@nickbellofficial's plasmapheresis testosterone claims, fact-checked

What did @nickbellofficial actually say?

Nick claims plasmapheresis, a procedure he describes as removing "toxins" from plasma, caused his free testosterone to jump from roughly 600 to 1,432 and dropped his SHBG from 92-120 down to 50. He's attributing the change entirely to the procedure, saying it "removed all these toxins that suppress my testosterone." He also claims he gained four to five kilograms of muscle in two weeks without training, which he's now crediting to this testosterone surge.

Worth noting: he also mentions he was "looking to go on testosterone replacement therapy" before this blood test, which raises an obvious question about whether something else was already in play. He says he hasn't started TRT yet, but that detail is doing a lot of work in this story.

Does the science back this up?

No credible clinical evidence supports plasmapheresis as a mechanism for raising testosterone. The procedure has legitimate medical uses, but "boosting hormones by removing toxins" is not one of them.

Plasmapheresis is an evidence-based intervention for autoimmune conditions like myasthenia gravis, Guillain-Barre syndrome, and thrombotic thrombocytopenic purpura (Winters et al., 2012, Journal of Clinical Apheresis). It works by physically removing large molecules, including antibodies and immune complexes, from plasma. It does not selectively remove "testosterone-suppressing toxins" because that category of molecule is not clinically defined or measurable in a way that maps to this claim.

SHBG, which Nick correctly identifies as a binding protein that reduces free testosterone, can fluctuate due to liver function, thyroid status, insulin levels, and acute illness. A sudden drop in SHBG would raise free testosterone without any change in total production. That's real physiology. Plasmapheresis causing it? That's speculation dressed as explanation.

What did they get wrong (or right)?

Nick actually gets the basic SHBG-free testosterone relationship right. He explains that SHBG "bounds all the free test up" and that lower SHBG means more circulating free testosterone. That's accurate. His numbers are also internally consistent in a way that's plausible: a drop in SHBG from 100 to 50 could realistically push free testosterone higher even without a major change in total testosterone.

What he gets wrong is the causal story. Attributing this shift to plasmapheresis removing "toxins that suppress testosterone" is not a mechanism supported by any published research. The word "toxins" here is doing enormous lifting with zero clinical definition. SHBG is regulated by the liver and influenced by acute physiological stress, including illness, rapid weight changes, or significant metabolic shifts. The procedure itself, or recovery from whatever underlying condition prompted it, could theoretically stress the liver or alter metabolic signaling. But that's not the same as the clean "detox equals more testosterone" narrative he's selling.

The muscle gain claim is also unsupported. Four to five kilograms in two weeks without training almost certainly reflects fluid retention or measurement variance, not lean mass accrual.

What should you actually know?

If you're seeing a TikTok about plasmapheresis boosting testosterone and thinking about seeking it out as a wellness treatment, stop. This is a medical procedure with real risks, including hypocalcemia, hypotension, infection, and clotting complications. It is not approved or used clinically as a hormone optimization tool.

SHBG levels genuinely do affect how much free testosterone your body has available, and that's worth understanding if you're evaluating your own hormone panel. But SHBG optimization in a clinical setting happens through lifestyle factors, thyroid management, or in some cases, medication choices within a supervised TRT protocol. It does not happen through plasma exchange.

Nick's testosterone numbers before this, by his own account, were not low in total. A free testosterone of 600 with SHBG in the 90-120 range suggests he may have had high SHBG suppressing bioavailable testosterone, which is a legitimate clinical pattern worth evaluating. A telehealth provider or endocrinologist reviewing the full panel in context is the right move here, not a $3,000 plasma procedure chased by a TikTok video.

The bottom line

One person's blood test results after an unrelated medical procedure do not constitute evidence that plasmapheresis raises testosterone. Nick's SHBG dropped and free testosterone followed. Why SHBG dropped is unexplained and probably unrelated to "toxin removal." The muscle gain story is almost certainly not what he thinks it is.