Therapeutic Plasma Exchange: The Future of Detoxification

16:42Dr. Paul Savage:Yeah, I was the ER doc. I always say getting to health and wellness was my penance for all the stuff I did in the ER. Because I would have people show up at the middle of the night with really terrible problems like chronic fatigue, fibromyalgia. And I basically reiterated what I was taught is, what are you doing here? this is a psychological disease. You need to see a therapist get out of my emergency room. And I was that kind of asshole. In the ER, I mean, I was a very good ER doctor, but there were times that I looked back and said I was very inappropriate to a lot of the patients, and I didn't realize it at the time.

17:19Gwyneth Paltrow:Well, you didn't know what you didn't know.

17:21Dr. Paul Savage:You didn't know what you didn't know. And then when I got sick, and then I got better, and I realized at that point that there's this whole world out of there that I always was told was quackery. But when I found this new field and this new way of looking at things, where it wasn't just my hormones, he was also talking to me about my microbiome, and he was also talking about my nutritional needs. And he was also talking about my stress management and my sleep, and how to detox, because I was incredibly toxic, even at that point. This was all fascinating to me. So I actually, he convinced me to go to a meeting of an association called the American Academy of Anti-Aging Medicine, which is still today labeled as quackery.

18:05Dr. Paul Savage:But I showed up within the first couple years of this organization when there was like less than 100 of us. And I remember walking into this room going, what am I getting myself into? But I walk into a room and I'm listening to them going, I'm in the right room. Because if you're in the room where you're the smartest person in the room, you're in the wrong room. And these people were way smarter than I was. And I was like fascinated by the fact that they really had a lot of science. And this is stuff I never heard of. I mean, this was about salivary testing for hormones. This was about urine testing for nutrients.

18:40Dr. Paul Savage:This was about all these different ways of testing for detox and why it was important about testing for toxins. and I was absolutely drawn in because like this is real and my mathematical mind could grasp it what they were trying to say and they were all getting together to talk about what the next phase of medicine could look like.

19:01Gwyneth Paltrow:And what year was this?

19:03Dr. Paul Savage:1999. So this is early. Oh I was way early adopter. I was way early adopter into this. The only me too. The only early I know the only The earlier adopter than me was my mentor, Dr. Pamela Smith, who had been in it for 40 years. And she was at the first meeting. And then it was kind of funny because I met her later at this meeting. And she was my residency director in ER back in the day that she took off. And I didn't know she was actually becoming one of the national experts on hormone therapy for women. So it's always serendipity. Serendipity is such an amazing thing in my life.

19:39Gwyneth Paltrow:Yeah. Yeah. You know, it's so interesting to hear you talk about that because, you know, you are, you are a doctor who kind of really has lived through this pre longevity, you know, you had a full career almost pre, which is, and you know, and now the longer,

19:56Dr. Paul Savage:And then I retired. Right.

19:59Gwyneth Paltrow:And it must be interesting to see from that vantage point, you know, that I said, what do you think now about like this kind of craze around, you know longevity or i mean i think it's really so as a patient as somebody who's been trying to figure out their own stuff for a long time which you helped me a lot with i'm so i don't know it's it's sort of thrilling to see medicine start to accept that we are one whole organism with a system that is all interconnected instead of what you said like you have one symptom you get a pill for that symptom. And it seems to be that the consumer, aka the patient, has really led medicine in this way, which I think is so interesting.

20:47Gwyneth Paltrow:Always.

20:47Dr. Paul Savage:You know, it's been fun for me. You're right. Because back in the day, way back in the day, I started out with hormones, with the natural bioidentical hormones. And I was very grateful to build a company. I think I told you about this, but my first company was called BodyLizocMD. And it had to do with giving bioidentical hormones to men and two women, both very early on. But when I first started, I was just going to do men because there was a lot of people doing the women, like Diane Swartzbein and Pamela Smith. And then it must have been like not even a couple months into opening my first clinic.

21:19Dr. Paul Savage:And my office manager came into my office and he goes, Suzanne Summers is in the waiting room. And I was like, Suzanne Summers, three company, Thigh Buster, Suzanne Summers. He goes, yeah. And now mind you, I'm doing men's health. And I'm like, okay. He goes, she wants to talk to you. And I said, well, send her in, have her come in. She came in. And this woman is still, in my opinion, the woman who probably most shaped my career early on. She's powerful. She's smart. She was a patient advocate. It's nothing like the Christie that you saw on Three's Company. This woman was amazing. And she came in and she sat down and we talked for a little bit.

22:02Dr. Paul Savage:And then she looked over to me and she goes, I need you to do me a favor. I need you to treat the women. And I said, but you know, Ms. Summers, I think I got this really neat idea here of just treating guys, you know, and nobody's doing that yet. And it's kind of a niche. And I think I can really build that into something. And she looked at me, she goes, Paul, you treat the women, they'll bring their husbands. So from the hormones, it went to the microbiome, it went to the brain, it went to the immune system. And one by one, I just started compiling more and more information from the longevity world or the integrative world.

22:39Dr. Paul Savage:I like the word integrative medicine because I'm not against medications. I want to use them. I want that to be a tool in my tool belt. I just don't think that it's only medications that I want. I want everything else. And so I like the word integrated medicine because that means you're integrating traditional with all this other stuff.

23:00Gwyneth Paltrow:So then at what point, you know, you're studying these systems, you're studying hormonal pathways and the gut brain access and all of these things. And so at what point are you starting to say to yourself, what is the link between these chronic things like fibromyalgia and toxins? How did you make that connection? Because you were very early there as well.

23:23Dr. Paul Savage:So I built BodyLogicMD from 2002. I left in 2008. The whole idea with BodyLogic would get all these centers up, and then I get to go build this software system that integrates all the clinics because there wasn't any program that gave the doctor the ability to just use one software. And so then I went on to build a company called Power to Practice, and that was the first EHR that was built for the integrative space and decided I would move on to get into the chronic illness people. And these are the people that I used to tell get out of my emergency room. I mean, these are the fibromyalgias, the people with chronic Lyme, chronic fatigue.

24:03Dr. Paul Savage:And during this period of time, because the five tenets of integrative medicine, the personalized medicine is exercise, nutrition, sleep, stress management, and detoxification. And the detoxification stuff is something I've always been aware of. I knew it was a problem. But watching it for 30 years, 30 years ago, it wasn't that prevalent. But around 2015, it really kind of took a turn. And that was the same year that Stephen Hawking said that the only threat to the existence of humans is pollution and our stupidity to it. And that resonated with me. And we had tools to deal with detoxification, you know, with cleaning up your diet, elation for heavy metals.

24:47Dr. Paul Savage:We had binders for molds. We had saunas for a lot of different things. That worked. That used to work. I mean, I always tell people, detoxification 20 years ago was me sitting in a sandbox with a sand shovel, and how long would it take me to empty the sandbox using the sand shovel? I could do it, but it would take a while. Suddenly, that sandbox just kept getting bigger and bigger, to now it's the size of Miami Beach. And all these things that we had wasn't enough anymore. because now there was the PFAS, the forever chemicals, non-removable. A lot of the pesticides, the plastics, I mean, they didn't come out no matter what you did.

25:27Gwyneth Paltrow:And why doesn't the body know that it should push them out or why can't the body push it out?

25:33Dr. Paul Savage:The body just doesn't have a mechanism to break it down. I read one paper about how serial plasma exchange made people with mild Alzheimer's much better. And then I read another paper about how serial TPE reversed the biomarkers of aging, including making telomeres longer, immune system stronger, inflammation down. My brain put the two together and said, wait a minute, the two things that those two entities have in common are toxins, are chronic toxins. And so I said, the only way you could have that result is that you got the toxins down. It was a very spiritual moment for me. Another one of those corners of my life.

26:10Dr. Paul Savage:When I read that second paper, I was standing on the balcony in Brazil of our apartment, and I must have been standing there for a half hour. My husband came out and said, what's wrong? And I turned to him, and I had tears going down my face, and I said, I think the universe just gave me an incredible gift. I think I know how to fix the toxin problem. It's just that's never been needed. We don't have it, so you can't get rid of these things. Even when you looked at the CDC website about PFAS, the Forever Chemicals, it says there's only one therapy, and that's avoidance. Don't let them in because the half-life is like 25 years before it breaks down to half the level.

26:51Dr. Paul Savage:The body never had to learn, how do I get these things out of the body? Because they had never been in the environment before.

26:57Gwyneth Paltrow:So how does the immune system react to something that it can't identify?

27:01Dr. Paul Savage:Oh, it can identify it.

27:03Gwyneth Paltrow:It can identify it. It just can't break it down.

27:05Dr. Paul Savage:Right.

27:05Gwyneth Paltrow:So is there an inflammatory response to that?

27:08Dr. Paul Savage:That's what the immune system does is it sends out the antibodies and the antibodies start attaching to the toxins. And that causes this inflammation response. It's very interesting because when you start putting together with the fact that if you look up the definition of chronic inflammation, just chat GPT, it will say caused by diet, lifestyle and environmental toxins. But that's all it says. We haven't really quite put together yet. What is the real cause? I'm pretty sure I know what it is now, and especially in a lot of these people in many of the cases, because with this new method that we devised of utilizing not only TPE and series, but adding things to the TPE in an integrative personalized medicine approach, now we have what we call advanced serial TPE, and we're getting these toxins out, and we're also seeing the immune system get stronger, less confused, inflammation drop, oxidation dropped, telomeres get longer, cancer markers dropped, Alzheimer's patients' memory getting better.

28:08Dr. Paul Savage:So suddenly we put together this protocol and I'm relatively confident that a vast majority of chronic inflammation is toxin related. It's the immune system attacking the toxins, but you can't get a lot of these toxins out.

28:24Gwyneth Paltrow:Even with TPE?

28:25Dr. Paul Savage:No, with TPE we get everything. It was kind of like this keystone about TPE fell into place and suddenly all the bricks fell into place around it. And it had to do with marketing, which was my first company, and computer software, which was my second company, and toxicity, which was my third company, and knowing about integrated medicine, which is where I've been for 30 years. And had challenges with all those companies and been through a lot of difficult times in my life because of those things. Suddenly, my life came into focus. I was like, it was kind of like God said, this is why you did all that stuff, because now you need to do this.

29:00Dr. Paul Savage:by this point I was already retired because I'd realized the toxins were not going away and I couldn't get them out and I couldn't look at patients anymore who I'd been treating for so many years and give them assurances that I could get them better because I didn't believe I could anymore I just didn't think that I didn't have any tools left in my tool belt and so I retired and moved to Brazil because, fortunately, Brazil is a very toxic minimum country. I mean, we in the United States in 2003, it was reported that we put 100 million tons of toxins into our environment that year, of which 65 million tons was air pollution.

29:48Dr. Paul Savage:25 million tons were industrial toxins, and about 10 % were what we call high toxicants, with 2 million tons being the worst of the worst. And that's just per year.

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31:51Gwyneth Paltrow:So I want to get into my case a little bit because, well, I think the results are. So I mean, it's funny. I think it was the 90s when my father was diagnosed with cancer, which kind of put me on this whole path of trying to understand why people get cancer, which is too complex and difficult, I think, for anybody to fully understand. But I had, I guess, some kind of an instinct that my father, the toxins that he had been exposed to, right? Cigarettes, alcohol, whatever else. obviously we knew things like that played a role but as he was being treated i thought you know what else what else should we be looking at what else should we be doing you know it comes from that place of heartbreak and desperation and that's when i started to contemplate like and ask the questions what is in this stuff what is in fire retardant that we're spraying on everything you know what is in pesticides what is it doing to our body this is like very early.

32:58Gwyneth Paltrow:And I remember even starting to talk about detoxification. I remember at Goop, when we started to talk about detoxification, getting a lot of shit in the press and from doctors saying the body knows perfectly well how to detoxify itself. This detox thing is quackery, which turned out not to be the case because as you say, and have tons of data and research behind, we are exposed to so many toxins that the body does not know how to detoxify from. And what I came to understand about myself much later is the genetic mutations that I have that make it specifically hard for me, you know, on top of everything else.

33:39Dr. Paul Savage:Individual susceptibility.

33:40Gwyneth Paltrow:Right. So when I came to you and said, okay, I think, you know, I have a feeling and instinct that I might be carrying extra toxins, and you set out to give me these labs that I have before me. What did you find?

33:57Dr. Paul Savage:What I found when I got your toxin report back is you are one of the top toxin-carrying women or patients I've ever seen in 40 years. You had more toxins on your toxin report than I had seen except for a very rare occurrence.

34:16Gwyneth Paltrow:What were some of those toxins?

34:18Dr. Paul Savage:You had everything. I mean, you had mycotoxins, you had plastics, you had phthalates, you had pesticides, you had herbicides, you had heavy metal, you had the whole gambit of even, and you had the whole gambit of everything. And which is not uncommon because we all carry toxins, It's just certain people carry more than others. In our original research that we did in 2003, where we looked at about 300 people who are healthy 50 to 65-year-olds, that we did toxin tests on them, the average number of toxins in the high range were 5, and the average toxins in what we call the suboptimum range were 8.

34:55Dr. Paul Savage:We'll get into that range issue in a moment, just to say, but that's just kind of how we, to compare to people, that's what we're looking at. I said about 13 toxins on healthy people. And you had 47 or 49. I forget. I was like, wow. And this was out of 109 toxins that we test for. Now -

35:15Gwyneth Paltrow:I'm an overachiever, you know.

35:17Dr. Paul Savage:Yeah, obviously, obviously. That was, it was impressive. I was, but back to the group I was talking about that we tested, they were all around 13.2 total toxins, plus or minus five. So it went from eight to like 18. That's where the vast majority of people were, except for this group of women. And they were all women. They're all in their 50s or above. They're all low body weight. They all have a tendency to have been using beauty products throughout their life. And they tend to have bad detox genes. So these were characteristics. So I already knew when I met you, I was like, yep, you might end up being one of these women in this high category.

35:58Dr. Paul Savage:Little did I know you'd end up being the highest woman in that category.

36:03Gwyneth Paltrow:And so in a way, I was relieved to hear that because I had been dealing with fatigue and brain fog and all of these issues. And I was happy to know that there was actually a reason that I was symptomatic.

36:21Dr. Paul Savage:We, at the time, we thought that might be the reason. We didn't know because one of the things about this type of medicine with detoxification, the way we're using with plasma exchanges, you don't know until you remove, you get some of the toxins, get that level down, get that toxic load down, and then patients get better. Now, I'm very grateful to say the patients that we've selected to work with that they've gotten the vast majority, 95 % or more, have also gotten better during the process. But I always tell people, as I've told you, this isn't the end of feeling bad. This is the beginning of getting better.

36:55Dr. Paul Savage:Because once you unburden the body from this chemical burden that some susceptible people have, now the body can start functioning the way it knows how to function. Because these toxins interfere with everything, including your energy production. It occurs in the mitochondrial level, where the mitochondria are generating energy. These toxins inhibit all that. It actually inhibits biochemical pathways. It actually causes a lot of immune system dysfunction. But also in the biopath, the biopathways that toxins interfere, it also interferes with your detox pathways. So here's the double door, right?

37:35Dr. Paul Savage:It's not only do these toxins make you toxic, but they inhibit your ability to get rid of them. So then all of a sudden it starts snowballing.

37:43Gwyneth Paltrow:Right. So what can you, can you talk a little bit about, I'm giving you permission to share a little bit from my case, like what were you really happy with after the five sessions of TPE?

37:57Dr. Paul Savage:The thing that I was most happy about and thrilled with is that you felt better. I like watching trends. I like watching numbers. But if the numbers are going the direction you want to do and the patient's not feeling better, then you're really not doing anything for the patient itself. And I have a lecture that I give to very frequently to doctors called Mathematics, Medicine and You, Why You Can't Paint Medicine by the Numbers. Because doctors are so ingrained about, oh, your numbers are fine, so therefore you're fine. No, that's not true. Matter of fact, one of the things about toxins is it's so insidious, it's so slow, that it starts breaking down your energy production.

38:41Dr. Paul Savage:It starts breaking, your immune system starts to dysfunction. The people start noticing brain fog, and they start noticing this fatigue that never quite goes away. And they have all these other symptoms like anxiety, irritability, not sleeping well. And it's all doctors attributed to your labs all look fine because they're doing traditional labs. And your symptoms are so vague that they're like, this is just part of aging. And it's not. That's the whole thing here. So the thing that I was most grateful about is I got your lab results back on the final one, and I was very impressed on how well you had done.

39:15Dr. Paul Savage:I mean, you are an overachiever, and you knocked it out of the park because you did the parts that were important. Our program involves not only serial plasma exchange, one every month, and we do it once a month because the studies that we've done found out that you get the most toxin removal if you give a month between the plasma exchange. because the tissues have to release their toxins back into the plasma. If you do the plasma exchange too quick, you're not getting the bang for the buck. But we also added into a 65 different nutrients that we put into a powder drink. We also added in to an IV, we give back of IV nutrients.

39:55Dr. Paul Savage:So where the plasma changes and oil change for people, the supplements are kind of like the air for the tires, the gas for the tank, and the spark for the plug. We're rebooting the system. And then finally, you're pretty good with knowing how to keep your toxic levels minimum in your house, which I tell people all the time. Before you do plasma exchange in our program, you need to put things into play in your house with water filters and air filters, learning what's dangerous in your kitchen and getting rid of it, because you need to minimize your toxic exposure. You can't get it to zero, but you can bring it down a lot.

40:36Dr. Paul Savage:And it matters for the people that have too many toxins and like you who are susceptible. Yeah.

40:42Gwyneth Paltrow:And it's why, you know, obviously this is no surprise, but why we think clean beauty is so important and good, you know, until I was about 32 years old when I first was, when I had my kids and it was the first time that I started to question fragrance and microplastics in products. I mean, you know, all these things we put on that are transdermally absorbed that are really not good for us and which accumulate over time.

41:10Dr. Paul Savage:Yeah. And that's a huge factor in that group of women that I'm talking about is not only are they 50 plus, so they've had a lot of time to accumulate that data or that amount of toxins, because a lot of these toxins, the phthalates, the plastics, the things that are in beauty products, the heavy metals, the lead, These things accumulate in the body.

41:32Gwyneth Paltrow:Yeah. So give me a couple of examples of things that turned out really well pre and post.

41:40Dr. Paul Savage:So your toxin levels massively decreased. From 47, you had, I believe, 28 in the high critical level, and they went down to 7, I think, right? I think so. So it was like a 70 % decrease in all the ultra-high chemicals. and then in the suboptimum level that went down by an amazing amount too like i think it went down from 28 to 19 on that level so overall your toxin your total toxic burden if you want to call it that of the toxins we measured went down over 50 so people are like well it didn't go down to zero i never try to get people to zero you would have to do a lot more plasma exchange what i try to do is get the levels low enough so that your body can resume more normal biochemistry.

42:30Dr. Paul Savage:And so that if you start feeling better, your brain fog gets better, your depression and anxiety goes away, your sleep gets better, the aches and the pains that you might have had go. These are the things that I'm really judging and looking at. So besides the toxin test, the other one that I was really thrilled by was your CNS vital signs. This is a test on your neurocognition. You do it on the computer. It's been around for 20 years. It's been used a lot in research. It measures the memory. It measures your motor skill. It measures your executive function. And you scored well on your first test.

43:03Dr. Paul Savage:But you scored almost perfect on your second test. And so I saw the toxins go down. I saw your...

43:11Gwyneth Paltrow:And the microplastics went down by like 90 % or something. And your microplastics went down 91%.

43:15Dr. Paul Savage:Amazing. Yep. Which is, again, this program that we've not yet found a toxin that this doesn't reduce. This is a universal, safe and effective way of getting out virtually every toxin. The other thing that I was very pleased to see were your hormones got much better. Your adrenals, your cortisol levels, which were spiking in the morning and spiking at night, which is very not healthy because that's not the way the body works, had actually leveled out pretty normally by the time we were done, which means that we must have gotten the inflammation out because the cortisol is your anti-inflammatory.

43:53So it normalized because, and your inflammatory markers went down.

43:58Dr. Paul Savage:And then finally, your immune system got much better by 25 to 40%. And then we also saw your oxidating factors fall as well. So there wasn't any category that you didn't improve on. But I remember seeing the results and you and I hadn't talked for a little bit. and so we were going to get on this virtual meeting and go through these things and I remember thinking god I hope she feels better because these numbers look great and then you told me I feel amazing and so how how did you change symptomatically what were you like before and then what what are

44:32Gwyneth Paltrow:you like now yeah I was really really struggling before I came I had extreme chronic fatigue brain fog and you know i couldn't tell what was what right it's like is it because you're in perimenopause is it because you have you know old lyme markers in there even though they're not active is it because you have dysbiosis in your gut it's like always like a multi-pronged and it

44:57Dr. Paul Savage:still is and it still and it still is but here's the interesting thing is the toxins just add this level of severity right to the whole program right because the hormones don't work the way they should. So you're still in perimenopause. I mean, the interesting thing is when we're done, your hormones started out kind of oddball distribution, but on the low end. And by the time we're done, you're way over the top because you were overdosing on the hormones because the toxins were interfering it. So you took more because that should overpower the toxins. But the fact is it doesn't work because the toxins are binding up the receptors.

45:33Dr. Paul Savage:And now that the the toxins were gone, the dose that you run, we had to reduce, we got to cut you back on your hormones now because they're working better. So I should stop for a second here and mention something. I had two dozen scientific advisors behind me, including top leading cardiologists, neurologists, oncologists, gynecologists, obstetrics, rheumatologists, stem cell experts, lab experts, and they all advise this company about how to proceed forward as we start kind of trying to untangle this gorgon knot of toxins as it is and try to really define out what is the toxins and what is all the other stuff.

46:15Dr. Paul Savage:Because this is just one piece of the puzzle. So the backbone of our protocol is the timing of the TPE, the number of the TPE, the supplements that we use, and the avoidance therapy. Matter of fact, it was so novel and the results were so amazing that we actually got an international patent and we've taken that procedure and said, now, how do we really apply this to the mold patients, the Lyme patients, people with autoimmune diseases, people with cognitive issues, either cognitive decline or early Alzheimer's? How do we apply this to people with heart disease? Because this is all part of it. It's not that the toxins are the end-all, be-all cause of everything bad, but they sort of complicate all this stuff and add a level of difficulty that if you can and you can remove these toxins, patients get better.

47:07Right, right.

47:16Gwyneth Paltrow:So, I mean, when I came for the first time, I think I brought one of my best friends, Beatrice. That was the first time it came, right? And that first TPE, I was, you know, you, you had said you might feel something you might not, you might feel a bit sick. Everybody has a different response the first time. I felt amazing after the first one, like I felt this immediate unburdening and clarity and lightness and Beatrice felt the same way as well. and that just sort of continued over time. And I mean, it's in the data, right? You can see these markers and, and how, and how they've gone down. And I think just giving, giving my body the chance to return to, you know, a state where it can deal, right.

48:03Gwyneth Paltrow:It's like you've taken out all, all the trash. Are there downsides to doing it? Are there any people who aren't candidates for this? So are there risks?

48:16Dr. Paul Savage:I guess there are always risks. There's always risks for everything. And plasma change is not the exception. Although in the world of medicine, plasma change is considered to be a relatively safe and effective procedure with very minimal risk. The difficulty for MD Lifespan is that we are setting up centers in doctor's offices, not hospital settings. And there are just some people who are too sick for us to do in an outpatient setting. So one of the first things that we do with patients is we put them through a screen. Because if they have, for example, if they can't walk, you know, if they're not ambulatory, if they don't follow orders, you know, if they can't sit in a chair and stay there for four hours and squeeze the ball and work with our nurses, we just don't have the personnel to make this happen.

49:06Dr. Paul Savage:Because you can't give these people anesthesia because plasma exchange is taking everything out of the plasma, including the anesthesia. So we have a lot of patients that we just don't have the facility to work with right now. We also can't do people who are on blood thinners because they have multiple blood clots because plasma exchange takes out the blood thinner. We don't do it on patients who have epilepsy that is not well controlled. We don't do it on people that have asthma that need their medications and aren't well controlled. So we have a whole list of things of people that we can't do or we choose not to do simply for patient safety and the fact that we're doing it in an outpatient setting.

49:45Dr. Paul Savage:But the vast majority of people do qualify to move forward. The side effects for plasma change are limited. Again, you're taking everything out, good, bad, and ugly. So one of the more common things we see is people get a little low blood sugar. because again, your sugar runs in your plasma. But we have people eat a very complex breakfast and we frequently give them juices or protein shakes and that's what we see is the low blood sugar happens with people that are thinner, less weight because they don't tolerate sugar changes a lot, not like you have a lot in your blood as well. But the other thing that can happen is sometimes people get a low blood pressure because you're moving fluids around, especially patients that are on ACE inhibitors or certain blood pressure medicine.

50:32Dr. Paul Savage:We have to be careful of that. There are certain people who get a low response to low calcium because we're giving you a natural product called citrate that we add into the tubing before the blood goes through the machine to make sure that the blood doesn't clot. So this citrate binds calcium. Calcium is needed for clotting. So we make your blood low calcium as it goes through the machine. but then we add it back in the albumin that we're giving back to you at the end. So we don't see that very often. There are some people that get an allergic reaction to the citrate, and they get hives over their body.

51:06Dr. Paul Savage:It's not dangerous. It's not the type of anaphylactic where you can't breathe and your lips swell up. This is just a rash that is itchy and it's bothersome. That happens most commonly in people who are hypersensitive. And what I mean by that is a lot of the patients that come to us is, what can I do for you? I respond negatively to everything. I think of one of our clients who was a patient of mine for many years. She couldn't go to restaurants because the fumes would take her down. She couldn't go shopping because the perfumes would bother her. She couldn't go to the stadium or anywhere there was smoking because the smoke would bother her.

51:40Dr. Paul Savage:She would use epinephrine pens frequently. She'd be on steroids a couple times a year. And we put her through this process. And by the end of it, she's much less hypersensitive than she was originally, significantly so. So it's been, you know, but those are the patients, those hypersensitive patients, she got a rash. And so we're kind of getting like, we kind of know who's going to do what. And with you, I always let people know, you know, you might be tired. You might have difficulty. Probably the ones that have the most difficulty with the procedure are the people who are chronically ill with a chronic infection.

52:17Dr. Paul Savage:or a chronic fatigue or mold toxicities, we generally do a half procedure on them, not a full procedure. Because those patients are patients that I've treated for 30 years that stay a mold toxic person. And you just give them a little bit of any medicine and they react negatively to it. So they're hypersensitive from these type of things as well. So when you do a fold exchange and that really changes those levels a lot, the body really can react quite dramatically to that.

52:49Gwyneth Paltrow:Interesting. So if TPE is a clearing, what comes next? Like what does the body do after the clearing?

52:59Dr. Paul Savage:It resumes normal activity. It just

53:01Gwyneth Paltrow:resumes normal activity. And you build more plasma and that plasma is clean?

53:07Dr. Paul Savage:Correct. So when we take out your plasma. We give you back albumin. Albumin is like this little sponge that's in the plasma, and it grabs everything, including toxins. So it's a good replacement fluid. By the way, these centers that are using other people's plasma for you as the exchange, don't go there.

53:28Gwyneth Paltrow:Okay.

53:28Dr. Paul Savage:Period. End of story. Plasma from another person has a risk of transfusion reactions, And it's not a small risk. We're talking about adverse reactions when you exchange albumin less than 6%. Our center has less than 2.7%. But when you give somebody else's plasma, that risk goes up to 27%, including anaphylactic reactions where you can't breathe, and also something called TRAIL, transfusion-related acute injury to the lung. People go into congestive heart failure. Their lungs fill up with fluid in minutes.

54:04Gwyneth Paltrow:Oh, my gosh.

54:05Dr. Paul Savage:And they die. So I tell people all the time, there's this thing out in the longevity world like, I'm going to give you a young person's blood. I'm going to give you a young person's plasma. Don't do it. Okay. It's a really bad idea. This is an elective procedure. There's no reason whatsoever that you, this, it's not about what you're giving the person. It's what you're taking away. Right. That's what, this all started with those two mice that they sewed together in Stanford about 20 years ago, but put their circulation together, and the old mouse got younger. And they're like, my God, what is it that the young mouse gave the old mouse, and everybody went around for 12 years trying to figure out, is it growth hormone?

54:43Dr. Paul Savage:Is it a cytokine? And they couldn't find it because there wasn't anything that the old mouse gave to the, or the young mouse gave to the old mouse. It was what the old mouse gave to the young mouse, which was half the toxin load. Oh. That's what it was. It was getting... So it's not about what you're getting. It's about what you're diluting out. And so albumin is a much better choice.

55:06Gwyneth Paltrow:Okay. And albumin is... What is it?

55:08Dr. Paul Savage:Albumin is a protein. It's the most abundant protein inside your vascular system. It carries everything because your blood is water. And a lot of the stuff that wants to go through your system in the water tube isn't soluble in water. Fat, toxins, all these things need to be carried. So what the body does is it makes these proteins or other proteins, but albumin is the major one. And albumin basically wraps itself around this toxin or this fat or this whatever, and it binds it up so that now you can put it inside the water because all the water seizes the protein, which is the albumin. So albumin acts like a sponge.

55:52Dr. Paul Savage:It also acts like a carrier. Okay.

55:56Gwyneth Paltrow:Who is a good candidate to come and do TPE?

56:01Dr. Paul Savage:There's a couple of things we need to talk about here. A good candidate, you know, one of the things I want everybody to hear very clearly is not everybody needs TPE. Right. Period. Some people do. And those are the people who are symptomatic. Those are the people who have a lot of toxins, and we believe that there's a relationship between the type and the quantity of the toxins you have and the disease state. But also, there's a lot of people who aren't sick who are getting plasma change, and there does seem to be some real benefit from that because we're seeing their...

56:36Gwyneth Paltrow:Like as a longevity tool.

56:37Dr. Paul Savage:As a longevity tool because we're seeing their immune systems get stronger, their inflammation get even better, their oxidation get even better, The toxin levels go low. Their cognitive functions get better. The telomeres, which are the end of the DNAs, which are kind of like little bus tickets. So every time the DNA replicates, you lose a ticket. And when you're out of tickets, you're out of time. And so the plasma change in our protocol helps extend the length of those telomeres. That was a published study by Dobry Kiproff about two years ago. So there's a lot of this science out there already.

57:11Dr. Paul Savage:But the one thing that really needs to be talked about is the price. Right. I mean, that's a real... It's expensive. It's expensive, yes. MD Lifespan, when we built it three years ago, again, with all these other people that I'm working with who are amazing, we've all done real well in the world of medicine. And I'm very happy to help change so many different people's lives. But we decided at that point that we were going to make MD Lifespan a public benefit corporation. What that means for people is that the mission statement of the company is going to be on a bigger footing than the financial stake of the company.

57:51Dr. Paul Savage:We need to be profitable because we need to be able to pay employees and do everything. But this company will never be so overtly profitable. So all of us understand the need to bring this price down. Even though the process is still very expensive, we've been able to bring the price down substantially. Typically, plasma exchange around the United States runs between$5 ,000 and$10 ,000 every plasma exchange. And again, one's not going to do you much. You're looking at somewhere between$40 ,000 and$50 ,000 just for the TPE. The other thing at MB Lifespan is we finance internally, so we don't hit the person with the costs all up front.

58:30Dr. Paul Savage:We have it so that you can pay half down, and then you start paying the other half off at$30 ,000,$60 ,000, and$90 ,000 after you start the program. So I'm also very pleased to say in the last three years, we dropped the price by over$10 ,000, still adding more things into the program. And what we're seeing is our protocol, for example, our Toxin 3 protocol, which is three TPEs, all the labs, all the IVs, all the nutrients, all the doctor visits, all the avoidance therapy, works better than five serial TPEs on itself. Again, there's that difference. at so if you did five serial tps a lot of these places you're 40 to 50 000 our toxic three protocol is 23 000 and so even there i mean so you got to look at the what you're getting

59:15Gwyneth Paltrow:for the value yeah yeah absolutely so two two last things so where is your the md lifespan

59:23Dr. Paul Savage:protocol available so currently we have 12 centers so there and they can find those on our website at mdlifespan.com. We have locations just outside Manhattan in New Jersey. We have it in Detroit, Chicago, Tampa, Orlando, Sarasota, Miami, Houston, Denver, Mesa, Arizona, and Beverly Hills.

59:51Gwyneth Paltrow:I can tell you have low toxins. You have a very good memory.

59:57Dr. Paul Savage:and i'm very pleased to say we just signed a deal with a large group of clinics named cenogenics they're one of the leaders in the longevity world and they've we've gotten in to deal with them or we'll be putting one of our services in each one of those centers so that will expand to how many 20 more amazing yeah so again the biggest besides the cost the biggest problem is since people come once a month, it's the travel. I mean, you traveled to Chicago. And so, but now we have Beverly Hills, which is a lot closer than Chicago. Our goal is to have a hundred centers in the next two years. Currently we'll probably be somewhere around 30 by the end of this year.

1:00:38Dr. Paul Savage:And again, the more centers we get up, the lower the price can go down because it's economy of scale. And so that's really what's driving this whole thing.

1:00:46Gwyneth Paltrow:Congratulations.

1:00:47Dr. Paul Savage:Thank you.

1:00:48Gwyneth Paltrow:And tell me about the book that you have coming out.

1:00:51Dr. Paul Savage:So we have a book coming out. It's called Avoiding Toxins. This was written by myself and an author named Lisa Byer, who I've worked with for 20 years. But we've had contributions from one of the top clinical toxicologists, one of the top public health toxicologists, one of the top environmental toxicologists, one of the top mold toxicologists, and one of the best nutritionists that I've ever met. And we all got together because we realized that not everybody needs TPE, but everybody needs to understand how you can reduce your toxic exposure. Because we hear this all the time. Toxins are everywhere.

1:01:30Dr. Paul Savage:You can't avoid them. Toxins are everywhere, but you can avoid them. And it's not all that difficult. Right.

1:01:36Gwyneth Paltrow:You can't avoid all of them all the time.

1:01:38Dr. Paul Savage:But it's about minimizing your risk. I mean, there's, and we, so we wrote a book that is more of a how to and gave examples of this is what air filters look like. This is what air quality monitors look like. This is what a dehumidifier looks like. If you're trying to get your mold levels down in your house, get your humidity down in the house. What do you think are the most critical interventions in terms of reducing toxins in a household?

1:02:08Gwyneth Paltrow:Is it a water filter? Is it an air filter? Is it your cleaning products?

1:02:11Dr. Paul Savage:It's the water filter. Is that number one? That's number one. Beauty products, number two. I mean, you got to stop putting these things in and on your body. I mean, that's just, I mean, and the air is number three. And mostly it's, yes, you need a HIPAA filter. But what you really need is a dehumidifier because mold is a huge problem for so many different people. Matter of fact, I see patients come to see us, and I've seen this for 30 years, and they say, I'm mold toxic. And they are. But what I try to explain to them is you're everything toxic, including mold, because it's the accumulative effect.

1:02:50Dr. Paul Savage:We have a lot of data on various different toxins and their toxicity to humans. We have very little data about chronic levels of low-level toxins of a lot of toxins in people and we don't know how these things cross react with each other my environmental toxicologist dr lynn patrick is frequently telling me one plus one equals a thousand in other words there's research out there that shows if you have two different pesticides it's just not you're doubling the difficulty you're probably multiplying it by a much higher level than that and that probably is true with a lot of the different toxins because all these toxins, they're toxins because they're toxic.

1:03:32Dr. Paul Savage:And that means they're not good for you. They all have different ways of injuring your body. But when you throw even a little bit of all of them into the mix, we have no real idea about what level that is safe for people. That's why we go back to the original conversation with you is, what am I trying to do? I want to start seeing people feel better. When I start seeing them feel better, then we can say, okay, now let's go do the avoidance therapy, Let's do some other with your functional medicine doctor. Because MD Lifespan, we aren't the long-term functional medicine doctors for people. We specialize in this.

1:04:09Gwyneth Paltrow:Right.

1:04:09Dr. Paul Savage:We do this well, which is why we've made a very, very nice niche. Yeah, absolutely.

1:04:15Gwyneth Paltrow:Well, I mean, thank you so much for doing it. I feel like it's materially impacted my health trajectory, and it's made a big difference. So thank you.

1:04:26Dr. Paul Savage:So you're very welcome. And so, you know, just as a reminder for people, this book, Avoiding Toxins, go to mdlifespan.com forward slash goop. This is free. This is a book written by some of the leading experts in the country. It's not fear-based. It basically gives you very good information, gives you very good suggestions, and helps you learn how to make yourself and your family and the people you love in a less toxic exposure world.

1:04:57Gwyneth Paltrow:It's a great Bible for that kind of thing. And it really is a gift that you are releasing this to the world. So it's such good information in there.

1:05:06Dr. Paul Savage:The other thing that I always tell people is everybody needs to do avoidance therapy and everybody needs to test their toxins because you don't know what you don't measure.

1:05:16Gwyneth Paltrow:So how do we do that? You go to a Quest lab. What if your doctor's like, this is crazy. I'm not giving you an organic acids test or whatever.

1:05:24Dr. Paul Savage:You can get the test from our website. You can purchase it from our website. And when the results come back, you'll talk to one of our clinicians, and we will help you interpret that. You can get it from any functional medicine doctor.

1:05:36Gwyneth Paltrow:It's a urine test. It's a urine test.

1:05:38Dr. Paul Savage:There's a lot of different toxin tests out there. And one of the things I want to say about toxin tests is you have to take it from the 30 ,000-foot view. What I mean is this. You had 47 out of 109 toxins. And we could delve into exactly what toxins you have, but that's irrelevant. It really doesn't matter all that much. What matters is that you had a lot and that you had a lot of them that were in the high levels that were what we call high toxicants. It's really the type of toxins that you have and how many that you have. because the world has tens and thousands of toxins out there, and we're only testing a very small sample.

1:06:18Dr. Paul Savage:So there's a lot of toxins that are in your body or have been in your body that we didn't test for. So many people come in and, I need to focus on this one toxin. No, you don't. You have to focus on all the toxins. So don't get too much into the weeds where people are like, this pesticide or this PFA and I suppose only really if it's, if it's, I mean, the thing about

1:06:45Gwyneth Paltrow:mold toxins is that it can, it's obviously like a canary in the coal mine for, right. And, and you can do, if you find the source of the mold in your home, that's obviously important to remediate, right?

1:06:58Dr. Paul Savage:Correct. So there's a very good company that we can recommend and you can get that from the book that it's a dust sample that you send off. I really enjoy that for the people who are mold toxic because then I can get your toxin test and I can compare the two and say, these are coming from your home or they're not coming from your home. So finally you can get the toxin testing. Again, there's a lot of different toxin tests out there. They're all good. There's none of them. Yeah, they're all good. I recommend, I do like the urine testing better than the blood testing, but there's most traditional doctors rather have the blood testing than the urine testing.

1:07:32Dr. Paul Savage:There's good and bads in both of that. But what really matters is people get tested. And I like the Vibrant America Total Toxic Burden plus PFAS because it's a lot of toxins for not a lot of money.

1:07:48Gwyneth Paltrow:That's great. Well, you know, my fantastic GootPod listeners are really curious about this kind of thing. And I think, you know, there's a great drive to have real agency over health and to be able to ask questions and look deeper. So I really appreciate your time here today. My pleasure. It's been so educational and thank you so, so much. Thank you for your life's work, which culminates in this amazing modality. Oh, thank you for having me.

1:08:16Dr. Paul Savage:Seriously.

1:08:21Gwyneth Paltrow:Thanks for tuning in. This has been a presentation of Cadence 13 Studios. I hope you'll listen, follow, rate, and review all of our episodes, which are available for free on Apple Podcasts, Spotify, Odyssey, or wherever you get your podcasts.