TPE vs. EBO2
When you see a phrase like TPE vs. EBO2, it might sound like a competition—or a ‘which is better’ argument. In reality, both therapies offer unique benefits, and understanding how they differ can help you (and your provider) decide which one best fits your health goals—or whether a combination might be ideal.
Both are powerful, blood-based therapies gaining traction in functional medicine and regenerative health—but they work in very different ways. Here’s a clear breakdown to help you understand how each therapy works, what benefits they offer, and when you might consider one over the other.
How They Work
Therapeutic Plasma Exchange (TPE)
- Process: TPE removes the plasma portion of your blood (where toxins, inflammatory proteins, and autoantibodies often circulate) and replaces it with a clean solution of albumin and saline.
- Goal: To filter out harmful circulating factors, reduce systemic inflammation, and create a “younger” biochemical environment.
- Mechanism: Think of TPE as a total plasma “refresh.” It’s not adding anything to your blood—it’s replacing and cleaning it.
EBO2 (Extracorporeal Blood Oxygenation and Ozonation)
- Process: EBO2 filters the blood through a dialysis-like membrane while infusing ozone (O3), which is known for its antimicrobial, anti-inflammatory, and oxygenating properties.
- Goal: To reduce chronic infections, optimize oxygen delivery, and decrease systemic inflammation.
- Mechanism: EBO2 cleans the blood and delivers oxidative therapy in one session.
Conditions & Goals They Target
TPE: Often used in longevity research, autoimmune conditions, high-inflammatory states, neurological conditions (e.g., Alzheimer’s research), and advanced biohacking protocols.
EBO2: Commonly used for chronic infections (e.g., Lyme, viral conditions), environmental toxin exposure, mold toxicity, and for athletes looking to optimize recovery and performance.
What the Research Says
Groundbreaking Research on TPE and Aging
Brand-new results from the Circulate Trial, led by the Buck Institute for Research on Aging, have put Therapeutic Plasma Exchange (TPE) in the spotlight for its potential role in reversing biological age. Published in Aging Cell (May 2025), this randomized, placebo-controlled clinical trial found that:
- TPE combined with IVIG reduced participants’ biological age by an average of 2.6 years,
- TPE alone produced an average reduction of 1.3 years,
- The greatest improvements were seen in people with elevated glucose, bilirubin, or liver enzymes, suggesting those with greater health burdens may benefit the most.
Researchers used a multi-omics approach—analyzing everything from epigenetics to immune markers—and found broad benefits including reduced inflammation, improved immune cell profiles, and better balance and strength.
While the study was small and short-term, it provides the strongest evidence to date that TPE may help reset aging biology at the molecular level, opening doors for larger studies in longevity medicine.
Emerging Evidence on EBO2 and Ozone Therapy
While EBO2 (Extracorporeal Blood Oxygenation and Ozonation) is newer to the functional medicine world than TPE (which has been used conventionally for more than 50 years!), a growing body of research highlights its anti-inflammatory, immunomodulatory, and oxygenating benefits.
A controlled clinical trial comparing EBOO (another name for EBO2) to intravenous prostacyclin in patients with peripheral artery disease found that:
- EBOO significantly reduced skin lesions, pain, pruritus, and leg heaviness
- Patients reported an overall improvement in well-being
- Across 210 treatment sessions, no adverse effects were reported
- Treats up to 4,800 mL of blood per session—far more than traditional ozone autohemotherapy (~250 mL)
- Induces controlled oxidative stress that triggers beneficial immune and molecular responses
- Has shown promise in degenerative, immune, and vascular conditions
Finally, broader ozone therapy research demonstrates that ozone activates the Nrf2 pathway, boosting antioxidant defenses, improving oxygen delivery, and reducing inflammatory markers like IL-6 and CRP—effects that may explain many of the therapy’s reported benefits.
Patient Experience
TPE: A longer, more involved procedure—typically 2–3 hours, performed less frequently, with effects lasting weeks to months.
EBO2: Shorter (60–90 min), often done in a series, with cumulative benefits over multiple sessions.
TPE vs EBO2: What's the Verdict for YOU?
The decision often comes down to goals:
If you want systemic plasma “clean-up” and longevity research-backed protocols, TPE may be the better fit.
If you’re dealing with chronic infections, environmental toxins, or want regular oxidative therapy, EBO2 might be your go-to.
Many patients at functional medicine clinics choose both, using EBO2 for ongoing detox and TPE periodically for a deeper reset. If cost is an issue, EBO2 is less of an investment.
Both TPE and EBO2 represent the future of functional and regenerative medicine—giving patients proactive tools to detoxify, reduce inflammation, and potentially slow the aging process. Which one is right for you depends on your health goals, underlying conditions, and long-term wellness plan.
Call us today for a consult: 561-283-1166
Elizabeth Tringali, PA-C
Elizabeth Tringali, PA-C is an expert in functional medicine. With over 20 years of experience, Elizabeth is renowned for her holistic approach to health, uncovering the root causes of conditions such as autoimmune diseases, thyroid disorders, hormone imbalances, gut health issues, and more. Her blend of traditional and integrative medicine ensures patients receive comprehensive care tailored to their unique needs.
Book with Elziabeth: 561-283-1166
