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Therapeutic plasma exchange (TPE) personal experience

plasma exchange parabiosis tpe

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#1 resveratrol_guy

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Posted 02 July 2022 - 03:33 AM


I swapped out 2/3 of all protein in my blood on 12/30/2021, then again on 02/11/2022, and one more time on 03/31/2022. The mechanism was therapeutic plasma exchange (TPE) supported by an aphoresis machine under the supervision of a doctor and 2 nurses.

 

Each time, they swapped out my plasma for 5 bottles of sterile plasma containing nothing but albumin and appropriate electrolytes at the appropriate pH. Notably, I never had IVIG (intravenous immunoglobulins) which are supposed to enhance the antiinflammatory effects but carry some theoretical contamination risks.

 

With respect to brain health, this resulted in a marked improvement in visual episodic memory (such as remembering where I parked the car) and verbal fluidity (fewer pauses in ad lib speech). I had also been suffering from chronic shooting pains in the left shin from an injury I had suffered a couple of months prior to the first procedure, which as of now is barely detectable.

 

But what about the hematology? Let me explain how I did the blood tests.

 

I took the first test on 12/27/2021 and the second on 06/06/2022. I wanted to determine if the procedure was materially "rejuvenating". But I also wanted to learn something about durability, which is why the second test was over 2 months after the final procedure. (The cost of each procedure was about $4800. It's also not available everywhere, so you might have to add flight, hotel, food, and a rental car to that number. I did it in the US.)

 

I also wanted to be as uniform as possible about the tests, so I maintained more or less the same diet, calorie intake, and exercise regimen throughout. Furthermore, in order to remove any noise based on recently eaten meals, I fasted for about 84 hours prior to each blood test. (I scheduled the fasting so that I could eat right after the tests. The time delay was chosen so as to allow me to empty my gut of any residual food that might skew the results. During the fast, I consumed no calories, although I did have diet soda on the second cycle.)

 

I posted this in the Brain Health section because the effects in this regard were salient. However, I did this experiment for general health maintenance.

 

Here are the results. "L" means "low" and "H" means "high":

 

Marker,12/27/21,06/06/22
TNF,1.51H,0.7 <- SHIN PAIN SUBSIDED
APOLIPOPROTEIN A1,183,202 <- BETTER HEART DISEASE PROTECTION
GLUCOSE,70,45L <- OMG!
BUN,9,10
CREATININE,0.88,0.94
eGFR NONAFRICAN,102,95 <- FASTING STRESS ON KIDNEYS?
SODIUM,137,137
POTASSIUM,3.9,3.9
CHLORIDE,101,101
CARBON DIOXIDE,20,18L <- PROBABLY NOISE
CALCIUM,9.2,9.3
PROTEIN TOTAL,7.2,7.6
ALBUMIN,4.6,4.9
GLOBULIN,2.6,2.7
ALBUMIN/GLOBULIN RATIO,1.8,1.8
BILIRUBIN TOTAL,1,1.6H <- WEIRD
ALKALINE PHOSPHATASE,60,70 <- ANOMALOUS LIVER STRESS
AST,30,33
ALT,18,26
HEMOGLOBIN A1C,5.2,5.1 <- MEH... BUT WOW THAT GLUCOSE FLOOR!
EAG,103,100
% CD4,46,42
ABSOLUTE CD4+ CELLS,534,483L <- IMMUNE SYSTEM CHILLED OUT
% CD8,25,27
ABSOLUTE CD8+ CELLS,292,307
CD4/CD8 RATIO,1.83,1.57
ABSOLUTE LYMPHOCYTES,1158,1139
INTERLEUKIN 2,<38,<38
INTERLEUKIN 6,<1.40,1.61 <- INFLAMMATORY OR ANTIINFLAMMATORY?
TESTOSTERONE TOTAL,1001,576 <- SURVIVAL MODE
TESTOSTERONE FREE,111,63.9
PARTIAL THROMBOPLASTIN TIME, ACTIVATED,30,31
PROTHROMBIN TIME INR,1.1,1.1
PROTHROMBIN TIME,11,10.5
HS CRP,<0.3,<0.3
IMMUNOGLOBULIN A,293,266 <- MORE EVIDENCE OF CHILL IMMUNE SYSTEM
IMMUNOGLOBULIN G,1104,1035
IMMUNOGLOBULIN M,152,136
FIBRINOGEN ACTIVITY, CLAUSS,251,271
WHITE BLOOD CELL COUNT,3.8,4.6 <- CHILL, BUT MORE SOLDIERS ON PATROL
RED BLOOD CELL COUNT,5.68,5.42 <- RED CELL BREAKDOWN LIFTING BILIRUBIN?
HEMOGLOBIN,17.1,16.6
HEMATOCRIT,49.1,48.8
MCV,86.4,90
MCH,30.1,30.6
MCHC,34.8,34
RDW,13.3,13.3
PLATELET COUNT,220,254 <- A BIT CLOTTIER, MAYBE DIET NOISE?
MPV,9.5,9.5
ABSOLUTE NEUTROPHILS,2432,2829
ABSOLUTE LYMPHOCYTES,988,1293
ABSOLUTE MONOCYTES,342,432
ABSOLUTE EOSINOPHILS,38,46
ABSOLUTE BASOPHILS,0,0
% NEUTROPHILS,64,61.5
% LYMPHOCYTES,26,28.1
% MONOCYTES,9,9.4
% EOSINOPHILS,1,1
% BASOPHILS,0,0
FERRITIN,96,95
COMPLEMENT COMPONENT C3C,92,108 <- NO CLUE
PSA TOTAL,0.65,0.6 <- REDUCED PROSTATE CANCER RISK
ANA SCREEN IFA,NEGATIVE,NEGATIVE
 

 


Edited by resveratrol_guy, 02 July 2022 - 03:45 AM.

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#2 johnhemming

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Posted 02 July 2022 - 09:05 AM

Sad you did't have Interleukin-10.  My view is that this is the key cytokine that causes senescence.  It is hard to test for, however.

 

The problem with plasma swapping is that it does not deal with underlying senescence, but it does wash out the interleukin-10, which is then recreated by SASP.

 

It is a nuisance when CRP is below the measurement threshold.  AFAIK it comes in part from IL-6.  IL-6 is also part of SASP.  

 

My own approach is to aim to make senescent cells function.  My experience with hair follicles is that they do start functioning - slowly and not particularly well.  However, if they are doing that then at least they are probably not emitting IL-10.   I think it is IL-10 that creates patches of senescent cells and it probably does not go that far.

 

There is a really big problem with the reliability of blood tests.  I do weekly tests and have moved to a lab that I take my sample to personally and which does a same day test.  I am in fact at times doing two tests of the same sample (in the sense that I fill a number of vials of blood from a single needle, the actual serum levels of biomarker will be pretty much the same although not precisely the same depending upon how many decimal points of precision one is working to).

 

On 16th June for glucose the postal lab came back with 3.7 mmol/L the lab I took the sample to came back with 5.57 mmol/L

 

There clearly are biomarkers that metabolise in blood (this is well known). Other ones don't  eg Aspartate Transferase hand delivered-19.98 postal 20. (IU/L)

 

IMO the worst was creatinine hand delivered - 85.64, postal 122.   In this case the postal lab indicated I had a kidney disease.

 

The hand delivered lab I used this week gave me same day results within 6 hours of me handling in the sample and the result for creatinine was 74.37 (umol/L)

 

Coming back to Glucose the postal lab once phoned up my doctor to say my glucose was a dangerous 2.9 mmol/L which was a value mainly created by delay in testing.

 

 

Looking again at your figures you need to know the time between sampling and testing.  I would not be at all surprised if the variation in your creatinine figures was entirely a different delay in testing.

 

MCV going up in EDTA indicates delay as well.  It may also be caused by a warmer environment.  (winter vs summer) Hence I think your second sample had a longer/warmer period between sample/centrifuge/test than the first.

 

I intend doing a couple of tests later in the year where a sample of blood is centrifuged and then sent to a postal lab and compared to the same day service.

 

 

 

 


Edited by johnhemming, 02 July 2022 - 09:15 AM.

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#3 resveratrol_guy

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Posted 02 July 2022 - 03:45 PM

Thanks for mentioning IL-10. I had no idea about that. I was just measuring those particular parameters based on suggestions from my doctor.  It's hard to say what's up with my IL-6, for that matter. Wiki says it can be (anti)inflammatory depending on the cause.

 

Your comments about postal issues are well placed. At least in my case, I was inside the same Quest branch both times, which has a refrigerator onsite and their own specialized equipment used to transport samples to the lab. My appointments were also within an hour of each other both times. Not that that solves everything, but it's a lot better than a hot postal truck.

 

And you're right: TPE doesn't do anything to remove or remediate senescent cells. It just gets their pollution out of the way for a while, which does have a synergistic effect of allowing the organs to function better courtesy of less noisy cellular communication.

 

The glucose discrepancy is an oddity. I doubt that such a professional setup could just mistake 70 for 45. It also seems unlikely that, even if I had unstable blood glucose (which can happen in diabetes), that after 84 hours of fasting, it would still be bouncing out of control. So it seems real. On the other hand, the HbA1c is telling a far less impressive story. It's almost as if the most durable benefit of the therapy was to allow me to reach much deeper depths of ketosis when fasting but otherwise had no material effect on glucose control. Well, that, and the beautiful collapse in TNF. (I suspect the TNF had been coming from my shin, but perhaps I'm wrong. Either way, forcing it back down can only be a good thing for suppressing brain fog.)


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#4 johnhemming

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Posted 02 July 2022 - 04:26 PM

It is difficult to say without further information, but I would watch the MCV.

 

My view on type 2 diabetes is that it arises from too many pancreatic cells becoming adipocytes which is a differentiation issue.  Luckily one of my protocol participants can test that.


Edited by johnhemming, 02 July 2022 - 04:28 PM.


#5 resveratrol_guy

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Posted 03 July 2022 - 12:25 AM

Thank you, I had never heard of such a connection, so I'll monitor it. My MCV hit 95 back at the end of 2015, then backed off to the 86 that you see above (6 years later). Could you explain the reference to your protocol participants?



#6 johnhemming

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Posted 03 July 2022 - 03:25 AM

I would expect that blood used to test for MCV etc is stabilised in EDTA and if left too long MCV trends up. Two main causes otherwise: alcohol, shortage of B12/ folate

https://pubmed.ncbi....h.gov/10089718/

I have a protocol which is designed to improve differentiation of cells. My own hba1c is quite low (and has been going down), but there are 7 people currently that i am working with on the protocol and i expect that we will see the effect on some of their results.

Edited by johnhemming, 03 July 2022 - 03:36 AM.


#7 resveratrol_guy

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Posted 04 July 2022 - 02:30 AM

I would expect that blood used to test for MCV etc is stabilised in EDTA and if left too long MCV trends up. Two main causes otherwise: alcohol, shortage of B12/ folate

https://pubmed.ncbi....h.gov/10089718/

I have a protocol which is designed to improve differentiation of cells. My own hba1c is quite low (and has been going down), but there are 7 people currently that i am working with on the protocol and i expect that we will see the effect on some of their results.

 

I had no clue about the MCV thing. I'll make sure to do another CBC next time so I can keep tabs on it (and ideally on a cold day near the lab). Thanks!

 

If you post about your protocol, feel free to drop a link here. I'm always looking for cheats to lower HbA1c without really trying!



#8 johnhemming

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Posted 04 July 2022 - 06:59 AM

https://johnhemming....cent-cells.html

 

My Hba1c went from 30 to 24.  That may be a testing artifact, but probably isn't. In % that is I think about 5% to 4.3%.



#9 resveratrol_guy

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Posted 05 July 2022 - 12:57 AM

https://johnhemming....cent-cells.html

 

My Hba1c went from 30 to 24.  That may be a testing artifact, but probably isn't. In % that is I think about 5% to 4.3%.

 

Uh, so you're 62 and you have an HbA1c of 4.3%? Can you please double check all the numbers? In my hardcore fasting days, at 35, I never went below 4.9% and I was lean as a rail. I'm sure that I was nowhere near 4.3% even in my keto period, several years later.

 

Unfortunately for me, I'm in no position to sign your NDA but I hope you'll publish more on your protocol in due course. Your sprouting black hairs are intriguing. (The state-of-the-art in hair repigmentation is a lung cancer therapy, if I recall, which was covered somewhere here several years ago.)



#10 johnhemming

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Posted 05 July 2022 - 05:18 AM

I have not always tested for HbA1c, but I have the following resullts:  1/5/21 - 4.9, 8/2/22 4.8, 31/5/22 4.9, 23/6/22 4.3

I am testing every week now and will have another result on Thursday.  4.3 may be an artifact, but it is possible it is not.

 

My view on HbA1c is that it demonstrates the response to glucose.  Individual responses to glucose vary depending on how much the pancreas has a tendency to absorb fat. Hence some people are diabetic when they are quite lean and others are not diabetic even if they are obese.  My hypothesis is this about some pancreatic cells not functioning properly and becoming adipocytes.  

 

 

More recently I have obtained a better understanding of the metabolic pathways for my protocol and how to facilitate them.  However, whether that impacts on the biomarkers I cannot say as yet.  I want to see consistent results rather than just one week's figures.

 

The May 2021 result was just after losing about 33% of my body mass

https://twitter.com/...381767866441728

 

There are a variety of new hairs, some are white and some pigmented.   They are generally, however, finer.  The second person who went on to the protocol was not bald.  He says his hair is growing more quickly.  Hence there is clearly some effect on hair.

 

 


Edited by johnhemming, 05 July 2022 - 06:04 AM.

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#11 resveratrol_guy

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Posted 06 July 2022 - 01:16 PM

Yes, it does stand to reason that it's possible to have pancreatic senescence manifest irrespective of overall adiposity. Either way, that 4.3% is way way out there on the distribution, so I'll be very interested to see your next measurement. If it comes back low again,then it's probably time to try another lab and/or a home test kit. My assumption is that it reflects shoddy lab work, but if it doesn't then it's seriously interesting.



#12 johnhemming

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Posted 06 July 2022 - 07:03 PM

With a bit of luck i will know by 5pm tomorrow. I am happy with this lab (I am still doing two tests tomorrow) i think i have sussed out some important points, but will find out tomorrow.

#13 johnhemming

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Posted 07 July 2022 - 03:02 PM

Apologies I had some confusion between labs and my blood test today does not have HbA1c.

 


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#14 johnhemming

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Posted 19 July 2022 - 05:37 PM

I did a blood test this morning and now have a result of 4.38 for HbA1c.  There was no testing delay and I kept the sample in a cooled bag as I drove it to the lab. Hence I think it is probably accurate.



#15 resveratrol_guy

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Posted 24 July 2022 - 04:34 PM

I did a blood test this morning and now have a result of 4.38 for HbA1c.  There was no testing delay and I kept the sample in a cooled bag as I drove it to the lab. Hence I think it is probably accurate.

 

Any chance you can use a different lab next time? This is just astonishingly low if true.

 

One interpretation (apart from testing error) is that you're on something close to a zero-carb diet. Another interpretation would be that you're not all that low-carb, but you're somehow interfering with the glycation of hemoglobin, intentionally or not, which would be impressive but plausible.



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#16 johnhemming

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Posted 24 July 2022 - 09:10 PM

Looking at my history with various labs I have (starting with the oldest) 4.9, 4.8,4.9,4.5,5 (but measured on blood that had sat around for at least 24 hours),4.38

 

I intend using another completely new lab soon, but need to wait for something to change first (which may happen this week). I have not checked whether that includes Hb1Ac.

 

My own view is that my HbA1c may be low because I have avoided having cells in the pancreas which store fat.

 


Edited by johnhemming, 24 July 2022 - 09:13 PM.

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