INUSpherese® (blood apheresis)

The serious core: apheresis is clinical routine

Cleaning blood outside the body is not esoteric. Therapeutic apheresis has existed for decades; in its 2026 guidelines, the American specialist society ASFA rates 183 areas of use in 93 fact sheets according to the quality of the evidence. In lipid apheresis, for example, LDL is regularly filtered from the blood of people with severe familial hypercholesterolemia, and in certain autoimmune and neurological diseases plasma exchange helps. These are clearly defined diagnoses with a measurable goal.

Technically, INUSpherese is a variant of this. A first filter separates the plasma from the blood cells, a second, finer filter is supposed to retain unwanted substances, and then the cleaned plasma flows back together with the cells. According to providers, a session takes 2 to 3 hours; usually 2 sessions on consecutive days are recommended. The procedure is offered by a network of private centers; the brand name has been protected since 2016.

What is promised

The list is long: heavy metals, pesticides, microplastics, PFAS, inflammatory substances and autoantibodies are supposed to be removed. The procedure is advertised for chronic fatigue, Long Covid, ME/CFS, autoimmune diseases, environmental illnesses and as an anti-aging detox for healthy people. The boom has two reasons. Since studies have detected plastic particles in blood, placenta and brain tissue, the desire for an elimination button has been growing. And in the longevity scene, blood rejuvenation is currently considered one of the hottest topics.

From patient circles with Long Covid, ME/CFS and environmental exposure there are numerous, sometimes very detailed reports of marked improvement after several treatments, as well as of relapses after a few weeks. These are experience reports from people who have invested a lot of money, and they cannot be separated from expectation effects and the natural course. They should nonetheless be taken seriously, because they show where controlled trials are most urgently lacking.

What ends up in the filter

The most interesting research comes from the working group of endocrinologist Stefan Bornstein at the University Hospital Dresden. In a 2025 study, the filter residue, the eluate, was examined by infrared spectroscopy after at least 2 treatment cycles. Found were 14 substances or substance mixtures resembling plastics such as polyamide and polyurethane, which did not occur in the samples of the filter pre-rinse. A case series from a center in Abu Dhabi that works with the INUS system also measured that fat-soluble, protein-bound pollutants such as PCBs accumulate in the filter, but that some substances flow back from the tissue into the blood.

The everyday alternative

The body runs its own cleaning around the clock, via the liver, kidneys and gut. The strongest lever against microplastics and forever chemicals is more mundane than any machine: take in less. Water from glass instead of plastic, do not heat food in plastic, dust and air the rooms regularly, pans and rain jackets without PFAS. This costs little and works every day, not just on two afternoons a year.

What the studies show

Microplastic-like particles in the eluate, Brain Medicine 2025

Bornstein and colleagues examined the eluate of 21 patients with post-infectious ME/CFS after at least 2 cycles of INUSpherese. Infrared spectroscopy found 14 substances or mixtures with a plastic-like signature. The authors themselves write that the method does not measure amounts, only presence, and that the polyamide signals could partly also come from proteins. Several co-authors work for the INUS Medical Center. Clinical endpoints were not recorded.

Biomarkers in Long Covid, Molecular Psychiatry 2023

Achleitner and colleagues analyzed biomarkers before and after therapeutic apheresis in various Long Covid cohorts. In patients who reported marked improvement after 2 cycles, neurotransmitter autoantibodies, blood lipids and inflammation markers decreased, fibrinogen by 70 percent. There was no control group with sham treatment; the improvement is based on the patients’ own reports.

Where the data stop

That something ends up in the filter does not yet prove a benefit. That would require randomized trials with clinical endpoints, ideally against a sham apheresis, and these do not exist for the advertised uses. In 2022, the German Society of Nephrology stated that there are many case reports but no randomized trials, and it rejects use in Long and Post-COVID outside of trials. On lipid apheresis in Long COVID it wrote that there is neither a plausible rationale nor scientific evidence. Sham-controlled trials, for example on the related immunoadsorption in ME/CFS with 66 planned participants, have only just started.

There are also two errors in reasoning. First, the advertised removal of environmental toxins is a different claim from the studied lowering of autoantibodies. That these substances caused the symptoms and that their removal ends them is untested. Second, microplastics and PFAS come back in with the next meal, and according to the Abu Dhabi case series, some substances flow back from the tissue. Without less exposure in everyday life, it is like washing a car that is standing in the rain.

Status, approval and legal

INUSpherese is a medical procedure, not a medicine, and is offered in Germany by private centers. Statutory health insurance does not pay for it for the advertised uses; it is a self-pay service. According to provider price lists, a session costs 2,000 to 3,000 euros; with diagnostics, a treatment weekend quickly comes to 5,000 to 7,000 euros. For competitive athletes the procedure is delicate: under M1, the WADA Prohibited List 2026 prohibits the withdrawal of blood components, including apheresis, except for analysis or donation purposes, as well as any physical manipulation of blood in the circulation, at all times.

Safety

Apheresis is an invasive procedure with an extracorporeal machine circuit. You lie for 2 to 3 hours with one or two venous accesses while the blood circulates continuously through the machine. Many people feel mainly tired afterwards. Possible effects include a drop in blood pressure, tingling caused by the anticoagulant citrate, bruising and irritation at the access sites. The filter retains not only unwanted substances but also clotting factors such as fibrinogen, proteins and signaling molecules. In a medically justified apheresis this is a calculated price; in a wellness application in healthy people it is an open bill. The safety data come from established apheresis in other indications, not from this application. Serious complications are rare with experienced teams; the procedure nonetheless belongs in practiced medical hands.

Sources

• Bornstein SR et al., Brain Medicine 2025 — microplastic-like particles in the eluate after INUSpherese
• Achleitner M et al., Molecular Psychiatry 2023 — biomarkers after apheresis in Long Covid
• Castillo-Aleman YM et al., Journal of Clinical Apheresis 2025 — pollutant removal with the INUS system, case series
• German Society of Nephrology (DGfN), statement of August 11, 2022 — apheresis therapy in Long/Post-COVID
• German Society of Nephrology (DGfN), press release of October 7, 2022 — Post-COVID and apheresis
• German Society of Nephrology (DGfN), statement of January 3, 2022 — lipid apheresis in Long or Post-COVID
• Zantek ND et al., Journal of Clinical Apheresis 2026 — ASFA guidelines, tenth edition
• Preßler H et al., Trials 2024 — protocol of a sham-controlled trial of immunoadsorption in ME/CFS
• WADA Prohibited List 2026, officially published in the Austrian Federal Law Gazette III No. 219/2025