Persistent Symptoms Post-COVID (Long Hauler’s) Is Optional!
Post-COVID
Now, with the first waves of the COVID-19 battle done and the casualties counted, we are realizing that it is time to focus on the people who didn’t die—but who also don’t completely recover.
Many infections trigger chronic fatigue syndrome and fibromyalgia (CFS/FMS). COVID is simply one of dozens, even after mild infections. Although estimates vary dramatically, my estimate is that about 10 percent of symptomatic cases will end up having persistent disabling fatigue and other symptoms. This translates to about 4 million new CFS and fibromyalgia cases.
As usual, the health care system will continue to largely focus on finding expensive new medications for this condition, which will take well over a decade to develop and get through the regulatory system—while ignoring low cost and effective treatments. Because of this, people with “long haulers syndrome” will soon be looking to holistic medicine for help.
The Good News
Both the post viral CFS/FMS and the effects on the heart, brain and lung are very treatable, using a CAM mix of natural and prescription therapies. In this article, I will teach you what is needed to help people effectively recover.
How I Got Interested in Post Viral CFS/FMS?
The same way so many holistic practitioners do. Having the illness, or a family member who had the condition, and having been failed by the standard health care system.
In 1975, I came down with a nasty viral illness that I call the “Drop Dead Flu.” It knocked me out of medical school and left me homeless for a good part of the year. But it was as if the universe put a “Holistic Homeless Medical School” sign on my park bench. Naturopaths, herbalists, energy healers, nutritionists and a wide array of other healers found their way to my park bench. Sometimes they even had a pizza with them, and I ate. But this was the venue in which I learned the bits and pieces of what I needed to recover from my own post viral CFS and fibromyalgia. I was able to return to medical school, get honors in medicine, and I have spent the last 47 years researching, writing, treating and teaching about effective treatments for these conditions. This includes four new treatment studies that I have been principal investigator on in the last 18 months.
The Confusion Over Names
Unfortunately, any persistent symptoms lasting over three months is being lumped into the diagnosis of post COVID “long haulers,” or PASC (post-acute sequelae of COVID). So whether you simply have some decreased sense of smell/taste, or are bedbound with a CVA or massive myocardial infarction, or have post COVID CFS/fibromyalgia, they are all lumped under the same diagnoses. This is unfortunate as these are multiple different conditions and this difficulty with nomenclature will further delay effective research.
But there is no need to wait 20 years to be able to help people. You’ll have a pretty good idea how to once you finish this article.
The Treatment Protocol
Step One
Begin with the Basics–Shutting Down Excessive Inflammation and Free Radical Reactions
I find the products by EuroMedica (available at Emerson Ecologics) to be superb. I would note that I take no money from this company. Payments I receive for being on their Scientific Advisory Board go to charity. So let’s begin.
Balance the inflammation and free radical excess with a mix of CuraPhen and Clinical Glutathione. These are my two favorites. The former is a mix of curcumin and turmerone essential oil, which increases absorption of the curcumin about 693 percent. To put this in perspective, turmeric is only about 2 percent curcumin. So it takes 50 pills of turmeric to get the active amount of one capsule of curcumin. Then the absorption of curcumin is increased almost sevenfold by adding in the essential oil. Translation? One Curaphen replaces hundreds of turmeric pills.
Meanwhile, while the curcumin is balancing the cyclooxygenase inflammation system (e.g. – joints), the CuraPhen also contains boswellia (a.k.a. frankincense), which balances the lipoxygenase (LOX) pathway of inflammation, which is so important in the gut and lungs. The CuraPhen then also has phenylalanine to increase endorphin levels for pain and nattokinase to help break down the debris from the excess clotting and inflammation. As you can see, this single compound is outstanding for healing. It is also the first thing I go to in helping most people who have chronic pain, and it has been a pain relief miracle.
Bottom line? Start with 1-2 caps three times of CuraPhen daily.
I also consider Clinical Glutathione one tablet twice daily. This contains the glutathione in a reduced and highly absorbable form. So this simple mix can go a long way to shutting down any persistent inflammation.
The third arm of balancing both the immune system and clotting systems are the omega-3s. Most fish oils have a relatively small percent of omega-3s, and the remainder are largely useless oils that goes rancid and causes “fish oil burps.” By vectorizing the omega-3 oils, as is done in EurOmega 3, one simple pill replaces seven large fish oil pills. I give one tablet twice daily. For those who can prescribe, I recommend adding low dose naltrexone 3-4.5 mg a night from a compounding pharmacy to rebalance immunity. This takes eight to 10 weeks to start working, but can be very beneficial I give the above three supplements for three months plus the LDN will the person is adequately better to rebalance the immune system.
Step Two
Restore energy production and mitochondrial and hypothalamic function with the SHINE Protocol.
Basically, post viral CFS and fibromyalgia represents an energy crisis with resultant mitochondrial and hypothalamic dysfunction. Presume this is present if the person has any two of the following: fatigue, brain fog, nonrestorative sleep or chronic widespread pain.
The hypothalamus is like a “circuit breaker” which controls:
1. Sleep, so inability to get restorative sleep is critical. I use a mix of natural and low-dose prescription treatments for this. 2. Almost the entire hormonal system, especially thyroid, adrenal and ovarian/testicular. Function needs to drop enough to put the person in the lowest 2.5 percent of the population (two standard deviations) before the blood tests become “abnormal.” In an analogy that I give to patients that they find helpful is that if you went to a “shoe doctor,” any shoe between size 6 and 12 would be considered in the normal range. No matter how big your foot is. Another analogy is that using medical norms, any income over $8,100 a year would be defined as “normal.” So, diagnosis should be based on symptoms and response to treatment, rather than on labs alone. Tired, achy, weight gain or cold intolerant? Consider a trial of thyroid hormone. Irritability when hungry, low blood pressure, sugar cravings? The research is showing low cortisol/adrenal functions is one of the major predictors for long COVID.
3. Autonomic function. Gravity causes blood to drop to our legs when we stand up. The autonomic system is what sends it back to our muscles, and the brain and other organs. When this does not work properly, the person develops Postural Orthostatic Tachycardia Syndrome or Neurally Mediated Hypotension (POTS/NMH/Orthostatic Intolerance). These can be easily screened for with a two minute quiz or a 10 minute pulse test. It is often remarkably simple to treat as well, starting with medium pressure (20-30 mm compression stockings, increasing salt intake and adrenal support, and then progressing to numerous available other treatments as needed. Orthostatic intolerance has been found to be especially common in post COVID CFS/FMS.
To address this mitochondrial/hypothalamic dysfunction, several of my published studies, including a randomized double-blind placebo-controlled prospective study, showed that the SHINE Protocol, which optimizes:
Sleep
Hormones/Hypotension (orthostatic intolerance)
Immunity
Nutritional support and
Exercise as able (mild to avoid postexertional malaise) resulted in an average 90 percent increase in quality-of-life (p<.0001 vs placebo) in people with CFS/fibromyalgia, including post viral.
How to apply the SHINE Protocol is discussed in depth in earlier articles and in the newest fourth edition of my bestselling book From Fatigued to Fantastic (Penguin/Avery June 15, 2021). It is geared for both practitioners and the public and will make you an expert in these conditions.
An easy way to get started are with free treatment tools which I am happy to send you. Simply email me at FatigueDoc@gmail.com and ask for the free treatment tools (SHINE Protocol overview, intake and treatment protocol check lists, and orthostatic intolerance information sheet). Do let me know if you are a health practitioner, so I know what to email you. These will help you learn what you need quickly.
Step Three (or an easy way to begin)
Because of this severe need, my research team and I recently completed a series of four studies on new supplements we were finding to be highly effective at improving energy and function.
Ginseng – the Asian Miracle Recovers
For more than a millennium, ginseng has been the most popular herb in China and much of Asia. Unfortunately, the overharvesting of wild ginseng led to it becoming insanely expensive. The newer farmed ginsengs often just didn’t work as well, so its popularity started to wane.
Old wild ginseng produces more than 50 different ginsenosides, as a protective response to the insect attacks and difficult weather. But these are usually not found in most farmed ginseng.
But now, a unique new hydroponic farming technique that reproduces the plant’s challenges faced in the wild has allowed grown ginseng to have the same active component profile as the old wild plants, creating new health possibilities—including in this situation.
I tried it myself and was astounded how quickly I felt more energized. If I have a busy workday, this is what I take myself. I found the same degree of benefit in about 60 percent of people I treated. So, I decided to do a study on it in people who had a greater than 50 percent decrease in function.
HRG80- Red Ginseng Energy
In our recent study of 188 people, about 40 percent had onset of symptoms post viral infection. About 60 percent improved showing an average (p <.0001 for each outcome measure):
1. 67 percent increase in energy
2. 44 percent increase in overall well-being
3. 48 percent improvement in mental clarity
4. 58 percent composite improvement in the above 3 (primary outcome measure)
5. 46 percent improvement in sleep
6. 33 percent decrease in pain
7. 72 percent increase in stamina
The HRG 80 Red Ginseng (Red Ginseng Energy from EuroMedica – Emerson Ecologics) is the form I recommend for anybody who wants more energy. I recommend 1-2 capsules daily.
I recently completed a fourth study looking at a mix of six nutrients/herbs which has also been very helpful. But that data is still being analyzed, so I will save that discussion for a future article.
Outside of the U.S.?
Another two studies I recently completed were done using a unique oral European serum bi and tri-peptide formula. Many of you are familiar with the blossoming use of these peptides intravenously, but so many find it unaffordable. Called Recovery Factors (www.recoveryfactors.com ), it is available worldwide except in the United States (but hopefully will be available in the U.S. in about six months). But for those of you outside of the United States, feel free to email me (fatiguedoc@gmail.com) and ask for the Recovery Factors studies.
For stubborn cases, including oddly enough even cases where people developed debilitation from the vaccine itself, we are starting to see benefits from Ivermectin 21-28 mg a day for five days, repeating as needed. This is generally available by prescription through compounding pharmacies.
The bottom line? A comprehensive treatment approach helps most people with persistent post-COVID symptoms improve dramatically, and they can often recover full health.
Addressing the Individual Key Organs—Heart, Lungs and Brain
People are understandably frightened. They have shortness of breath and presume their heart or lungs are damaged beyond repair. They have palpitations with the shortness of breath and are convinced they have heart failure. Meanwhile, given the “brain fog” common with post viral CFS/fibromyalgia, many are convinced they have permanent brain damage as well.
What I’m finding is that, by and large, they don’t. It is important that people be assessed, and then be given accurate information. This usually turns out to calm them considerably. Especially as they improve with treatment.
One of the most important tools you can recommend for people with shortness of breath? A simple $25 pulse oximeter available on Amazon. Quality varies, and I have found the ZacUrate brand to be reasonably helpful and reliable for home use.
Let people know to simply check the oxygen saturation using the pulse oximeter when they are short of breath. If it is over 95 percent, especially if oxygen saturation increases with walking, it is not likely to be coming from severe heart or lung damage. Most often it is coming from anxiety. In addition, breathlessness is a common non heart/lung symptom of fibromyalgia. Interestingly, an old study by the Korean acupuncturist Neoh Aum Chu found that stimulating three acupuncture points on the back of the skull could make the breathlessness in fibromyalgia go away. Sometimes, so can the pulse oximeter and its reassurance.
But many do have significant post COVID organ involvement. When this is present and significant, here’s how to help it.
Cardiac Involvement
If their oxygen saturation goes over 95 percent and increases with exercise while the breathlessness is worsening, it is less likely that the shortness of breath is cardiac. Palpitations are also routine in fibromyalgia despite healthy cardiac function, and usually are PVC’s or a pounding heart from excess adrenaline tone—both of which are usually benign (although they should be evaluated) and resolve with treatment.
But for those who do have a decreased ejection fraction or symptoms of heart failure (from most causes), here is a simple recipe that can leave them feeling dramatically better in six weeks. It increases cardiac muscle efficiency:
1. Ribose 5 g of the powder three times a day
2. Coenzyme Q 10. I use the chewable 100 mg CoQ10 by EuroMedica as this is equivalent 800 mg daily
3. B Complex ~ 50 mg
4. Magnesium 150-plus milligrams (if kidney function is okay). Optimal B complex and magnesium can both be found in the “Essential Multivitamin” by EuroMedica
5. Also consider acetyl l-carnitine 1,000 milligrams, twice a day
If evidence of decreased cardiac function or the need to increase efficiency persists despite these, see other recommendations under “Heart” in the Cures A-Z Phone App.
Persistent Lung Damage Improves Gradually After COVID-19
Fortunately, lung damage with ARDS, including Post-SARS, tends to improve and often resolves after two years. So, often all that is needed is reassurance and the pulse oximeter so they can see improvement over time. Several treatments may help to speed this lung healing along. I usually simply begin with the CuraPhos, two caps (3x day), plus Clinical Glutathione, one twice a day discussed above. In more severe chronic cases, I consider colchicine .6 mg twice a day and other anti-fibrotic agents.
Post Viral Brain Involvement
Given what we are seeing from numerous other forms of post viral CFS/fibromyalgia, the brain fog usually does not likely represent long-term brain injury. Rather it represents the 25 percent decreased blood flow in the brain when standing from the orthostatic intolerance discussed above, microglial activation, persistent free radical irritation, and alterations in temporal blood flow (contributing to the difficulty with word finding and substitution). But people with the condition are understandably afraid that they have suffered permanent brain damage. You can reassure them that with a high probability their cognitive function will recover with the protocol.
We routinely find that the brain fog resolves with the SHINE Protocol, using the Recovery Factors and Red Ginseng Energy, addressing the immune and free radical activation, and settling down the microglial activation with low-dose naltrexone (3-4.5 mg at bedtime giving it at least 10 weeks to work) or other nonprescription alternatives. As well as with the entire SHINE Protocol.
A Few Other Persistent Problems
Although there are countless other problems and symptoms which may persist, most are treatable. Loss of taste and smell seems to be the hardest to eliminate currently. But a few other considerations:
1. COVID-19 may reduce fertility in men. Increasing both male and female fertility can be done naturally and very effectively. Although beyond the scope of this article, simply email me (FatigueDoc@gmail.com ) for the free “Infertility Information Sheet.”
2. Posttraumatic stress disorder (PTSD) may occur in up to a third of patients who recover from severe COVID-19 infection, as can other severe emotional traumas. Although beyond the scope of this article, the new fourth edition of From Fatigued to Fantastic discusses how to heal emotional trauma, including PTSD, at length. It also discusses how to reset the autonomic nervous system/limbic system using the ANS Rewire or Dynamic Neural Retraining System.
3. Hyperthyroidism/thyroiditis is sometimes present with elevated free T4s and decreased thyroid scan uptake in f those with post COVID symptoms.
Conclusion
CFS and fibromyalgia, especially following COVID, can be very frightening to the people affected and challenging for the practitioners treating them. The good news? Although complex conditions, they can be effectively treated and often eliminated.
A recognized authority on chronic fatigue syndrome (CFS) and fibromyalgia, Dr. Jacob Teitelbaum is medical director of the Fibromyalgia and Fatigue Centers nationally, and does phone consultations with CFS/fibromyalgia patients worldwide. He is the author of the popular iPhone application “Cures A-Z,” and author of the best-selling books From Fatigued to Fantastic! (4th revised edition, Avery/Penguin Group) and Pain Free 1-2-3—A Proven Program for Eliminating Chronic Pain Now (McGraw-Hill). His newest book is Beat Sugar Addiction NOW! (Fairwinds Press; 2010). Dr. Teitelbaum does frequent media appearances, including Good Morning America, CNN, Fox News Channel, the Dr. Oz Show and Oprah & Friends.
