Excerpt from a YouTube video (Paul Savage MD) discussing a clinical wellness strategy: for toxic/sick patients the speaker prioritizes therapeutic plasma exchange (TPE) to remove offending factors, then gut repair and stress reduction. The speaker also highlights adjunct compounded therapies—low-dose naltrexone to modulate immune dysregulation and methylene blue to support mitochondrial function and cognitive symptoms.
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Paul Savage MD
July 25, 2025
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But what I'm kind of learning is, is because we're getting so many sick patients that are so toxic, it really starts us, we need to start doing tpe, clean that up, then fix the gut, then reduce stress and we'll have better success. So I do feel like TPE is that one thing. And then that's the part where I feel like some of the newer therapies that we use on the compound side, things like low dose naltrexone which modulates the immune system, the, that gets out of B, out of whack during inflammation, actually has the ability to work better. One of the big things right now we're compounding a lot of is something called methylene blue. Methylene blue is another thing that works to help the mitochondria. If you've got a sluggish mitochondria with fatigue, tiredness and all that stuff, it actually can circumvent a dysfunctional mitochondria and allow it to better produce energy. It also is good for like brain fog, memory cognition issues, which parlays onto TPE because it's been shown to do the new thing.