Daily function · ADCS-ADL
Everyday activities, such as dressing and managing daily tasks.
52%
less decline reported
p = 0.03
Statistically significant difference
+3.5 points versus sham
95% CI: +0.4 to +6.6
Start with what life feels like now
What makes plasma exchange appropriate for a condition?
We help people with unpredictable reactions, fatigue and brain fog by examining immune symptoms alongside other systems so that they can work toward a day that is easier to plan.
How we look at the whole picture
A meal, a smell or an ordinary outing can leave you feeling unwell, and the pattern is difficult to explain.
You may be tracking triggers while also dealing with poor sleep, fatigue or trouble thinking clearly.
You do not need to know which treatment to ask for. Start with what has changed and what you want to be able to do again.
The 7 Domains of Recovery™
Your symptoms may belong in the same conversation.
Immune symptoms can coexist with changes in energy, autonomic responses and concentration. We look across the seven domains without assuming that one label explains everything.
Neuregen's proprietary 7 Domains of Recovery framework organizes that conversation around seven connected parts of your life and health. We consider all seven, then focus the evaluation on the questions your history raises.
Explore our clinical framework- 1Brain function & neural networks
What has changed in your memory, concentration, balance or sensory tolerance?
- 2Autonomic & nervous system regulation
What happens when you stand, move, rest or encounter stress?
- 3Immune function & neuroinflammation
What immune history, reactions or symptoms need a closer look?
- 4Brain energy & metabolic health
What affects your energy through the day and after activity?
- 5Structure, stability & body-to-brain signals
How do pain, posture, movement and stability affect what you can do?
- 6Psychological flexibility & behavioral recovery
How are mood, stress and patterns of coping affecting your day?
- 7Life, relationships & environment
What demands, relationships and support shape your recovery?
A plan starts with the things you want to do again.
We review the timing of symptoms, suspected triggers, prior diagnoses and current care. Testing is chosen to answer specific questions rather than adding a standard panel for everyone.
01
Tell us what you want your life to look like
We start with what has changed, what you have tried, and the activities you most want to return to.
02
Answer the questions the history leaves open
We review prior reports and select relevant assessments. You should understand what each assessment is meant to clarify.
03
Agree on the priorities and the first steps
We discuss the findings, possible approaches, costs and practical constraints. The plan sets an order that fits your situation.
04
Check what changes and adjust together
We compare your response with the starting point, including daily function. If something is not helping, we discuss what needs to change.
Only then do we discuss which therapies, if any, belong in your plan. The choice depends on the findings, the evidence, your preferences and how you respond.
Talk through your situationBlood Rehabilitation
Therapeutic Plasma Exchange (TPE)
Your plasma carries more than nutrients — it can carry the inflammation, antibodies, and toxins that are quietly working against your brain. TPE clears it and replaces it with a cleaner foundation to rebuild on.
Clinically: An apheresis-based exchange that reduces circulating inflammatory mediators, pathogenic antibodies, and immune complexes — an established therapy in select autoimmune neurologic disease, and an emerging tool in our practice for Alzheimer's, mold-related neurologic illness, and post-viral neuroinflammatory presentations, always clearly labeled by evidence level.
Indications & evidence levels
Neuregen labels evidence honestly. The same therapy can be established for one indication and investigational for another. What follows is that breakdown for TPE at Neuregen.
Albumin-replacement research in Alzheimer’s: moderate evidence, with important uncertainty.
The overall functional result was statistically significant; the cognitive result was not. Research findings apply to a specific protocol and population. This is not an established standard of care for Alzheimer’s.
Classic Autoimmune Neurologic Disease
Evidence: EstablishedStandard of care with strong evidence — e.g., Guillain–Baré syndrome, Myasthenia gravis, certain forms of Autoimmune encephalitis.Therapeutic Plasma Exchange is an established medical therapy for numerous neurologic, hematologic, and autoimmune disorders. For conditions such as Guillain–Baré syndrome, Myasthenia gravis, and some forms of Autoimmune encephalitis, the mechanisms are well supported by evidence.
Alzheimer’s Disease (AMBAR-Informed)
Evidence: ModerateFor the studied albumin-replacement protocol in mild-to-moderate Alzheimer’s; further confirmation is needed.AMBAR was a multi-center trial of plasma exchange with albumin replacement in mild-to-moderate Alzheimer’s. Neuregen draws on this line of investigation for selected patients as part of a comprehensive Alzheimer’s program that includes diagnostics, brain rehabilitation, metabolic support, and a caregiver pathway.
Mold-Related & CIRS-Linked Neurologic Illness
Evidence: InvestigationalEarly-stage evidence only; offered with explicit informed consent and no outcome guarantee.In selected patients with neurologic illness attributed to mold or environmental toxin exposure, TPE may be considered as part of a broader plan that also addresses Domain 3 (Immune & Neuroinflammatory Regulation) and Domain 7 (Environmental Context).
Plasma exchange & Alzheimer’s research
Plasma Exchange & Alzheimer’s: What the Research Shows
Evidence: ModerateFor the studied albumin-replacement protocol in mild-to-moderate Alzheimer’s; further confirmation is needed.
Plasma exchange with albumin replacement has moderate evidence for slowing decline in mild-to-moderate Alzheimer’s disease. AMBAR found less decline in daily function; its overall cognitive result favored treatment but did not meet the conventional statistical-significance threshold. This remains a developing approach, not an established standard of care.
496 people screened → 347 randomized across 41 centers in Spain and the United States. Three active treatment arms were compared with sham exchange.
Study entry
Mild-to-moderate Alzheimer’s
Diagnosed participants, with baseline MMSE scores of 18–26.
Initial treatment
6 weekly exchanges
Conventional plasma exchange with albumin replacement.
Maintenance & follow-up
12 months of monthly exchange
Low-volume exchange; primary outcomes assessed at month 14.
Some active arms also received intravenous immunoglobulin (IVIG). This diagram describes the research schedule; it is not a prescribed treatment package. AMBAR study design (2019)
Two primary outcomes. Different levels of certainty.
Pooled treatment groups versus sham exchange at 14 months. “Less decline” compares average changes between groups; it does not mean regained ability or the chance that an individual will improve.
Cognition · ADAS-Cog
Memory, language and other thinking abilities.
66%
less decline reported
p = 0.06
Did not meet the conventional p < 0.05 threshold
−2.1 points versus sham
95% CI: −4.4 to +0.2
How TPE works
Plasma is separated from blood cells using an apheresis machine.
The separated plasma — which carries circulating inflammatory mediators, pathogenic antibodies, immune complexes, complement proteins, and cytokines — is discarded.
The blood cells are returned with replacement fluid (typically albumin).
By removing these plasma constituents, TPE aims to reduce the factors that may be contributing to disease in appropriate patients.
The exact substances removed depend on their size, protein binding, distribution, and the underlying condition.
Who it may help
TPE at Neuregen may be considered for selected patients with classic autoimmune neurologic disease, for selected patients with diagnosed mild-to-moderate Alzheimer's enrolled in the comprehensive Alzheimer's program, and for selected patients with complex neurologic illness linked to mold or environmental exposure. We determine candidacy after a full medical review.
AMBAR did not establish benefit for mild cognitive impairment or prevention. A strategy consultation with our clinical team is the first step — a real clinical conversation, not a sales call. No treatment plan is set before that review.
What to expect
TPE is performed in a clinical setting. Sessions involve vascular access and the apheresis circuit. The number of sessions and the pacing of the plan are set by our clinical team after a full medical review — they are not determined before that review. Blood rehabilitation is typically followed by neurorehabilitation and metabolic support as subsequent steps in the recovery sequence.
Where TPE fits in the 7 Domains
TPE maps most strongly to Domain 3 (Immune & Neuroinflammatory Regulation), where it has its strongest mechanistic rationale: removing circulating immune mediators and pathogenic plasma constituents in appropriate diseases. It may secondarily affect Domain 4 (Metabolic / Brain Energy), though this remains hypothesis-generating for many chronic conditions. Domain 2 (Autonomic Regulation) and Domain 1 (Neural Networks) effects are considered indirect — improved physiology may create more favorable conditions for rehabilitation.
Important to know
Neuregen is an out-of-network specialty clinic. Patients are responsible for fees at the time of service.
A Strategy Consultation determines candidacy before any treatment is recommended.
All treatment plans are set by our clinical team after a thorough medical review.
How it fits your plan
Your care · Treat
Blood therapies only make sense in relation to a specific clinical question. We review the indication, evidence and risks for TPE or EBOO separately, then consider whether either has a role alongside rehabilitation and your existing medical care.
We review your history, explain the findings, agree on next steps and check how you respond.
TPE by indication
Apheresis and environmental-medicine credentials behind this program
Neuregen brings the blood-therapy discussion into the same plan as neurologic, autonomic and functional care. We ask what a proposed intervention would change in daily life and how that change would be assessed.
Dr. David George: Board certifications and training in functional neurology, integrative psychiatry, and mental health; certified brain injury specialist.
Training most relevant to this area
- Member, American Society for Apheresis (ASFA)
- GCP Certified (NIDA)
These are the founder’s qualifications. We confirm the treating clinician and their role when discussing your plan.
See Dr. George’s full credentialsTPE pricing
| Service | Price |
|---|---|
| Therapeutic plasma exchange, single procedure | Confirmed in writing at your Strategy Consultation |
| TPE seriesSeries length depends on the indication and your response | Confirmed in writing at your Strategy Consultation |
Neuregen is an out-of-network specialty clinic. Most therapies listed here are not covered by insurance; we provide itemized documentation you can submit to your insurer, and we tell you before any therapy which parts, if any, are typically reimbursed.
Financing options are reviewed at your Strategy Consultation before any plan is finalized.
Frequently asked questions
What is Therapeutic Plasma Exchange (TPE)?
TPE is an apheresis-based procedure that removes plasma and replaces it with a clean substitute. In doing so, it reduces circulating autoantibodies, immune complexes, complement proteins, inflammatory cytokines, and other plasma constituents. It is an established therapy for several neurologic and autoimmune diseases, and is being investigated as an emerging tool for Alzheimer’s and other complex inflammatory presentations. Neuregen labels evidence levels explicitly.
Is TPE appropriate for Alzheimer’s at Neuregen?
Plasma exchange with albumin replacement has moderate evidence for slowing decline in mild-to-moderate Alzheimer’s disease. AMBAR found less decline in daily function; its overall cognitive result favored treatment but did not meet the conventional statistical-significance threshold. This remains a developing approach, not an established standard of care. We consider it within a comprehensive program after medical review.
How many TPE sessions are typically needed?
The number of sessions in a TPE plan is set by our clinical team after a full medical review, based on the underlying condition, the patient’s clinical response, and the specific indication being addressed. Neuregen does not state session counts before that review.
What are the risks of TPE?
Like any medical procedure, TPE carries risks including those related to vascular access, electrolyte shifts, and reactions to replacement fluid. We review the specific risks relevant to your situation during the medical consultation and informed-consent process.
Is TPE covered by insurance?
Neuregen is an out-of-network specialty clinic. Patients are responsible for fees at the time of service. Pricing is provided in writing at the strategy consultation.
How does TPE connect to the rest of the rehabilitation model?
TPE is described as preparing the soil before planting a garden. Step 1: Improve the internal biologic environment. Step 2: Support cellular recovery. Step 3: Drive neuroplasticity. Blood rehabilitation is the first stage that aims to make subsequent neurorehabilitation more effective.
Every plan starts from the same map: the 7 Domains of Recovery.
Start with a Strategy Consultation
Ongoing fatigue or difficulty thinking may already be limiting your work and family life. An evaluation can help organize what is known, what remains uncertain and whether further investigation is useful before considering blood therapy.
8090 N. 85th Way, Suite 100, Scottsdale, AZ 85258 · Mon–Thu, 9:00 AM – 5:30 PM