Food is more than just fuel – every bite we take has a profound impact on our biology. In this episode, I explain the principles of the Pegan diet, emphasizing the importance of quality, nutrient-dense foods. Joining me are some incredible guests: Dr. Cindy Geyer, a renowned expert in functional medicine, and Dr. Elissa Epel, a leading stress researcher. Together, we’ll explore how chronic stress and poor sleep are intricately connected to major health issues like obesity, diabetes, and neurodegenerative diseases. Learn how specific dietary choices can serve as powerful medicine, improving your overall health and longevity. Plus, explore actionable tips and expert insights on integrating these health-boosting foods into your daily routine.

Dr. Geyer received her bachelor of science and her doctor of medicine degrees, with honors, from the Ohio State University. She completed residency in internal medicine at Strong Memorial Hospital in Rochester, N.Y. and is triple board certified in internal medicine, integrative medicine and lifestyle medicine.

Elissa Epel, PhD is an internationally renowned health psychologist who focuses on how to live well and thrive with existential stress, despite the challenges we face personally and globally. She is a professor at UCSF and the director of UCSF’s Aging, Metabolism, and Emotion Center.

She is a member of the National Academy of Medicine, past president of the Academy of Behavioral Medicine, and serves on scientific advisory committees for the National Institutes of Health. She has received awards from Stanford University, the Society of Behavioral Medicine, and the American Psychological Association. She is the coauthor of the New York Times bestseller The Telomere Effect which is in 30 languages. Her new book is THE STRESS PRESCRIPTION: Seven Days to More Joy and Ease.

This episode is brought to you by Rupa Health, Neurohacker, and Cymbiotika.

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Full-length episodes of these interviews can be found here:
How to Follow the Pegan Diet
What Is Driving Your Poor Sleep and How Can You Fix It?
How To Reduce The Harmful Effects of Chronic Stress

Ever dream of a procedure that could extend your life and keep your mind razor-sharp? Sounds like something straight out of a sci-fi film, right? 

But guess what? This futuristic concept is already a reality in clinical practice.

Meet plasmapheresis—a groundbreaking procedure that’s like an “oil change” for your blood—a part of your blood plasma is replaced with a substitute fluid to filter out harmful substances to slow down aging and disease processes. It also protects the brain from cognitive decline by “cleaning out” blood from pathological clutter—damaging substances that accumulate over time and contribute to cognitive decline.

Plasmapheresis can significantly reduce inflammation and rejuvenate your body. It might even safeguard your brain cells, helping you stay sharp as you age. It’s like giving your body and brain a fresh start.

Oh, and because it’s been around for decades to treat various conditions like autoimmune diseases and neurological disorders, we know it’s really safe.

So let’s dive into the science behind plasmapheresis and explore what the future holds for this promising new approach to healthy aging of your body and brain. 

How Plasmapheresis Saves Lives

Plasmapheresis (sometimes called “plasma exchange”) involves taking out the plasma portion of your blood and replacing it with a substitute fluid (either fresh plasma or a plasma substitute). This procedure effectively filters out certain components from the plasma, such as antibodies, toxins, and other harmful substances, that may contribute to various diseases and aging processes.

Plasmapheresis isn’t a new concept; it’s already making a significant impact in the medical field as a treatment for many diverse conditions.¹ Here are examples of conditions in which plasmapheresis is commonly used as an effective therapy:

Neurological disorders: This treatment has been used to manage chronic conditions like myasthenia gravis, multiple sclerosis, neuromyelitis optica spectrum disorders, and Guillain-Barré syndrome. 

Autoimmune diseases: For autoimmune conditions such as Goodpasture’s syndrome, lupus, antiphospholipid antibody syndrome, and others, plasmapheresis acts as a crucial intervention. 

Blood disorders: It’s a vital treatment for conditions like thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome, and hyperviscosity syndromes. 

Toxin/drug removal: In cases of severe intoxications and overdoses of highly protein-bound drugs (like tricyclic antidepressants), plasmapheresis can literally be a lifesaving treatment.

Covid-19: Plasmapheresis is also very effective in treating COVID-19 patients who have lung issues. It helps improve their symptoms and cuts down on the high inflammation (called a “cytokine storm”) that makes COVID so dangerous. Research shows that patients had better oxygen levels and lower inflammation after the treatment, which is pretty remarkable.²

How Plasmapheresis Slows Aging

The idea that plasmapheresis could promote longevity stems from research into how the components of your blood change as you age.³ As you get older, your blood accumulates various factors that can contribute to aging and age-related diseases. These factors include inflammatory molecules, metabolic waste products, and dysfunctional proteins.

One compelling piece of evidence comes from animal studies. When older mice were given young plasma through a process similar to plasmapheresis, the aging rodents showed improved physical and cognitive function.⁴ This means that rejuvenating the blood may help reduce the burden of pro-aging factors and promote a more youthful systemic environment, potentially extending lifespan and improving healthspan.⁵

How Plasmapheresis Protects Your Brain

Your brain is particularly vulnerable to the effects of aging, with conditions like Alzheimer’s disease and other forms of dementia becoming more common as you get older. So finding innovative ways to protect brain health and slow cognitive decline is crucial for maintaining quality of life as you age.

► It Reduces Inflammation

Reducing inflammation is key since it’s a major player in many age-related diseases, especially those targeting the brain.⁶ By filtering out harmful substances from your blood, plasmapheresis reduces systemic inflammation, improves cellular function, and potentially slows down the aging process.⁵ 

Ultimately, this procedure may help protect your brain cells from damage and enhance overall brain health.

► It Enhances Blood Flow

Improved blood circulation is another benefit of plasmapheresis. By removing harmful autoantibodies and pro-inflammatory cytokines that cause vascular inflammation and clotting issues, it can help your blood move more freely. Plus, it gets rid of cell adhesion molecules that make blood cells clump together and mess with circulation. 

Better blood flow means more oxygen and nutrients are delivered to the brain, which is crucial for maintaining cognitive function and preventing brain-related disorders.

► It Removes Toxic Proteins

In neurodegenerative diseases like Alzheimer’s, toxic proteins such as amyloid-beta and tau build up in the brain, causing cell death and cognitive decline. Research shows that plasmapheresis can help lower these toxic protein levels in the blood, potentially slowing the progression of these diseases.⁷

Here’s how it works: Plasmapheresis removes harmful proteins like amyloid-beta from your blood and introduces fresh albumin. Albumin is a natural component of our blood that acts as a powerful antioxidant, stabilizes blood vessels, traps toxins, and reduces inflammation by influencing certain cytokines (inflammation molecules).

In people with Alzheimer’s, albumin gets damaged and can’t function properly. (It becomes glycated— that is, it’s covered in sugar molecules—and nitrotyrosinated, meaning it’s been chemically altered by a reactive molecule.) 

Plasmapheresis removes the damaged proteins and replenishes the body with fresh albumin, which then acts like a sponge to soak up and remove the toxic proteins.

The result? Plasmapheresis improves cognitive function and slows disease progression in patients with mild or moderate Alzheimer’s disease, according to clinical trial results published in Alzheimer’s & Dementia.⁸

How the Procedure Works

A typical plasmapheresis session takes about 1-3 hours, and usually involves the following:

1. Blood extraction: Blood is drawn from the patient and sent to a machine that separates the plasma from the blood cells.
2. Plasma separation: The plasma contains various components, including proteins, antibodies, and waste products. This is the part that gets filtered out.
3. Replacement fluid: Depending on the condition being treated, the plasma is replaced with a substitute fluid such as saline, albumin, or donor plasma.
4. Blood return: The cleaned blood cells are then mixed with the replacement fluid and returned to the patient’s body.

Is Plasmapheresis Right for You?

If you’re intrigued by the idea of plasmapheresis and its potential benefits, it’s worth noting a couple of important points: 

1. This procedure isn’t yet widely accessible as an anti-aging or brain health treatment for the general public. It’s only available primarily in medical settings for specific conditions. 
2. At the moment, it can be quite expensive—so cost could be a significant barrier for many people.

However, as with many medical technologies, costs are likely to decrease as plasmapheresis becomes more widely adopted and integrated into the longevity space. Increased demand, technological advancements, and more streamlined procedures can all contribute to making this groundbreaking therapy more accessible and affordable in the future. In the meantime, maintaining a healthy lifestyle through a balanced diet, regular exercise, stress management, and targeted supplementation remains the best strategy for promoting longevity and brain health. And who knows? In the future, plasmapheresis might just be added to this list of health-promoting practices

References

1. Lin Y, Oji S, Miyamoto K, Narita T, Kameyama M, Matsuo H. Real-world application of plasmapheresis for neurological disease: Results from the Japan-Plasmapheresis Outcome and Practice Patterns Study. Ther Apher Dial. 2023 Feb;27(1):123-135. doi: 10.1111/1744-9987.13906. Epub 2022 Jul 17. PMID: 35765859; PMCID: PMC10084057.
2. Hassaniazad M, Vahedi MS, Samimagham HR, Gharibzadeh A, Beyranvand S, Abbasi H, Nikpoor AR. Improvement of clinical outcome, laboratory findings and inflammatory cytokines levels using plasmapheresis therapy in severe COVID-19 cases. Respir Med. 2021 Nov-Dec;189:106669. doi: 10.1016/j.rmed.2021.106669. Epub 2021 Oct 26. PMID: 34757278; PMCID: PMC8547850.
3. Kheifets V, Braithwaite SP. Plasma-Based Strategies for Therapeutic Modulation of Brain Aging. Neurotherapeutics. 2019 Jul;16(3):675-684. doi: 10.1007/s13311-019-00746-z. PMID: 31161489; PMCID: PMC6694331.
4. Villeda SA, Plambeck KE, Middeldorp J, Castellano JM, Mosher KI, Luo J, Smith LK, Bieri G, Lin K, Berdnik D, Wabl R, Udeochu J, Wheatley EG, Zou B, Simmons DA, Xie XS, Longo FM, Wyss-Coray T. Young blood reverses age-related impairments in cognitive function and synaptic plasticity in mice. Nat Med. 2014 Jun;20(6):659-63. doi: 10.1038/nm.3569. Epub 2014 May 4. PMID: 24793238; PMCID: PMC4224436.
5. Bieri, G., Schroer, A.B. & Villeda, S.A. Blood-to-brain communication in aging and rejuvenation. Nat Neurosci 26, 379–393 (2023). https://doi.org/10.1038/s41593-022-01238-8
6. Holmes C, Cunningham C, Zotova E, Woolford J, Dean C, Kerr S, Culliford D, Perry VH. Systemic inflammation and disease progression in Alzheimer disease. Neurology. 2009 Sep 8;73(10):768-74. doi: 10.1212/WNL.0b013e3181b6bb95. PMID: 19738171; PMCID: PMC2848584.
7. Imbimbo BP, Ippati S, Ceravolo F, Watling M. Perspective: Is therapeutic plasma exchange a viable option for treating Alzheimer’s disease? Alzheimers Dement (N Y). 2020 Mar 17;6(1):e12004. doi: 10.1002/trc2.12004. PMID: 32211508; PMCID: PMC7087432.
8. Boada M, López OL, Olazarán J, Núñez L, Pfeffer M, Paricio M, Lorites J, Piñol-Ripoll G, Gámez JE, Anaya F, Kiprov D, Lima J, Grifols C, Torres M, Costa M, Bozzo J, Szczepiorkowski ZM, Hendrix S, Páez A. A randomized, controlled clinical trial of plasma exchange with albumin replacement for Alzheimer’s disease: Primary results of the AMBAR Study. Alzheimers Dement. 2020 Oct;16(10):1412-1425. doi: 10.1002/alz.12137. Epub 2020 Jul 27. PMID: 32715623; PMCID: PMC7984263.