A prescription transplant medication that blocks the cell's central growth switch. It extends animal lifespan more consistently than anything else tested; human gains are narrow: fewer skin cancers at transplant doses, better vaccine response, lean tissue in women only. Documented costs: mouth ulcers, raised blood fats, lowered blood counts, slower wound healing. An experiment, not an established intervention. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Whole-blood sirolimus trough | Under 3 ng/mL at 24 hours post-dose | Dose does not predict exposure |
| Complete blood count | Hemoglobin, platelets, neutrophils stable vs baseline | Marrow suppression |
| Lipid panel with apolipoprotein B | ApoB under 80; triglycerides under 80; LDL under 100 mg/dL | Most reproducible metabolic effect |
| Fasting insulin | 2–5 µIU/mL | Rises before glucose |
| Fasting glucose | 75–90 mg/dL | Metabolic drift at higher exposure |
| Glycated hemoglobin | Under 5.4% | Average blood sugar over three months |
| High-sensitivity C-reactive protein | Under 0.5 mg/L | Low-grade inflammation |
| Estimated glomerular filtration rate | Above 90 mL/min/1.73 m² | Kidney handling |
| Urine albumin-to-creatinine ratio | Under 10 mg/g | Kidney-filter protein leakage |
| Alanine aminotransferase | Under 25 U/L men, 20 U/L women | Liver handling; clearance is hepatic |
| Reproductive markers: morning testosterone in men, cycle log in women | No established target; tracked against baseline | Reproductive-axis effects reported but unquantified |
Cadence: Drug level and blood count at four weeks and after any dose change or new interacting medication; full panel at three months, then every six months.