Therapeutic Plasma Exchange in NYC: Where It's Offered, What It Costs, and How to Choose

Three clinics in New York City currently offer therapeutic plasma exchange (plasmapheresis) for longevity and anti-aging: Liondale Medical on the Upper West Side, Extension Health in West Village and Midtown East, and Next Health in Flatiron. Published pricing ranges from $8,000 to $10,000 per session. What you get for that price varies considerably. Here is a factual breakdown of each, and what actually matters when choosing. For detailed cost information including annual program costs and what is typically included, see our TPE cost guide.

The Three NYC Clinics Offering TPE for Anti-Aging

Liondale Medical - Upper West Side

Liondale is a boutique concierge practice founded and led by Dr. Lionel Bissoon, D.O., a board-certified osteopathic physician. We are a Circulate Health partner - Circulate is the organization that partnered with the Buck Institute for Research on Aging to run the 2025 clinical trial that produced the most significant human evidence for TPE's anti-aging effects.

What that partnership means in practice: our clinical approach to patient selection, lab monitoring, and IVIG incorporation decisions is informed by the same methodology used in the trial. That alignment shapes how we structure protocols and what we measure. It does not mean our results will replicate the trial - every patient is different. But it means the decisions we make are grounded in the same evidence base the research was built on.

The things that distinguish how we practice:

• Dr. Bissoon personally oversees every patient's protocol. Not a nurse coordinator reviewing remotely. Not a national clinical director you will never speak to. The physician who designed your plan is in the room.
• Each session includes pre- and post-treatment lab panels: inflammatory markers, metabolic panel, and where appropriate, biological age biomarkers. We include this because the only way to know if TPE is working for a specific patient is to measure what changes. Ask any clinic you consider whether they do this - the answer matters.
• TPE is integrated into a broader longevity program at Liondale, not sold as a standalone procedure. For patients who are also managing hormones, NAD+ protocols, or other anti-aging interventions, that integration matters.

Pricing is discussed at consultation. We do not post a per-session number because the cost depends on your protocol - IVIG inclusion, session frequency, and whether labs are already on file.

Extension Health - West Village and Midtown East

Extension Health is run by Dr. Albert Kuo and has two Manhattan locations. They publish their pricing: $10,000 per session, self-pay only. Dr. Kuo has been practicing TPE for longevity longer than most providers in the city, and Extension Health has published their own clinical data - including a 77% reduction in BPA (bisphenol A, a common plasticizer) following TPE. That is one of the more specific environmental toxin datasets we have seen from any NYC TPE provider.

Their website has extensive educational content on TPE. For patients who want to do research before a consultation, Extension Health's published material is worth reading.

Two locations means more scheduling flexibility, which matters for patients who need to fit sessions around a demanding schedule.

Next Health - Flatiron

Next Health is a national chain with 15-plus locations across the US. Their Flatiron location is part of a membership-based model that integrates TPE with aesthetics, IV therapy, and other longevity services. They publish bundle pricing: $24,000 for three sessions, $45,000 for six sessions. Their program includes a Baseline Test and Total Tox Burden Test, which is a meaningful differentiator - they frame the toxin testing as part of the clinical rationale for TPE.

The chain model means standardized protocols and consistent systems. It also means you are working within a membership structure with a national brand rather than with a specific physician.

What Actually Matters When Choosing a Provider

The question I get asked most often is some version of "which one should I go to?" My honest answer is that the right choice depends on what you are prioritizing. But there are a few factors that I think are genuinely clinical, not just preference.

Physician oversight model. This is the one that matters most to me as a physician. TPE is a medical procedure with real physiological effects and real contraindications. The person monitoring your protocol should be a licensed physician who has reviewed your complete medical history, your medications, your current labs. At Liondale, that is Dr. Bissoon. At Extension Health, that is Dr. Kuo. At Next Health, the model is chain-based, which means the oversight structure is different. Ask directly: which physician will review my protocol and be responsible for clinical decisions?

Lab tracking. If a clinic does not measure your biomarkers before and after treatment, you are flying blind. You have no idea whether the procedure is moving your inflammatory markers, your biological age metrics, or anything else you care about. The lab panel is not optional - it is how you know if TPE is working for you specifically, rather than working on average for a study population. Ask any clinic you consider: what do you measure before session one, and what do you measure after?

IVIG inclusion and decision-making. The 2025 Aging Cell trial showed a 2.61-year biological age reduction with TPE plus IVIG, compared to 1.32 years with TPE alone. That is a meaningful difference. But IVIG is not appropriate for every patient - it has its own contraindications and adds cost. Whether IVIG belongs in your protocol is a clinical determination, not a menu selection. Make sure whoever is making that call has reviewed your full history.

Protocol continuity. TPE is not a one-time intervention. For the effects observed in the trial, patients received multiple sessions over a defined period, followed by maintenance. If the clinic you choose is structured around one-off sessions rather than ongoing protocol management, that is worth knowing before you start.

Integration with your other treatments. If you are managing hormone optimization, NAD+ protocols, peptides, or other longevity interventions, those interact with how your body responds to TPE. A clinic that treats TPE in isolation from your broader health context is giving you less than the full picture.

What Joe Rogan and Ben Greenfield Got Right (and What They Didn't)

Joe Rogan posted about therapeutic plasma exchange on Instagram to roughly 20 million followers. He called it "changing the oil in your body." Ben Greenfield ranked TPE among his Top 10 Biohacks of the Year. Both mentions helped push TPE into the biohacking mainstream. But they do not tell you which clinic runs it well.

Rogan's metaphor is actually a fair lay description of what TPE does. Your plasma accumulates inflammatory proteins, environmental toxins, metabolic waste, and other circulating factors over time. TPE removes that plasma and replaces it with fresh albumin. The "oil change" analogy holds up mechanistically, even if it undersells the clinical complexity.

But neither Rogan nor Greenfield is a guide to which NYC clinic to choose. The fact that a prominent podcaster did the procedure tells you the procedure is real and available. It does not tell you whether the clinic running it measures your biomarkers before and after, whether a physician is designing your protocol, or whether IVIG is part of your specific plan. Those are the questions that determine whether you get results or just a session.

And they are not choosing from the same three NYC providers you are. Use their mentions as a starting point for research, not as a recommendation.

What the Science Shows

The primary evidence base comes from a randomized, placebo-controlled trial published in Aging Cell in May 2025, conducted by the Buck Institute for Research on Aging in partnership with Circulate Health. Forty-two healthy adults over 50 participated. The key findings:

• Participants receiving TPE combined with IVIG showed an average biological age reduction of 2.61 years
• TPE alone produced an average reduction of 1.32 years
• Benefits were strongest in participants with worse baseline health markers
• Only two participants discontinued the trial - the safety profile was strong

The biological age measurements used epigenetic clocks - validated molecular tools that are widely used in aging research to assess biological age. This is not a self-reported wellness score.

"Science is showing that while chronological aging is inevitable, biological aging is malleable. There's a part of it that you can fight."

- Dr. Eric Verdin, MD, Co-Founder of Circulate Health, CEO of Buck Institute for Research on Aging

The honest caveat: this is one trial, 42 participants. It is the best human evidence currently available for TPE's anti-aging effect, and it is encouraging. It does not prove TPE will extend your lifespan. Further research is needed.

Safety and Side Effects of TPE

TPE has been used in hospital medicine for over 50 years. In large retrospective studies, serious adverse reactions occur in roughly 0.12% of procedures. Common side effects are temporary: fatigue, lightheadedness, mild tingling from calcium shifts during the session, and occasional bruising at the IV site. These typically resolve within 24 hours.

TPE is not appropriate for everyone. Patients with active bleeding disorders, clotting factor deficiencies, hemodynamic instability, or albumin allergy are not candidates. Anticoagulants and some immunosuppressants require individualized review before treatment. IVIG, when added to the protocol, carries separate contraindications. The pre-consultation screening at each clinic should identify these before any session is scheduled - ask whether they do it and what the process looks like.

Questions Patients Usually Ask

Is TPE the same as plasmapheresis?

Yes. Plasmapheresis and therapeutic plasma exchange describe the same procedure: blood is drawn, plasma is separated and removed, and a replacement fluid (albumin or donor plasma) is infused while the blood cells are returned. The terms are used interchangeably. You may also see it called plasma exchange therapy. Same thing.

Do I need a referral to start?

No referral is required at Liondale. You contact us directly to schedule an initial consultation. At that consultation, Dr. Bissoon reviews your health history, current medications, and recent labs. If you are a candidate, we design your protocol at that visit.

What is the difference between TPE and young blood transfusions?

Different procedures entirely. TPE removes your own plasma and replaces it with albumin - a protein solution, not donor blood products (beyond possible IVIG, which is immunoglobulin, not plasma). Young blood or young plasma infusions involve receiving plasma from younger donors, based on the hypothesis that donor plasma carries beneficial signaling proteins. The evidence bases are different, the mechanisms are different, and the risk profiles are different. TPE has 50-plus years of clinical use and a randomized controlled trial. Young plasma transfusions have more limited and more contested evidence.

Can I combine TPE with NAD+ or ozone therapy?

Generally yes. These are different mechanisms and do not conflict. We typically space them out to avoid overlapping recovery windows, but patients doing both NAD+ and TPE are common in our practice. The consultation and lab review is the right place to map out the sequencing.

How do I know if I'm a good candidate?

The initial consultation and baseline lab work answer that question. The patients most likely to see strong benefit are adults over 50 with elevated inflammatory markers, elevated toxin burden, or metabolic markers that are trending in the wrong direction. Patients who are already highly optimized and have pristine baseline labs tend to see smaller effects - which is consistent with the trial data showing strongest benefits in participants with worse baseline health. We tell you honestly whether the data supports TPE for your specific situation.

Is Joe Rogan's procedure the same thing?

Yes. Therapeutic plasma exchange is the medical name for what he described. Whether his clinic uses the same protocol, IVIG combination, or lab monitoring approach that we do is a separate question - we cannot speak to that. But the procedure itself is the same.

What are the risks and side effects of TPE?

The most common side effects are temporary: mild fatigue, lightheadedness, and tingling (from calcium shifts during the session) on the day of the procedure. Bruising at the IV site occurs occasionally. These resolve within a day in most patients. Serious adverse events are rare - large retrospective studies report a rate of roughly 0.12%. TPE has been used in hospital medicine for over 50 years for autoimmune and neurological conditions. For elective longevity use on healthy patients, provider experience and protocol design matter for minimizing risk. The pre-consultation screening and lab work at each clinic should be identifying contraindications before your first session.

What is the difference between the NYC clinics for someone new to this?

The most useful way to think about it: Extension Health and Liondale are physician-led independent practices with clinical depth on TPE specifically. Next Health is a chain with broader service integration. Liondale is a Circulate Health partner - the organization behind the 2025 Buck Institute trial - which informs how we structure protocols and what we measure. Extension Health has published the most specific environmental toxin data. The right choice depends on whether you prioritize a specific physician relationship, published protocol alignment, or broader wellness integration.

Why Patients Choose Liondale for TPE

The Circulate Health partnership is the clearest differentiator. Circulate ran the Buck Institute trial - the same research covered by the New York Times, Fortune, CNET, the Washington Post, and Axios. At Liondale, our clinical approach is informed by that same evidence base - how we structure sessions, what labs we run, how we handle IVIG decisions. Not a marketing claim. A clinical alignment.

Dr. Bissoon reviews every patient's baseline before their first session. He reviews post-treatment labs. He adjusts protocols when the data calls for it. That is a different relationship than a national brand's rotating care team, and for a procedure where individual response varies considerably, it matters.

Each session includes pre- and post-treatment lab panels - CRP, IL-6, fibrinogen, metabolic, lipid, and biological age markers where appropriate. You leave with data, not just a sense of how you felt. Some patients prefer a private practice setting because follow-up is handled by the same physician rather than a rotating team. For the kind of patient who treats TPE as a tracked longitudinal protocol, not a one-time purchase, that continuity makes a real difference.

The patients who come to us for TPE typically describe the same cluster of symptoms: unexplained fatigue that hasn't responded to lifestyle changes, persistent aches, brain fog, slower recovery, a dip in energy that doesn't match their bloodwork. If that sounds familiar, the right next step is a consultation and a baseline lab panel, not another supplement.

Schedule a consultation with Dr. Bissoon to discuss whether TPE is appropriate for your situation. For a deeper look at our specific TPE approach, see our TPE service page.

For detailed pricing information including per-session and annual program costs, see our TPE cost guide. For information on the microplastics and inflammatory burden angle, see Can TPE remove microplastics from your blood?

This page was written and reviewed by Lionel Bissoon, D.O., founder of Liondale Medical. Dr. Bissoon is a board-certified osteopathic physician specializing in anti-aging and concierge medicine on the Upper West Side of Manhattan. Liondale Medical is a Circulate Health partner.

This content is for educational purposes only and does not constitute medical advice. Individual results may vary. Consult a qualified physician before beginning any new treatment.