Episode 131: What If Inflammation Could Be Removed? Therapeutic Plasma Exchange with Dr. Pamela Smith
What if inflammation isn’t just something to manage… but something you could actually remove?
For decades, chronic inflammation has been treated with suppression — steroids, biologics, immune blockers. But what if there were a way to physically remove inflammatory burden from the bloodstream?
In this episode, we sit down with Dr. Pamela Smith — ER physician, toxicologist, hormone specialist, and pioneer in therapeutic plasma exchange (TPE) — to explore the emerging science behind physically reducing inflammatory load.
We break down:
• What actually happens during therapeutic plasma exchange• How inflammation, cytokines, and antigen load circulate in the blood• Why autoimmune disease may be driven by persistent toxin burden• The connection between mold, plastics, metals, and immune dysfunction• Whether TPE can help long COVID, PCOS, cardiovascular disease, and cognitive decline• Who should — and shouldn’t — consider this therapy
This is not a hype episode.It’s a grounded, nuanced exploration of what’s possible when inflammation is treated as something measurable — and potentially removable.
If you’re navigating autoimmune disease, chronic illness, hormone resistance, long COVID, or simply want to understand the future of inflammation science, this conversation will challenge how you think about immune regulation.
Is therapeutic plasma exchange the next frontier in functional medicine — or an emerging tool still finding its evidence base?
Let’s explore the science.
EPISODE HIGHLIGHTS:
[00:04:24] - Early TPE Experience in Emergency Medicine
- Dr. Smith used TPE before Narcan existed to treat drug overdoses by removing toxins from the body
- Key quote: "TPE has been around for over 50 years. So we've been using it long term for many different things." [4:40]
[00:05:27] - Transition to Personalized Medicine
- Moved from emergency medicine to personalized medicine approach focusing on root causes
- Key quote: "I spent some time bridging the time between ER and a personalized medicine practice, but had a practice for a long time looking at the cause of the problem and not just treating symptoms" [5:27]
[00:08:46] - TPE Alone Isn't Enough
- Discovery that TPE requires additional protocols including nutrients, stem cells, and exosomes
- Key quote: "We discovered that TPE by itself does not work for getting rid of the toxins because we were doing toxin tests before, after each exchange and then at the end" [7:23]
[00:11:36] - PCOS as Autoimmune Disease
- Revolutionary perspective on PCOS as an autoimmune condition requiring comprehensive treatment
- Key quote: "PCOS is an autoimmune disease... the body seems to be attacking itself, which is what an autoimmune disease is with PCOS" [11:36] [13:18]
[00:17:00] - The TPE Procedure Explained
- Four-hour procedure with IVs in both arms, plasma removal and albumin replacement
- Key quote: "You basically sit in a chair with an ID in each arm for three hours for the plasmapheresis and about another hour for the IV nutrients" [17:57]
[00:23:47] - Antigen Load and Immune System
- How TPE reduces persistent viral antigens and rebalances immune system function
- Key quote: "When you get something like COVID for example, then you end up with an antigen response antibody response and antigen, we've really never been able to lower that response" [24:28]
[00:28:27] - Treatment Protocol Requirements
- Most patients need 3-5 sessions, with toxins moving from tissue to plasma over time
- Key quote: "The average person needs three to five sessions because the first one or two or maybe three, it's getting it out of the plasma, it's still in the tissue" [28:27]
[00:37:25] - Strongest Evidence Areas
- Autoimmune diseases show strongest evidence, followed by heart disease and emerging memory research
- Key quote: "The strongest evidence is autoimmune diseases followed by heart disease just emerging now, but we're starting to get strong evidence on is memory" [37:25]
[00:46:33] - Personal Gut Health Story
- Dr. Smith's near-death experience and loss of ileum shaped her understanding of gut importance
- Key quote: "Your gut is the most important thing. I may talk about hormones a whole lot and I do, but if the patient's gut's not healthy and they're not hormonally balanced, they're not healthy" [47:42]
[00:50:45] - Choosing Credible Providers
- Importance of certification and proper training in TPE protocols
- Key quote: "If they're just doing TPE, then TPE, as you heard me say, we did a study, TPE itself does not work... Please make sure you see somebody who actually is certified in this field" [50:45]
RESOURCES MENTIONED:
- MD Lifespan clinic: Patient intake and TPE treatments
- University of South Florida: Leading TPE certification program [56:39]
- Mount Sinai College of Medicine: TPE certification program [56:39]
- Personalized Medicine Certification websites: personalized medicine certification.com and personalized medicine tpe certification.com [57:01]
- Books by Dr. Smith: "What You Must Know About Women's Hormones," "Maximize Your Male Hormones," "How to Prevent Breast Cancer Before and After" [58:28] [58:45]
KEY TAKEAWAYS:
- TPE alone is insufficient - requires combination with nutrients, peptides, and other therapies for effective toxin removal [7:23]
- Inflammation is the root cause of most chronic diseases including heart disease, cognitive decline, autoimmune diseases, and cancer [7:11]
- PCOS should be viewed and treated as an autoimmune condition with comprehensive protocols [11:36] [13:18]
- Most patients require 3-5 TPE sessions, with toxins mobilizing from tissues to plasma over time [28:27]
- Proper certification and training are essential for safe and effective TPE administration [50:45]
- Gut health is fundamental to overall health and hormone tolerance [47:42]
Thank you for tuning in to The One Thing Podcast with Dr. Adam Rinde ! If you enjoyed this episode, don't forget to subscribe for more insightful discussions. Feel free to leave us a review and share your thoughts. Stay connected by subscribing to this page for updates and behind-the-scenes content. Until next time, keep healthy and stay empowered.
EPISODE HIGHLIGHTS:
[00:04:24] - Early TPE Experience in Emergency Medicine
- Dr. Smith used TPE before Narcan existed to treat drug overdoses by removing toxins from the body
- Key quote: "TPE has been around for over 50 years. So we've been using it long term for many different things." [4:40]
[00:05:27] - Transition to Personalized Medicine
- Moved from emergency medicine to personalized medicine approach focusing on root causes
- Key quote: "I spent some time bridging the time between ER and a personalized medicine practice, but had a practice for a long time looking at the cause of the problem and not just treating symptoms" [5:27]
[00:08:46] - TPE Alone Isn't Enough
- Discovery that TPE requires additional protocols including nutrients, stem cells, and exosomes
- Key quote: "We discovered that TPE by itself does not work for getting rid of the toxins because we were doing toxin tests before, after each exchange and then at the end" [7:23]
[00:11:36] - PCOS as Autoimmune Disease
- Revolutionary perspective on PCOS as an autoimmune condition requiring comprehensive treatment
- Key quote: "PCOS is an autoimmune disease... the body seems to be attacking itself, which is what an autoimmune disease is with PCOS" [11:36] [13:18]
[00:17:00] - The TPE Procedure Explained
- Four-hour procedure with IVs in both arms, plasma removal and albumin replacement
- Key quote: "You basically sit in a chair with an ID in each arm for three hours for the plasmapheresis and about another hour for the IV nutrients" [17:57]
[00:23:47] - Antigen Load and Immune System
- How TPE reduces persistent viral antigens and rebalances immune system function
- Key quote: "When you get something like COVID for example, then you end up with an antigen response antibody response and antigen, we've really never been able to lower that response" [24:28]
[00:28:27] - Treatment Protocol Requirements
- Most patients need 3-5 sessions, with toxins moving from tissue to plasma over time
- Key quote: "The average person needs three to five sessions because the first one or two or maybe three, it's getting it out of the plasma, it's still in the tissue" [28:27]
[00:37:25] - Strongest Evidence Areas
- Autoimmune diseases show strongest evidence, followed by heart disease and emerging memory research
- Key quote: "The strongest evidence is autoimmune diseases followed by heart disease just emerging now, but we're starting to get strong evidence on is memory" [37:25]
[00:46:33] - Personal Gut Health Story
- Dr. Smith's near-death experience and loss of ileum shaped her understanding of gut importance
- Key quote: "Your gut is the most important thing. I may talk about hormones a whole lot and I do, but if the patient's gut's not healthy and they're not hormonally balanced, they're not healthy" [47:42]
[00:50:45] - Choosing Credible Providers
- Importance of certification and proper training in TPE protocols
- Key quote: "If they're just doing TPE, then TPE, as you heard me say, we did a study, TPE itself does not work... Please make sure you see somebody who actually is certified in this field" [50:45]
RESOURCES MENTIONED:
- MD Lifespan clinic: Patient intake and TPE treatments
- University of South Florida: Leading TPE certification program [56:39]
- Mount Sinai College of Medicine: TPE certification program [56:39]
- Personalized Medicine Certification websites: personalized medicine certification.com and personalized medicine tpe certification.com [57:01]
- Books by Dr. Smith: "What You Must Know About Women's Hormones," "Maximize Your Male Hormones," "How to Prevent Breast Cancer Before and After" [58:28] [58:45]
KEY TAKEAWAYS:
- TPE alone is insufficient - requires combination with nutrients, peptides, and other therapies for effective toxin removal [7:23]
- Inflammation is the root cause of most chronic diseases including heart disease, cognitive decline, autoimmune diseases, and cancer [7:11]
- PCOS should be viewed and treated as an autoimmune condition with comprehensive protocols [11:36] [13:18]
- Most patients require 3-5 TPE sessions, with toxins mobilizing from tissues to plasma over time [28:27]
- Proper certification and training are essential for safe and effective TPE administration [50:45]
- Gut health is fundamental to overall health and hormone tolerance [47:42]
S
MD
Pamela Wartian Smith, M.D., MPH, MS spent her first twenty years of practice as an emergency room physician in a level 1 trauma center with the Detroit Medical Center and then 29-years as a Functional/Personalized Medicine specialist. She is an internationally known speaker and author. She also holds a Master’s Degree in Public Health with a Specialization in Toxicology along with a Master’s Degree in Metabolic and Nutritional Medicine. Dr. Smith is in private practice and is the senior partner for The Center For Precision Medicine with offices in Michigan and Florida. She has been featured on CNN, PBS, and many other television networks, has been interviewed in numerous consumer magazines and has hosted two of her own radio shows. Dr. Smith was one of the featured physicians on the PBS series “The Embrace of Aging” as well as the on-line medical series “Awakening from Alzheimer’s” and “Regain Your Brain”. Dr. Pamela Smith is the co-director of the Personalized Medicine Certification at The Morsani College of Medicine, University of South Florida. She is the author of fourteen best-selling books. Her book: What You Must Know About Women’s Hormones, 2nd edition was released in 2022. Her book, Maximize Your Male Hormones, was released in 2023, and her book What You Must Know About Thyroid Disorders, 2nd edition, was released late last year. Her newest book, How to Prevent Breast Cancer: Before and After has just been released. She has newly been appointed the Chief Growth Officer and Chief Education Officer at MDLifespan, a cutting-edge medical practice with offices aroun… Read More
