Therapeutic plasma exchange: changes over time and biological-age research
Healthy Longevity Clinic’s longitudinal follow-up recorded LDL cholesterol falling from 165 to 64 mg/dL before the fifth therapeutic plasma exchange (TPE) session. A second report tracked metals, BPA, pesticide metabolites, mycotoxins and PFAS over three months. A controlled 2025 study adds biological-age findings, including a 2.61-year reduction with TPE plus IVIG at its intermediate assessment.
Therapeutic plasma exchange (TPE) is attracting interest because it can change the circulating environment in which our cells work. At Healthy Longevity Clinic, two internal reports follow changes in metabolic measurements and environmental-toxin biomarkers over a course of treatment. A separate controlled study published in Aging Cell in 2025 adds evidence of changes in biological-age estimates.
These sources address complementary questions: what changes between clinic visits, which exposure markers change over months, and whether treatment alters molecular patterns associated with aging.
What happens during plasma exchange?
TPE separates plasma—the liquid part of blood—from blood cells. The cells return to the circulation with replacement fluid, often containing albumin, a protein normally found in blood. Removing plasma also removes substances carried in it. The replacement fluid, medicines used to prevent clotting and treatment schedule are chosen for the clinical protocol. 1
The procedure has established uses in selected medical conditions. Its applications in preventive and longevity care are being investigated. A useful assessment therefore looks at the exact protocol and at measurements taken over time.
Our clinic follow-up: lower values before the fifth session
The general blood-work report compares measurements before session 1 with measurements before session 5, approximately three months later. The later blood sample was taken before that day's treatment, after the preceding four sessions. This comparison describes the course of treatment, rather than the immediate effect of one procedure.
Measurement | Before session 1 | Before session 5 | Change |
|---|---|---|---|
Total cholesterol | 251 mg/dL | 94 mg/dL | 62.5% lower |
LDL cholesterol | 165 mg/dL | 64 mg/dL | 61.2% lower |
Triglycerides | 279 mg/dL | 113 mg/dL | 59.5% lower |
Glucose | 122 mg/dL | 94 mg/dL | 23.0% lower |
Creatinine | 0.92 mg/dL | 0.94 mg/dL | Similar at both measurements |
Source: unpublished Healthy Longevity Clinic general blood-work report, longitudinal comparison on page 6. Percentage changes are calculated from the reported values.
The size of the lipid changes and their presence before a later treatment are the clinically interesting observations. They give a reason to examine how the response develops between visits. Because this is an individual follow-up without a comparison group, it cannot separate the contribution of TPE from medicines, diet or other changes during the same period.
The report also records lower IgG and IgM antibody levels before session 5. Those findings belong in clinical monitoring: a lower result is useful only when its meaning fits the treatment goal and the person's health.
A second clinic report: toxin biomarkers over three months
The environmental-exposure report follows a five-session program with an initial assessment, an intermediate assessment and a final follow-up over roughly three months. It tracks metals, chemicals associated with plastics and pesticides, mold-derived toxins and PFAS, a family of persistent industrial chemicals.
Selected changes from the first to the final assessment are:
Biomarker | Category | Reported reduction |
|---|---|---|
Aluminum | Metal | 93.3% |
Thallium | Metal | 81.7% |
Cadmium | Metal | 65.6% |
Bisphenol A (BPA) | Plastics-related chemical | 77.6% |
Dimethyl phosphate (DMP) | Pesticide metabolite | 76.1% |
Fumonisin B1 | Mold-derived toxin | 71.5% |
GenX / HFPO-DA | PFAS | 52.5% |
PFOA | PFAS | 37.1% |
Source: unpublished Healthy Longevity Clinic TPE treatment-effectiveness report, pages 3–6. These are longitudinal changes across the program. The source materials describe blood and urine testing; the percentages summarize measured toxin biomarkers and should not all be labeled blood concentrations.
The three assessments also show that the pattern varies. Some metal measurements fell markedly at the intermediate assessment; cadmium subsequently rose somewhat while remaining below its initial value. A final percentage alone would hide that detail. Following the trajectory can make the clinical conversation more informative.
These findings support further investigation of exposure-related outcomes. They do not isolate treatment from changes in exposure or establish how much of a substance was removed from the whole body. The sample type and collection conditions matter when interpreting each result.
What the biological-age study adds
The 2025 study by Fuentealba and colleagues included 42 adults and compared TPE schedules, TPE with intravenous immunoglobulin (IVIG, an antibody preparation), and sham treatment. It assessed biological age using 36 DNA-methylation clocks—models based on chemical marks on DNA. Samples were taken before sessions 1, 4 and 6. 3
Before session 4, after three treatments, the largest reported average reduction was 2.61 years with TPE plus IVIG; monthly TPE showed a 1.32-year reduction. The Buck Institute describes accompanying molecular and immune-system changes. 5
At the later assessment before session 6, the overall differences from sham were no longer statistically significant. 3 This makes timing part of the finding. The study gives TPE a concrete place in biological-aging research; “2.61 years” describes a calculated age measure, rather than a guaranteed response or extra healthy years for an individual.
Where Alzheimer’s research fits
The AMBAR trial studied 347 people with mild-to-moderate Alzheimer’s disease, using albumin replacement with or without immunoglobulin. Compared with sham treatment, the pooled treatment groups had less decline in daily activities over 14 months; the cognitive endpoint did not reach the conventional significance threshold. This concerns people with diagnosed disease and a particular protocol. It is a separate question from biological-age changes in generally healthy adults. 2
Protocol differences also help explain why results should not be combined indiscriminately. A separate 2025 plasma-donation study without albumin replacement, coauthored by Petr Šrámek, did not demonstrate epigenetic rejuvenation. Plasma donation and therapeutic exchange with replacement fluid are different interventions. 4
How Healthy Longevity Clinic experts evaluate the evidence
Our clinic reports make the question practical: which changes are still present when a person returns, and what do they mean for the next care decision? The controlled biological-age study adds a comparison group and molecular measurements. Together, they justify careful investigation of who responds, how the response evolves and which treatment schedule is useful.
For a patient, we connect this with an agreed goal: improving an identified risk profile, evaluating exposure markers or investigating a specific health problem. Follow-up should also track how the person feels and functions. Lowering a test result has more value when it supports a meaningful decision.
TPE requires clinical supervision. Blood pressure, calcium balance, antibodies and other plasma components need attention, alongside possible allergic reactions and vascular-access complications. 1 6 A clear plan should specify the intended benefit, monitoring and reasons to continue, adjust or stop treatment.
What remains uncertain
The clinic observations are drawn from unpublished reports rather than an independently audited dataset. Without a comparison group, they cannot isolate TPE from concurrent treatment or exposure changes. Blood and urine markers require specimen-specific interpretation. The biological-age study’s aggregate difference from sham was no longer significant at its later assessment.
References
- Cambridge University Hospitals: Plasma exchange · Checked 2026-09-28
- Boada et al.: A randomized, controlled clinical trial of plasma exchange with albumin replacement for Alzheimer’s disease—Primary results of AMBAR · 2020 · Checked 2026-09-28
- Fuentealba et al.: Multi-Omics Analysis Reveals Biomarkers That Contribute to Biological Age Rejuvenation in Response to Single-Blinded Randomized Placebo-Controlled Therapeutic Plasma Exchange · 2025 · Checked 2026-09-28
- Human clinical trial of plasmapheresis effects on biomarkers of aging (efficacy and safety trial) · 2025 · Checked 2026-09-28
- Buck Institute: Clinical trial and multi-omics analysis demonstrates the impact of therapeutic plasma exchange on biological age · Checked 2026-09-28
- University College London Hospitals: Plasma Exchange Service at NHNN · Checked 2026-09-28
Disclosure
Healthy Longevity Clinic has a commercial interest in its services, including TPE. Petr Šrámek coauthored the cited plasma-donation study. The biological-age trial was sponsored by Circulate, which has commercial interests in plasma-exchange research. Produced with AI-assisted editorial support. Educational content, not an individual treatment recommendation.