September 30, 2025 • 22 mins
The mystery of Long COVID continues to puzzle both patients and medical professionals. Why do some people recover completely from COVID-19 while others experience debilitating symptoms for months or even years? This deep dive into the biology of Long COVID reveals the hidden mechanisms driving persistent symptoms that affect millions worldwide.
At its core, Long COVID involves multiple overlapping biological disruptions. Fragments of the virus may remain in tissues long after the acute infection, continuing to trigger low-grade inflammation. The immune system becomes dysregulated, sometimes attacking the body's own tissues or reactivating dormant viruses. Tiny blood clots form in small vessels, starving tissues of oxygen and nutrients. The autonomic nervous system—which controls unconscious bodily functions—falls into disarray. Mitochondria, our cellular power plants, become damaged and inefficient. Even the gut microbiome shifts in ways that perpetuate inflammation throughout the body.
These biological mechanisms manifest as the constellation of symptoms that define Long COVID: crushing fatigue that worsens after even mild activity, cognitive "brain fog" that impairs thinking and memory, shortness of breath, heart palpitations, dizziness, joint pain, and mood disturbances. For those suffering, understanding these mechanisms offers validation and direction. This isn't psychosomatic—it's a complex physiological condition with measurable biological markers.
Recovery requires a multifaceted, individualized approach. Strategies that have shown promise include energy pacing to avoid symptom flares, prioritizing restorative sleep, adopting an anti-inflammatory diet rich in whole foods and omega-3s, stress management techniques, and targeted therapies like red light therapy and specific supplements based on individual needs. Though progress is typically slow, understanding the biology of Long COVID is the first step toward developing effective treatments and reclaiming health.
If you're struggling with Long COVID symptoms or know someone who is, reach out for support. Recovery is possible with the right approach and patience. Contact us to learn more about personalized strategies to address your specific symptoms and begin your healing journey.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:26):
Dr Enrico Dolcecori, md, mph, md, phd, phd, phd, phd,
phd, phd, phd, phd, phd, phd,phd, phd, phd, phd, phd, PhD,
phd, phd, phd, PhD, phd, phd,phd, phd, PhD, phd, phd, phd,
PhD, phd, phd, phd, phd, PhD,phd, phd, phd, phd, PhD, phd,
phd, phd, phd, PhD, phd, phd,phd, phd, PhD, phd, phd, phd,
phd, PhD, phd, phd.
Not just the lingering cough orfatigue, but the hidden changes
inside the body that makerecovery complex.
We'll walk through what'shappening at the physiological
level, why many people strugglewith symptoms long after the
acute infection and what stepsyou can take to help support
healing.
Whether you had COVID monthsago or you care for someone that
has, this episode will give youthe understanding, hope and
actionable insights.
Let's get into it.
(00:48):
When most people think of COVID,they think of the initial
infection, the fever, the cough,the respiratory distress and
then recovery.
But for a subset of people,symptoms persist for weeks to
months.
That's why we call it longCOVID.
It's also called post-acutesequelae of SARS-CoV-2 infection
or PASC.
(01:10):
Long COVID is often defined assymptoms lasting more than three
months after infection thatcannot be explained by another
diagnosis.
Symptoms are very broad.
Symptoms are very broad Fatigue, brain fog, post-exertional
malaise, shortness of breath,chest pain, autonomic
(01:35):
dysfunction, joint pain,gastrointestinal issues, mood
and sleep disorders and more.
It's important to note thatlong COVID can occur, even in
people who had mild acuteinfections.
You don't have to behospitalized to develop
lingering issues and that's fromnature.
But why do some people recoverfully while others carry
symptoms for months or years?
That's what we're going toexplore in this episode together
(01:58):
.
What we need to understand ishow long COVID works.
We need to peek inside thebiology.
Multiple overlapping mechanismsseem to drive the persistent
symptoms.
No single mechanism explainsall cases, but the research
points to a few reoccurringthings and I'll break them down,
at least the major ones.
(02:19):
The first one is the viralpersistence and residual viral
components.
In some people, fragments ofthe SARS-CoV-2 or even
reservoirs of the virus mayremain in tissues months after
acute infection.
These residual viral proteins,or RNAs, are called spike
(02:41):
proteins that can continue tostimulate low-grade immune
activity, and it's thatlow-grade immune activity that
persists the symptoms of malaise, brain fog and a bunch of other
things that can happen.
Some studies have found thatviral antigen, or RNA, in gut
tissue, blood plasma, lymphnodes, even brain tissue and
(03:03):
other organs long after theacute phase.
So these fragments are lastinga long time.
This leftover antigen exposurecan trigger chronic inflammatory
signaling in the body and we'reall a little different on how
we respond to that signaling.
The second thing is immunedysregulation and chronic
(03:27):
inflammation in the body.
After the acute infection theimmune system doesn't always
fully reset.
Some cytokines and inflammatorymarkers remain elevated, for
example, interleukin-6 orinterleukin 1 beta, tnf and
other chemokines can just stayelevated for long periods of
(03:48):
time, causing immune systemdysregulation and constant
fighting.
There's evidence ofautoimmunity, that is, the
immune system begins targetinghost tissues or autoantibodies
or dysregulated immune signalsso they compete for binding
sites and cause chaos in ourimmune system and our immune
(04:09):
system starts fighting itself.
Reactivation of latent viruses,so maybe a stacking effect of
like old flu viruses, and thenreactivation of other things
like EBV or HHV-6 orEpstein-Barr or other things
that can be lingering in thereold chickenpox virus, herpes
(04:32):
viruses, all these things thatcould be in our tissues already.
And having this stacking effectOof COVID's been a mess, hasn't
it?
It has been documented in longCOVID patients possibly
triggered by immune strain.
The net result an immune systemthat is stuck on low level,
alert, causing tissue stress,oxidative damage and metabolic
(04:54):
disruption.
So that's what's happening on ascience-based level, behind the
scenes, where I don't think Igave you any clarity on that.
But the stacking effect and adysregulated immune system can
just linger these symptoms for areally long time.
It's like a really bad flu, buteven if you've been through
those, we eventually get overthem.
It feels like some of theselong COVID patients are.
(05:15):
We're like a year down the roadand they're still trying to get
back to normal.
There's endothelial dysfunction,microclots and coagulation.
In some studies that show thatSARS-CoV-2 infects or injures
the vascular endothelium, whichis the lining of blood vessels,
that can lead to dysfunction,leakage, microvascular injury
(05:38):
and small microclots.
Microclots or microthrombireduce capillary blood flow.
This impairs tissue perfusionwhich can starve tissue,
including the brain tissue andmuscle tissues, of nutrients or
oxygen.
Hence the fatigue.
Endothelial injury triggersfurther inflammation and
(05:59):
oxidative stresses.
In some patients coagulationmarkers remain abnormal for
prolonged periods of time.
There's also autonomicdysregulation and dysautonomia.
Many long COVID patients showsigns of autonomic nervous
system imbalance, like heartrate variability changes,
orthostatic intolerance, potssymptoms, which is postural
(06:23):
orthostatic tachycardia syndrome, blood pressure dysregulation,
because autonomic function isintimately connected with the
vascular tone, heart andrespiratory control.
Dysfunction here produces manyof the hallmark symptoms
lightheadedness, palpitations,fatigue, brain fog helped many
(06:44):
POTS symptoms patients over theyears Post COVID.
It's been kind of weird becausewe're seeing a lot of the POTS
type symptoms but they're notqualifying with POTS because
it's actually long COVID, sothey're not getting the same
testing positives that POTSpatients were, where if you put
them on an inversion tableimmediately, their blood
(07:05):
pressure decreases, they feelfaint and all this.
You put somebody with longCOVID, they flip them over,
they're not feeling faint andlong, so there's little things
that are happening there.
Where it's not quite POTS, itcould be long COVID.
Then we get mitochondrialdysfunction and energy
impairment.
This is where the fatigue andmalaise comes from.
With the mitochondrialimpairment that happens from
(07:27):
inflammation.
So inflammatory and viralstress can damage mitochondria.
The mitochondria are the cell'spower plant inside of each and
every cell.
This leads to less efficientenergy production, atp and
reactive oxygen species.
For metabolic fatigue.
Some studies draw parallelsbetween long COVID and myalgic
(07:48):
encephalitis orencephalomyelitis chronic
fatigue syndrome wherein ahallmark is impaired cellular
energy metabolism.
So it's masking a lot of theseprevious diagnoses that we've
done and causing a lot ofturmoil and chaos in the medical
industry because we just don'tknow what to do for patients.
We can't really treat them forthe disease because they don't
(08:09):
have POTS or encephalomyelitisor chronic fatigue syndrome.
They're having long COVID.
So how do we help these people?
It also affects the neurologicaland central nervous systems.
The spike protein or viralfragments may cross the
blood-brain barrier or damagebarrier itself, allowing
inflammatory molecules into thebrain.
(08:31):
Microglial activation thebrain's immune cells,
micro-glial activation, thebrain's immune cells and neural
inflammation have been impactedin cognitive symptoms, memory
issues and brain fog.
Some studies suggest a leakyblood-brain barrier might
underline brain fog, allowingproteins like S100B to leak into
(08:51):
the blood.
Disrupted neural networkscoherence, for example via
infected glial astrocyte cells,might impair communication
between brain regions.
Some experimental modelingsuggests this.
This is from axial studies.
And then gut microbiome anddysbiosis.
So the SARS-2 infection canshift the gut microbiome,
(09:15):
leading to dysbiosis, imbalanceof bacterial populations, gut
barrier dysfunction leaky gutcan allow microbial products and
endotoxins into circulation,triggering systemic inflammation
.
Because the gut is deeplyconnected to the immune
regulation, the gut immune axis,this pathway may perpetuate
inflammatory circuits in longCOVID.
(09:37):
And finally, interconnectedfeedback loops and allostatic
load.
Many of these mechanisms feedinto one another.
For example, inflammationcauses mitochondrial damage,
which causes more oxidativestress, which further activates
immune signaling.
It's almost like this negativefeedback loop or this negative
tornado that's happening,causing all these other effects.
(10:00):
The body's allostatic load, thecumulative stress burden, is
often high in long COVIDpatients, meaning the
physiologic system are understrain and less able to recover.
There may be an individualsusceptibility factor like
genetics, prior health, age, sex, metabolic status and
(10:21):
nutritional reserves that canalso play into this role.
So we got to map all thesetypes of symptoms into the
mechanisms to truly understandwhat is happening with this long
COVID.
So we got to connect thebiological changes to what
people feel so that we canunderstand and help target
recovery.
Here are some common symptomsthat we're seeing in my practice
(10:44):
just from people with longCOVID.
The fatigue and post-exertionalmalaise are number one.
People are like I just don'thave the energy, can't do my
workouts.
We have mitochondrialdysfunction and immune over
activation and autonomicdysregulation.
People often feel a crash aftermodest exertion.
For these people what we'vedone is we've put them through
(11:05):
regimens of red light therapy tohelp photomodulation increase
mitochondrial repair in theinflammatory body.
So we have like a tanning bedin our office.
They lie there for 12 minutesat the right frequencies and
we've been seeing like people'sbrain fog clears up right away.
The malaise is happeningthrough some targeted
(11:25):
supplements that each patientneeds review on through blood
work or testing, or even guttesting to see what they need.
But glutathione, eitherintravenously through IV or
liposomal underneath the tongue,along with red light and
chiropractic adjustments toregulate the autonomic nervous
(11:48):
system, that has been reallygood since 2020, when this all
started.
That has been our recipe forthe people that come in saying
they just don't have the energy.
Others come in with otherissues like the brain fog,
memory issues and cognitiveslowness.
The red light does work therebecause of the neuroinflammation
, but blood-brain barrierdisruptions and glial activation
(12:09):
can also cause a bunch of otherstuff.
We need some brain supplementsfor those types of patients.
Shortness of breath and chesttightness.
I brought in NAC very quicklyinto our office in like April
2020 for my senior patients.
I was worried about them.
I was like man, these peopleare going to hospital, there's
(12:30):
respiratory distress.
So we brought in NAC Somepeople call it NAC and they
started taking this and I swearAt the end of the year I was
sending out surveys to patientsand asking them how they're
doing.
We had zero hospitalizations inour patient base in our office
in all of 2020.
Zero people went to hospitalZero spouses went to hospital
(12:53):
and zero kids went to hospitalfor COVID.
Don't know what that means, butI saw the news and I saw
everyone going there.
But I was like who has been tothe hospital?
And I did as much as I couldchecking in on our patient base
and it was amazing that no onewas going to the hospital.
I'm like, okay, well, peoplethat are out taking care of
(13:13):
themselves or doing better thanthe people, maybe other people
who maybe don't have a chance todo that, so I don't know.
But that was that.
And NAC so up to today, Ialways like, I'm like man.
That was probably one of thesmartest things I've done in my
career is bring in NAC so peoplecould grab it right off the
shelf and start taking it rightaway, whether they were coughing
or whatever.
I just told them take it and Ithink that's been in the
literature now showing to bevery beneficial.
(13:36):
Shortness of breath and chesttightness this is like we were
talking.
Possible micro clots in thelung vascular, you know,
endothelial injury, impaired gasthis is pulmonology, this is
cardiology.
I highly recommend gettingthose tests done.
It could be a angiogram CT withdye of the chest, whatever it
is, to find any micro clotting,um.
And then medicine can reallyhelp with this, with coagulants
(13:59):
and things that can help removethe stress of the vascular
system so that you can continuedoing what you need to do to
repair the vascular systemthrough exercise and good diet.
That could be the step for thatone.
So we don't have the answersfor everyone.
Palpitations, dizziness,orthostatic intolerance this
comes from the autonomicdysfunction, dysautonomia,
(14:20):
vascular tone, instability, 100%.
Get adjusted, get the atlascheck, get the vagal response
synthesized there withchiropractic adjustments.
And there's other techniques aswell cranial, sacral technique,
kinesiology.
There's a lot of things you cando for that one as well.
Pain in the joint, aches, muscleweakness that's from chronic
(14:41):
inflammation that the spikeproteins have been shown to do,
that it could be autoimmuneresponse, nervous system
sensitization to that.
Again, red light therapy, coldlaser or class four laser on the
joints that are sore has beenvery successful.
In our office We've beenputting class four laser right
on the joints.
Immediately decreasesinflammation, decreases pain.
(15:02):
People feel good there and Ithink some studies have shown
that by pushing thatinflammation out of the joint
and stimulating mitochondrialfunction in the joints that the
pain doesn't return to thejoints too.
That was cool too.
So some people are gettingpermanent improvement from that
GI symptoms bloating, diarrhea,nausea this is from the
(15:23):
dysbiosis that we're talkingabout.
So some people react to the gutlining with the spike proteins
as well, got barrier leak,immune activation in the gut.
Then we have the mood swings,anxiety and sleep disruption.
That's from chronicinflammation the HPA axis that
we talked about from the brainand the gut, and then the brain
(15:43):
network and oxidative stresses.
So we have to repair diet, wehave to get probiotics in there,
and these all can be tested forin one way, shape or form.
But because we've seen so manypost COVID patients, we've
blanketed them into these sevengroups that we know straight to
where to go to to help them tosave not only cost and testing
(16:03):
but time to get them feelingbetter faster.
So that's really cool too.
So this is where functionalmedicine really kicks in and you
can reach out to us at info atfulllifetampacom to get started
virtually on many of thesethings and we can guide you in
the right direction on that aswell.
So here's some strategies tosupport this, to help yourself
move forward.
These are evidence-based andlogical, grounded strategies
(16:25):
that I always encourage you knowthe listeners for these types
of things to find medicalprofessional to help you with
this.
Doing this on your own,especially long COVID If you've
been suffering with it, you knowthis isn't like getting better.
You need help with this and alot of people say they help with
long COVID but they have to gothrough these steps to figure it
out.
So, pacing and energy managementwe want to adopt a listen to
(16:47):
your body approach.
We have to avoid pushing pastour limits right now just
because of the mitochondrialfatigue.
Use activity pacing, so breaksinto small portions.
Rest.
You can't work out like youused to.
You're going to have to doshort bursts or short, less
intense exercises or maybe justsome lifting for now, without
the cardio burden, and avoid andavoid the boom bust cycle that
(17:08):
exacerbates symptoms.
You know what I'm talking about.
If you're suffering from that.
Uh, gentle movement andrehabilitation, low impact
practices, walking mildly um,autoimmune tolerances improve
when we do this.
And uh, be watchful in anactivity worsens symptoms over
24 to 48 hours after you do it.
You got to stop doing it.
It's just the way that you gotto switch it.
(17:29):
You got to do something else.
We need to prioritize sleep.
Sleep's now got to become topof the list.
You have to have a consistentbedtime and awake times seven
days a week.
You're just going to have tofit in the time to get restful
sleep.
Whether you can fall asleep ornot, whether you have insomnia
or difficult fallings, itdoesn't matter.
You're going to bed at 10 andyou're waking up at six.
It's just you have to set upthat schedule to get the
(17:56):
circadian rhythm back.
That's some things that you cancontrol and that's one of them.
Inflammation plus autonomicstress can impair sleep.
That's what makes it poor.
But if you create the sleep asa priority, you we do see
improvement quite quickly.
We have to get intoanti-inflammatory nutrition and
gut support.
Focus on whole foods,phytonutrient rich vegetables,
omega-3 fatty acids andantioxidants into the diet.
(18:19):
Avoid processed processed sugar, refined carbs, trans fats,
because these just worseninflammation every single time.
Support your gut health withprebiotics, postbiotics,
probiotics, fermented foods andfiber, as tolerated, of course.
And work with functional orintegrative practitioners If the
barrier repair, likesupplements like glutamine and
(18:39):
zinc, are indicated.
You don't want to dose thatstuff on your own or try and
guess.
Have someone give the rightprotocol for you.
Stress management, mind and bodypractices, breathing exercises,
vagus nerve stimulationtechniques like slow,
diaphragmatic breathing,meditation, guided imagery,
journaling offloading yourmental stress in one way, shape
(19:01):
or form is going to truly helpGrounding.
Guided imagery, journalingoffloading your mental stress in
one way, shape or form is goingto truly help Grounding nature,
exposure, gentle socialconnection these things are all
really good ideas and these aretargeted therapies and clinical
options when they're appropriate.
For dysautonomia would be likeincreasing water and salt intake
, compression garments andmedications guided by a
(19:23):
physician to help with thisautonomia.
On that way, trials of low-doseanti-inflammatories or
neuroimmune modulators these arestill in research but have been
effective.
Treatable trait approaches arelike focused on dominant
mechanisms in each person, likeclotting markers are abnormal,
or therapies targetingmicroclots, like we talked about
with CT imaging, and thenmonitoring and addressing
(19:46):
co-infections or reactivatedviruses if present.
This is where gut testing canreally bring out the virus load
that's in the body and someblood testing to show what
antibodies are fighting for what.
You may be fighting two orthree different viruses at the
same time because the spikeproteins brought them all out,
so that could be an issue too.
(20:07):
So physical rehabilitation undersupervision as well, like PTs,
that no long COVID will put youthrough minimalistic joint
loading so that you can havemovement and therapy to help you
with with that as well, andthen just keep symptoms.
You got to journal this stuff,see what's going on there If
you're truly struggling withthis and want to get to the
bottom of it journal.
We got to mark the triggers andresponses, like after exertion
(20:30):
how you feel, or after eatingcertain foods how you feel, and
just work with practitionersthat monitor your labs.
So inflammatory markers,vitamin D levels, thyroid and
mitochondrial function are allreally important to test.
Progress will be slow.
This is a slow and steadyrecovery.
You got to be patient.
(20:50):
We'll be compassionate for youand we'll help you each step of
the way through that.
So lots of information.
I tried to keep it scientificfor you so you know that there's
mechanisms that are not, sothat you know you're not crazy.
If you know someone's sufferingwith long COVID or you think
it's long COVID, reach out to usso we can guide you in the
(21:10):
right direction.
Some people do need in-depthmedical care from an MD
professional that does this, butmany other functional medicine
practitioners like NPs andchiropractors that are
internists that know this stuffcan help you as well, we got
resources for you all over theplace.
Info at fulllifetampacom.
Have a healthy week, stay well,stay healthy and take care.
Dr Enrico Dolcecori, md, mph, md, phd, phd, phd, phd,
phd, phd, phd, phd, phd, phd,phd, phd, phd, phd, phd, PhD,
phd, phd, phd, PhD, phd, phd,phd, phd, PhD, phd, phd, phd,
PhD, phd, phd, phd, phd, PhD,phd, phd, phd, phd, PhD, phd,
phd, phd, phd, PhD, phd, phd,phd, phd, PhD, phd, phd, phd,
phd, PhD, phd, phd.
Not just the lingering cough orfatigue, but the hidden changes
inside the body that makerecovery complex.
We'll walk through what'shappening at the physiological
level, why many people strugglewith symptoms long after the
acute infection and what stepsyou can take to help support
healing.
Whether you had COVID monthsago or you care for someone that
has, this episode will give youthe understanding, hope and
actionable insights.
Let's get into it.
(00:48):
When most people think of COVID,they think of the initial
infection, the fever, the cough,the respiratory distress and
then recovery.
But for a subset of people,symptoms persist for weeks to
months.
That's why we call it longCOVID.
It's also called post-acutesequelae of SARS-CoV-2 infection
or PASC.
(01:10):
Long COVID is often defined assymptoms lasting more than three
months after infection thatcannot be explained by another
diagnosis.
Symptoms are very broad.
Symptoms are very broad Fatigue, brain fog, post-exertional
malaise, shortness of breath,chest pain, autonomic
(01:35):
dysfunction, joint pain,gastrointestinal issues, mood
and sleep disorders and more.
It's important to note thatlong COVID can occur, even in
people who had mild acuteinfections.
You don't have to behospitalized to develop
lingering issues and that's fromnature.
But why do some people recoverfully while others carry
symptoms for months or years?
That's what we're going toexplore in this episode together
(01:58):
.
What we need to understand ishow long COVID works.
We need to peek inside thebiology.
Multiple overlapping mechanismsseem to drive the persistent
symptoms.
No single mechanism explainsall cases, but the research
points to a few reoccurringthings and I'll break them down,
at least the major ones.
(02:19):
The first one is the viralpersistence and residual viral
components.
In some people, fragments ofthe SARS-CoV-2 or even
reservoirs of the virus mayremain in tissues months after
acute infection.
These residual viral proteins,or RNAs, are called spike
(02:41):
proteins that can continue tostimulate low-grade immune
activity, and it's thatlow-grade immune activity that
persists the symptoms of malaise, brain fog and a bunch of other
things that can happen.
Some studies have found thatviral antigen, or RNA, in gut
tissue, blood plasma, lymphnodes, even brain tissue and
(03:03):
other organs long after theacute phase.
So these fragments are lastinga long time.
This leftover antigen exposurecan trigger chronic inflammatory
signaling in the body and we'reall a little different on how
we respond to that signaling.
The second thing is immunedysregulation and chronic
(03:27):
inflammation in the body.
After the acute infection theimmune system doesn't always
fully reset.
Some cytokines and inflammatorymarkers remain elevated, for
example, interleukin-6 orinterleukin 1 beta, tnf and
other chemokines can just stayelevated for long periods of
(03:48):
time, causing immune systemdysregulation and constant
fighting.
There's evidence ofautoimmunity, that is, the
immune system begins targetinghost tissues or autoantibodies
or dysregulated immune signalsso they compete for binding
sites and cause chaos in ourimmune system and our immune
(04:09):
system starts fighting itself.
Reactivation of latent viruses,so maybe a stacking effect of
like old flu viruses, and thenreactivation of other things
like EBV or HHV-6 orEpstein-Barr or other things
that can be lingering in thereold chickenpox virus, herpes
(04:32):
viruses, all these things thatcould be in our tissues already.
And having this stacking effectOof COVID's been a mess, hasn't
it?
It has been documented in longCOVID patients possibly
triggered by immune strain.
The net result an immune systemthat is stuck on low level,
alert, causing tissue stress,oxidative damage and metabolic
(04:54):
disruption.
So that's what's happening on ascience-based level, behind the
scenes, where I don't think Igave you any clarity on that.
But the stacking effect and adysregulated immune system can
just linger these symptoms for areally long time.
It's like a really bad flu, buteven if you've been through
those, we eventually get overthem.
It feels like some of theselong COVID patients are.
(05:15):
We're like a year down the roadand they're still trying to get
back to normal.
There's endothelial dysfunction,microclots and coagulation.
In some studies that show thatSARS-CoV-2 infects or injures
the vascular endothelium, whichis the lining of blood vessels,
that can lead to dysfunction,leakage, microvascular injury
(05:38):
and small microclots.
Microclots or microthrombireduce capillary blood flow.
This impairs tissue perfusionwhich can starve tissue,
including the brain tissue andmuscle tissues, of nutrients or
oxygen.
Hence the fatigue.
Endothelial injury triggersfurther inflammation and
(05:59):
oxidative stresses.
In some patients coagulationmarkers remain abnormal for
prolonged periods of time.
There's also autonomicdysregulation and dysautonomia.
Many long COVID patients showsigns of autonomic nervous
system imbalance, like heartrate variability changes,
orthostatic intolerance, potssymptoms, which is postural
(06:23):
orthostatic tachycardia syndrome, blood pressure dysregulation,
because autonomic function isintimately connected with the
vascular tone, heart andrespiratory control.
Dysfunction here produces manyof the hallmark symptoms
lightheadedness, palpitations,fatigue, brain fog helped many
(06:44):
POTS symptoms patients over theyears Post COVID.
It's been kind of weird becausewe're seeing a lot of the POTS
type symptoms but they're notqualifying with POTS because
it's actually long COVID, sothey're not getting the same
testing positives that POTSpatients were, where if you put
them on an inversion tableimmediately, their blood
(07:05):
pressure decreases, they feelfaint and all this.
You put somebody with longCOVID, they flip them over,
they're not feeling faint andlong, so there's little things
that are happening there.
Where it's not quite POTS, itcould be long COVID.
Then we get mitochondrialdysfunction and energy
impairment.
This is where the fatigue andmalaise comes from.
With the mitochondrialimpairment that happens from
(07:27):
inflammation.
So inflammatory and viralstress can damage mitochondria.
The mitochondria are the cell'spower plant inside of each and
every cell.
This leads to less efficientenergy production, atp and
reactive oxygen species.
For metabolic fatigue.
Some studies draw parallelsbetween long COVID and myalgic
(07:48):
encephalitis orencephalomyelitis chronic
fatigue syndrome wherein ahallmark is impaired cellular
energy metabolism.
So it's masking a lot of theseprevious diagnoses that we've
done and causing a lot ofturmoil and chaos in the medical
industry because we just don'tknow what to do for patients.
We can't really treat them forthe disease because they don't
(08:09):
have POTS or encephalomyelitisor chronic fatigue syndrome.
They're having long COVID.
So how do we help these people?
It also affects the neurologicaland central nervous systems.
The spike protein or viralfragments may cross the
blood-brain barrier or damagebarrier itself, allowing
inflammatory molecules into thebrain.
(08:31):
Microglial activation thebrain's immune cells,
micro-glial activation, thebrain's immune cells and neural
inflammation have been impactedin cognitive symptoms, memory
issues and brain fog.
Some studies suggest a leakyblood-brain barrier might
underline brain fog, allowingproteins like S100B to leak into
(08:51):
the blood.
Disrupted neural networkscoherence, for example via
infected glial astrocyte cells,might impair communication
between brain regions.
Some experimental modelingsuggests this.
This is from axial studies.
And then gut microbiome anddysbiosis.
So the SARS-2 infection canshift the gut microbiome,
(09:15):
leading to dysbiosis, imbalanceof bacterial populations, gut
barrier dysfunction leaky gutcan allow microbial products and
endotoxins into circulation,triggering systemic inflammation
.
Because the gut is deeplyconnected to the immune
regulation, the gut immune axis,this pathway may perpetuate
inflammatory circuits in longCOVID.
(09:37):
And finally, interconnectedfeedback loops and allostatic
load.
Many of these mechanisms feedinto one another.
For example, inflammationcauses mitochondrial damage,
which causes more oxidativestress, which further activates
immune signaling.
It's almost like this negativefeedback loop or this negative
tornado that's happening,causing all these other effects.
(10:00):
The body's allostatic load, thecumulative stress burden, is
often high in long COVIDpatients, meaning the
physiologic system are understrain and less able to recover.
There may be an individualsusceptibility factor like
genetics, prior health, age, sex, metabolic status and
(10:21):
nutritional reserves that canalso play into this role.
So we got to map all thesetypes of symptoms into the
mechanisms to truly understandwhat is happening with this long
COVID.
So we got to connect thebiological changes to what
people feel so that we canunderstand and help target
recovery.
Here are some common symptomsthat we're seeing in my practice
(10:44):
just from people with longCOVID.
The fatigue and post-exertionalmalaise are number one.
People are like I just don'thave the energy, can't do my
workouts.
We have mitochondrialdysfunction and immune over
activation and autonomicdysregulation.
People often feel a crash aftermodest exertion.
For these people what we'vedone is we've put them through
(11:05):
regimens of red light therapy tohelp photomodulation increase
mitochondrial repair in theinflammatory body.
So we have like a tanning bedin our office.
They lie there for 12 minutesat the right frequencies and
we've been seeing like people'sbrain fog clears up right away.
The malaise is happeningthrough some targeted
(11:25):
supplements that each patientneeds review on through blood
work or testing, or even guttesting to see what they need.
But glutathione, eitherintravenously through IV or
liposomal underneath the tongue,along with red light and
chiropractic adjustments toregulate the autonomic nervous
(11:48):
system, that has been reallygood since 2020, when this all
started.
That has been our recipe forthe people that come in saying
they just don't have the energy.
Others come in with otherissues like the brain fog,
memory issues and cognitiveslowness.
The red light does work therebecause of the neuroinflammation
, but blood-brain barrierdisruptions and glial activation
(12:09):
can also cause a bunch of otherstuff.
We need some brain supplementsfor those types of patients.
Shortness of breath and chesttightness.
I brought in NAC very quicklyinto our office in like April
2020 for my senior patients.
I was worried about them.
I was like man, these peopleare going to hospital, there's
(12:30):
respiratory distress.
So we brought in NAC Somepeople call it NAC and they
started taking this and I swearAt the end of the year I was
sending out surveys to patientsand asking them how they're
doing.
We had zero hospitalizations inour patient base in our office
in all of 2020.
Zero people went to hospitalZero spouses went to hospital
(12:53):
and zero kids went to hospitalfor COVID.
Don't know what that means, butI saw the news and I saw
everyone going there.
But I was like who has been tothe hospital?
And I did as much as I couldchecking in on our patient base
and it was amazing that no onewas going to the hospital.
I'm like, okay, well, peoplethat are out taking care of
(13:13):
themselves or doing better thanthe people, maybe other people
who maybe don't have a chance todo that, so I don't know.
But that was that.
And NAC so up to today, Ialways like, I'm like man.
That was probably one of thesmartest things I've done in my
career is bring in NAC so peoplecould grab it right off the
shelf and start taking it rightaway, whether they were coughing
or whatever.
I just told them take it and Ithink that's been in the
literature now showing to bevery beneficial.
(13:36):
Shortness of breath and chesttightness this is like we were
talking.
Possible micro clots in thelung vascular, you know,
endothelial injury, impaired gasthis is pulmonology, this is
cardiology.
I highly recommend gettingthose tests done.
It could be a angiogram CT withdye of the chest, whatever it
is, to find any micro clotting,um.
And then medicine can reallyhelp with this, with coagulants
(13:59):
and things that can help removethe stress of the vascular
system so that you can continuedoing what you need to do to
repair the vascular systemthrough exercise and good diet.
That could be the step for thatone.
So we don't have the answersfor everyone.
Palpitations, dizziness,orthostatic intolerance this
comes from the autonomicdysfunction, dysautonomia,
(14:20):
vascular tone, instability, 100%.
Get adjusted, get the atlascheck, get the vagal response
synthesized there withchiropractic adjustments.
And there's other techniques aswell cranial, sacral technique,
kinesiology.
There's a lot of things you cando for that one as well.
Pain in the joint, aches, muscleweakness that's from chronic
(14:41):
inflammation that the spikeproteins have been shown to do,
that it could be autoimmuneresponse, nervous system
sensitization to that.
Again, red light therapy, coldlaser or class four laser on the
joints that are sore has beenvery successful.
In our office We've beenputting class four laser right
on the joints.
Immediately decreasesinflammation, decreases pain.
(15:02):
People feel good there and Ithink some studies have shown
that by pushing thatinflammation out of the joint
and stimulating mitochondrialfunction in the joints that the
pain doesn't return to thejoints too.
That was cool too.
So some people are gettingpermanent improvement from that
GI symptoms bloating, diarrhea,nausea this is from the
(15:23):
dysbiosis that we're talkingabout.
So some people react to the gutlining with the spike proteins
as well, got barrier leak,immune activation in the gut.
Then we have the mood swings,anxiety and sleep disruption.
That's from chronicinflammation the HPA axis that
we talked about from the brainand the gut, and then the brain
(15:43):
network and oxidative stresses.
So we have to repair diet, wehave to get probiotics in there,
and these all can be tested forin one way, shape or form.
But because we've seen so manypost COVID patients, we've
blanketed them into these sevengroups that we know straight to
where to go to to help them tosave not only cost and testing
(16:03):
but time to get them feelingbetter faster.
So that's really cool too.
So this is where functionalmedicine really kicks in and you
can reach out to us at info atfulllifetampacom to get started
virtually on many of thesethings and we can guide you in
the right direction on that aswell.
So here's some strategies tosupport this, to help yourself
move forward.
These are evidence-based andlogical, grounded strategies
(16:25):
that I always encourage you knowthe listeners for these types
of things to find medicalprofessional to help you with
this.
Doing this on your own,especially long COVID If you've
been suffering with it, you knowthis isn't like getting better.
You need help with this and alot of people say they help with
long COVID but they have to gothrough these steps to figure it
out.
So, pacing and energy managementwe want to adopt a listen to
(16:47):
your body approach.
We have to avoid pushing pastour limits right now just
because of the mitochondrialfatigue.
Use activity pacing, so breaksinto small portions.
Rest.
You can't work out like youused to.
You're going to have to doshort bursts or short, less
intense exercises or maybe justsome lifting for now, without
the cardio burden, and avoid andavoid the boom bust cycle that
(17:08):
exacerbates symptoms.
You know what I'm talking about.
If you're suffering from that.
Uh, gentle movement andrehabilitation, low impact
practices, walking mildly um,autoimmune tolerances improve
when we do this.
And uh, be watchful in anactivity worsens symptoms over
24 to 48 hours after you do it.
You got to stop doing it.
It's just the way that you gotto switch it.
(17:29):
You got to do something else.
We need to prioritize sleep.
Sleep's now got to become topof the list.
You have to have a consistentbedtime and awake times seven
days a week.
You're just going to have tofit in the time to get restful
sleep.
Whether you can fall asleep ornot, whether you have insomnia
or difficult fallings, itdoesn't matter.
You're going to bed at 10 andyou're waking up at six.
It's just you have to set upthat schedule to get the
(17:56):
circadian rhythm back.
That's some things that you cancontrol and that's one of them.
Inflammation plus autonomicstress can impair sleep.
That's what makes it poor.
But if you create the sleep asa priority, you we do see
improvement quite quickly.
We have to get intoanti-inflammatory nutrition and
gut support.
Focus on whole foods,phytonutrient rich vegetables,
omega-3 fatty acids andantioxidants into the diet.
(18:19):
Avoid processed processed sugar, refined carbs, trans fats,
because these just worseninflammation every single time.
Support your gut health withprebiotics, postbiotics,
probiotics, fermented foods andfiber, as tolerated, of course.
And work with functional orintegrative practitioners If the
barrier repair, likesupplements like glutamine and
(18:39):
zinc, are indicated.
You don't want to dose thatstuff on your own or try and
guess.
Have someone give the rightprotocol for you.
Stress management, mind and bodypractices, breathing exercises,
vagus nerve stimulationtechniques like slow,
diaphragmatic breathing,meditation, guided imagery,
journaling offloading yourmental stress in one way, shape
(19:01):
or form is going to truly helpGrounding.
Guided imagery, journalingoffloading your mental stress in
one way, shape or form is goingto truly help Grounding nature,
exposure, gentle socialconnection these things are all
really good ideas and these aretargeted therapies and clinical
options when they're appropriate.
For dysautonomia would be likeincreasing water and salt intake
, compression garments andmedications guided by a
(19:23):
physician to help with thisautonomia.
On that way, trials of low-doseanti-inflammatories or
neuroimmune modulators these arestill in research but have been
effective.
Treatable trait approaches arelike focused on dominant
mechanisms in each person, likeclotting markers are abnormal,
or therapies targetingmicroclots, like we talked about
with CT imaging, and thenmonitoring and addressing
(19:46):
co-infections or reactivatedviruses if present.
This is where gut testing canreally bring out the virus load
that's in the body and someblood testing to show what
antibodies are fighting for what.
You may be fighting two orthree different viruses at the
same time because the spikeproteins brought them all out,
so that could be an issue too.
(20:07):
So physical rehabilitation undersupervision as well, like PTs,
that no long COVID will put youthrough minimalistic joint
loading so that you can havemovement and therapy to help you
with with that as well, andthen just keep symptoms.
You got to journal this stuff,see what's going on there If
you're truly struggling withthis and want to get to the
bottom of it journal.
We got to mark the triggers andresponses, like after exertion
(20:30):
how you feel, or after eatingcertain foods how you feel, and
just work with practitionersthat monitor your labs.
So inflammatory markers,vitamin D levels, thyroid and
mitochondrial function are allreally important to test.
Progress will be slow.
This is a slow and steadyrecovery.
You got to be patient.
(20:50):
We'll be compassionate for youand we'll help you each step of
the way through that.
So lots of information.
I tried to keep it scientificfor you so you know that there's
mechanisms that are not, sothat you know you're not crazy.
If you know someone's sufferingwith long COVID or you think
it's long COVID, reach out to usso we can guide you in the
(21:10):
right direction.
Some people do need in-depthmedical care from an MD
professional that does this, butmany other functional medicine
practitioners like NPs andchiropractors that are
internists that know this stuffcan help you as well, we got
resources for you all over theplace.
Info at fulllifetampacom.
Have a healthy week, stay well,stay healthy and take care.
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