Treatment for Long Haulers Syndrome (May 2022)
Contents
Symptoms of Long Haulers Syndrome2. Probiotics
3. Melatonin
4. Vitamin C
5. Omega-3 fatty acids
6. Quercetin, EGCG and Curcumin
Post-Vaccination Long Haulers?
Symptoms of Long Haulers Syndrome
If the symptoms include major shortness of breath, cough with blood in it or pain on one side when you take a deep breath, it could be due to a late pulmonary embolism or a blood clot going to the lungs.
FLCCC I-Recover Protocol
- Ivermectin: 0.2mg/kg body weight. Once daily for 1 week. Discontinue after 2 - 4 weeks if all symptoms have resolved. A repeat course is recommended in those who respond poorly or relapse once the treatment is stopped. The anti-inflammatory properties of ivermectin may mediate this benefit. (Find a Doctor)
- Prednisone: 10–15mg daily for 3 weeks. Taper to 10mg for three days, then 5mg for three days and then stop.
- Low dose naltrexone (LDN): Begin with 1 mg daily and increase to 4.5mg as required. May take 2–3 months for full effect.
- Omega-3 fatty acids: Vascepa, Lovaza or DHA/EPA 4g per day. Omega-3 fatty acids play an important role in the resolution of inflammation by inducing resolvin production. [Ref, Ref]
- If symptoms do not improve after 1–2 weeks continue steroids, omega-3 fatty acids and Naltrexone and add second line medications.
- Vitamin D: The majority of those with post-COVID-19 syndrome continue to have hypovitaminosis D. See tables 1 or 2 for vitamin D supplementation.
- Fluvoxamine (low dose): 25mg once daily. Stop if the symptoms increase. Caution with the use of other antidepressants and psychiatric drugs. Taper and discontinue once symptoms improve.
- Atorvastatin: 20–40mg once daily. Caution in patients with Postural Orthostatic Tachycardia Syndrome (POTS); may exacerbate symptoms.
- Maraviroc: 300mg PO twice a day If 6–8 weeks have elapsed and significant symptoms persist, consider either getting an InCellDx test to assess long hauler index profile prior to initiating or can consider initiating empirically. Note maraviroc can be expensive and it has risk for significant side effects and drug interactions.
- Curcumin: has anti-inflammatory and immunomodulating properties and has been demonstrated to repolarize macrophages.
- Nigella Sativa: which like curcumin has anti-inflammatory and immunomodulating properties.
- Vitamin C: 500mg BID (vitamin C inhibits histamine and repolarizes monocytes). [Ref]
- Melatonin: 2–8mg at night (slow release/extended release) with attention to sleep hygiene. Increase dose from 1mg as tolerated (may cause severe nightmares at high dosages).
- Kefir, probiotic yogurt and/or Bifidobacterium Probiotics (e.g., Daily Body Restore) together with Prebiotics (e.g. XOS Prebiotic, Bio Nutrition Pre-Biotic) to normalize the microbiome. Prolonged dysbiosis has been reported following COVID-19 infection.
- Behavioral modification, mindfulness therapy and psychological support may help improve survivors’ overall well-being and mental health.
- Luteolin 100–200mg day or Quercetin 250mg day (or mixed flavonoids). Luteolin and quercetin have broad spectrum anti-inflammatory properties. These natural flavonoids inhibit mast cells, and have been demonstrated to reduce neuroinflammation. [R]
- H1 receptor blockers (for mast cell activation syndrome): Loratadine 10mg daily, or Cetirizine 5–10mg daily, or Fexofenadine 180mg — daily.
- H2 receptor blockers (for mast cell activation syndrome): Famotidine 20–40mg, or Nizatidine 150mg — twice daily as tolerated.
- Montelukast: 10mg/day (for mast cell activation syndrome). Caution as may cause depression in some patients.
- Anti-androgen therapy: Spironolactone 50–100mg twice a day, and Dutasteride 1mg daily.
- Aspirin — 325 milligrams a day.
Be on the Lookout for Blood Clots for 90 Days
If you’ve had COVID-19, especially if it was a severe case, be aware that blood clots and heart problems, including heart attack, can occur for 90 days or more. It’s believed that remnants of the virus remain in the nervous system, the lungs, the heart and other organs.If the symptoms include major shortness of breath, cough with blood in it or pain on one side when you take a deep breath, it could be due to a late pulmonary embolism or a blood clot going to the lungs. “We’ve seen this on more than one occasion,” Dr Peter McCullough said.
Aside from a CT scan to rule out pulmonary embolism if you’re having symptoms and possibly a D-dimer test, McCullough suggests a high-sensitivity C-reactive protein (CRP) test, which provides a general index of inflammation. Keep in mind, though, as McCullough said:
“This pursuit of a blood clot is very important. I’ve seen multiple cases now where blood clots have been missed … this is now almost a daily occurrence, particularly within the first 90 days after COVID-19. I think after that period of time it becomes progressively less likely.”
Natural Key Supplements for Long Haulers
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Nutraceutical Therapy by Mode of Action |
1. Vitamin D
Vitamin D3 is essential for supporting healthy immune system function. It works hand in hand with your body to modulate both innate and adaptive immune responses which regulate everything from reactivity to antigens and pathogens.Much has been written about the emerging link between COVID severity and vitamin-D deficiency. A pilot study in Spain found that adding oral D3 supplementation significantly reduced the need for ICU treatment among people hospitalized after infection.
Leo Galland, MD, a functional-medicine internist in New York City notes that D is an important promoter of ACE-2 activity. He recommends that people with long COVID supplement with up to 5,000 IU of D3 daily.2. Probiotics
COVID can wreak havoc on the gut microbiome, but research on specific probiotic strains that can best restore balance following the syndrome’s particular damage is in its infancy. Leo Galland, MD, a functional-medicine internist in New York City, is looking into soil-derived bacteria of the genus Bacillus because it may have natural antibiotic properties, though there’s not yet enough data to make specific recommendations.Eating fermented foods, such as sauerkraut, yogurt, kefir, and kimchi, can help fortify and support the gut’s microbiome. And in the event of ongoing gut disturbances, working with a functional-medicine provider to design a well-rounded prebiotic and probiotic protocol can help bring the microbiome back into balance.
3. Melatonin
Supplementing with 1 - 2 mg of melatonin at bedtime might benefit those whose sleep–wake cycles have become dysregulated with long COVID.
4. Omega-3 fatty acids
5. Vitamin C
6. Quercetin, EGCG and Curcumin
Quercetin appears to bind to the spike protein of the coronavirus, inhibit inflammatory pathways, and block replication of infected cells. It is also antiviral and completely safe. In addition to getting sources of quercetin from diet, long-COVID patients can supplement with 250 - 500 mg a day.
7. N-Acetyl-L-Cysteine (NAC)
NAC is an amino acid that the body uses to create glutathione, the body’s master detoxifier. Glutathione is your master detoxifier and the most powerful free radical scavenger produced by your body.
Eating plenty of cruciferous vegetables (such as kale, broccoli, and cabbage), as well as avocado, okra, spinach, and alliums, can help bolster levels of glutathione, as can supplementing with NAC.
A 2017 paper found NAC has potent thrombolytic effects, meaning it breaks down blood clots once they've formed.
Importantly, NAC may also protect against other problems associated with COVID-19, including the hypercoagulation that can result in stroke and/or blood clots that impair the ability to exchange oxygen in the lungs.
Many COVID-19 patients experience serious blood clots, and NAC counteracts hypercoagulation, as it has both anticoagulant and platelet-inhibiting properties.
Aaron Hartman, MD, founder of the Richmond Integrative and Functional Medicine clinic in Richmond, Va., describes one patient, a 26-year-old woman, whose symptoms — persistent low oxygen and shortness of breath — following a bout of COVID resolved after treatment that included NAC as well as omega-3 fish oil.
“NAC is one of the more important nutrients for people who get shortness of breath with COVID, because of its ability to break down those really, really small blood clots called micro-emboli,” explains Hartman.
Many COVID-19 patients experience serious blood clots, and NAC counteracts hypercoagulation, as it has both anticoagulant and platelet-inhibiting properties.
Aaron Hartman, MD, founder of the Richmond Integrative and Functional Medicine clinic in Richmond, Va., describes one patient, a 26-year-old woman, whose symptoms — persistent low oxygen and shortness of breath — following a bout of COVID resolved after treatment that included NAC as well as omega-3 fish oil.
“NAC is one of the more important nutrients for people who get shortness of breath with COVID, because of its ability to break down those really, really small blood clots called micro-emboli,” explains Hartman.
8. Zinc
Zinc is essential for healthy immune function. A 2020 review published in the International Journal of Infectious Diseases has found that zinc deficiency can increase the risk of poor outcomes in viral infections, including COVID-19.Foods that are rich in zinc include meat, poultry, shellfish, eggs, dairy, seeds, nuts, legumes, sweet potatoes, quinoa, and green leafy vegetables.
9. Resveratrol
Resveratrol is a polyphenol with antioxidant and anti-inflammatory effects that’s found in red grapes, red wine, peanuts, and some berries. It’s also available as a supplement.
Leo Galland, MD, a functional-medicine internist in New York City, has found it to be particularly helpful in restoring his COVID patients to health. “Resveratrol has a number of beneficial effects on coronavirus infection,” he notes. “It supports ACE-2 function, it inhibits the growth of the deadly MERS coronavirus through multiple mechanisms, and it diminishes the kind of inflammation associated with coronavirus infection.”
He recommends long-COVID patients supplement with 200 mg of resveratrol twice a day.
10. Lumbrokinase and Serrapeptase
If you’ve had COVID-19, especially if it was a severe case, be aware that blood clots and heart problems, including heart attack, can occur for 90 days or more. It’s believed that remnants of the virus remain in the nervous system, the lungs, the heart and other organs.If the symptoms include major shortness of breath, cough with blood in it or pain on one side when you take a deep breath, it could be due to a late pulmonary embolism or a blood clot going to the lungs.
A safer and likely equally effective alternative to aspirin is digestive fibrinolytic enzymes like lumbrokinase and serrapeptase. You can alternate between the two enzymes — one day take lumbrokinase and the next take serrapeptase — because you’ll need to be on it for about three months and you can develop a sensitivity to them over time.
Anyone who had COVID-19, especially with significant symptoms, should consider taking digestive fibrinolytic enzymes to be sure you don’t have any clotting. An alternative to determine if clotting is occurring is a test called D-dimer, although it can be pricey. D-dimer is a protein fragment produced by the body when a blood clot dissolves.
It’s typically undetectable or present only at very low levels, buts its level may significantly rise when the body is forming and breaking down blood clots (R). If your d-dimer test is low, then you don’t need to take the enzymes. Likewise, if you had a very mild, cold-like case, of COVID-19, you probably don’t need them.
Intermittent Fasting
Fasting also supports the turnover of damaged cells throughout the body, making room for new, healthy mitochondria and cells to take their place.
Time-restricted eating can take a variety of forms. One of the most popular is simply eating all your day’s meals within an eight-hour window, then going 16 hours without food or calories.
Diet and Nutrition
“Diet can be a source of inflammation, and whatever we can do to lower [inflammation] will allow the immune system to work better,” says Elizabeth Boham, MD, MS, RD, a functional-medicine physician and medical director at the UltraWellness Center in Lenox, Mass.Supporting a good nutrient baseline is also key. “We see a significant amount of nutrient deficiencies and insufficiencies in the United States,” Boham says. Notably, insufficient levels of zinc and selenium are associated with worse outcomes from viral infections. Good sources of zinc include oysters, hemp seeds and pumpkinseeds, beans, nuts, and animal protein; sources of selenium include mushrooms, Brazil nuts, and seafood.
“Make sure you’re getting eight to 12 servings of phytonutrients a day from vegetables, fruits, spices, herbs, and tea,” she advises. Phytonutrients such as EGCG (epigallocatechin gallate, a polyphenol found in green tea) and curcumin (found in turmeric) can decrease inflammation and rebalance the immune system.
Exercise could help moderate the effects of Long COVID
Vaccine Related Side Effects, Niacin and Niatonin Protocol
You got vaccinated and now you want that stuff out of your body? Sorry to break the news, but that isn’t possible.Vaccine side effects are due in part to the spike protein. Many ill effects from the COVID-19 virus are also from the spike protein. Therefore, it follows that what helps with COVID-19 infection may also help after COVID-19 vaccination. Niacin has three additional actions which are worth mentioning on that front. First, niacin helps convert dietary cholesterol into steroid hormones, which are essential in the body’s response to any stress. Second, niacin increases the concentration of adiponectin, a molecule with anti-inflammatory and anti-cytokine actions. It’s important to keep cytokines in check as severe COVID-19 infection and some autoimmune reactions after vaccination are likely due to destructive cytokines causing tissue damage. Third, niacin deficiency leads to paranoid and suicidal behaviors, as well as auditory and visual hallucinations. There are disturbing reports of psychiatric breakdowns post-COVID-19 vaccination, therefore it’s prudent to make sure your body’s stores of niacin are topped off.
Flush Niacin (nicotinic acid form)
- Take 2-3 times per day with melatonin
- Start with 500 mg dose, work up to 1,500 mg – 2,000 mg per dose as tolerated*
- Ex. 500 mg 3 times a day on Day 1, 1,000 mg 3 times a day on Day 2, etc.
Melatonin
- Take 2-3 times per day with flush niacin
- Start with 10 mg dose, work up to 20 mg per dose^
- Ex. 10 mg 3 times a day on Day 1, 15 mg 3 times a day on Day 2, etc.
Also key:
- Do not drink alcohol during any of this (or ingest other intoxicating substances)
- Get plenty of sunlight for natural vitamin D, but feel free to add a vitamin D supplement, especially if you live in cold, dark climates
- Consider adding a vitamin C supplement, but no sooner than two weeks after your last vaccine dose. In the meantime, get vitamin C from natural food sources. The theoretical reason to wait two weeks to supplement vitamin C is to avoid your immune system going into overdrive and activating those destructive cytokines.
- There is great ambiguity on the timing of niacin and melatonin related to vaccination. Some discuss using this protocol before going for a vaccine, others immediately afterwards, and others only if side effects develop.
- There are not many FDA / academic peer reviewed studies related to this.
- Avoid taking melatonin with any SSRIs like fluvoxamine. If you are on a SSRI then take a lower dose of melatonin.
- Long-term use of high dose melatonin causes habituation, meaning your body builds up a tolerance to that dose, and may also decrease your body’s natural production of melatonin.
Editor's Notes:
-
Low dose aspirin (75 mg) for two weeks post vaccination to reduce
risk of clotting (patrickholford.com, drmalcolmkendrick.org).
-
On 26 May 2021, the COVID-19 subcommittee of the WHO Global
Advisory Committee on Vaccine Safety (GACVS) issued a statement
reviewing initial reports of mild myocarditis following COVID-19
mRNA vaccines. They also pointed out that "available data suggest that the immediate course of
myocarditis and pericarditis following vaccination is generally
mild and responds to conservative treatment (e.g. rest, treatment
with non-steroidal anti-inflammatory drugs etc)."
COVID Jab Injuries Treatment for Kids
“If you're making spike [protein], even though kids don't have a lot of ACE2 receptors, those spikes are everywhere. In mice, it is shown that they cross the blood-brain barrier. They're disseminated, and then they tend to focus in your area of weakness.
They go into fat-loving tissues, they go into the ovaries, they seem to go everywhere. So, binding the spike protein, that's one aspect, and there are different things you can do, both pharmaceutical and non-pharmaceutical.
My favorite is ivermectin for the spike. I was giving kids 12 milligrams, initially, once a day. I went up to 12 mg twice a day for Omicron, but it depends on the size of the kid. For bigger kids, it’s 18 mg twice a day.
I didn't see any toxicity with ivermectin. I've used ivermectin before, mostly for parasitic infections, and I never had any problem with ivermectin. I have not used hydroxychloroquine before, but now, for Omicron, I would use hydroxychloroquine, 200 mg twice a day.
I use a lot of quercetin and zinc together ... To decrease inflammation, especially IL6, you also want to use a lot of immunomodulators, and a lot of supplements can do that.”
The Path Ahead
One of the pandemic’s few bright spots is the way it’s accelerated telehealth services. Patients now enjoy unprecedented access to a broad range of healthcare providers across the nation.- List of Doctors that will prescribe Ivermectin and Hydroxychloroquine
- List of Pharmacies that will fill Ivermectin
- www.ifm.org/find-a-practitioner (Functional Medicine)
- https://covidlonghaulers.com/.
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Ingredients:
- Epigallocatechin gallate (EGCG) is an extract of green tea and is a powerful zinc Ionophore (zinc delivery system).
- N-acetyl cysteine (NAC) is a supplement form of cysteine. It may prevent blood clots and is an antioxidant.
- Zinc is critical for immune cell development. Dozens of different enzymes in the body rely on zinc.
- Vitamin C is an essential nutrient involved in the repair of tissue and the enzymatic production of certain neurotransmitters.
- Vitamin D is a group of fat-soluble secosteroids responsible for increasing intestinal absorption of calcium, magnesium, and phosphate, and many other biological effects.
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- This post is not medical advice. This post is for informational and educational purposes only.
- Always see or talk to your doctor before taking these drugs, supplements and over the counter products. Be aware that most of the 'treatment' dosages are above the recommended dietary allowance (RDA) and therefore such dosages should not be maintained on a long term basis.
- Our aim here isn't to replace your doctors' advice. It is intended as a sharing of knowledge and information. Do take note that supplements are not 100% protective or curative against COVID-19.
- You still need to follow the advice given by CDC, WHO and your local authority in terms of local guidelines such as mask wearing, social distancing, vaccination and avoiding crowds. It's better to combine multiple strategies in order to defend yourself against this virus.
- According to US NIH: "...Guidelines should not be considered mandates. The choice of what to do or not to do for an individual patient is ultimately decided by the patient and their provider."
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