Longevity with Dr. David Haase: Rational Wellness Podcast 252

Dr. David Haase discusses Longevity and Regenerative Plasma Therapy with Dr. Ben Weitz.

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Podcast Highlights

4:17  When dealing with a patient with memory problems or other signs of cognitive impairment, we need to understand that dementia is accelerated aging of the brain and dementia literally means un-braining.  Alzheimer’s is a process rather than a disease. Often patients with dementia are in denial, which is understandable. But denial makes it difficult to get help. And the other side of the coin is despair, which is also not helpful. Unfortunately, once patients are having symptoms of dementia, they are already at an advanced stage of their disease.  Our brain has amazing resiliency and is overbuilt so that we can handle an injury or trauma and if it slowly degenerates, we can keep compensating and compensating until symptoms become apparent. In Parkinson’s Disease, we may have lost almost 90% of the neurons in the substantial nigra before we start having shakes.

9:12  Conditions that are precursors for neurodegenerative diseases are all the degenerative medical conditions like diabetes and prediabetes, heart disease, depression, and also head injuries.

17:47  Regenerative plasma therapy.  This is a form of apheresis, which is when you take the blood out of the body, do something to it and then put it back in the body. What Dr. Haase is doing is separating the plasma, the liquid part of the blood, and replacing it with young plasma.  There are compounds in the plasma of older individuals that are perpetuating aging that you will be removing.  When you take the stem cells from an old mouse and place it in the plasma of a young mouse, the stem cells start behaving young again. Dr. Haase is running the largest, free standing outpatient plasma exchange center in the US and they are providing this plasma exchange for patients with neurodegenerative diseases as well as for longevity and wellbeing.  The AMBAR trial was published in July of 2020 [Boada M, Lopez OL, Olazaran J, et al.  A randomized, controlled clinical trial of plasma exchange with albumin replacement for Alzheimer’s disease: Primary results of the AMBAR Study.] and they did plasma exchange on patients with Alzheimer’s disease and they showed that over 14 months in individuals with moderate Alzheimer’s disease, they had a 60% decrease in the rate of progression.

36:25  Where does the new plasma come from?  It is a pharmaceutical plasma. They take plasma from plasma donors and they separate out the albumin and then heat it for about 160 degrees for a full day, which kills off anything that could possibly be hanging in there and that albumin is no longer a tight bundle of an amino acid chain. This means that the albumin can now function like a biological sponge again.



Dr. David Haase is an Integrative Medical Doctor from Vanderbilt and MayoClinic.  In his MaxWell Clinic in Nashville, Tennessee he is innovating in the fields of nutrition, genomics, systems biology, apheresis, and brain assessment to help his patients slow the aging process and live longer and healthier lives. One of the techniques that Dr. Haase has been pioneering is the use of is Regenerative Plasma Exchange.  He wrote a book, Curiosity Heals the Human and his website is MaxWellClinic.com

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.


Podcast Transcript

Dr. Weitz:            Hey, this is Dr. Ben Weitz host of the Rational Wellness podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest and cutting edge health information. Subscribe to the Rational Wellness podcast for weekly updates, and to learn more, check out drweitz.com. Thanks for joining me. And let’s jump into the podcast.

Hello, Rational Wellness podcasters. I’m very excited today to be having a discussion with Dr. David Haase on longevity and brain health. Dr. David Haase is an MD from Vanderbilt and Mayo Clinic and in his Maxwell Clinic in Nashville, Tennessee, he’s innovating in the fields of nutrition, genomics, systems biology, apheresis and brain assessment to help his patients slow the aging process and live longer and healthier lives.  He’s written a book, Curiosity Heals the Human. And one of the innovative techniques that he’s been pioneering is the use of regenerative plasma exchange, which we’ll be discussing in our talk today. So welcome, Dr. Haase.

Dr. Haase:           Ben, thanks so much for having me on. We appreciate it.

Dr. Weitz:            Absolutely. So let’s see, I listened to your Ted Talk and your Fireside Talk and I wanted to say, I relate to the fact that like you, I did not get into functional medicine because I was suffering some disease that I needed to heal, but just wanted to help others.  And it just seemed like a really good way for me to do it by trying to get to the root cause of some of the problems.

Dr. Haase:           Gall-Lee, right? I love the title of your podcast, Rational Wellness. I mean, to me, that’s exactly right. It’s like some of it just, why are we doing this?  When that question doesn’t have a good answer well, you get to start looking deeper, so.

Dr. Weitz:            Right. When you have Alzheimer’s, why are we going to prescribe a drug that costs $60,000 a year that doesn’t make anybody better?  There’s one example. Why not use it a functional medicine approach, which has been shown to reverse the aging process and restore brain health?

Dr. Haase:           Yeah. It really is a challenge, especially when we’re dealing with unique humans. And we have a system that doesn’t really acknowledge or support individual variability because the whole realm of the blockbuster. The blockbuster is what our economic world and the pharmaceutical schema is based on to have one intervention that’s going to fix everybody. And-

Dr. Weitz:            Really?

Dr. Haase:           And it’s never been the way humans have kind of worked, right? The way you raise one child doesn’t work for the way you have to raise the next two or three or four or five. Right.

Dr. Weitz:            Exactly. So when you give one of the patients that drug and they don’t respond, then we conclude, they had a side effect, instead of that drug was never going to work for that individual patient. It’s their unique physiology and biochemistry and everything else.

Dr. Haase:           Mm-hmm (affirmative). Mm-hmm (affirmative). Yeah. Yeah. So it’s interesting. I think honoring individual is for really what each one of us want to do. It’s also what makes us have fun in healthcare. I mean, I love what I get to do. I love practicing medicine. I love teaching other clinicians. And I think that’s because, like I said not plugging my book, but I did write a book called Curiosity Heals the Human. And I think that’s the first step is just to be curious as if what you’re doing right now isn’t working for you. Then the first step is to be curious about why that might be, and then dig in further, so.

Dr. Weitz:            Yeah. Good, good, good. So why don’t we start, maybe with, let’s say a patient comes into your office, how would you work them up? What sort of questions would you ask? What tests would you give them? What panels might you run? And maybe we can start with a patient who is concerned about their memory or has signs of cognitive impairment.

Dr. Haase:           Mm-hmm (affirmative). Yeah. Wow. That’s a big question.

Dr. Weitz:            I know.

Dr. Haase:           Yeah. You got-

Dr. Weitz:            Let it go wherever you want it to go.

Dr. Haase:           You got a couple weeks to answer that one, so. I think-

Dr. Weitz:            Just looking for a couple of clinical pearls.

Dr. Haase:           Well, I would say a couple of the clinical pearls are really important thing when dealing with somebody with dementia is to recognize you really have three goals and helping patients recognize this is really helpful. That really, we have a… That’s because dementia is really accelerated aging of the brain, it is dementia literally means un-braining. And so that’s where name a process rather than actual disease. I like to say that, hey, people are Alzheimering rather than have Alzheimer’s.  And that’s actually really useful for patients to recognize that, wow, I don’t have a disease. I am involved in a process. And if that’s the case, then there is the possibility of saying, “Well, how might I understand this process and change my trajectory in that way?” So I think that, and if you recognize that aging is essentially having more damage in any period of time than you have regeneration. More injury versus repair, that’s what aging is.

Dr. Weitz:            Right. Because we’re constantly in this process of building up and breaking down and it’s a question of which way the balance is tipping.

Dr. Haase:           Right. Right. And how much have we accumulated in that way? So I’d say one of the first things I do with patients is I step back and I really ask what is their understanding about their present condition? What do they understand about dementia? And that’s really useful because a lot of people are caught in either, just a cage of a denial. So the family member has brought them in and they’re trying to say something. And if they’re in denial, man, they’re doomed.  Denial is the worst comorbidity when it comes to neurodegenerative disease. Because, and I think it’s rational to have denial because we’ve lived in a world that we’ve been preached at for so long that, well, there’s nothing you can do about it when your brain’s going well, just, there’s nothing to do. So kind of a rational course of action would just be to deny that it’s a problem.

So you have this quality of life. You don’t worry about those things, but denial is a problem. But also the other side of that is despair. So if people are just realizing that they can’t do anything about it, that’s going to be the other side of the coin. So either denial or despair, the two polar opposites kind of have… I think of them as two valleys that you can fall into. And we have to ride this ridge in between the two valleys of being proactive and rational in the assessment.  And it’s just really helpful to talk to people about how are they feeling denial and how are they feeling despair. And especially when we’re in this endeavor, golly, it’s a big deal to try to deal with neurodegenerative disease, because when people first start having symptoms, they are in an end stage of the disease.

I mean, that’s not something people like to hear, but when you first start having a symptom, because our brain is built with such amazing resiliency and we have so much… Our brain is overbuilt so that we can handle an injury or a trauma, but, and if it slowly degenerates, we can keep compensating and compensating and compensating until we can’t compensate anymore. And that’s when we start having symptoms.  Well, in Parkinson’s, we may have lost almost 90% of the neurons in the substantial nigra before we start having shakes. And people don’t understand that. And as a result, they come in with their first symptom, they think, “This is early. This is the first symptom I’m having.” And it’s a challenging and sad thing to have to orient them to say, “Yes. I’m really happy you got in when you did and we’re already behind the ball here. So it’s a full court press moving on.”

Dr. Weitz:            Just back up for a second, what would be some early signs before they’re advanced, where we might be able to identify somebody who’s starting down the road towards Alzheimer’s or Parkinson’s?

Dr. Haase:           Yeah. Well, gosh, name a degenerative medical condition, because they’re kind of all a pre dementia. I hate to say it that way. So if you think of diabetes we already know that Alzheimer’s we’ve thought of it as like type 3 diabetes in some cases, because there’s insulin dysregulation. So just me having insulin dysregulation is a predisposing factor to this multi-system degeneration. Individuals that have depression, a lot of depression is inflammatory based. So if we think about neuro inflammation as another pathway towards moving towards depression, that’s something that should be paid attention to.

What about having a head injury? That’s a predisposing factor. And even I’m always amazed by just how much resiliency comes from people having more education, right? So individuals who don’t work their brain are going to have more likelihood of progression on towards dementia. Now, I went way back there. You were asking me, “Hey, what are some of the early signs?” I didn’t list out symptoms that you would think would be neurodegeneration, but neurodegeneration really is a multi-system failure. That’s how we get to where we are. It’s why it’s so challenging to treat.  It’s not as simple as early insulin resistance or diabetes you can start changing the diet and exercise and see massive transformation in the process. But if you already have neurodegeneration there’s problems with your mitochondria, with lysosome function, with intercellular aggregates of abnormal proteins, of extracellular aggregates of abnormal proteins, you have senescent cell accumulations. There’s so many pieces of dysfunction that accompany neurodegeneration.  That’s why it’s been very frustrating to the pharmaceutical industry to have a single pill for an ill because you can only address one or two things in that process.

Dr. Weitz:            Yeah. I mean, pharmaceutical industry has been focused on the one pathway and the one drug that interrupts that pathway. And when you have a multisystemic condition, it’s not going to work.

Dr. Haase:           Yeah. You mentioned my Ted talk and I just noticed my background here I have my tensegrity structure. So I have had… And yourself in the chiropractic background, you’ve seen some tensegrity structures, but most of my medical colleagues have never seen one of these things. Right. And aren’t they fun?

Dr. Weitz:            Yeah. Cool.

Dr. Haase:           I think everybody should have one to play with. I really do. I do because, it’s this beautiful representation of a complex dynamic system. You’ve got a whole bunch of components that don’t seem to be linked to each other, but those are the items of integrity like the bell rods. And then you have all of these rubber bands that are the tensioners. So you have a tensegrity system and this is a great model of biology. It’s not just a model of structure. It’s actually a model of how hormone structure can work. If you affect one part of the system, the entire rest of the system will adapt and change if it’s healthy.  But if it starts getting stuck, you get this integrity structure that starts getting tied onto to itself and twist it around if you start putting a stressor onto it can’t adapt. It can’t bounce back. And I think that’s so much the cause of so aging is a multifactorial process and that’s one of the reasons why it’s not any type of intervention that kind of only does one thing. I don’t hold a lot of hope for it. Finding that one gene that’s going to turn off aging, good luck.

Dr. Weitz:            There was the hope that the mapping the human genome was going to be the key to curing all human disease. And that hasn’t really worked out.

Dr. Haase:           Yeah. But hasn’t it taught us just how miraculous we are. I mean, wow, wow. Our ability to self heal is just profound. I think that’s what I always anchor back on is that the body is really designed to heal. We cut our hand, it knows how to knit itself back together. That knowledge, the body is way smarter than I am is actually what inspires me all the time to say, “What are those factors that I could find to open the body to healing and yep.”

Dr. Weitz:            Yeah. I mean, what are the things that are interfering with our bodies innate ability to heal? And then what are the things the body doesn’t have enough of that it needs to heal?

Dr. Haase:           Mm-hmm (affirmative). And then I put two more categories in there. What dysfunctional cycles is the body caught in that it needs to be retrained out of. And also what type of a damage needs to be repaired. So for me, it’s remove, replenish, retrained and repair. Because and that when it was start getting-

Dr. Weitz:            A variation on Jeffrey demands for our program. Yeah.

Dr. Haase:           Well, I think it’s from the wonderful law of the tax. If you’re sitting on attack it takes a lot of aspirin to feel better. That was Sid Baker. Sid Baker said, “Well, the foundation of functional medicine was really to rid and get. What bad things you need to rid, what things do you need to get.” But as you start traveling into longevity medicine, we need a couple of more categories. We really have to think about what are we stuck in that we need to retrain? And then also if it’s damaged, we’re going to need to repair or regenerate.  And that is a… And especially if we have lost our internal resiliency and we have accumulated a lot of damage. We just keep getting… It’s like a spiral. Health is either a spiral up as people get better or more commonly, it’s a spiral going down as we keep losing capacity that causes an acceleration of our decline down. And that’s why the repair starts becoming more and more important.


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Dr. Weitz:            So what are some of the most important ways to repair our bodies?

Dr. Haase:           Well, to talk about is our regenerative plasma exchange that we’ve been doing. But I think the why, behind this is super interesting. So let me say what it is first of all. So regenerative plasma exchange is a type of apheresis. Apheresis is when you take blood out of the body, do something to it and then put it back in the body.  And we had a conversation before starting this recording you can apheres out LDLs, you can remove out cholesterol and help turn back heart disease. Or you can use apheresis to remove cancerous cells or to treat a certain subset of cells. Or you can even use apheresis to remove red blood cells in a sickle cell patient and then replace them with a transfusion of healthy cells.  What we’re doing is plasma apheresis. And that means the blood is pulled out of the body. We process it live in such a way that the plasma, the liquid part of the body gets separated from all the rest, the cells and the platelets, and then the cells and the platelets are recombined with a clean replacement fluid. And then that gets put back into the body and that’s done continuously and that’s not done in a small amount. So if you were sitting in our chair, we’d remove about three liters of your plasma in a single setting. That’s what the plasma exchange is really about, but the, why behind it becomes really interesting, so.

Dr. Weitz:            Is this similar at all to, I heard discussion at some seminar years ago of some clinic overseas where you get young blood.

Dr. Haase:           Yeah. So actually, if we go back to the rationale behind this, it does go back to this idea of young blood. Young blood is such an interesting story. I mean, this goes back to Russians on the battlefield taking in-

Dr. Weitz:            Oh, boy. Are you talking about Russians on a battlefield.

Dr. Haase:           How about that? Yeah. Bad timing.

Dr. Weitz:            On the day of World War III.

Dr. Haase:           I mean, well, bad timing for that to come. But anyway, so there’s somebody who actually experimented by taking the blood of some other youth and infusing it and thinking that was going to help them. Well, they eventually died from that practice because that’s a challenging thing to do. They didn’t know a lot about immunology 80 years ago. But there’s all this idea that’s the health is in the blood. The health is in the blood. Studies were done called parabiosis. So they took this into the research laboratory. And they took mice that were clones of each other and they’d have an old mouse and a young mouse and they’d actually sew them together. They’d sew them together so that they had a little flap of skin in their abdomen that connected them.  And low and behold after about a week an amazing thing started to happen that the old mouse that was connected to the young mouse started to turn young, multi tissue, regeneration started to occur. The skin cells started to become healthier. Fatty liver started to reverse, bones started to become thicker again from osteoporosis. The sense of smell improved, T cell and B cell function improved.  I mean, it was really quite remarkable and that young mouse got stunted by exposure to the toxin of old, cause old is toxic. I mean, I hate to say that, it’s not a popular thing to say, but there are compounds in the bloodstream of an aged individual that are perpetuating aging that are actually moving aging forward. That’s a remarkable insight. But anyway, if you separate these mice, there’s no harm done to the young mouse. And there may even be some age extension in the old mouse.

Not a lot of those studies have been done, but it’s really remarkable. So then they went to start looking at stem cells. Well, we know that cells in culture grow better when they’re in a healthy culture media. That’s just something we’ve known. We’ve been growing cells at every university ever. And we know that the culture media makes a big difference as to the health of the cells. Well, no, duh, because that’s the same way it is in our body. Our cells are deeply terrain dependent. Our cells are deeply dependent on the habitat that they live in.  What they did is they took the plasma from a young mouse and they put it into a Petri dish that had stem cells from an old mouse. And those old stem cells started to behave young again. So if you change the environment, the stem cells will change their behavior. That’s very interesting. That’s very interesting. So everybody got really excited about all this and said, “Hey, let’s start infusing plasma from young individuals.”  And I think that still holds promise. That’s not done in the United States yet. Or I mean, that can be done, absolutely can be done. And I actually did the first young plasma exchange, or that’ll actually going to be published soon. And through a American Association of Blood Bank certified, a blood bank and such, and actually pretty remarkable results in an individual with Alzheimer’s disease. Now, that’s not something that’s widely available, but that can get distracted, because people can think, “It’s all the good stuff in young plasma that’s actually there.”  Turns out it’s not so much this good stuff that’s in young plasma, which I think there’s plenty there. It’s the bad stuff that’s in old plasma that needs to be removed. So anyway, it’s so interesting to me, Ben, because this whole field of plasma exchange is proving what we’ve been talking about in lifestyle integrative functional medicine forever.  If you have healthy plasma as a result of living a healthy life, your cells are going to behave healthier and going to live longer. Anyway, so it’s a really fascinating story. And I think it’s one of the most exciting stories in all of longevity medicine.

Dr. Weitz:            And that’s why there’s so much focus now on fasting and intermittent fasting because that stimulates this process where we get rid of old broken parts of the cells. We know clearing out broken junky parts of our metabolism, our cells, proteins that are tangled and not working well is an important part of longevity.

Dr. Haase:           Yeah. So if you think about this, so what’s a very important human trial that supports a lot of what we’re doing because we have the largest free standing outpatient plasma exchange center in the United States. And we are providing this plasma exchange service for people with neurodegenerative disease, as well as individuals that are looking for improving their wellbeing and longevity, we’re tracking longevity markers. Lots of interesting fun stuff there.

Dr. Weitz:            Are you looking at DNA methylation as part of that?

Dr. Haase:           Yeah. We’re looking at DNA methylation, glycan patterning, telomere lengthening. Actually doing additional studies in large throughput single cell RNA transcriptomics. I mean, we’ve got all kinds of… We’ve got a couple of IRBs that are out and it’s fun because I really think this is at the cutting edge of what’s going to happen because if you can clean the blood, the body and brain work better. I mean, that’s just pretty straightforward. But what’s interesting, anyway, so there’s a human study that really backs up what we’re doing and that’s called the AMBAR trial.  AMBAR trial ended up being published in July of 2020. I’ve been tracking this study for the last five years. And it’s where they looked at individuals with Alzheimer’s disease and they did this plasma exchange procedure on them. It was a multinational, double blind, randomized, placebo controlled, sham controlled trial and done in the United States and Spain.  And they looked at about 350 or so individuals with Alzheimer’s disease, mild or moderate disease. And what they were able to show is that over the course of 14 months in individuals with moderate Alzheimer’s disease, they had a nearly 60% decrease in the rate of progression, 60% decrease in-

Dr. Weitz:            That’s great.

Dr. Haase:           The rate of progression with this therapy and that was doing a plasma exchange once a week for six weeks and then a monthly plasma exchange after that. And so they had highly statistically significant findings in functional improvement and just missed a statistical improvement in their primary measure of cognitive performance. But they did have several secondary measures of improvement in cognitive performance that met secondary criteria, but they also showed that the CSF of these individuals with Alzheimer’s disease normalized when they had plasma exchange.  They also did FDG-PET scanning, and they showed that there was less cellular death in the brains of individuals at had a plasma exchange compared to the ones who had placebo. So all of that together is like that was really profound to start taking a look at one of the worst degenerative diseases that exist in Alzheimer’s disease could be that the trajectory could be shaped differently based upon this cleansing intervention.

Dr. Weitz:            And I’m assuming this would just be part of a functional medicine protocol for you.

Dr. Haase:           Yeah. For us, yes. I mean, I was like when we talk about plasma exchange, plasma exchange is standard of care for severe autoimmune diseases. And we treat those patients as well. And we’ve actually had some wonderful success with scleroderma. We’re looking to run a trial on that, but we are also… See, plasma exchange think about it. It’s a little bit like a snowblower. I grew up in South Dakota, so I know snow and I went to did residency at Mayo clinic.  So Rochester, Minnesota has lots and lots and lots of snow. And so when it snows a whole lot, and I think of snow is all these dysfunctional problems. These extracellular aggregates, these oxidative molecules, these amyloid beta proteins that are building up, if those are built up and built up, and it’s amazing, you can take in with plasma exchange and really clean it out.  But the problem is if you’re not addressing how much it’s snowing, it’s not going to work as well. So I really think that this is a wonderful adjunct therapy and we have several functional colleagues that are sending patients to us for this. And they’re doing all the additional supportive care, but I mean, I think it’s always important to treat people as comprehensively as we can. But what’s interesting is even without all of that, even without the functional medicine approach, this still had a larger effect size than any other intervention that’s ever been documented at large scale.  So it’s anyway, pretty exciting stuff. Hey, I got a quiz for you. So what component in the blood has the most antioxidant potential? What component in the blood is your most important antioxidant? Nobody gets this Ben, so don’t feel bad.

Dr. Weitz:            Well, which is why I’m not going to mention any the obvious ones. So I’m going to guess platelets, how about platelets?

Dr. Haase:           Okay. Any guess is a good guess, but by far it’s albumin. Albumin, the actual main protein that it floats in the bloodstream has huge antioxidant potential. As it’s floating around, it is constantly scavenging all kinds of reactive oxidative species and toxins that are electrophilic and it’s going around and it’s absorbing amyloid beta to itself. And it’s becoming glycated so albumin has a limited functional lifespan. So as you get older, the fresh albumin your liver makes doesn’t take very long for it to get fully polluted as it’s-

Dr. Weitz:            Well, it sounds like it’s a chelating agent, a natural chelating agent.

Dr. Haase:           There you go. Yes, exactly, it is. You look at calcium levels in the bloodstream, they’re highly dependent upon how much albumin is there. You have a free calcium level or a total calcium or iodide calcium. And it depends upon how much albumin is there. So albumin is so important, but it’s like the water we swim in or wait a second. It’s the water that swims inside of us and…

Dr. Weitz:            Essentially it’s a finding protein, right?

Dr. Haase:           God, that does so many things. It can’t be put into a box. And so this whole idea that if we remove the old albumin and put in albumin that is essentially fresh and clean, or has less of this impairment, is that going to be a benefit? And that’s what the whole AMBAR trial was based on. So it’s really, there’s so much to learn here. Every good answer brings up an additional three or four questions, so.

Dr. Weitz:            Yeah. It sort of reminds me of some of the research that Dr. Perlmutter is doing with fecal microbial transplant and putting in a new microbiome.

Dr. Haase:           Yeah, exactly. Because think of what that does. It changes the plasma. So listen, it all comes back to plasma, Ben. I have now developed a bias. I have developed a bias. I’m proud of it. But plasma is the great interface between the outside world and your innermost parts. If you really think about it, if you breathe something in, or if you put it on your skin or it’s absorbed through your gut, how does it get to your brain? It has to go through the plasma. Unless of course, you breathe in, it goes straight through your olfactory system. There’s exceptions, but the plasma is the great river.

Dr. Weitz:            Now, what about treating a blood with ozone, like a lot of functional medicine practitioners there?

Dr. Haase:           That’s really not part of the protocol that we do here. I mean, I’m very familiar with that. We’ve used that as a therapy. And I think that, again, what role does each of these interventions play? The reason I love our regenerative plasma exchange so we can really stay on the shoulders of really good research and make sure that moves forward. But I think each one of these tools has different utilization, but here’s the interesting thing. I want to come back to the plasma exchange because stem cell therapy is almost synonymous with talking about longevity.  And I’m always been a little bit reticent to really dive into stem cell therapies because you’re taking cells from another person’s body and injecting them into you. And I think it really has some purpose, but what stem cells are the most important? The stem cells that are in your own tissue. You have stem cells in every organ of your body, everywhere in your body.

And when you cut your skin, it is those stem cells. So there are those multi potent cells that activate and then heal that tissue. So what’s fascinating is what we found in the mouse study is that when you do an albumin exchange, with regenerative plasma exchange, you get body wide stem cell activation, body wide. So the stem cells all over in your system, because the environment has gotten healthier, start to act healthier. Now, there’s lots of science and wonderful stuff we need to figure out, but it’s really exciting to think that we can get our native stem cells to function better. And that’s part of what happens when you’re doing fasting.  So with fasting, you’re turning on stem cell activity, super important, wonderful intervention. But if you think about fasting, fasting may actually just be really a mini version of what a plasma exchange is. You’re just, you’re decreasing the amount of stuff from your gut that is going into your plasma and you’re getting an opportunity to clean out more than you are polluting. So I had lots of questions to answer, but it makes sense.

Dr. Weitz:            And then when you clean out the plasma and you put new plasma in, where’s that plasma coming from?

Dr. Haase:           Yeah. That plasma is a pharmaceutical plasma. So plasma from plasma donors. And it’s very interesting process about how albumin is actually made. So most of the albumin is coming through the same process that people get IVIG. So IVIG is used for pandas and used for many their autoimmune diseases those come from plasma donors. And then immunoglobulins are one of the proteins that are in plasma. And then this albumin is the other protein that’s in there. That albumin is separated from the antibodies and then it’s processed in some unique ways. And the unique ways almost always involve slightly heating that albumin.  Matter of fact, beginning it up to about 150, 160 degrees for a full day. And that’s what ends up happening. It kills off anything that could possibly be hanging in there. And it partially causes not full denaturing, but a slight shift and so that albumin is no longer a tight bundle of an amino acid chain, but it loosens up. And when it loosens up all that stuff, that’s hanging on the outside falls off. So you can start refreshing the albumin in a way that helps make it be more of a biologic sponge again. So there’s a really interesting idea here. It’s like, wow, how-

Dr. Weitz:            Can’t we do that with sauna?

Dr. Haase:           Well, I don’t think you can handle that much sauna. If you can hang out at…

Dr. Weitz:            No, but you can do 130.

Dr. Haase:           Absolutely. You can. But the problem is if anything would denature, it would shrink right back and you wouldn’t have removed the junk that was there to begin with, but great heat shock protein in activation. I love sauna, love sauna. I think that’s amazing intervention, but not quite the same thing here.


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Dr. Weitz:            So let me ask you a question about diet and longevity. What style of diet do you personally follow? What have you seen that makes the most sense, and that might be impactful in terms of let’s say style of diet?

Dr. Haase:           Yeah. Yeah. So I’m largely a vegan who cheats and who does a lot of who does a lot of fasting and intermittent fasting. So I really think that the plant forward is always a great thing. My favorite food component is fiber. I mean, if you want to really get bored, just bring up fiber to me, because I love fiber in all it’s many forms. Because fiber does so many things. One of the interesting things fiber does is it it converts into butyrate in the gut, but why do we care? Because butyrate is one of the most important triggers for LL37 or cathelicidin induction.  LL37 is probably our most important innate defensive peptide. So it is a antimicrobial that goes against viruses, bacteria, fungi, and LL37, also complex with some of the amyloid beta. It can actually decrease the aggregation of amyloid beta. And matter of fact, it may be the lack of our bodies producing LL37 that causes our body to make the backup protein amyloid beta.

So anyway, but that all goes back to fiber. So lots of plants. I say a vegan who cheats because I think I look at the mouth and it’s pretty plain we’re omnivores. Our dental structure is meant to be able to handle anything. And then I think fasting is one of the most amazing interventions that exist. And once a month I will do about an 80 hour water fast. And it’s incredibly easy. I think that’s one of the things people just…

Dr. Weitz:            And you come up with 80 hours.

Dr. Haase:           Well, and about 80 hours, you have what I think from the literature is the most induction of intestinal stem cells, immune stem cells, muscular, skeletal stem cells. And you’ve already started a neurologic stem cell activation. And then at about 80 hours is when growth hormone that typically escalate during the first 80 hours starts to drop off. I cut it off at 80 because I don’t want to have atrophy. I don’t want to have a protein breakdown occur, but I think if there’s adequate testosterone present and you’re not doing your fast for too long, I think that 80 hours is really where I cut it off.  I really would not recommend one going over a 100 hours. If what you’re trying to do is maintain your lean body mass, which I think is super, super important. That’s why I don’t extend it out further than that. And I fast, well. It’s not easy for everybody, but for me, it’s no problem to say, “Fine, not eating good. One less thing I have to think about today, so.”

Dr. Weitz:            Get more accomplished. You mentioned peptides. What about the role of peptides in a longevity practice?

Dr. Haase:           Boy, that’s a big open question. There’s so many peptides.

Dr. Weitz:            You know there are.

Dr. Haase:           And so many and the FDA has not made it easier for us by decreasing access to peptides in clinical practice or by improving access. I have several patients who are just getting their peptides online going on an internet forum and injecting themselves with one thing or the other. And I’m like, “Wow, that would sure be something I would love to-“

Dr. Weitz:            I have a few patients that are doing that too. What’s the status of… What’s the FDA current… What is their stand these days? What can you prescribe in terms of peptides?

Dr. Haase:           So what happened in 2019 at the end of December in the omnibus bill, they basically declared everything that was greater than 40 amino acids in length that was now equals a drug. And which is really fascinating. They just declared, this category of molecules are now drugs. For instance, there are not many peptides that actually are in the list of… So they’re not FDA approved peptides. Physicians, it’s just a big gray area at this time. If you’re asking me for actually what’s the latest update, I can’t really tell you the details of that.  I can tell you a whole lot about the science behind peptides, but the FDA has made it very difficult to operate in this and those are discussions best had in a doctor-patient relationship, I think, so.

Dr. Weitz:            Nice. Okay. How about the role of prescription drugs or specifically nutritional supplements for longevity purposes? Maybe you can talk about some of your favorite substances.

Dr. Haase:           Yeah. Yeah. So I mean, you can’t open up, you can’t do an internet search on longevity without seeing Metformin pop up. Oh my gosh, I was kind of chuckling. It was like here’s this popup telemedicine service. “Hey, here, call us and prescribe Metformin for your longevity.” Some little vertical that somebody has built. Anyway, I think what’s-

Dr. Weitz:            We have the natural version, which is berberine.

Dr. Haase:           You beat me to the punch there, you beat me to the punch, Ben. That was exactly where I was going. Exactly. That probably works by a slight amount of complex one inhibition of the mitochondria and what makes us stronger is our challenges. So Metformin and berberine probably work to a degree by giving an extra challenge level to the mitochondria, making it a little harder to make cellular energy, therefore inducing PGC-1 alpha and causing mitochondrial replication and mitophagy and improve mitochondrial functioning.  So I think that, absolutely, anything that can improve your mitochondrial density and number is going to be tremendously important with regard to longevity. One of the things that I think the whole field of antioxidants has been, I’m glad that it’s been blown up. Always annoyed me when people are saying, “Take more antioxidants. They’re good for you.” And because we have direct antioxidants like vitamin C and vitamin E and you need enough of those around. Absolutely. But I’m always amazed like the indirect antioxidants, the compounds that are in plants that can be so powerful.  One of my very favorite is [inaudible 00:47:51] and glucosinolate. I really think that compound, that is in extract typically of broccoli seeds or broccoli sprouts, there’s some certain forms that have more of it than others, but it does such a great job of inducing NRF-2. And we’ve been watching oxidative stress levels come down with the utilization of that particular compound. I think that has a lot important part to play. Gosh, the list is so long when you start thinking about…

Dr. Weitz:            What do you think about NR or NMN?

Dr. Haase:           Yeah. So nicotinic or riboside it’s great if you’re a mouse and you can drink about 10% your body weight NR, then it looks like there’s an effect. But I think I’ve been greatly disappointed with the oral forms of NR as a therapeutic endeavor. I think that there’s a lot of… Because there’s two ways to look at the whole fact that in the body NAD diminishes as we age. That’s well established. Sinclair’s work on that is great. But if you really think about it, when we exercise, what occurs? We see a change in the ratio of NAD to NADH. So NADH is the energized molecule. We exercise, we use up our NADH and our NAD rises. When our NAD rises, it turns on mitochondrial activation.  It turns on along with the sirtuin gene, it starts to promote all types of components towards longevity. What happens when we fast? When we fast, we run out of NADH, we raise NAD a little bit. That’s fascinating. If you give somebody IV NAD you’re jamming up that NAD level really high. And I think what it’s doing is it’s tricking the body into thinking that it is energetically depleted and therefore it’s inducing the genetics that cause mitochondrial activation to occur.  So taking NAD as a supplement, probably doesn’t have anywhere near the same effect as getting it as an IV or doing the things that are going to cause NAD elevation naturally in the body. Really looking forward to seeing positive studies come out from NAD and NMR. But they’re thin at the present time, so.

Dr. Weitz:            Right. Yeah. You mentioned there are two ends, I guess, a similar story for resveratrol, which seemed very promising, but maybe has some benefit, but maybe not as much as we thought, unless you get some huge dosages.

Dr. Haase:           Yeah. And think about, but I also think that we’re not necessarily using them rhythmically, like we should. But because what if you’re fasting? If you’re fasting, taking a whole bunch of maybe NR and resveratrol at that time may have a whole different effect. It may have a real augmentation effect at that time, whereas taken with a regular diet, it won’t. I mean, I think that fasting and our contextual metabolism is something we have to pay a lot more attention to because if you think about supplements as just a, here’s a replacement for a pharmaceutical rather than, here’s a natural compound that fits inside a very complex biology and a person’s behavior and a person’s diet and lifestyle, we’re missing the boat.  So I mean, even what time of day that we take these compounds. So I think there’s… What a great feel to be in, to be continually thinking about when is the best time. I haven’t yet figured that out. For me clock genes like when exactly you want to have resveratrol, there’s some pretty good arguments both in the morning and the evening. I think you needed around if you want your clock jeans activated effectively.

Dr. Weitz:            I see, what about rapamycin?

Dr. Haase:           Again, I mean, I’m not utilizing rapamycin in my patients the present time, but if you really think of mTOR inactivation, it’s kind of the opposite effect of what you’d see with alpha lipoic acid. So alpha lipoic as you think of AMPK and mTOR are the opposite of each other. So I haven’t actually used rapamycin, I think there’s some really good and exciting opportunity in rapamycin. But at the same time there’s some case reports of people being harmed by rapamycin. So it is not a negligible substance. It needs to be respected as a pharmaceutical and basically a poison because that’s what all our drugs are. They’re well dosed poisons and…

Dr. Weitz:            It’s designed to suppress the immune system, right?

Dr. Haase:           Yeah, yeah. It is. Yeah, it is. But again, what is exercise? Exercise suppresses the immune system in the short term. If you’re over exercising that becomes a toxin. We are wave-like dynamic beings that are highly complex. And I love the idea of having a high amplitude life. High ups slow downs and training for recovery in everything we do. So, and I think that’s probably a good place to pull this together, because that’s what longevity is really all about. It’s how do you have a high quality life, a life that has a lot of resilience to it because it’s inevitable that we’re going to be hit with challenges that we didn’t expect. So the best thing that we can do is to train for those, do everything possible to give ourselves healthy challenges and surround ourselves with people that we love and love them well in return, so.

Dr. Weitz:            That’s the best exercise for longevity.

Dr. Haase:           Yeah. It is. Love is the answer, really the answer. It is. And otherwise, if you don’t have days worth living, why have more of them? Of course. So definitely engage that question has to be answered first. Some people I’ve worked with, I will say this, we’ve had some people that we’ve gotten to work with in the longevity space that realized that they wanted longevity because they really hadn’t figured out why they’re here yet.

And no, it was beautiful. It was absolutely beautiful. And by engaging people in a wholesome conversation, you asked about, well, hey, what kind of evaluation do we do? We ask them what do you want your health for? What do you want your health for? Why are you doing this? And why would you invest your limited time, money, energy and effort in this kind of an activity? What’s your why? And if you can really get to the depth of someone’s why, you often make different treatment decisions, number one, but you also have the possibility of seeing them actually enjoying their life focusing on the things that matter again. And wow, what a great privilege to be get to be in a space like that with people.

Dr. Weitz:            Great. I think that’s a great way to bring this interview to a close. Any final thoughts and then how can folks get a hold of you if they want to find out about regenerative plasma therapy or some of the other things that you offer?

Dr. Haase:           Sure. Well, I would say you’d find us at maxwellclinic.com. That’s M-A-X-W-E-L-L clinic.com. That’s really the single best way to find all the things that we do and…

Dr. Weitz:            Do you have practitioner training programs as well?

Dr. Haase:           Yeah. We’re developing those because I think that I’ve been probably the most experienced individual in our corner of the field and in this apheresis space and we’ve actually built a center here so that we can enable training and all those things are in process. So please, if anybody has interest in that just contact our clinic, we’re always looking for how we can help individuals to make a difference in the world.  And when we’re looking at longevity, I would say one last thought. One of the things that really drove me forward in looking into the longevity space is this desire to see more wisdom in the world and wisdom is really held to a great extent in elders. People that have been around the block I think of eldership as something that we don’t honor enough. And it’s not something that we talk about enough, that it is a goal in life to get to the stage of being an elder and to take one’s life experience and be able to transmit that to the next generations in a way that helps our species move forward in a beautiful way.  To me, a major reason why I work in longevity is I want to see more wisdom in the world and that means healthy elders. So I would encourage everybody out to seek wisdom and hug an elder, so.

Dr. Weitz:            Thank you, David.

Dr. Haase:           You bet. You bet.



Dr. Weitz:            Thank you for making it all the way through this episode of the rational wellness podcast. And if you enjoyed this podcast, please go to Apple Podcasts and give us a five star ratings and review. That way more people will be able to find this Rational Wellness podcast when they’re searching for health podcasts.  And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition clinic. So if you’re interested, please call my office 310-395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.


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