “Jardian”, dapagliflozin / “dapa gllivin”)

• Rationale: beyond glucose control, outcome trials show benefits like:
  • reduced heart failure hospitalization
  • reduced cardiovascular death
  • slowed kidney disease progression, potentially even in non-diabetics
• Proposed longevity mechanisms (as described):
  • resembles mild caloric restriction / ketosis-like state
  • reduces inflammation
  • improves mitochondrial efficiency
  • may reduce senescent cell burden
  • may influence autophagy and oxidative stress response

Acarbose (“carbos”, e.g., Precose / Prois e)

• Rationale: slows digestion of complex carbs → less glucose spike
• Proposed longevity evidence:
  • mouse studies showing increased lifespan (sex-specific effects described)
  • follow-up work suggests improved metabolic/liver/kidney health and glucose response
• Gut-focused angle:
  • shifts starch digestion downstream → changes gut bacteria
  • increases short-chain fatty acids (e.g., proprionate) tied to better metabolic/gut-barrier outcomes
• Side-effect workaround mentioned:
  • activated charcoal can be used, but not at the same time as the drug (so the medication still works).

Low-dose naltrexone (LDN)

• Rationale: immune and neuroinflammation modulation
  • blocks opioid receptors briefly at low doses → body compensates with increased endogenous endorphins, potentially shifting inflammatory regulation
• Evidence cited:
  • autoimmune conditions (e.g., MS, Crohn’s, fibromyalgia) with minimal side effects
  • less positive evidence for certain chronic arthritis pain outcomes (speaker says no difference in one area)
• Practical dosing: see dosing section below.

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Research-based dosing summary (as stated in the subtitles)

• Tadalafil: ~5 mg daily, taken at night
• SGL2 inhibitors:
  • Jardiance/Jardian: typically 10 mg or 25 mg once daily (speaker suggests starting lighter, e.g., 10 mg)
  • dapagliflozin (“dapa gllivin”): speaker suggests 10 mg
• Low-dose naltrexone: 1.5 to 4.5 mg (speaker states this is <10% of the addiction dose)
• Acarbose:
  • start 25 mg three times daily with the first bite of each meal
  • titrate up over weeks to as high as 100 mg three times daily if tolerated
  • speaker frames titration as “until bad farts, then stop”
• Rapamycin / rapamycin-like:
  • explicitly not recommended internally by the speaker
  • topical rapamycin cream is mentioned as an exception for skin longevity, if compounded

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Access / compliance tips (as described)

• Need a doctor’s permission in the US
  • Speaker suggests discussing the dosing and research with a physician and asks for support.
• Telehealth / cash pay options
  • If regular doctors refuse, speaker notes cash-pay longevity/functional medicine/telehealth clinics may be easier.
• Avoid insurance hassles
  • Speaker advises not expecting insurance to pay and to just pay cash where possible.
• Don’t treat as a starting point
  • “Don’t start with pharmaceuticals” — only after sleep, movement, nutrition, and vascular basics.

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Presenters / sources mentioned

• Dave Asprey (host/presenter; “The Human Upgrade” / “Upgrade Labs”)
• Unlimited.life (concierge VIP; mentioned as a practice/source of lab work)
• Steven Sin(at)ra and Julian Whitaker (doctors referenced as former cardiology voices opposing statins)
• Dr. Bernard Bihari (mentioned in context of LDN inventor/concept)
• National Institute on Aging (NIA) (mouse testing program referenced for rapamycin)
• Pearl trial (mentioned as a 2025 human study on rapamycin)
• PERCIS(A) / “Procissa” study (statins muscle symptom study referenced; exact name is unclear due to subtitle errors)
• Timeline (supplement brand; contains “euro/urelithn A” and “Mopure”; includes human trial claims)
• FactCheck.org (mentioned in relation to a dispute about misinformation)
• NIH / National Institutes of Health (or “National Institutes of Aging” referenced for acarbose mouse program—subtitles mix phrasing)
• UN/other sources
  • Superhuman (speaker’s longevity book; cited for causes of aging and other drug context)
  • Diary of a CEO (mentioned—episode refusal claim)
  • COVID / Fouchy (mentioned as context; “Fouchy” likely Fauci—no further detail)

(Note: some names/sources may be slightly mis-transcribed in the auto-generated subtitles.)