In Episode #8, Dr. Jill interviews Dr. David Haase, founder of MaxWell Clinic in Nashville, TN about new treatments for dementia with plasma exchange
MaxWell Clinic: https://maxwellclinic.com/
Dr. Jill Carnahan is Your Functional Medicine Expert® dually board certified in Family Medicine for ten years and in Integrative Holistic Medicine since 2015. She is the Medical Director of Flatiron Functional Medicine, a widely sought-after practice with a broad range of clinical services including functional medical protocols, nutritional consultations, chiropractic therapy, naturopathic medicine, acupuncture, and massage therapy. As a survivor of breast cancer, Crohn’s disease, and toxic mold illness she brings a unique perspective to treating patients in the midst of complex and chronic illness. Her clinic specializes in searching for the underlying triggers that contribute to illness through cutting-edge lab testing and tailoring the intervention to specific needs.
A popular inspirational speaker and prolific writer, she shares her knowledge of hope, health, and healing live on stage and through newsletters, articles, books, and social media posts! People relate to Dr. Jill’s science-backed opinions delivered with authenticity, love and humor. She is known for inspiring her audience to thrive even in the midst of difficulties.
Featured in Shape Magazine, Parade, Forbes, MindBodyGreen, First for Women, Townsend Newsletter, and The Huffington Post as well as seen on NBC News and Health segments with Joan Lunden, Dr. Jill is a media must-have. Her YouTube channel and podcast features live interviews with the healthcare world’s most respected names.
Dr. Jill 0:12
Awesome. We’re live!
Dr. Haase 0:14
Dr. Jill 0:15
So we are on, Dr. Haase. It is so good, my friend, to see you.
Dr. Haase 0:21
It’s so great to be with you, Jill.
Dr. Jill 0:23
Yes, and I just love it because we get to talk over dinner at the IFM with friends or wherever we’re at, and it’s just like—boom, boom, boom!—the energy and the ideas flow. I actually chose specifically [to have you on]. You’re one of my favorite people for that, so that’s why you’re here. I want to introduce you, and I’ve got your bio here. I won’t read it all, but I want people to know just a little bit about you, so hopefully, I’ll pick the highlights and then we’ll just dive right in.
Dr. Jill 0:48
Dr. Haase is a doctor, teacher, entrepreneur, and innovator. And you’ll see just from today some of his ideas on what he’s doing. I’m so excited to talk about this because he is on the cutting edge. He’s deeply committed to maximizing wellness for everyone. He received his medical training at Vanderbilt and completed his residency in family medicine, just like me, in Rochester, Minnesota. He’s board certified in family and integrated holistic medicine. He realized something important was missing early in his clinical practice. I’ll just put it in a nutshell: He’s been a real detective in discovering the root cause of illness. But what I love about him is that he’s such a great businessman and entrepreneur. He not only takes the idea of seeing patients in the clinic and [practicing] functional medicine, but he really goes to the next level by creating systems and programs to reverse disease. And we are going to dive into that today. So welcome, David, to the call today!
Dr. Haase 1:41
Dr. Jill 1:43
I love stories. So what I’d love to start with is just a little bit about: How did you get interested in medicine? Where did you grow up, first of all? Where were you born?
Dr. Haase 1:52
Yes. I’m a dairy farm boy from South Dakota, so I grew up on a dairy farm. Unfortunately or fortunately, I was plagued with many small illnesses as a child. So I visited my local family doctor, who was this amazing Filipino general surgeon who took care of our town of 850 people. We had a hospital in the town. I had several issues. I had mono, [for which] I got to be hospitalized. During that time, he gave me a little lecture on immunology. He’d teach me, and then he’d quiz me the next day. These were the eras where they’d put you in the hospital for a while. He said, “You should be a doctor,” and I was like, “Eh, okay.” And then he invited me to come and actually assist him in surgery. So here I was, a high school junior, with my hands inside another person, assisting with cholecystectomies. I was like, “This is pretty cool.” I also knew that medicine was maybe the one thing I could do for the rest of my life and not get bored, and I was right.
Dr. Jill 3:02
Yes. That is so cool. Oh my gosh. And then from there, you kind of knew… What age was that? That you thought you were going to go into medicine?
Dr. Haase 3:11
Really, it was in high school. Mom said it was younger than that, but I don’t really have any recall of that. I kind of was a covert pre-med during college. I didn’t want anybody to know I was pre-med because I wasn’t that nerdy. So I kind of did that on the sly. But really, I loved it. I love the practice of medicine. It is always an opportunity to be humbled and challenged.
Dr. Jill 3:45
I couldn’t agree more. I grew up on a farm too—corn and soybeans. There’s something about that. I always think of this nourishment of the earth, and for me, there was also toxicity with the environmental chemicals and things—this dichotomy. Also learning to thrive and grow and the work ethic—there’s something really special about us farm kids.
Dr. Haase 4:06
Where was that, Jill?
Dr. Jill 4:08
Central Illinois. I was right in Illinois. Yes. Did you not know that I was a farm girl too?
Dr. Haase 4:14
This is interesting because I think functional medicine is totally an agricultural model of healthcare. So allopathic medicine is really more of a militaristic model. We look at disease as something to hunt and kill, in allopathic medicine. But in functional medicine, we know that the creation of health—the growth [and] nurturing of our health—health has to be grown; it can’t be forced. That’s why the doctor-patient relationship has to be sacred because it’s the patient who really does all the important work. I think it is part of the mindset that we just grew up seeing things grow on a regular basis. And there’s a time for planting. There’s a time for cultivating. There’s a time for waiting, a time for harvesting, and then a time to rest. That cyclicity of life, I think, resonates with what reality is. And when we operate outside of those expectations of life and the rules of biology, the rules of reality, that’s where we get into trouble.
Dr. Jill 5:33
I love that analogy. I haven’t thought of it that way, but that makes so much sense. My family is still farming in central Illinois, and it’s more like an agro-business because it’s grown. I am one of five. I have three brothers: One is an engineer, and the other two are farming. But what’s interesting to me is that my oldest brother has a very good business mind and is a very good detective. He has gone into soils and soil ecology; he’s like a functional medicine Ph.D. of the soil. I love it because we get together and have these conversations, and what we realize—I know you understand this better than probably anybody—[is that] the soil is a mirror of our gut ecosystem. A lot of what we see in functional medicine [is] a mirror of the disequilibrium of our soils, the overgrowth of crops, and an over-circulation without adding nutrients back. It’s so parallel. Literally, Jeff is a farmer; he has nothing to do with medicine. I’m a medical doctor; I have nothing to do with farming. Yet we can have these conversations about pH in the soil or about magnesium in the body, and it’s so parallel. It’s so interesting to me because of the health of the soil.
Dr. Jill 6:39
I know that when I had cancer at 25, my family started to listen and learn. “How in the world could Jill have had cancer at 25?” And then my sister, David, got cancer at 28. So all of a sudden there are two girls in this family system who grew up in the same environment [and got cancer]. Clearly, genetics had a role, but clearly, environment had a role, right? And then my mother had Hashimoto’s. So there was this whole thing [to which] my family started to pay attention. And now they are some of the only farmers in Illinois that not only [grow] 100% non-GMO crops with corn and soy, which is kind of unheard of—
Dr. Haase 7:12
That’s really hard to do.
Dr. Jill 7:14
It is. This is like 10 thousand acres plus. This is not a small business. And the second thing they’re doing is [planting] a lot of organic plots as well. And again, this is kind of cutting-edge for central Illinois farming. So I’m really proud of them for that because that is going to reflect on the health of our nation as farmers do that.
Dr. Haase 7:32
It’s one system. We can’t live with the hallucination that somehow we are outside of the entire living system that is our environment. We’re part of it, and I think that’s just something that you and I understand deeper than what we could articulate, right?
Dr. Jill 7:52
It comes naturally, right?—the understanding of it.
Dr. Haase 7:56
Well, you know I love brains. I’m always thinking about the brain. Our connectome is all of the sum connections in the brain, and we’ve been doing quantitative EEG analysis for like 12 years. We do a lot of volumetric MRI studies to try to figure out: How is that particular brain not functioning at optimal [levels]? And when we think of the connectome, it’s a wiring process. When we’re really little, the very first steps we take [are filled with] all kinds of sprouting going on—the first things we see. So the things that happen [when we are] very young give us the foundation upon which we build the next layer, and then that builds the next layer. That’s why early childhood education is so important—all that stuff. But the way we saw the world and the way all of our patients see the world [makes] it so interesting to go back. That’s why I like the functional medicine timeline—you go back. Sometimes how somebody views the world is actually the most important part of their health care, right?
Dr. Jill 9:05
Yes. I love that perspective. When you’re in front of a patient, how do you gather [pertinent information]? What’s your question for: How do you view the world?—because that’s a really good place to start. Is there any particular way that you start to get information from them about the view of the world, or do you just listen? What’s your secret there?
Dr. Haase 9:21
I guess it’s my gut. I first start with: “What is your health for? Why do you want to work together?—because I’m not easy to work with. We’re going to do a lot of stuff.” Anyway, so “What is your health for?” And then just listening starts to open up opportunities to ask questions. My first question is not [something] like, “What is your relationship to your mother?” That would be a little creepy. But that one may come, right? And you can learn a lot about somebody by their relationship with their mother because that is really the bedrock when you think of the layering of our brain and how we view the world, etcetera.
Dr. Jill 10:08
That’s my screening question for who I’ll date. You know, like, “What’s your relationship with your mother?”—because it tells a lot about how they’re going to treat the woman in their life, right?
Dr. Haase 10:15
Yes, a lot. A lot. Exactly.
Dr. Jill 10:18
So one question before we go to all the stuff you’re doing with brain health. I want to talk about that, but we talked about terrain and soil and this analogy with farming. I would love [to hear] your thoughts about the terrain of our environment and this pandemic that we’re experiencing because it’s relevant, right? Like, how did this happen to us? And what soil did we have that made it happen in this type of extreme? I would love to talk about your thoughts around that because I think there are a lot of things that set us up for this worldwide.
Dr. Haase 10:48
Oh, man! There are so many things. When you take an ecological perspective on how this emerged and where we went from here, it’s massive. Just starting from where this virus probably mutated out of was this really adverse environment of all kinds of animals in very close quarters and high frequency with humans. You had so many opportunities for a cross-species jump. And that is fundamentally where this came from. Fundamentally, it was our relationship with our food being dysfunctional that started this process. I say “we” as in China.
Dr. Jill 11:28
The world, right? Yes.
Dr. Haase 11:29
The virus didn’t sprout here. But then I find it really fascinating that this is showing so many interesting parts of what we’ve always talked about in functional medicine, right? I wrote this in an early blog [post]—I think [it was] on March 3rd or so—that it’s the people with inflammation and oxidative stress. If we started looking at the viral population with those two markers, I mean, high ferritin is amazingly predictive of the predilection towards a cytokine storm, right? We have been measuring ferritins forever, not just to measure iron. We know that that’s an acute-phase reactant. It’s like, “Wow, if that’s high,…” you know. Even if you just have high iron, that’s a problem because that’s going to [cause] feed-forward oxidative stress. Those are not measuring the virus. It’s not measuring the immune system; it’s measuring a marker of how the system itself is functioning. I think that’s the huge part here. We’re being invited to ask questions about the system. And if we take that invitation, there’s a lot of growth that’s going to happen as a result of this. If we don’t take that invitation, guess what? We’re going to have another opportunity to be invited.
Dr. Jill 12:48
Absolutely. I don’t know where I heard this; this is an original, but I grabbed a hold of it and it made sense to me. Hundreds of years ago, we talked, and even in the last decade, we talked about germ theory. Clearly, this is valid—infections. People didn’t even know that washing their hands protected them from these surgeons, who were taking corpses and then going to do surgery and passing infection. So this is clearly valid. But we need to now move from pure germ theory to the theory of terrain because the terrain is all about: Why are some people having a resilient immune system? I heard the story of a close friend who had a friend who was on the cruise ship, and it was a husband and wife and their parents for their 50th anniversary. The father died, the mother got very sick, the husband didn’t get sick at all, and the wife got sick and recovered. So there were these four people, same family, same room, from all ends of the spectrum, from death to no experience.
Dr. Jill 13:44
So to me, going from germ theory and purely thinking about protecting ourselves with a mask and “don’t go outside”—well, there are two sides to that story. When we don’t go outside, don’t touch the dirt, and don’t breathe fresh air, our immunity is actually inhibited because, by touching dirt and touching things and our system interacting with the germs in the environment, that’s how it’s trained. Now, I’m not saying we shouldn’t follow precautions at all; I’m not that person. But what I’m saying is that there are other sides of this, and social isolation creates its own set of traumas and its own set of immune dysfunction. But there’s a balance here, and the real issue in functional medicine, which is what we do every day, David, is the terrain. Is there an infectious burden? Is there a toxic load? Is there inflammation? If you get exposed to the virus, there are some people that will not get ill, and we know that. There are some people who will die. So what’s the difference? It’s not the germ, right? It’s the terrain, not the germ. And I love talking about that because that’s functional medicine at the core; it’s what we do.
Dr. Haase 14:46
Absolutely. And it’s so interesting; there is no relevant answer that allopathic medicine gives for that, right? The germ theory is absolutely correct, 100% correct, and… there’s more!
Dr. Jill 15:03
Yes. So wait, there’s more!
Dr. Haase 15:05
But wait, there’s more!
Dr. Jill 15:09
Yes, totally. And I love thinking about that because that’s what we deal with every day. I do a ton of stuff with environmental toxicity. What I see is the load that we’re experiencing even compared to 20 years ago when I started in functional medicine. We’d have someone come in with menopause symptoms, hypothyroidism, Hashimoto’s, or [other] simple, straightforward things that got better. Nowadays, I rarely see something that straightforward. It’s layer upon layer upon layer, and the system is breaking under the load. To me, with what I see and teach, a big part of that is our environmental toxic load: The air we breathe, the food that we eat, the water that we drink, the stress that we live [with]—these are all burdensome and becoming more so every day so that they break the system internally and [affect] our ability to fight infection.
Dr. Haase 15:56
Okay, you hold that thought because I have something very interesting to tie into that when we start talking about… We need to talk about dementia and what I’m doing.
Dr. Jill 16:07
Yes, let’s go right into that because it’s not [about] what I have to say. Tell me what you’re doing with dementia. Let’s dive right in. I really want to hear about this.
Dr. Haase 16:15
Okay. So let me just say right off the bat that we’re literally doing plasma cleanses to reverse Alzheimer’s. So, I mean, this is just bizarre. Honestly, you sit back and you’re going like, “What the heck is that about?” It’s something called “therapeutic plasma exchange,” and this is where you have two large IVs put in the arm. Blood is pulled out of one arm, goes in, and gets mixed with an anticoagulant. It goes into a big centrifuge that’s continuously running. It pulls off the solid cells, and it pulls off the plasma. The plasma, the liquid part of blood, is then discarded. And the solid cells are then mixed with the replacement fluid. We typically use albumin or immunoglobulins, and then that’s returned to the body. This goes on continuously until we exchange 1 to 1.5 times that person’s entire plasma volume. For a guy my size, we’ll run eight or nine liters of my blood through the machine in a single setting, so it’s a total plasma exchange. I’m a certified apheresis specialist, so this is not something you can commonly find. It’s mostly done in hospitals, but this is an exceedingly safe process.
Dr. Haase 17:40
I wanted to jump in on what we were doing because of what you just said. You said that it’s so environmental. All this stuff is environmental. Well, what is plasma? And this is going to blow your mind, Jill. You’re going to hear it first here. I’m going to start talking about this. This is one of the first times I’m going to be talking about it. I’ve been pondering on this. What is plasma? The plasma is the interface between your outside world and your inside world. Plasma is the interface where everything that comes into your gut, all the microbiome activities, all the metabolites—
Dr. Jill 18:21
Dr. Haase 18:21
All that stuff, right? It’s transmitted through the plasma to the brain. How about the things you breathe? You’re talking about what you breathe in. Guess what? You have to go through the plasma to get to the brain. How about what you put on your skin? You have to go through the plasma to get to the brain. This entire idea—we have so much interest in toxicity in functional medicine because we know it impairs the body’s systems’ ability to function. Well, this is literally an oil change; we’re pulling out the old plasma and putting in fresh. There’s a tremendous amount of science on this. But anyway, it’s fascinating.
Dr. Haase 19:07
Let me tell you about the major study that supports what I’m doing. It’s a major study called the AMBAR trial. One of the reasons you may not have heard about it yet is because it hasn’t been published. The results have been done for over a year. The results have been presented at three major international meetings on apheresis. It was sponsored by a drug company called Grifols, and they actually make albumin and IgG. They’re a major pharmaceutical company that takes the plasma that people donate. Group plasma all gets separated into its component parts, and they make bottles of albumin, usually used in the ICU. So they said, “Hey, this makes sense.” They recognize that albumin… Albumin in the body is one of our major antioxidants. It is actually the major antioxidant in our blood. We talk about glutathione; we talk about uric acid; we talk about… No. Its albumin has the most antioxidant potential. It’s in our bloodstream. So albumin can get oxidized reversibly or irreversibly. If it’s irreversible, that’s done, right? It’s no longer available to be used. So there’s a difference between the albumin that’s actually poisoned and irreversibly denatured as a result of toxic intermediation, and it’s higher in individuals who have dementia than in people who are normal. And they went, “Hey, there’s something here!”
Dr. Jill 20:39
Just to clarify, would that be basically like a sponge or like a neutralizing agent? When you’re talking about albumin, for the layperson, could they consider it like this neutralizing agent or just a sponge to sop up toxins? Or is it not quite that?
Dr. Haase 20:50
Yes, absolutely. I think a sponge is relevant. I would also think of it more like a Swiffer. You’ve got those little Swiffer pads [where] things will stick on and you pull it off. But every once in a while, you get something on a Swiffer and it’s never going away, so the Swiffer is not going to work again.
Dr. Jill 21:06
Got it. Okay.
Dr. Haase 21:10
Then they looked at the albumin, because albumin is in our CSF, our cerebral spinal fluid, which is actually the fluid that bathes the brain and which has this carefully guarded interface with the bloodstream. The albumin in the CSF of people with dementia is insanely denatured [and] is super oxidized—about 40-fold what it is in an individual without dementia at that same age. So, “Oh my gosh. This albumin is the problem. Let’s remove the albumin and put in fresh albumin.” Interesting thought. So they did the study with about 490 participants, multi-national, [and] multi-center, with many academic institutions involved. [It was a] double-blind, randomized, placebo-controlled trial doing plasma exchanges. There were a total of 18 plasma exchanges done over 14 months, and then they tracked both mild and moderate Alzheimer’s disease. Well, [for] the individuals with moderate Alzheimer’s disease, guess what happened over 14 months? What kind of trajectory change happened when they got these 18 plasma exchanges compared to a placebo? Remember, this is a placebo-controlled trial, so we have an idea. What change do you think happened?
Dr. Jill 22:42
Gosh, maybe a 20% improvement.
Dr. Haase 22:47
Would 20% be good in the world of Alzheimer’s?
Dr. Jill 22:48
Yes, 20% would be great.
Dr. Haase 22:52
Okay. [There was a] 61% decrease in the rate of progression—a 61% decrease. I have these in presentations I do.
Dr. Jill 23:04
Dr. Haase 23:05
But in mild Alzheimer’s, what do you think happened? In mild Alzheimer’s [disease], these people got better.
Dr. Jill 23:14
I’m guessing the results were even better.
Dr. Haase 23:15
They got better. They improved. Over [the next] 14 months, they improved. Now, that’s insane, right? Now, it wasn’t really powered to give all of the insight that we wanted to do in mild Alzheimer’s disease. In the group model, it was absolutely clear; it’s highly statistically significant. Not only that, they did CSF measurements of the amount of phosphorylated tau and amyloid-beta 42 in the CSF, and this process stabilized. It stabilized the abnormal relationship of these damaged molecules in the fluid that was around the brain. Okay. So now it’s like, “Oh, we did plasma exchanges”—
Dr. Jill 24:00
You’re saying that it’s not just their symptoms but objective data; that’s important.
Dr. Haase 24:04
But there’s more! There’s more! They actually also did PET FDG scans, which measure how much energy [by means of] glucose is being consumed by the brain. What happened is that that stabilized as well. So compared to the placebo, the individuals that had the plasma exchange done had less decline in the metabolic activity of the brain, meaning less death of brain cells.
Dr. Jill 24:38
Wow! So you said this was presented, and what happened with the publishing? That’s what I want to know.
Dr. Haase 24:44
That’s the right idea, right?! This is just a hypothesis. I don’t know why they haven’t [been] published yet. I am so thankful to Grifols for doing this. This is the largest apheresis study that has ever been done in the world—more procedures. This is a huge investment. I have worlds of respect for Grifols as a company, okay. So please let me just say that off the bat. They went where other people weren’t willing to go, and they put their money where their mouth was. So, hats off. But I think the reason they haven’t published is because this was a generic [product]. Albumin and immunoglobulins are kind of generic products; one is not so from one supplier to the next. So they’re possibly currently making an improved version of a plasma derivative. So when the plasma comes in, it’s going to be… But it will be a separate drug that will have its own indication for Alzheimer’s, whereas other albumin will not.
Dr. Haase 25:45
I’m a certified apheresis specialist. I think it’s unethical that we’re not doing this at the present time. I think there’s enough data. I think the risk-benefit ratio [is good], especially if there’s peripheral access for an individual that clearly has Alzheimer’s disease or is going down that pathway. Alzheimer’s is a terminal diagnosis. We see it happening, right? I’m using an FDA-certified machine and all FDA-certified and approved medications, but just for an off-label purpose. There can be no promises made about what actually occurs because we don’t have a classic indication yet. So this has to be very plain with people that come in. And again, it’s: How do you see a benefit from this? Now, I have seen some cool things happen with apheresis, but they have to do with blood viscosity and things like that.
Dr. Jill 26:46
This is so fascinating, Dr. Haase. I’m sure right now this is probably not typically covered by insurance, which is so okay because the cutting-edge things that we do are worth it in spades to reverse Alzheimer’s, right? And hopefully what you’re doing is going to lead the way for the kinds of things that someday make it covered. So I love that.
Dr. Haase 27:09
Absolutely. No question. But there are a lot of hurdles that have to be overcome. This is an expensive procedure. It takes dedicated personnel [and] a lot of machinery. Anyway, this is not something that you’re going to see pop up in a lot of places quickly, and it needs to.
Dr. Jill 27:31
But that’s the great thing about what you’re doing. I love this. I love that you’re sharing this, and I love that you’re putting yourself out there to really make a difference in these people’s lives and to do the work. A lot of doctors would be too afraid to be the ones on the cutting edge because you’re changing medicine—you really are. I love that. [For a] typical patient, how many times would they need to get treated?
Dr. Haase 27:58
Until they want their brain to start degenerating again.
Dr. Jill 28:01
Okay, so it’s kind of an ongoing for those—
Dr. Haase 28:02
This is ongoing, and that’s the challenge. So now let me tell you the Grifols study didn’t do anything of what we do in functional medicine, right?
Dr, Jill 28:11
Dr. Haase 28:12
Let me go back to what I said initially, that the plasma is the great interface, right? We know you and I have both had many cases of patients that come in with a diagnosis of dementia, and we search for the multiplicity of clues. I’ve actually created a software database called Maxwell Brain that we’re going to be making available to physicians soon that takes in all the data—historical data, laboratory data, genetic data, and things like that—and helps make a plan. We’re working with laboratory companies to actually make this [at] no cost to patients [and] no cost to doctors. And I needed this platform for my studies in plasma exchange because, frankly, I need a whole bunch of people out there using the platform to get some benefit because I think that needs to be our new standard of care. That needs to be our new standard of care, and then we can have something to actually do clear efficacy comparisons on because, again, it’s expensive [and] time-consuming. It needs to become more accessible, but there are a whole lot of hurdles that have to come. But you’ve got to start somewhere, right? You have to start, and then once you start, there’s a possibility you can [inaudible].
Dr. Jill 29:31
I love that you’re collecting data too, because that’s really how we’re going to move functional medicine and what you’re doing forward. And I’ve got a million questions, as you can imagine. Like right now, this is so fascinating. So I’m really familiar with IVIg; I have a lot of patients who get it because of these complex [illnesses]. How would this compare? It sounds like a step above because a lot of the treatment still includes the IgG in the plasma exchange, but what would be the difference between what you’re doing and a typical IgG treatment?
Dr. Haase 29:57
IgG—you’re putting something in, right? And we should do another whole call; we’ll talk about plasma in more depth because there’s so much more to actually talk about here. But [with] IgG, you’re putting in immunoglobulins. And [with] these plasma exchanges, you’re actually removing them; you’re removing all the plasma. So what are the typical indications for IVIg? They’re severe autoimmune diseases, right?
Dr. Jill 30:21
That’s where I’m going with this. Totally.
Dr. Haase 30:23
Guess what is the defined standard for the treatment that is utilized when all else fails in autoimmune disease? It’s plasma exchange.
Dr. Jill 30:36
Dr. Haase 30:37
Plasma exchange. So this is the Mac Daddy of therapies for autoimmune disease. So you want to stop something short; well, let’s remove the antibodies. And that works because IVIg—we think that’s actually binding a lot of the excess antibodies and decreasing the propensity. And actually, the cost is similar, but the availability of somebody who is able to do this and has the equipment to do this is harder to find than somebody to give IVIg [to]. Finding somebody to give IVIg [to] is tough too, right?
Dr. Jill 31:14
Yes. Now again, I’m really familiar with IVIg, and there are significant side effects for people. A lot of the volume changes and those types of shifts can really cause symptoms, and usually, they get better and [are] rate dependent and all that. Is it similar with you as far as the side effects or watching people, or is it a lot easier for people to tolerate?
Dr. Haase 31:33
So I’ve given a fair bit of IVIG in my 20+ [year] career in functional medicine as well. It’s just so much fun talking to you, Jill, because we just go right there. There are so many basics that should happen before—a lot of things that we’re talking about.
Dr. Jill 31:50
Right. We’re at this level.
Dr. Haase 31:51
Yes, I know. We’ve just got to make sure people recognize that, though, because you can get so much done with the fundamentals, and those are what you should focus on and do first. But IVIg causes a lot of histamine-type reactions. There’s a lot of immune activation; you have volume issues. In plasma exchange as well, there’s a condition called TACO, transfusion-associated cardiac overload. We don’t see that because our machine is basically measuring what comes in and out of the body down to about a 10 cc level. So we can very tightly control all the fluid volumes coming in and out. We have a protocol for preparation for doing plasma exchange that deals with a lot of the excess histamine issues. So knock on wood, we just don’t have a histamine reaction yet. And that’s really abnormal; I need to publish that as well.
Dr. Haase 32:56
When you’re pulling things in and out of the blood and you’re adding in citrates and a lot of these other things, you’re just stirring the system up. And if your mastocytes are twitchy, then they’re going to be angry, and you need to calm them down before you start this process. And the nice thing [with] what we’re doing is that it’s totally elective; it’s totally outpatient. We can schedule these things months ahead [and] get people studied. And Jill, one of the other things I’m really excited about [is] I’ve been doing a lot of transcriptomic analysis, so I actually have before and after transcriptome analysis to take a look at: What are the effects of the expression pattern of DNA in the various white blood cells? And how is that manifesting [itself] in the process? I’m going to be presenting some of that—
Dr. Jill 33:43
Oh, this is so fun. We have to do another call now because this is like… You know, that’s what it’s going to take—someone like you who’s collecting the data.
Dr. Haase 33:51
Well, you have to. Really good evidence [exists that] this is a reasonable thing to do in a field where nothing freaking works in the conventional world. But we’re treating the plasma. We’re optimizing hormones, we’re detoxing, we’re working with nutrition, and we’re changing the ketones. I mean, that’s working with the plasma, literally. But I think if we add these two, we can get so much more bang for the buck. I think we can have fewer treatments [and] fewer plasma exchanges. I have a lot of hope for that. It’s still early. I don’t want to make any claims. I think the people who engage in this process early, [such as] my patients, are incredible contributors to the world because we’ve first got to learn it somewhere. And the major academic centers are not going to go here in the way that we know they need to go there. We just need to be so careful, and we need to be humble in this process and make sure that we’re loving people as we go through this endeavor.
Dr. Jill 35:09
Oh, I love that. So this is just going out on a limb, and maybe we don’t have the answer. But I could see this being [beneficial] not just for your patients who [have a] terminal diagnosis, but I’m assuming [that for] someone who wants to be [at] optimal performance, who’s young and healthy, this might be really beneficial too. My world is, like, where are we biohacking [for] optimal performance? And again, there are no studies on this, I know, but I’m assuming this would help anyone who has a toxic load or who potentially wants better performance.
Dr. Haase 35:41
I think that’s a really good hypothesis right now—it really is. It’s all about risk/benefit. What is the potential risk? And like I said, on a standard plasma exchange, we go through an extensive informed consent process. People have to actually take a test before I will see them because we have to be realistic about these things. But I do think we’re going there, Jill. I do think we’re going there.
Dr. Jill 36:10
Or [it can possibly be used for] PANS and PANDAS, which [affect] young people with severe autoimmune encephalopathies. We don’t know. I know there’s no evidence yet, but I could see this potentially being studied in those kinds of patients.
Dr. Haase 36:21
We have people seek us out and ask us questions. If people are engaged and are open to us gathering the data necessary to track—”Is this of benefit or is this not of benefit?”—and again, have very clear, informed consent, I think that’s a very reasonable path to go down.
Dr. Jill 36:46
Do you have just a couple more minutes? I’ll try to wind this down here, but this is so great. I want to ask you [about this] because people are going to be asking you. You’re there doing this. This is amazing, the work you’re doing. Hopefully, you’ll get a Nobel Prize for this someday. I mean, this is the kind of stuff that we need. Are you training other physicians yet? Where are we at with starting to maybe get other physicians doing this? Is that possible?
Dr. Haase 37:11
We’re not there yet. Well, COVID threw a whole big monkey wrench in this whole process, like it did with almost everything, because the people who have dementia are going, “I need to stay at home.” And now what people are finding out is that people with dementia… Everybody that’s close to them is going, “You need help.” So I think we’re going to have an explosion of people seeking interest in this. And like I said, I’ve just been very quiet. Jill, like I said, this is the first Facebook live I’ve ever done. I’m really not out there telling the story. I want to figure it out. Once the story gets out, I think we’re going to have a lot more interest. I love teaching. You know that’s my real favorite thing to do. So absolutely, we’ll be teaching doctors how to do this and how to get it up and running in their own areas. But apheresis, this is not something—
Dr. Jill 38:12
It’s not for the faint of heart.
Dr. Haase 38:13
You can’t take a weekend course on this and get started. This is not that kind of thing.
Dr. Jill 38:19
And if anyone is doing it and [is] able to do it right, kudos to you for being the pioneer out there. I know you’ve got a million things you could be doing instead of talking to me, but I’m really delighted and honored that you took the time. And I want to let people know: If they want to know more about your clinic [or] what you’re doing, where can they find you? Tell us how to find Dr. Haase.
Dr. Haase 38:38
Sure. Well, it’s just David Haase, MD, on Facebook. I have a website, DavidHaseyMD.com, and you can find more information there—not as much as you need to find, I’m certain; you can ask for more information. And we’ll start getting it up more. Like I said, this is really the first time I’m talking publicly about this. And I’ll be on [with] Dave Asprey on Bulletproof Radio pretty soon talking about this as well. So that’s one of the best ways. My clinic in Nashville is [called] MaxWell Clinic, and it’s for maximizing wellness. We’re proud to be one of the longest-running functional medicine clinics, certainly in the Southeast. It’s a privilege to get to do what we do. We just need a whole lot more doctors doing it.
Dr. Jill 39:32
Us little farm kids— who knew what we were capable of?
Dr. Haase 39:36
Well, we’re growing health. We’re literally still back on the farm, Jill.
Dr. Jill 39:41
Yes. I’m honored to have you. I’m grateful for your time. I will be here to share with our colleagues. And let me know how I can continue to support you because I’m one of your biggest fans.
Dr. Haase 39:56
Thank you, Jill. And thank you. You do such a great job of communicating what we’re doing and attempting [to do] in such a high-integrity fashion. There are a lot of people out there doing functional marketing instead of functional medicine, right? People are making clickbait blogs and making ridiculous claims, and there’s a lot of BS. You really stand above [with] everything you put out. I’m thankful for your standards.
Dr. Jill 40:30
Oh, that means so much. I really, really appreciate it. Well, enjoy your weekend, and thanks for spending time with us here. I’m sure we’ll connect soon.
Dr. Haase 40:38
All right. Bye.
Dr. Jill 40:39
Okay. Take care.
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