General Disclaimer: This blog is for informational purposes only. It is not an advertisement for exosomes. The clinical use of exosomes has not been FDA-approved for prevention nor treatment of any disease condition and may carry unknown risks. Anecdotes provided do not constitute scientific proof and all patients were treated in the context of a fully informed consent and legally protected patient-physician relationship.
EXOSOMES 35: Cold Hands and Feet
A few days ago was Mother’s Day but instead of the usual card and flowers, I decided to take a different approach. At age 83, mom used to suffer from chronically cold hands and feet. Now, three weeks after our latest adventure began, she enjoys toasty digits 24 hours a day, 7 days a week.
Three weeks ago, I performed an injection of 2.5B IV MSC exosomes into each of her radial arteries feeding her hands. Overnight, she said her hands became warm and they have remained that way. She asked whether the same thing could be done with her feet which are chronically cold. So I decided to treat her at my sister’s house on Mother’s Day. Of note, I offered my sister a treatment for her chronic knee problems but she declined.
The pulses in the top of mom’s feet were weak and I could barely locate them with doppler ultrasound. Unlike the wrists which were easy to obtain real time intra-arterial access, the feet arteries were impossible. It is no wonder that they were chronically cold – her circulation was poor. She has had hypertension for decades, no diabetes, and basically was suffering from vascular insufficiency from aging, whatever that means.
So I decided that the best course of action was to improvise and inject 2.5B exosomes all around the arteries, hoping they would be taken up and passed along. I don’t know if it worked but she says the pulses are stronger, both feet are now constantly warm, and that she is beyond thrilled.
Mom loves exosomes. All told, she has received three vials IV, one in her shoulder, three treatments nasally, one by microneedling her face, one in her knee, one in the knuckles of her hands (after wrist nerve blocks), and one in her epidural lumbar spine.
Here is a picture of her hands showing what she believes are straighter digits and smaller nodules. She has Bouchard’s and Heberden’s nodes from chronic Rheumatoid arthritis but they no longer hurt as much.
After her year of various exosome treatments, she and I agree that her mind seems sharper and she is more optimistic about her quality of life. But her body is still negotiating with blood pressure regulation. Sometimes it is too high and sometimes it is too low. I believe that is because the medicines and supplements, her hypothalamus/pituitary control, and circulatory regulation are struggling with establishing a new normal. Although the arteries remain stiff, her pharmacological regimen sometimes overshoots what her real time regulation is signaling. Luckily, she takes her blood pressure often and is quite good and sensing when it is out of range and how to manage it.
But I digress. Back to the hands and feet – why did I even want to do arterial and not venous injection?
My rationale was that since billions of exosomes are two orders of magnitude less than the quadrillions of available exosomes, location matters since they are quickly are absorbed by any and all cells that they come into contact with. Obviously the many treatments she received were not enough to make her hands and feet warm so they must be somewhat precious and fleeting.
We know that exosomes are small and go everywhere but that like any therapy, the lungs, spleen, and liver get much of the “first pass” of circulation and that having them collected by macrophages in the spleen is sort of a waste when you are trying to rejuvenate tissues and microcirculation in the extremities.
So I reasoned that if the exosomes are like precious little Velcro Nerf balls and they bind randomly, then arterial transport to the organ of interest was a logical strategy to get the most out of their encounters with the first cells that they meet.
Think of arterial circulation as the clean water going to your house and intravenous circulation as the waste water collected from your house. You may not remember that arteries get smaller and smaller until they become capillaries and then the blood goes to the organs where they leak their substances into the tissues and then become venous capillaries. If you are able to deliver exosomes to the arteries that supply specific organs then they have a higher likelihood of being impactful on that organ before they get taken up by sewage system and circulated back to the lungs and spleen.
The bottom line is that only four days after Mother’s Day, mom’s feet are toasty and warm. It may have been helpful to the arterioles and capillaries and it will be interesting to see if those endothelial cells revert back or whether this is a longer lasting phenomenon. I reasoned that since we are trying to get the exosomes to bind to and repair the arteries, then it would make sense to start upstream rather then downstream.
Because these arteries on the hands anastomose extensively and because the dorsalis pedis is readily accessible and visible, I thought it would be easy to monitor. It should be noted that arterial puncture is more risky than venous introduction and I would not recommend this technique unless you are comfortable and have experience. There are greater risks of bruising so you need to hold pressure. But there is also the risk of dissection, meaning the walls of the arteries start to separate because of mechanical defects allowing high pressure separation of layers. This can be ruinous if it causes occlusion without anastamosis (blood supply from other arteries). That is why med students learn the mnemonic “fingers, toes, penis, nose!” Vasoconstricting epinephrine is commonly included to local anesthesia to prolong duration of action and reduce bleeding but we must NEVER use it in those areas or it can kill those tissues.
Intra-arterial delivery to specific organs is a well established art form when you use certain techniques involving guide wires and fluoroscopy. If you are wanting to treat other areas and organs, the risk would vary a lot depending on the techniques and the anatomy. Some day when the use of exosomes is validated by the FDA for safe use, I hope interventional doctors will be able to guide exosomes to organs such as the heart (for people with cardiomyopathy) and perhaps even other damaged organs using specifically selected exosomes like those of convalescent kidneys to reverse renal failure.
This technique of arterial and peri-arterial injection is not FDA approved and I have no way of knowing if what mom experiences is all in her head. But for now, she believes that her hands and feet are warm and it is possible that exosomes may have positively impacted her circulation without untoward side effects. Most importantly, I might have improved my chances at being mom’s favorite child even without needing to buy a bouquet and a card!
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Archived exosome blogs….Please read them all.
I still have voluntary ASMR. Mom’s arthritis is greatly improved.
I explain why I believe exosomes aren’t inert. An amazing case of an overnight in heart rate variability is presented.
A case of whiplash and traumatic brain injury improved after exosome use.
After exosome injection, two runners were able to return to running after limitations from tendinosis that plagued them for months (in the case of the 60-yo man, and years (in the case of the 53-yo woman)
In this blog, I discussed how complicated clinical medicine can be. Different treatment protocols, ambiguous results ethical dilemmas and strange phenomena like acquired coffee aversion are part of what make treating with exosomes so challenging.
Using my left foot as an example, I attempt to explain that while some exosome effects are immediate, others take time. Remodeling of damaged tissues is a complicated process. My foot is still scarred and probably will be for life.
A patient after dental exosome injection becomes pain free after 4 years of suffering.
I explain why lab testing of freshly thawed exosomes is SUPPOSED to come back as normal saline.
A nine-part comprehensive explanation of exosomes.
I interviewed the principal scientists of Kimera Labs and other experienced clinicians using exosomes
66-yo Deb B went from not being able to do one squat to 100 per day after exosome injection.
80-yo Doug describes in his video how much his knees have improved since getting exosome injections. He is reaching new athletic peaks with no signs of stopping.
My 82-yo mom underwent microneedling with exosomes with fantastic results. Most impressive was the absence of “downtime” from redness or bruising.
54-yo weightlifter with chronic pain from a rotator cuff tear shows remarkable improvement in just four days! He re-injured it at the gym so had to undergo a repeat shoulder injection
48-yo woman with severe face blindness experiences some improvement after nasal injections of exosomes. Her ability to remember new faces has improved permanently
I delivered two lectures in Hawaii. The first was about exosomes generally and the second is a password-protected video about clinical applications.
Three cases of middle-aged women reporting enhanced enjoyment and renewed capacity to read after nasal exosome therapy
Two cases of improved dental health presented. We discuss the hazards of EMF and the promising future of dental regenerative therapy
We discuss the notion of energy centers known as chakras and the fact that we are electrical beings
A case of improvement in Seborrheoic Dermatitis after microneedling with MSC exosomes is presented.
I explain how poor we are at assessing change and how attribution and recall bias play important roles
In the past year, there has been a lot of shifting loyalties in the exosome space resulting in a lot of rumor, innuendo, and bad press. With various parties trying to get each other in trouble with federal regulators, it is a treacherous business to be in.
I describe a case of an 86-yo woman whose chronic leg rash disappeared after improvement in her leg circulation
I use a car wash analogy to answer the question “how long do exosomes last?” The answer is it depends on how dirty and damaged the car is, how well you clean it, and how dirty you get it after washing.
I describe four cases of improvement of osteoartritic knees from my trip to Hawaii.
I explain the three definitions of placebo and why I believe most of the effects of exosomes cannot be attributed to the so-called placebo effect.
Some remarkable “soft signs” of exosome effects include itching (new nerves), twitching (new muscles), and heaviness (a healing FORCE).
Three amigos came to see me and all enjoyed benefits. The best was the 48-yo gentleman who had a dramatic improvements to his irritable bowel syndrome, varicose veins, and appearance.
I address the common observation from patients that exosomes seem “smart” or that they know where to go. In fact, I doubt this is true and that they are no smarter than player piano scrolls are good musicians.
I gave a lecture at the University of Hawaii with about 80 attendees. Around 10 of them were actual patients. Hear in their own words how exosomes helped them.
I describe two cases of improved leg swelling and explain what causes this common condition and how exosomes may be improving it.
We present an amazing case of overnight nerve regeneration after ultrasound-targeted exosome injections.
A fascinating case of resumption of menstruation after taking IV exosomes
I speculate why a patient reported improvement in her double vision after exosome injection