What if optimizing your health wasn’t just about diet, exercise, or the latest supplement, but hinged on the very “oil” running through your system? In this recap episode of the TPE Blueprint Podcast, host Joe Fier is back at some of our most impactful episodes of the year. We’ll take a look at conversations with Dr. Paul Savage, Dr. Jill Carnahan, Dr. Paul Anderson, Dr. Janet Eng, and Dr. Muhammad Mansour, to break down therapeutic plasma exchange (TPE), mitochondria’s critical role in health, toxic burden from mold, and actionable strategies for real healing. Whether you’re biohacking or desperate for answers, this episode digs beneath the surface to challenge conventional medicine and empower your physiological reset.

Topics Discussed

1. What Is Plasma Exchange? Dr. Paul Savage breaks down the history and modern mechanics of TPE—and why it’s not a fad.
2. The Car Analogy for Your Health: How your body’s plasma exchange is like an oil change for your engine, and why cellular “cleanliness” matters.
3. Mitochondria & Cellular Mechanics: The role of mitochondria in energy production and disease, with Joe Fier and guests highlighting how toxins can slow you down at the cellular level.
4. The Menace of Mold: Dr. Jill Carnahan explains mold’s surprisingly high prevalence, why genetics matter, and how environmental toxins can disrupt everything from your cardiovascular system to your hormones.
5. Building and Environmental Health:Modern building trends and errors that lead to hidden water intrusion—and how your home’s design may affect your well-being.
6. Assessment and Personalized Care: Dr. Janet Eng and Dr. Muhammad Mansour discuss unique approaches to evaluating metabolism, body composition, and toxic burden, emphasizing a multimodal, tailored plan for every patient.
7. Advanced Therapies & Testing: From blood and urine screens to light therapies, what works and why there isn’t a “silver bullet” in recovery.
8. Sympathetic Overdrive & Parasympathetic Healing: How modern stress affects our ability to heal, and practical tactics to shift toward true rest and recovery.

Full Episodes to Check Out

1. Dr. Paul Savage: https://mdlifespan.com/tpe-bp-podcast/tpe-blueprint-ep-03-what-is-plasma-exchange-a-deep-dive-with-dr-paul-savage/
2. Dr. Jill Carnahan: https://mdlifespan.com/tpe-bp-podcast/tpe-blueprint-podcast-ep-19-is-mold-behind-your-fatigue-brain-fog-dr-jill-carnahan-unpacks-the-hidden-epidemic-breakthrough-detox-solutions/
3. Dr. Paul Anderson: https://mdlifespan.com/tpe-bp-podcast/episode-05-early-aging-modern-toxins-and-the-path-to-cellular-vitality/
4. Dr. Janet Eng: https://mdlifespan.com/tpe-bp-podcast/tpe-blueprint-dr-janet-eng-left-the-er-to-fight-toxins/
5. Dr. Muhammad Mansour: https://mdlifespan.com/tpe-bp-podcast/dr-muhammad-mansour-plasma-exchange/

Connect with Us

1. MDLifespan Website: https://mdlifespan.com/
2. Subscribe and Listen: https://mdlifespan.com/the-tpe-blueprint-podcasts/
3. Guidebooks: https://mdlifespan.com/guidebooks/
4. Follow on Instagram: https://instagram.com/mdlifespan
5. MDLifespan Toxin Testing: https://mdlifespan.com/toxin-test
6. Use code “podcast200” for a discount.

Enjoyed the episode? Hit “subscribe” and leave us a review! Share the show with friends and family who want to stay ahead in the world of regenerative and preventive wellness. Join our community for more insights, bonus content, and upcoming guest features.

Disclaimer:

MDLifespan PlasmaXchange protocols are designed to support general health and wellness. They are not intended to diagnose, treat, cure, or prevent any disease. The information provided on this podcast is for educational purposes only and should not replace medical advice. Please consult with your healthcare provider before beginning any new health program, especially if you have a medical condition or are taking prescribed medications.

Most of us feel like we're living life in first gear, so we're revving the engine

hard, but we're not going anywhere.

We're feeling exhausted, we're feeling foggy, and we might be wondering why

the biohacks aren't working for us.

The truth is it's likely that your internal oil is dirty.

So my name is Joe Fier, and today we're gonna count down the top

five most impactful conversations we had here on the show in 2025.

We're gonna go deep into the science of the human oil change with Dr. Paul Savage.

Then we're heading over to talk about hidden mold and all and this pandemic

that we're facing with Dr. Jill Carnahan.

Then we're gonna dive into why your mitochondria is

stuck in this metabolic state.

This bottleneck with Dr.

Paul and.

Then we're also joined by Dr. Janet Ing and Dr. Mohammad Mansour, where

we're talking about recalibrating your nervous system and the truth about

detoxing in a post pandemic world.

So if you feel like your health is hitting the wall and you really

want that breakthrough moment, this is the episode for you right now.

Let's dive in and start counting down the top five.

All right.

We're back for another episode.

Dr. Paul Savage.

It's glad to be here with you.

How are you doing?

Doing good, doing good.

What were we talking about today, Joe?

We're talking about plasma exchange.

You know, this

My

been talking about,

favorite topic.

I know you live and breathe this stuff, huh?

And you're doing so much.

And that is why we started this podcast.

Of course, we've been talking about toxins and histories and the effects and how

that, how that really, you know, it lands with us as humans and even the unborn.

So, but let's talk about what plasma exchange is actually define it, you know,

give a nice overview for everyone who.

Is here and just wondering what the heck is plastic exchange

and how does it fit in?

You know, it's, it's, it's not known, but you take, you go to the average

person, say therapeutic plasma change.

And they're like, what's that?

Is that something new?

In fact, it's not new.

It's very old.

It's been around forever.

Matter of fact, in ancient times, they can grease and grease and Italy and stuff.

Remember when they used to put leeches on you and the leeches would draw blood out

or they'd actually cut you and let you bleed out for a certain period of time.

That, that, that used to get people better and now when modern medicine

came along and they're like, that has no evidence that that's just hillbilly stuff.

That's just a hill medicine.

It doesn't work and it got poo pooed.

You know, it's just basically we're throwing it out and not even looking

at it again until around 1950, 1960 when some doctors were looking at some

disease states and there was yeah.

Stuff in the blood, um, uh, these, these type of antibodies that are bad for the

kidney and they're like, wouldn't it be nice if we just get those antibodies out.

Well, if we could just get the plasma out, we get the antibodies out and that's how

plasma change came about and that's how the machine, the machine came on about 20

years later, but that's why at that time, what we do is just take blood out, spin

it, separate it, throw the plasma away.

Then we put the cells back in.

It was a very long, laborious process, process, because we'd only do little

bags at a time, and the whole process of spinning them and separating

them and then adding them and then letting them infuse back in, it was

very tedious and complicated, just redundant, redundant, redundant.

Um, fast forward to the 1970s, and it's funny, it's based upon

separating milk from cream.

It's how people get the idea of how to do this and they're

like, let's do that to blood.

And sure enough, it separated the plasma from the cells and they were able to do

it in the same kind of mechanism that a cream separator does it on an industrial

farm and they just basically made a machine and made it a 1 unit thing so

it could do it all at the same time.

Just like the cream separator did.

I found that very interesting when we

good visual too, for everybody to

farming community.

because as we've talked about before, a plasmic change is simply

an oil change for the human.

Now, You may be too young to remember when you used to bring the

cars in and put them up on skids.

You'd undo the, uh, the oil at the bottom, let the oil drop out, and then you'd put

the, put the, uh, screw back in, and you'd go up to the top, and you'd put new oil

in the, uh, in the car, and then you'd run it around the block for about a month.

And then you'd bring it in and drain out the dirty oil again, and put new

oil in, drain it, and run it around the block for three, four, three,

four weeks, and bring it back in.

And you keep doing it every time until the oil started running clean.

And then you knew you got most of the gunk out of the car and you

could go tear, tear out the rest of the car, do what you wanted to do.

But it was running much better because clean oil means a good car.

Well, clean plasma means a good human.

So, the plasma change is very much the same thing.

It's a process by which we take the blood out, we put it into a machine, it spins

it, it separates the liquid, which is the plasma, from the cells, which is the

solid, and then we throw the plasma away.

We add the cells back to another liquid called albumin, and we

infuse that back into your body.

Now, albumin itself is just a neutral solution that makes sure that your

vascular space stays open, because you need that to push the cells around.

And then within 24 hours, you make brand new, non toxic, non inflammed,

non oxidized, non cancer, perfectly baby fresh plasma, all by yourself.

And it's, it's a very safe procedure.

It's had, it's very effective at what it does.

Um, and so we just took that whole concept and we ended up doing it.

A series of them, so you do one and then we'd wait four weeks and do another one

and people are like, why would you wait four weeks in between because we studied

the amount of toxins that occurred after you had one plasma change and what we

saw was at three weeks, but especially at four weeks, that's when all the toxins

came back and equilibrated in your system, because if I'm going to do multiple plasma

changes, I want to make sure every time I do it, I want to get the toxins out.

yeah,

So that's, but this whole thing with serial plasma change has been around.

We treated.

Many different diseases.

Neurologic diseases like Alzheimer's, um, myasthenia gravis, Guillain Barre.

We treated kidney disease.

There's certain diseases of kidney from antibodies that we use plasma change for.

We use it for autoimmune diseases like rheumatoid disease, rheumatoid arthritis,

and other type of autoimmunities.

We use it on blood disorders because there's certain blood

disorders where you're making coagulation factors you don't want.

And we can, they're all in the plasma so we can take them out.

It wasn't until two years ago, myself, is the one that figured out, not

only can we take all this other stuff out, we can take toxins out too.

I was telling you right before we started that I have a test.

Yeah.

I had my whole toxin test and I have, I showed a lot of mold.

I don't have it pulled up right in front of me.

But, you know, I was like, that shocked me.

'cause I'm in San Diego, I'm in a hotter part of San Diego too.

I'm not right by the water.

So I'm like, how is that possible?

So, and that, you know, some of the stats that have come out and,

and even some of the stuff that you published is like, there's, there's a

lot of people dealing with this that probably are just completely unknown.

So like, I guess what I wanted to assume is that we probably have

mold in us at some sort, like, so to acknowledge your point, okay.

Mold is probably an issue.

So how do we deal with it?

So first of all, there is a genetic difference.

So there are some people you can have a, a building with a workplace with, you

know, 200 employees, or you can have a family with six people in the family, in

the house, and people respond differently.

So there is a genetic foundation of someone who has more trouble

eliminating the mold, toxins that tends to get really sick.

It's about a quarter of the population.

So an average building workplace home.

One out of four, maybe one out of three people are gonna have some symptoms.

The most common is allergic respiratory congestion.

Oh, that's actually something we're taught in medical school.

Mold is an allergen to many people, but that doesn't totally trash your immune

system and your nervous system and all these things we're talking about.

So the other, that quarter percent that's really susceptible tend to have much more

systemic, and we call it multi-system, multi symptom, meaning usually say the

cardiovascular might have tachycardia or um, higher heart, low heart rate, or.

Uh, irregular heart rate or things like that.

You might also have respiratory issues or GI issues.

Increased permeability, increased food sensitivities, um, uh,

nervous system where you have anxiety, depression, insomnia.

It can also disrupt our whole HPA access.

You can have really low cortisol where you can't get outta bed, or you can

have really high cortisol where you gain weight and you have put on, you know, the

typical cortisol types of, um, symptoms.

Um, or you can have hormonal disruptions.

Both men and women will aromatize.

Wonderful testosterone to make us strong and healthy, healthy bones

and healthy muscles into estrogen where we have, you know, man boobs

or belly fat or those things.

And it can disrupt thyroid too.

So it can really, really disrupt our whole entire system.

It can disrupt the microbiome.

So what we see often is this sequelae of this, and you kind of mentioned, alluded

to the fact that, do we all have this?

I think a couple things are happening.

First of all, if you look on the news, natural disasters, flooding, hurricanes,

water intrusions of all sorts, in places where we used to not see it are happening

more and more and more frequently.

Our weather's just getting more chaotic.

Number two, our buildings are being poorly constructed, constructed

quickly, constructed without proper.

I see all the time.

Simple things like.

My contractor installed the kitchen.

I mean, not saying mine, but someone will tell me, uh, my contractor installed

kitchen cabinets and they drilled right through the pipes in the kitchen.

We didn't know it until eight years later when that water was draining in the wall,

or, um, they forgot to hook the water filter in the fridge to the line and it

was just pouring into the wall, or someone didn't caulk or properly seal put a, a

barrier between the tiles in the bathroom and that, um, we think that grout is.

Not water permeable.

It is water permeable, so you must have a vapor barrier underneath your

tile, and if someone forgot to put that in, it just goes right into that

drywall and any number of things.

Where there is water intrusion into a building envelope, and even these

wonderful lead certified highly economic buildings that are very, very

efficient, if they're not properly built, they could be a massive source

because they're so airtight that there's no exchange of air properly.

There could be condensation inside, and when you're talking San Diego

or Arizona or places that are.

And dry.

They can have just as many issues because if that air conditioner is way too

running too high and there's condensation all the time, there's just, I could go

on and on as you can tell, but there's so many places where this can fail

and we just think our happy little box of a home is perfectly airtight and

and impermeable, and it's just not.

And part of that leads to what do you do?

You have to be properly maintaining gutters and spouts and water lines

and checking and putting, you know, there's just a lot of stuff to do if

you own a house or if you rent from a landlord, you gotta make sure that

that person is taking care of you.

I'd like to dive deeper into the cell mechanics and the mitochondria, because

I've been starting to see a lot more reports and, and things being talked

about from other, uh, doctors talking about how that really is kind of

the, the source of a lot of disease.

And of course, toxins play with that.

But break that down, how that works, why it's important for us.

so.

If we, if we look at the way it's set up to work and how it's

supposed to do business, most all of the cells in your body.

Uh, need energy that's produced locally, meaning within the

cell usually, or neighboring.

And that has to be done by the mitochondria, which are an

organelle, a little piece of the cell that's made to make energy.

It takes in nutrients.

And it, uh, does some manipulation with them and it creates

essentially electricity that runs a particular, uh, apparatus that

makes a TP, which is energy units.

Your cell then can take that a TP and break a energy bond off and.

Run all of its, uh, energy requiring, uh, processes, et cetera.

So that's, that's why that's so important.

And generally your cell has, you know, from hundreds to

thousands of mitochondria.

So it's a, that's a big business for your cell.

Um, the other thing is beyond energy and helping the cell

actually do its business, the, uh.

People usually somewhere in maybe grade school, high school, learn

about cellular respiration, which is so, uh, human respiration is, I

breathe in and out and oxygen goes in.

CO2 goes out.

Cell respiration, same thing.

Only, there's no lungs involved.

It's just oxygen goes in.

It helps to run this energy production system.

Carb dioxide goes out the other side and leaves Well, while that's

going on, in addition to helping us make energy, which obviously people

who have low energy states might have some mitochondrial issues.

' cause you feel your energy, you know, levels.

But in addition to that, a lot of the mechanics of cell, uh, maintenance are

based on the mitochondria doing their job.

So good stuff goes in, energy is made, bad stuff goes out.

The issue I think in modern life is that we're still doing all of that,

and obviously we're still alive and moving along and all that, but the

more stress we put on that system, uh, and all the basics I just said,

uh, the slower we are removing the bad things like toxins and just cell

debris that builds up and all of that.

And also we can get kind of, uh, metabolically confused in the cells.

Instead of running, you know, I, I'll tell patients, you know, instead of

running in, uh, top gear and, you know, like you're on the freeway, they're

stuck in second gear or first gear or something to protect themselves.

So they run more slowly,

But the engine is still revved up,

but the engine is trying to go faster.

Uh, but, but the, the cell mechanics are saying, you know,

we can only do this today.

This is all you're gonna get.

So it's a bottleneck of sorts

Yeah.

the body.

Yeah.

So, so a lot of the, you know, a lot of the troubles then come from not so much

we have bad equipment, but the equipment can only deal with so much going on.

And, you know, people should know that, like, this is not a, a brand new concept.

Um, e even if you go back, you know, 50.

70 years ago, but certainly around half century ago.

Every medical pathology book in the very beginning has a summary section,

and it essentially would say, again, even 50 years ago, disease in many cases

starts at the mitochondria and then you get cells that don't work right.

Then you have a tissue that doesn't work right, and maybe

an organ that doesn't work.

Right.

You build out and if you have enough dysfunction at the mitochondrial level,

it sort of brings everyone down with it,

I want you to break down this whole, like how you visualize it

and see it and communicate it.

This whole car analogy.

'cause it's so, yeah.

Dr. Savage, he has said on this podcast numerous times, it's, you

know, TPE Therapeutic Plasma Exchange is like an oil change for your body.

And the way he describes it, it makes perfect sense, but

it goes even deeper than that.

it does because, you know, you can get the best premium gas out there.

Right.

But if your cells can't take it in, if you can't get rid of the toxins, if,

like in the, at the cellular level, if you can't metabolize and, and use

that gasoline, you know, it's like putting all that gasoline in a car.

It's not gonna go any anywhere.

So, And so, and you know, I figured like the engine work that I do,

I'm doing the old fashioned spark plugs and those types of things.

Uh huh.

Well, mitochondria, right?

Like they're Yeah, they have to, they're being fed.

Um, what?

Oxygen, right?

Correct.

And, and yeah.

And so I guess what's, what's happening with a dirty engine or

the engines that aren't being, uh, maintained like you, you would like to.

Well, like, if you don't have the engines maintained, you're gonna have

chronic fatigue, you're gonna have increased aging, you're gonna have

more, uh, inflammation, joint pain broken down, you know, and it's gonna

lead to more diabetes, heart disease, strokes, those types of things.

And it's just, it's just that vicious cycle.

Um, it's, and people always go, what came first?

The chicken or the egg?

Sometimes we don't really know, but we gotta break the cycle somewhere.

And, and when you describe this to folks, is it, I guess, when is the

moment when you, is it when they're just asking about how this all works or is

it after a certain kind of test or, I. Just kinda curious how this fits in.

Well, when patients come to me, uh, they go, well, I don't feel very well.

And you know, of course I get the history and go, okay, why don't you feel well?

And then so I start looking at the ways and like I start with some of the basic

things I'd look at is body composition.

'cause you don't know where you're gonna go if you don't know where you're at.

And looking at resting metabolic rate, which is what is your metabolism.

And then like, You know, people, they wanna be able to do things.

And a lot of people think, I just deal with athletes.

And I said, well, I started with athletes because my kids were athletes.

But really, if you think about it, everybody's an athlete.

It doesn't matter what you wanna do, whether you wanna play hockey or

lacrosse or do that, or if you just wanna get up off the floor after

playing with your kids on the ground.

Or here's one if you wanna put your suitcase in that overhead bin in the air.

On the airplane, we're all athletes.

We have to do that.

And so I started looking at, you know, how can we function and what

do we need to do and what, what's our metabolism and, and what's our

heart rate and how well can we adjust?

And then, um, the other thing too I'd like to look at is we're all in this

fight or flight, sympathetic overdrive.

And part of healing is you need to be in what we call parasympathetics

or their rest, digest, and heal well in today's society.

We don't get to do that.

We're we on our cell phones?

We don't turn off.

We drive in traffic.

Someone cuts you off and the phone's always, you know,

something's always happening.

And we're constantly in sympathetic overdrive.

And so some of the things that I do looks at how can I look and get people back

into the parasympathetic mode so that they can start to rest, digest, and heal.

so definitely a multimodal approach is what I found to work best.

I don't see silver Bullets E even though I'm a naturopathic

doctor, I do love herbal medicine.

It's not always enough to, to really get somebody over the hump.

Um, it can definitely help.

It definitely can potentiate the effects of, uh, certain pharmaceuticals

as well, but in and of itself, I haven't found a lot of silver

bullets in the post pandemic era.

I guess like walk me through how you define that and kind of what

that kin, cartel, you know, like.

yeah.

I mean obviously you want blood work, you want basic, um, understanding

of, of a patient's physiology.

You want to understand what their toxic load is, what their body burden is.

Um, to mold is a big immunosuppressant.

It can make it very difficult to fight infections like COVI or

even, um, have overlap in terms of symptomology with long COVID.

even Bruce Patterson and people who are developing long COVID blood

work panels are realizing like, Hey, there's a lot of overlap.

We need to tease this apart.

Um, and so.

You definitely need a combination of blood work, environmental

toxicity panels, um, urine analysis.

Um, sometimes you need 24 hour urine because a lot of toxins

don't get excreted right away.

So it's not just about doing these direct to consumer kits and you know you're

gonna have everything in a snapshot.

It, it's not like that.

Your body doesn't work that way.

Um, it doesn't eliminate toxins like that.

And you need somebody who has a thorough understanding of half-life,

understanding how these toxins and, and potential triggers to infections, viral

or mold, et cetera, are even activated.

And then the sequestered in your body, they could be in your fat tissue, so

they're not even gonna show up in your blood, and they may not show up after

a sauna just because you pee one time.

So.

Every, every one of these toxicants, you know, heavy metals, each one has a story.

Each one can tell you something per fluorinate can tell you something else.

The forever toxins.

So it's like you really have to have someone who knows where to test, how

to test and then how long to test for, because you can't always get

the answer just from a snapshot.

Um, so that's kind of like the short of my approach.

The long of it is.

Well, what do they tolerate?

What is the patient actually able to do?

Um, and so a lot of times, you know, if they're able to tolerate, you

know, minuscule minerals, IVs, maybe they can't tolerate a lot of foods,

they have a lot of sensitivities.

Those are challenging cases.

I might do more neurological based therapies that focus on their vagus

nerve, that focus on recalibrating.

They're va, you know, vascular tone so that they can actually have good

perfusion, they're actually awake.

They can actually be alert enough to tolerate things and not react.

And then you might think of things like laser therapy.

So red light is a popular one, but there are many forms of, uh, laser therapy that

could be effective in the realm of chronic infections, COVID toxins, um, not just

red light, but blue light, green light.

Each one of these wavelengths have.

Uh, and a myriad of effects on your mitochondria, the powerhouses of your

cell, different parts of your cell can get activated with different wavelengths.

Um, so it's a, it's a much more nuanced approach than just like, Hey, I'm just

gonna get this red light pad, stick myself in a cryo chamber and call

it good, and I'm gonna be optimized.

I'm like, Hmm.

Not necessarily, not all the time.

A lot of people who have a good vitality could get away with that.

A lot of people, unfortunately, who are suffering, who have maybe subclinical

issues, they, that doesn't work for them.

So you have to have a more nuanced approach.