Start with what life feels like now
What questions come before considering TPE for MCAS?
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 in MCAS with CNS & Psychiatric-Dominant Presentations
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 — offered as an investigational approach in selected patients with mast cell activation syndrome where CNS and psychiatric symptoms are dominant, with explicit informed consent and no outcome guarantee.
Conceptual artwork for the care discussion. Individual findings and treatment options require clinical evaluation.
MCAS when the nervous system is the primary target
Mast cell activation syndrome can present with a wide range of symptoms. When the dominant pattern is CNS- and psychiatric-related — cognitive dysfunction, mood dysregulation, nervous-system hypersensitivity, autonomic instability — the immune and psychiatric domains are both implicated simultaneously.
The rationale for TPE in this context is to reduce circulating mast-cell mediators, inflammatory proteins, and immune complexes that may be sustaining nervous-system dysfunction. This is one step in a plan; it does not replace psychiatric integration, which is essential for patients with neuropsychiatric presentations.
MCAS with CNS-dominant symptoms is a named flagship condition in Neuregen's clinical framework. The psychiatric integration alongside blood rehabilitation gives Neuregen a clinical depth that a stand-alone blood clinic cannot offer.
Domains most involved:
Every plan starts from the same map: the 7 Domains of Recovery.
How it fits your plan
TPE in MCAS sits in the Treat phase — after mast cell workup, immune baseline, and psychiatric assessment have established which targets belong in the plan. For CNS-dominant MCAS, psychiatric integration (Domain 6) is concurrent, not sequential. The blood work and the psychiatric work happen in parallel.
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.
Potential Therapies
We use established medicine where it works, and emerging medicine where it makes sense.
These are options to discuss after evaluation, not a predetermined treatment plan. Each label refers to the condition or indication described beside that therapy; evidence can differ for another use. An evidence label does not mean FDA approval.
- Therapeutic Plasma Exchange (TPE)Evidence: Investigational
Investigational for MCAS with CNS and psychiatric-dominant presentations. Offered with explicit informed consent and no outcome guarantee.
Where the evidence stands
Early-stage evidence for TPE in MCAS with nervous-system-dominant symptoms. The mechanistic rationale — reducing circulating mast-cell mediators and immune complexes — is grounded in TPE's established role in autoimmune neurologic disease, applied here in an investigational context. Neuregen labels this honestly and discusses realistic expectations at every consultation.
Sources and what they support
- ASFA 2023 guidelines for therapeutic apheresis
Apheresis recommendations are indication-specific. An established use for one disease does not establish TPE for Alzheimer’s, Long COVID, MCAS or environmental illness.
How we grade evidence
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.
The training behind this care
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 credentialsFrequently asked questions
Is TPE established for MCAS?
No. This application is classified investigational at Neuregen — early-stage evidence, offered with explicit informed consent and no outcome guarantee. MCAS itself has a complex and still-evolving evidence base; applying TPE within it for CNS-dominant presentations is at the investigational frontier. Neuregen says that plainly.
Does psychiatric care happen alongside TPE for MCAS?
Yes. For MCAS presentations with psychiatric concerns, psychiatric care is considered alongside physical symptoms in the same rehabilitation plan. We discuss which clinicians and services fit your needs.
What distinguishes Neuregen's approach for MCAS from a stand-alone blood therapy clinic?
Neuregen integrates psychiatric care, autonomic rehabilitation, and the 7-Domain framework alongside the blood-based intervention. A stand-alone blood clinic offers the infusion. Neuregen offers the infusion as one step in a sequenced plan that also addresses the nervous-system consequences of mast cell activation.
How is candidacy for TPE determined in MCAS?
We determine candidacy after a full medical review that includes mast cell workup, immune panel, and assessment of the neuropsychiatric presentation. The decision is individualized. No treatment plan is set before that review.
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