Have Long Covid? Don't miss this...

If it all works together, it sounds great. If it's not working together, it's not going to sound very good. And that's what happens with your immune system in long COVID. Hey, it's Dr. A. Welcome to my YouTube channel where we're going to talk about long COVID. This is a big topic. The first thing I want to talk about is confusion around long COVID. So one of the problems in looking at the research around long COVID is people present differently. Now you can have 10 people with the same diagnosis of chronic illness and you have 10 different presentations. So one of the problems is that this doesn't lend itself to researching easily because it's so individualized. So if I take 100 people and the symptoms are, you know, of 50 different varieties, so different phenotypes of symptoms, it's harder to drill down and say that's what long COVID is or that's not, right? So it's very individualized. The next thing is that for some people it's a fair fairly shorter problem, and for some people it's been burning on for, you know, years at this point. The other problem that we have is chronic illness before COVID was not well treated or understood in the general medical community, and so long COVID has just brought a huge number of patients forward who are also chronically ill into a system that generally doesn't treat chronic illness very well. So you can be misunderstood maybe by your primary care or specialty providers because they weren't really treating chronically ill people before, or they didn't know they were. So confusion is a big issue. Also, the biochemical changes and the pathologic changes at the chemistry level in your body that happen with COVID are very unique. And how can they be so unique and different? And this is one of the slams about long COVID you see with some commentators. Well, they say, well, they did this big research study and they looked at all of these, you know, parameters in the blood and the person biochemically And there's not a pattern. There's not one thing that goes wrong. So how do we call that a disorder if, if there's not one unifying pattern for the problem? The biochemical changes. And so you might ask yourself, and you probably have, how can one insult, let's say an infection, lead to all these different manifestations of biochemical change and pathology? Well, it's because your immune system, when it gets dysregulated or challenged, has multiple potential outputs from the challenge. And depending on your health prior, depending on underlying diseases or the absence of them, depending on certain genomic genetic factors and all sorts of other things, you can have one input go in. And again, in 10 people, you can have 10 different outputs. What does an immune output look like? It's symptoms that our body has or sign presentations. Okay? So that means I'm not gonna have one unifying symptom picture for the most part. Now, there are things that are very common. Such as fatigue, brain fog, certain types of physical findings, and maybe a few other things. But a lot of people have very different presentations and manifestations. So long COVID is a post-viral syndrome that is in some ways more complex than a lot of previous post-viral syndromes. So what are the, some of the things that can happen downstream? Well, one is a change in your clotting functions, which can either be short-term or long-term. This doesn't sound good, and it's not. So if I'm having more propensity towards clotting, then I might develop, as we see in the research coming out now, microclotting. Okay. Now, obviously big clots are not a good thing. Microclotting is just what it says. It's very small types of clots that can go. And so they won't stop an organ from working, but they may decrease the functionality of a number of organs in the body. So clotting changes go on a lot of times in the long COVID population that we see. We look at their clotting laboratory tests and there's a number of things that you can look at. But a lot of times until their immune system goes back to being calmed down, the clotting abnormalities we see in the beginning of long COVID will not go down until the immune system is calmed down. And that's because clotting is triggered by immune chemistry. Okay. Very important to keep in mind. So we often watch those as a sign that we're finally getting ahead in the Immune balancing gain. So where does this come from? Comes from deregulation of the immune system. There is often found an imbalance in the cell-mediated immunity, the T-cell families. And so there are T-cells that are directly cytotoxic, the killer-type T-cells, if you will. There are memory T-cells and there are helper family of T-cells. The T-helper cells, often called Th. Are numerous subfamilies, and their job is to go and help you when you have this immune response to talk to the immune system so that we have a big response in the beginning, but then we start to shut it down and just have immune memory. And that's what happens with T-cell response. They can kind of go off the rails. And when T-cell responses go off the rails, you get either over or under activity downstream in your immune system. And then that can lead to increased inflammation, increased clotting problems, increased pain, all of these other things. So an imbalanced T system, especially the T helper system, is one of the core problems that goes on more at the beginning of your physiologic or biochemical changes. Then if you look at the way the immune system works, there's a communication between your cell-mediated immunity, your T cells, and then your humoral or antibody immunity, the B cells. And if we disengage the communication, or if we confuse the communication between those 2 big parts of your innate immune system, we get an abnormal output or a triggering problem in the antibody immunity community as well. And that's going to feed into another pathology we'll talk about in just a few seconds here. So the T cells are there for cell-mediated immunity, and that's largely the cytotoxic killer type T cells, and then the memory and helper families. But then they talk to the, the antibody side and antibodies are gonna be something that comes along and binds to a bad guy in your immune system and tries to alert other parts of the immune system to eliminate that bad guy. And then of course, your B cells, antibody immunity cells come in many different types and they will make memory against the bad guys. Well, you can imagine this is like a giant orchestra and if it all works together, it sounds great. If it's not working together, it's not gonna sound very good. And that's what happens with your immune system in long COVID, it can get sort of jumbled and all of this nice crosstalk and feedback goes out the window. So the T and the B cells are doing their job and then they get confused in their job and then we have downstream problems. So what are some of the problems? Well, the biggest problem underneath is global inflammation in the body, and that can then lead downstream to inflammatory changes in your big organ systems. So your brain, Your lungs, your kidneys, your heart, all your muscles, you know, all over your body. Digestive tract can be inflamed as well. As we said, the inflammation, the inflammatory chemistry in your immune system can lead to big clots or little microclots, which have their own problems. The other thing that is getting a little bit more noticed now is COVID often opens the door through this immune dysregulation to chronic co-infections That either you might've had before. And, and we, we all have a lot of infectious material in our body that just hangs out, that it's not making us sick. But if we get run down, could happen with the flu too, or pneumonia or something. But with COVID often you get run down, you mess up the immune system's response. Then these little infections that weren't a problem before now are, are infecting us on top of the COVID So a lot of times in our long COVID population, we will screen people for chronic infections because they're almost always there. Problem is they're not always the same thing. Yeah. Because the immune deregulation that happens for one group of people might increase viruses like Epstein-Barr or something. And another group of people, it might be more fungal problems. Resistant fungal problems are on the rise, or other issues that go on. And another big picture problem that often, if you had it before, might get way worse, but a lot of people didn't have it before and now they do in long COVID, is mast cell disorders. So you've heard about Mast cell activation syndrome, MCAS, or mast cell disease, mast cell disorders. These used to be thought to be extremely rare. Even before COVID we knew that they weren't as rare as we thought they were. It's very hard to diagnose in some cases. Mast cells are part of a 4-part activation system that includes mast cells and then basophils and eosinophils, and then another subclass of cell called CD40. That are triggering one of the B-cell populations, the IgE, like Edward, which is— we think of for allergy and, uh, you know, anaphylaxis and things, but also is part of the mast cell quartet there. Well, it turns out that the COVID experience can deregulate your immune system, so you become hypersensitive, and the mast cell quartet— so it's mast cells plus the other 3— start to pump out immune information that you don't want, very inflammatory, very dysregulating to your system. That's real common complicating factor in long COVID. So what do we do about this? It's nice to maybe know the underlying complexity of it. The first thing that you want to think about is some people, and if you're having great luck with a long COVID clinic, please keep going there. You know, people are getting help at some of those. But if you've been checked out and they basically said, look, your organs are fine, great, that's really wonderful. And maybe they offer some symptomatic treatment or they don't, depends on the long COVID clinic. What we find is usually if that approach not cutting it, you need to find an integrative practitioner. There are more and more integrative health practitioners in the world. And even if they weren't doing a lot of chronic illness things before with long COVID, they're seeing more of them. They're just more likely to take a step back and look more in a whole body, you know, kind of systems approach to what's going wrong with you, as opposed to a specialty approach where you start with the organ system and dive, you know, deeper. Both are necessary, but a systems approach is probably better for the long chronic illness. So looking for integrative practitioners, that might be a physician, nurse practitioner, physician's assistant. You might see an acupuncture oriental medicine person who specializes in long COVID. There are some chiropractic physicians and other types of physicians that work there. Licensed naturopathic physicians do a really good job with this in many cases and other integrative practitioners. So having somebody so they can, they may not need to do everything with you, but they can kind of give that macro look and Guide thing. Now I'm going to mention some therapies that people try, and and first we need to remember this is not medical advice. I'm just giving what I've seen other people do and people might consider. One that sounds unusual, but it's because of receptor binding that people have done is nicotine therapy. So a lot of people use low dose nicotine patches, and that can be quite helpful because nicotine, the receptors that it binds to, are not only in your brain but elsewhere in your body. You have to be very careful with nicotine therapy because especially if your body isn't used to nicotine, it's very easy to overdose on nicotine. And so you really want to do that with some guidance. But nicotine therapy is on the rise and helping a lot of people. Things that go and help your mitochondria, which are where we make our energy and it helps us recharge our body. Some therapies like NAD therapy, that is a common type of approach for mitochondrial support. There are oral therapies like nicotinamide riboside or nicotinamide a nucleotide that can be done. There's IV therapies, other things that goes directly to your mitochondria to help. Another one that goes to your mitochondria that we're seeing more on, we got a bunch of videos on all these, is methylene blue, which is the oldest synthetic drug that we have, at least in medical history. It's a dye, but it also is used if you have a pharmaceutical grade to go into your body and help the mitochondria kind of kick back in. Now, it helps your whole body, but we've seen a lot of benefit in people, especially where they They have neurological symptoms of long COVID. So that's something to keep in mind as well. Another one that I've had a lot of people do at home is red light or red light near-infrared pad therapy. We use it a lot with people with specific organ areas, so that'd be pelvic dysfunction, chest and lung, et cetera. Again, these are things that you can often get and do as at-home therapies. Again, work with your practitioner on that. Sauna and heat therapies, you may not tolerate it. Work with your practitioner on that. Sauna can be incredibly good. Usually you start really tiny and work your way up dose-wise. Hyperbaric oxygen is another one that really helps. There's some big universities that are doing trials on hyperbaric, and there's actually some hyperbaric research that's come out during COVID that's compelling. And then all sorts of other things that can just be supportive to the body, such as nutritional therapies, dietary adjustments, etc. Now keep in mind, this isn't medical advice, just what we see in patients. And you need to remember, not everyone can do these. You certainly We generally wouldn't do all of them, but sometimes it's finding like the, the 2 or 3 keys to go into the 2 or 3 locks that are your particular part of the problem with long COVID. And once you find them, then your body can be supported and you can kind of unwind the problem that started.