Long haul Covid can be effectively treated by addressing the underlying pathophysiology. While there are few studies on treatment of long haul Covid there are many studies describing the underlying biochemistry of Covid. We use these basic science studies to formulate our successful long haul protocols.
Long haul COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is a condition where individuals experience persistent symptoms and health issues following a COVID-19 infection. While most people with COVID-19 recover within a few weeks, some individuals continue to experience symptoms for several months or even longer.
We don't know for sure how common long-haul COVID-19 is yet, but studies show that it can affect a large number of COVID-19 survivors. A study published in The Lancet in January 2021 found that among individuals who had COVID-19, 76% reported at least one persistent symptom six months after infection. Another study, which came out in July 2021 in JAMA Network Open, found that 30% of people who tested positive for COVID-19 still had symptoms up to nine months later.
The symptoms of long-haul COVID-19 can vary widely and may affect different parts of the body.
Common symptoms include:
Shortness of breath or difficulty breathing
Chest pain or tightness
Brain fog or difficulty concentrating
Muscle or joint pain
Loss of taste or smell
Heart palpitations or racing heartbeat
Gastrointestinal symptoms, such as nausea or diarrhea
Other less common symptoms include skin rashes, hair loss, and autoimmune-like symptoms.
The duration of long-haul COVID-19 symptoms can vary widely, with some individuals experiencing symptoms for several months or even longer. According to a study published in The Lancet in January 2021, 63% of individuals with long haul COVID-19 reported symptoms for six months or more. However, some people may recover from their symptoms more quickly, while others may experience them for a longer period. In our clinic, we have identified three underlying conditions found in many long-haul patients.. Those conditions are glutathione deficiency, mitochondrial insufficiency, and mast cell activation syndrome.
In our experience, glutathione deficiency is one of the most typical causes of long-covid and is also one of the simplest to treat. Glutathione is the body’s primary antioxidant and defense against the cytokines like superoxide produced during a covid infection. The Russian scientist, Polinkov, found patients with low glutathione levels had more severe disease and were more likely to die. Dr. Horowitz, known for his work with Lyme disease, reported reversing acute COVID pneumonia in less than an hour with IV glutathione infusions. If the glutathione deficiency persists after the acute disease, patients may suffer from severe brain fog, fatigue and other COVID symptoms for months.
So What is Glutathione
Glutathione is a tripeptide composed of three amino acids: cysteine, glycine, and glutamic acid.
Multiple enzymes work together to keep glutathione levels in cells and tissues at a healthy level. This is important for protecting cells from oxidative stress and keeping an immune system that works well.
Fortunately, glutathione deficiency is easy to correct with IV infusions and oral supplementation.
A recent long-haul patient reported her energy and cognitive levels at 1/10 for eight months after her COVID infection. She had seen multiple physicians, but nothing helped. Her exam and lab tests confirmed a severe glutathione deficiency.
The day after her first IV, she reported that her brain function and energy improved from 1/10 to 3/10, and after subsequent treatments, she has fully recovered.
Depends on what appears to be the underlying cause: glutathione deficiency, mitochondrial dysfunction, or MCAS. In many cases, we find that both mitochondrial dysfunction and glutathione deficiency coexist, as glutathione is an important component of ATP production by the mitochondria.
Our treatment for glutathione deficiency consists of giving IVs of glutathione, and other antioxidants, like lipoic acid, that reduce oxidized glutathione back to its active form. Patients generally report rapid improvement with this treatment, it usually takes a few weeks to months to correct the deficits fully, but most patients see improvement over night.
Treatment Precautions: glutathione is required for normal detoxification. If normal detoxification has not been occurring, then the sudden influx of large amounts of glutathione can cause rapid symptomatic detoxification, so starting the treatment at a lower dose and working up is best.
Here is the glutathione protocol we use. You may be able to obtain glutathione therapy from a local nutritional IV that can be found in most larger cities now.
IV Treatments Recommended.
Here is our recommendation for those wanting glutathione treatment in their local areas.
IV glutathione starting with a dose of 1,000 to 1,500 mg is our normal starting dose increasing the dose to 3,000 mg as tolerated. A second IV of lipoic acid is given to reactivate inactive glutathione. This IV is especially effective as most covid patients have high levels of inactive glutathione, and results can be seen in as little as ten minutes after administering lipoic acid. Lipoic acid should always be administered separately. The effects of a glutathione IV wear off after five days, so we repeat this therapy weekly until the patient has recovered.
Glutathione can also release toxins from the liver, so we use binders (activated charcoal, pectin, etc.) to prevent the reabsorption of toxins by the intestinal tract. A typical dose is three charcoal capsules given every 3-hour intervals for a total of three doses.
Unfortunately, glutathione therapy is typically not available in hospitals but in many IV clinics and health spas that are popping up nationwide.
Oral glutathione is not effective as the dosing is much lower, but can still be helpful. The liposomal forms of glutathione work well. QuickSilver and Researched Nutritionals are the liposomal brands we use. Most glutathione is not well absorbed orally; NAC, a precursor, is absorbed and has been studied in treating acute covid. Our treatment plan utilizes both oral and IV forms of glutathione.
Mitochondrial Dysfunction in Covid
Mitochondrial dysfunction is another finding in long-haul covid. Mitochondrial are the powerhouse of our cells. The number of mitochondria in each cell depends on the cell's energy requirements. For example, a skin cell may have an average of 200 mitochondria per cell as compared to a cardiac cell with around 5,000 mitochondria per cell. The DNA of our mitochondria is different from our regular DNA. It is circular DNA versus the regular spiral form of DNA. Mitochondrial DNA does not have the self-healing properties of our cellular DNA and is more vulnerable to oxidative stress. The cytokines produced during a covid can damage all of our organs, but the mitochondria are particularly vulnerable.
Mitochondrial fatigue is a constant fatigue as compared to other causes of fatigue like adrenal dysfunction, where mornings can be ok, but afternoons are bad. Exercise helps many forms of fatigue but will make mitochondrial fatigue worse. Some people report it takes several days to recover from a workout.
Treatment of Mitochondrial Dysfunction
Avoid adding more stress by limiting exercise or physical work. Avoid all high-intensity workouts, which can be severely taxing to your mitochondrial DNA. Several mitochondrial support supplements work well. However, many if not most mitochondrial support supplements we have tested were ineffective.
The Genova Metabolomix or Nutrival tests provide a comprehensive look at the body’s biochemical markers and is helpful in identifying issues such as:
Low glutathione levels
Toxicity from chemicals and heavy metals
Oxidative stress levels
Vitamin, mineral, fatty acid, and amino acid levels.
Urine Organic Acid testing is less comprehensive but provides a subset of this information at a lower cost.
Of course, all of the standard tests should be run, such as:
Thorough thyroid testing including FT3, and FT4, TSH, Reverse T#
Thyroid AB testing
We find most of these tests have usually been run before they come to our clinic.
A genetic profile Is helpful in identifying SNPs, that could slow specific biochemical pathways, which may not cause any issues until the body comes under severe oxidative stress.
With these tests in hand, we are usually able to come up with some helpful treatment suggestions.
Mast Cell Activation Syndrome (MCAS)
MCAS has been well described on other websites and will not be gone into here. However, I have found that most of our long covid patients do not have MCAS after running a cytokine profile that can be used to identify patients with MCAS.