At age 83, mom used to suffer from chronically cold hands and feet. Now, she enjoys toasty digits 24 hours a day, 7 days a week.
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Exosomes 35: Cold Hands and Feet

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!


Feel free to bookmark the following link to have all my exosomes videos at your fingertips!

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2 thoughts on “Exosomes 35: Cold Hands and Feet”

  1. What a great Mother’s Day gift! 🎁

    I have cold hands sometimes and every now and then I get cold feet. I don’t have to worry about this during the summer. So, I’ll keep this in mind for a potential exosomes treatment.

  2. Bernard T Kitts

    I am so glad that your Mother’s cold feet are a thing of the past. Good news against the tide of ever increasing problems associated with aging. I remember your intervention for your father and his quick improvement but his Dr. doubled down with conventional treatment believing his therapy and not yours was the cause. This is a social issue we all face.

    I can already see a new book on the horizon that informs the layman about the benefits of exosomes. I was just getting used to stem cells. Anyway I wanted to express my thanks for your diligence and Godspeed.

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