December FMP Essentials Newsletter

In This Edition:

What’s New at FMP Essentials: Stay updated on upcoming courses, practitioner meet-ups, exciting announcements, and new educational content.
Plasma Exchange and Alzheimer’s Disease: This month’s feature examines the emerging role of plasma exchange with albumin replacement in slowing Alzheimer’s disease progression. We explore how this therapy works, why albumin matters, and what recent clinical trials reveal about its impact on cognitive decline.
Private Mastermind Podcast Spotlight: Don’t miss this month’s conversation with Dr. Joshua Helman, a Harvard-trained physician and biochemistry expert, on a root-cause approach to cognitive decline. He and Dr. Elyaman explore why Alzheimer’s rarely stems from a single issue, the key imbalances that drive memory loss, and the advanced tools that help uncover what’s truly happening beneath the surface.
Blog Feature: This month’s blog looks at how insulin resistance influences early cognitive changes and highlights key labs and dietary strategies to support metabolic health.
Stay informed, engaged, and ahead of the curve with this month’s updates!

What's New At FMP Essentials?

Mastermind Offers & Upcoming Opportunities: We have several special offers rolling out across our Mastermind tiers. Here’s what’s happening and what to look forward to:
- Silver → Gold Upgrade (Now Open for 2 Weeks): Silver members have an opportunity to upgrade to the Gold Mastermind with a special founder transition rate. If you're in Silver and considering expanding into leadership and success training, check your inbox for an email sent earlier this week with details.
- Gold Exclusive Next Week: 50% Off Deep Dive Courses: Gold members will receive exclusive discount codes next week for 50% off our two clinical deep dive courses, including the Advanced Lipid Course and the Fatty Liver Course.
- Bronze → Silver/Gold Promotion: A big offer is coming for Bronze Mastermind members at the end of the month. Here's a preview of what’s ahead:
  - Upgrade to Silver: $498 for 2 months, 4 months free, then $249/month (Reg. $399/month)
  - Upgrade to Gold: $698 for 2 months, 4 months free, then $349/month (Reg. $499/month)
  - This is an incredible opportunity for Bronze members to step into higher-level training and join the live monthly mastermind calls starting next month (January). Be on the lookout for the offer email!

A4M Longevity Fest Update: Dr. Elyaman will be speaking at A4M Longevity Fest next week, presenting “Targeting CKD as a Driver of Biological Aging: Precision Strategies to Restore Healthspan.” He’s hoping to connect with members of our community while he’s there. If you’ll be attending the conference and interested in meeting up, please fill out this form to be added to the WhatsApp group.

Public Podcast: Our public podast episode released this month features Dr. Datis Kharrazian in a deep, practical discussion on hypothyroidism, Hashimoto’s disease, and why so many patients continue to struggle despite “normal” labs. Dr. Elyaman and Dr. Kharrazian break down the root causes that drive persistent symptoms, the testing that truly matters, and the stepwise approach that helps uncover what’s actually happening beneath the surface. Available now on YouTube, Apple Podcasts, and Spotify. Subscribe on YouTube to stay updated with new episodes as they release. Click here to watch now!

Plasma Exchange in Alzheimer’s Disease

Alzheimer’s disease (AD) is marked by progressive cognitive decline, functional impairment, and neuropsychiatric symptoms. For decades, therapeutic strategies have attempted to reduce amyloid-β (Aβ) burden. While many antibody-based approaches have had limited or inconsistent clinical benefit, a renewed avenue of interest has emerged from an older but biologically compelling strategy: plasma exchange.

What plasma exchange is

Plasma exchange (PE) involves removing a portion of the patient’s plasma and replacing it with albumin solution. Because Aβ in the bloodstream circulates tightly bound to albumin, PE removes albumin-Aβ complexes from circulation while infusing fresh, Aβ-free albumin.

How it may work

Replacing older plasma with fresh albumin may help lower circulating plasma Aβ, improve albumin’s binding and transport capacity, reduce oxidative and inflammatory burden, and support healthier biochemical conditions for neuronal function. Together, these combined effects may help stabilize pathways that contribute to neurodegeneration.

What recent research shows

Results from the AMBAR (Alzheimer’s Management by Albumin Replacement) trials offer encouraging evidence for plasma exchange with albumin replacement in mild-to-moderate Alzheimer’s disease.

Brain imaging showed slower disease progression. Patients receiving high-albumin plus IVIG had less brain volume loss in vulnerable regions and more stable glucose metabolism on PET scans, both indicators of slower neurodegeneration.
Cognitive and functional decline was reduced. Plasma-exchange groups experienced smaller declines on standard measures of memory, thinking, and activities of daily living compared to placebo.
Neuropsychological performance improved in some patients. Mild Alzheimer’s disease patients showed gains in language fluency and processing speed, while moderate Alzheimer’s patients improved in short-term verbal memory.
Quality of life improved in mild Alzheimer’s disease, and neuropsychiatric symptoms remained stable, suggesting good tolerability.

Overall, the AMBAR data indicate that plasma exchange with albumin replacement may meaningfully slow clinical and radiologic progression in Alzheimer’s disease with the strongest effects observed in patients with moderate disease at baseline.

Clinical considerations

Plasma exchange is not yet a standard treatment for AD, and further trials are needed to refine patient selection, treatment schedules, and long-term outcomes. However, the AMBAR data provide an intriguing signal, suggesting that altering peripheral Aβ dynamics and improving albumin-related physiology may influence disease trajectory.

Consideration when PE isn’t accessible

Because PE requires specific equipment and staffing, many patients cannot access it. Dr. Elyaman notes that routine blood donation may offer some parallel physiological benefits, not through albumin replacement, but through periodic removal of blood components, which promotes natural turnover of plasma proteins and may modestly reduce circulating inflammatory factors. While this is not the same as therapeutic plasma exchange, it may be a potential option for patients unable to access this treatment.

References:

Cuberas-Borrós G, Roca I, Castell-Conesa J, Núñez L, Boada M, López OL, Grifols C, Barceló M, Pareto D, Páez A. Neuroimaging analyses from a randomized, controlled study to evaluate plasma exchange with albumin replacement in mild-to-moderate Alzheimer's disease: additional results from the AMBAR study. Eur J Nucl Med Mol Imaging. 2022 Nov;49(13):4589-4600. doi: 10.1007/s00259-022-05915-5. Epub 2022 Jul 22. PMID: 35867135; PMCID: PMC9606044.
Boada M, López OL, Olazarán J, Núñez L, Pfeffer M, Puente O, Piñol-Ripoll G, Gámez JE, Anaya F, Kiprov D, Alegret M, Grifols C, Barceló M, Bozzo J, Szczepiorkowski ZM, Páez A; AMBAR Trial Group. Neuropsychological, neuropsychiatric, and quality-of-life assessments in Alzheimer's disease patients treated with plasma exchange with albumin replacement from the randomized AMBAR study. Alzheimers Dement. 2022 Jul;18(7):1314-1324. doi: 10.1002/alz.12477. Epub 2021 Nov 2. PMID: 34726348; PMCID: PMC9540900.
Boada M, López OL, Olazarán J, Núñez L, Pfeffer M, Paricio M, Lorites J, Piñol-Ripoll G, Gámez JE, Anaya F, Kiprov D, Lima J, Grifols C, Torres M, Costa M, Bozzo J, Szczepiorkowski ZM, Hendrix S, Páez A. A randomized, controlled clinical trial of plasma exchange with albumin replacement for Alzheimer's disease: Primary results of the AMBAR Study. Alzheimers Dement. 2020 Oct;16(10):1412-1425. doi: 10.1002/alz.12137. Epub 2020 Jul 27. PMID: 32715623; PMCID: PMC7984263.

Check Out This Month's Podcast Episode

🎧 New Podcast Episode: the Functional Medicine Approach to Alzheimer's Disease with Dr. Joshua Helman

This month, Dr. Elyaman sits down with Dr. Joshua Helman, Harvard-trained physician, biochemistry expert, and clinician, to explore what’s possible when we look beyond the conventional approach to Alzheimer’s disease.

Drawing from years of clinical experience, Dr. Helman shares why memory loss is rarely driven by a single cause and why effective treatment requires identifying and addressing multiple imbalances at once. From toxins and infections to sleep, hormones, and traumatic brain injury, this conversation breaks down a complex condition into practical, actionable steps for clinicians.

Here’s what they cover:

Why Root-Cause Medicine Matters: How biochemistry, environmental factors, and lifestyle patterns converge to drive cognitive decline, and why Alzheimer's is rarely “one diagnosis, one cause.”
Key Drivers of Memory Loss: The roles of toxins, infections, head trauma, sleep disruption, oral pathogens, and hormonal shifts in accelerating neurodegeneration.
Clinically Meaningful Testing: What Dr. Helman orders beyond a CBC and CMP: toxin panels, tickborne testing, NeuroZoomer Plus, Alzheimer’s blood biomarkers, quantitative EEG, CNS Vital Signs, and advanced brain imaging (including PET scans with NeuroQuant).
Reading the Brain: How imaging reveals patterns linked to Alzheimer's, infections, trauma, and even long-forgotten head injuries and how these patterns guide treatment.
Treatment Priorities: Why he begins with detoxification before immune activation, and how tools like glutathione, phosphatidylcholine, hyperbaric oxygen therapy, hydrogen gas, exosomes, cerebrolysin, targeted supplements, and lifestyle interventions fit into the care plan.
Hidden Layers of Infection: A deep dive into biofilm, stealth pathogens, parasites, and viral reservoirs.
Hormone Optimization: How thyroid, estradiol, progesterone, and testosterone support cognition, and why correcting these imbalances can be a turning point for patients.

This episode is a thoughtful, clinically grounded look at what’s truly possible for patients with memory loss when we move beyond “there’s nothing we can do” and instead map out root causes, track objective progress, and layer therapies over time. It’s a valuable listen if you’re looking to expand your toolkit for patients with early cognitive changes, family history of Alzheimer’s, or complex neurologic presentations.

How to watch/listen: Log into your account, select the Bronze Mastermind, and scroll down to the "Expert Interviews, Insights & Podcasts" section to find the episode.

Check Out This Month's Blog Post

How Insulin Resistance Affects Brain Health

This month’s blog explores how insulin resistance affects memory, executive function, and overall brain health. It highlights why these changes can appear long before diabetes develops, reviews key laboratory markers to consider, and outlines dietary strategies that support better insulin sensitivity.

Click here to view the article!

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-The FMP Essentials Team

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December FMP Essentials Mastermind Member Newsletter

In This Edition:

What's New At FMP Essentials?

Plasma Exchange in Alzheimer’s Disease

What plasma exchange is

How it may work

What recent research shows

Clinical considerations

Consideration when PE isn’t accessible

Check Out This Month's Podcast Episode

Check Out This Month's Blog Post

Help Us Grow Our Community!

Responses

FMP Essentials Mastermind Newsletter

Stay ahead in your functional medicine practice with our Mastermind Newsletter! Learn about upcoming events and webinars, get news and updates, and discover actionable tips, as well as community highlights.

Get Your MASLD Liver Progression Guide!

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