Dr. Maigaelle Moulene Long Covid/Post-Viral Syndrome
Resource

 

 

 

 

Long Covid is Real. It is thought to be synonymous/similar to Post Viral Syndrome, a complex condition characterised by persistent pain, fatigue, musculoskeletal pain, neuropathic pain, cognitive difficulties, sleep disturbances and post exertional malaise.  

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For anyone who is suffering from Long Covid, I have created this for you so that you know that you are heard and recognised and validated. 

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Covid is still a novel, mysterious illness that has killed and affected millions of people worldwide since the pandemic began but the science still hasn't caught up to the disease. There are estimates that between 5-10% of covid infections will turn into Long Covid and that there are over 65 million Long Covid patients worldwide. There have been over 200 symptoms reported by patients with Long Covid, with new and emerging symptoms every day. But both patients and their doctors are scrambling to understand it and know what to do with it; there is no formal diagnosis or treatment, and any symptom could or couldn't be Long Covid. 

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This resource is to support Long Covid patients, but also help their carers, friends and family to understand this illness and find ways to support them. It is also for validation that this illness does exist; so many patients feel gaslighted or ignored or unsupported. It is one of the hardest obstacles facing Long Covid patients: trying to convince all those around them that this is real. We are not making it up. No, Cognitive Behavioural Therapy will not cure me. And please don't tell me I look so well and I don't look sick at all.

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I have collated various pharmacological, medical, over the counter supplements, and anecdotal treatments that have helped me or others. Some have evidence-based research backing them up, others are purely anecdotal, but based on logical physiological mechanisms.

 

We cannot wait for each treatment to gain years of research and evidence to start making us feel better. We need treatments now. Often, patients complain that doctors do nothing for them, but the reality is that doctors do not know what to do for their patients: no one *really* knows how to treat Long covid. They do the best they can, with what information they have. Doctors often aren't legally protected to start off licence medications that might or might not help their Long Covid patients and use a method of trial and error to treat their patients. They feel helpless because there is no 'official' treatment protocol as of yet. But I have seen Long Covid specialists in London, functional doctors in Austria, been offered THC in New York and have spent hours of Facebook Groups and Reddit to find treatments that have helped me and can hopefully help others. 

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Supplements and Medications​​ based on the Cause of Long Covid: ​​​​​

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All Long Covid patients should be on a general inflammation protocol and be treated for low serotonin and most will likely need treatment for Mast Cell Activation Syndrome and POTS if they have been diagnosed. Try the below protocols at your own risk. Check any drug interactions prior to trialling these medications and supplements. 

 

Take a stepwise approach, starting with the first treatment option for one week, and continue if tolerated. If symptoms are not sufficiently controlled, add the next treatment option. *Starred treatment are ones that helped me the most..*​​​​​

 

GENERAL INFLAMMATION: (all are anti - inflammatory)​

1. *NAC 600 - 1200mg / day (8)

2. Turmeric Up to 8g/ day (9)

3. Omega 3 0.5g / day (10) 

4. Gingko Biloba (11)

5. Zinc (12) 

6, Vitamin C (13)

7. L - Arginine (13) 

8.  Tea: Apigenin = Green tea , Nettle tea, ginger tea, Marshmallow root tea, cinnamon (16)

9 . CBD (14)

10. Propolis (15) 

11. Ginger (17)​​​

 

DRUG TREATMENT FOR INFLAMMATION:​

- LDN: General Inflammation

- Nicotine Patches: General Inflammation 

- Pregabalin: Neuropathic Pain 

- THC/CBD: pain, MCAS treatment, inflammation

- SSRIs: To increase Serotonin levels. ​​ ​​​​​

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GUT INFLAMMATION (Abdominal Pain/Bloating/Reflux) 

1. L-Glutamine to treat leaky gut​ (19)

2. Symprove Probiotics (20)

3. Proton pump inhibitors for reflux (22)

4. Probiotics for pain/bloating (20)

5. Butyric Acid to heal the gut (21)

6. Slippery Elm for reflux (22)

7. Aloe Vera juice for reflux and LC treament (23)

8. Fennel Tea/Marshmallow root/chamomile (22)

9. Inulin post biotics (20)

10. Collagen 

11. Creatinine​​​​​

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IMMUNE DYSFUNCTION (Increased Infections)

1. Vitamin C (13)

2. Zinc (12)

3. Vitamin D

4. Prevent infections: D-Mannose/Cranberry for UTI, Caprylic Acid for thrush/candida. 

5. Treat Infections: Antibiotics​​​​​

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AUTONOMIC DYSFUNCTION/POTS (Tachycardia/Fatigue/Hyperadrenaline)

1. Beta Blockers: Metoprolol or Propanolol​​​​​

 

CIRCULATORY SYSTEM DAMAGE & CLOTTING ISSUES (Breathlessness/Brain Fog)

1. Aspirin /OR Gingko Biloba /OR Nattokinase (dissolves blood clots)

2. L- Arginine for Endothelial dysfunction (​​​

 

NERVE DAMAGE/INFLAMMATION/PERIPHERAL NEUROPATHY (Neuropathic Pain Treatment)

1. NAC (8)

2. * CBD

3. Turmeric (9)

4. Quercetin (if tolerated)

5. Gingko Biloba

6. Sage/Rosemary

7, SNRIs: Pregabalin/Gabapentin/Amitryptiline

8. High dose Vitamin B

9. Acupuncture

10. Lidocaine patch/gel

11. GABA: 100-300mg

12. Anti-histamine

13 Berberine

14. Inositol Choline

15. N - Acetyl - Carnitine​​​

 

BRAIN INFLAMMATION (Brain Fog)

1. *NAC

2. Alpha Lipoic Acid

3. Inositol Choline4. Duloxetine

5. B12

6. Phosphatidyl Choline

7. Omega 3

8. Gingko Biloba

9. Turmeric 

10. Vagus Nerve treatment ​​

 

LOW SEROTONIN LEVELS (Shortness of Breath/Brain Fog/Fatigue/Low Mood)

1. *SSRIs: Duloxetine​​​​​​

 

MITOCHONDRIAL DYSFUNCTION/DAMAGE (Fatigue/PEM/Shortness of Breath/Low Energy)

1. CoQ10

2. NAC

3. Gingko Biloba

4. NMN​​

 

Brain Fog/Cognitive Dysfunction/Neuroinflammation: Treat Brain Inflammation and increase oxygen to the brain.

1. Hyperbaric Oxygen Therapy (as needed)

2. As per below MCAS Treatment: Nasal Cromolyn, Braingain: algonot.com/braingain, Neuroprotek, retrainingthebrain.com

3. Brain Inflammation treatment

4. Treat POTS: Inadequate blood flow to brain with poor oxygen delivery​​​​​​​​

 

Persistent Viral Reservoir

Nattokinase ​​​

 

Hormonal Problems 

1. HRT ​

2. Natural Menopause supplements

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MAST CELL ACTIVATION SYNDROME TREATMENT:

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Dr.  Monroy a MCAS specialist based in the US wrote an excellent protocol for MCAS Management: (7)

MCAS DIET:

- Exclude gluten/dairy/histamine food

- Avoid triggers (stress, mould, electricity, chemical triggers, hair colouring etc...)

- Good food: apples, brazil nuts, chamomile, high fiber diet, galangal, moringa, nettle tea, peaches, turmeric, Vitamin C and D. 

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- MCAS Step 1 Therapy:

Add one at a time every 4 days to test tolerance. 

1. H2 Blockers: Pepcid of Famotidine. Start 20mg twice and day and increase to 20mg three times a day. Or Nizatadine. 

2. H1 Blockers: Claritin 10mg or *Zyrtec (Cetirizine) 10mg twice a day or Allegra 180mg one to two times a day. 

3. Quercetin: 500-1000 mg twice a day

4. Vitamin C slow release: 500mg once a day up to 750/1000mg a day

5. Vitamin D 1000-5000 units per day (depending on blood levels).

6. Low Dose Naltrexone: to reduce inflammatory proteins which can trigger MCAS. Start at 1mg and gradually increase up to 4.5mg

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If tolerating the above yet symptoms not controlled, to try substitutes for LDN/Quercetin: 

7. Cromolyn- start at 1 ampule per week, slowly increase to 2 ampules four times a day over a few weeks.

8. *Ketotifen: 2mg (one - two capules) 1-2 times per day. 

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MCAS Step 2 Therapy

Low doses aspirin: start 81mg and increase to 650mg twice a day. 

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MCAS Step 3 Therapy

Immune Globulin Therapy: useful if co-morbid auto-immune POTS.

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Natural Therapies for MCAS:

1. Dynamic neural retraining system: http: www.retrainingthebrain.com

2. Vagus Nerve retraining

3. Gut health: Probiotics Lactobacillus Rhamonosus, Bifidobacter species. 

4. Gut health: Zinc, Carnosine, L-Glutamine with meals 2 times a day. 

5. DAO enzymes with meals. 

6. Alpha Lipoic Acid 600mg 

7. Omega 3 Fatty Acids

8. N-Acetyl-Cisteine

9. Mitochondrial Support: L Carnitine 2000mg twice a day and CoQ10 200mg twice a day. 

10. CBD Oil: ie. Hemp Meds, CBD Fx

11. THC: there are THC and CBD receptors on mast cells and can reduce inflammation. 

12. Adrenal Support: DHEA, Rhodiola, Ashwagandha helps sleep and may help decrease histamine hi