Post-COVID Syndrome: What does it mean?
In this hour‑long radio‑style presentation Dr. Paul Anderson explains post‑COVID syndrome (also called long‑COVID or COVID‑long‑hauler syndrome). He begins with a personal story of a pre‑COVID post‑viral illness to illustrate the pattern of lingering fatigue, pain, night‑sweats and intermittent respiratory problems that can persist for weeks to months after the acute infection clears. He then outlines the spectrum of outcomes – from rapid recovery, through mild‑to‑moderate lingering symptoms, to severe, months‑long or potentially permanent disability – and notes that both patients with pre‑existing chronic disease and previously healthy individuals can develop long‑COVID. The core of the talk focuses on why the syndrome occurs: SARS‑CoV‑2 provokes a profound, sometimes prolonged, immune‑inflammatory response that can damage multiple organ systems, reactivate latent infections, disturb hormonal axes, and upset the gut microbiome. Dr. Anderson argues that most clinicians only perform basic screening and therefore miss the underlying contributors (chronic infections, thyroid/ adrenal dysfunction, sex‑hormone imbalance, toxic load, dysbiosis). He recommends a systematic work‑up that includes testing for atypical pneumonias (Mycoplasma, Chlamydia pneumoniae), EBV/CMV, streptococcal antibodies, full thyroid panel with reverse T3, cortisol, sex hormones, and, when needed, toxicology screens. He also discusses the overlap with chronic‑fatigue syndrome and fibromyalgia, emphasizing that these diagnoses should be excluded only after exhaustive investigation of the physiological contributors. Finally, Dr. Anderson stresses the importance of finding a healthcare provider willing to listen, using nutrition, rest, probiotics, and targeted therapies to address the identified abnormalities, and he advertises an upcoming CME session for clinicians that will dive deeper into the science and management strategies.
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With Dr. Paul Anderson. That's me, I'm Dr. Paul. And today we're back here in the studio, coming to you with a new program about something that there's been a lot of talk about, and unfortunately a lot of people experiencing, which is never what we wanna see, but it's one of those realities of life. And there's just a lot of questions, way more questions than answers about our topic today. But I thought it was a good time to bring this up because of a few things. One is there's a lot of, a lot of people dealing with this particular issue. And there's a lot of, you know, kind of this collision of a lot of medical research going on, a lot of unknowns, a lot of people really frustrated with their illness. And so it's, it's very much like a lot of other things we've talked about. But today, I want to talk about post-COVID syndrome and the, what have become known as COVID long haulers or the long haul group. And the reason that this comes up, of course, is if somebody has any disease, but, you know, something like COVID and they get over it and they're all better, they, you don't hear much about it other than, well, I had it and I got over it and I'm all better. When people have an illness, which is bad enough that can you know, put you in the hospital or kill you or, you know, or just make you feel really bad for a while. Um, you know, that's bad enough, but when you have an illness like that and then it lingers on or things happen afterwards, you have a lot of, uh, obviously very, um, unhappy folks who happen to have had the illness. Because if you think about it, if this hasn't happened to you, um, you get one illness, it's bad enough, and you're worried about, you know, how bad is it going to be? Am I going to wind up the hospital, or is this going to be one of those things where, you know, I'm one of the unlucky, uh, people who, you know, goes in the hospital, gets on a ventilator, or something really bad happens? Um, that, that all is bad enough. Then you get to the end of it and it's like you're, you know, you're feeling, uh, better and you're testing negative, but you still don't feel great. And then it's a month later or 2 months later or longer, and you're still Not feeling well. Well, that is extremely demotivating at the very least, because your brain does this thing where when you're dealing with some bad event, it tries to seek out when the end is and when this is going to turn around for you. And what it hopes for is something really good on the other end of that timeline and spectrum. Well, the problem with that is if you get to the end of the official quote unquote disease and you no longer have SARS-CoV-2 or COVID-19, but you feel horrible and you maintain feeling horrible at some level or another, your brain doesn't understand why you didn't get to the good part. Where was the payoff and the thing you look forward to in going through the illness? And, you know, as I've mentioned before on the program a year ago, literally just about a year prior to COVID-19, I had traveled to China part of China, and was fine. And I got sick while I was there. I was working and teaching at a hospital there. And when I got home, I was extremely ill. I had been very ill while I was gone and had a— just a mystery illness that we figured out certain things about, but we never figured out what the original illness was. So you can draw any conclusions you want from that. But The biggest problem that I had was that when I started to get over the respiratory problems and, uh, and the fevers and all these weird things that were going on, um, what I noticed was that my energy just wouldn't return. And I still had a lot of pain and I would wake up on random nights sweating and fever. And I would have some days where I was breathing pretty good. And then I would go back to have some days that I wasn't breathing very good at all. And I would have to use an inhaler and Just all kinds of stuff that, you know, goes on. And so literally, you know, you consider that I did the trip really early in January over to part of China, was there, worked there about, I don't know, probably 10 days. I was probably sick 8 of those days, very quite ill. Got home, got sicker. I think I mentioned to you, one of my colleagues that I traveled with actually died when he got home because he had some underlying illness that kind of compounded. With whatever he and I got while we were there, it was really you know horrible. So you know it took a good sixty days before I started to feel like I was having more good days than bad, and it probably took ninety to one hundred and twenty days before I really felt like myself again. Now bring that up not because of anything other than that is the pattern when I talk to. people and patients who do have COVID long-haul syndrome or post-COVID syndrome, it's kind of a similar pattern to what they have. And it, you know, having gone through that a year before COVID you know, it was just pretty much me, you know, it wasn't like there was a pandemic of this going on or anything like that. So I just kind of got to experience it in sort of a vacuum, but to see what it was like, I'll tell you, it was no good. So Today, other than that particular story that I have some kind of firsthand experience with this sort of thing, uh, a lot of the, uh, people that I'm working with as a medical consultant and other areas that I get involved with medically, such as expert panels and, you know, things of that nature, we have contact with a lot of people who have had COVID-19 illness. And what we're seeing is the normal kind of distribution of what happens when you're done with the illness. And so there's the, you know, extremely, you know, terrible and unfortunate cases where the person gets extremely ill, they get hospitalized, and then they die. And that certainly is a percentage of people. Then there is the group of people who Go through and get hospitalized, maybe have an extreme, you know, they're in the ICU, other things going on, but then they get discharged. And there's a group that get hospitalized short-term and get discharged. And then there's a larger and larger group of what we call ambulatory folks, although they probably don't feel ambulatory, where they ride out the illness at home, because if you can, it's better at home than at the hospital. And they are then never in the hospital. They're just diagnosed and they're, they're never discharged from a hospital because they never went in. Now, in all of these groups, except the unfortunate group where people pass away, you then have different things that happen at the end of the illness. For some people, and if you take like, you know, we'll compare this to something close but not exactly the same, like influenza, especially influenza A. You get to the end of influenza A, if you've ever had that, the more severe influenza, and you can feel bad even after the virus has gone for 1 to 4 weeks. That's not unusual. Post-viral syndrome is pretty well known and characterized there. Most of the statistics say that somewhere within the first week to 4 weeks after your influenza, you will clear all of the residual symptoms, whatever they are. You can, within influenza, you can have residual fatigue, pain, night sweats, a little bit of cough, other stuff like that. And somewhere, you know, in those first 4 weeks, those usually go away for people. Some people they don't though. Well, with post-COVID, what, what we have now, and this goes back to what I say on every one of these programs, you don't want to be predicting the score of a game you're watching in the first 10 minutes of the game. And so I'm not going to quote statistics on post-COVID syndrome because I have Working up to 100 scientific papers that are written on or about or near post-COVID syndrome, and there's numbers all over the map. But what you have is a spread somewhere, like we see with, say, influenza and some other nasty things, where some of the people that come out the other side, whether they were in the hospital or not, have very low residual illness, like the influenza stats I said, and somewhere in the first few weeks. They get better and they're back to their normal power and doing everything that they usually do. Some people have, you know, a 1 to 2 month long post-COVID syndrome that they have. And then there are another group of people who have certainly a— at this point, I know of people at the, you know, 120-day mark, you know, 4 months plus, and they're still having symptoms. And most of the people, regardless of whether it's short, medium, or long, have some amount of symptoms. It's just the nature of getting over a pretty bad illness. And so they go through those things, and usually those things get better as they go, but the lingering things are the ones that normally are the most troublesome. And now if you go to, you know, there are a large number of online groups for people who are post-COVID survivors and are dealing with, you know, COVID long-haul syndrome or post-COVID syndrome, and they're reporting all sorts of, you know, post-viral problems that they're having. So here's the thing that you have to keep in mind, and this is just one of those numbers things, and like I always say, we're not going to know what the numbers really look like till we look back 5 years from now on this. So, you know, trying to sort out, is it half the people or a third or 70% or whatever, it— that's a pointless exercise at this point because that number will be different in 2 months anyway. So we don't know, but what we do know is there's people in each one of these groups. And so, um, what I wanted to talk about today are not so much the really happy events where the person has a pretty bad illness, it's diagnosed with COVID and then they're Done, and they've got, you know, 1 to 2 weeks or 3 weeks of a little bit of fatigue and other stuff, and then they're kind of back to their normal self. We hear— I hear a lot of that from people, which is great. But what I want to talk more about today really is the longer-term post-COVID syndrome that we're seeing develop. I want to talk about the science behind it. And again, that's emerging science, although we certainly have other models for this. There's a lot of other post-viral illnesses and things we can look at. And then I want to talk a little bit about why would I get this? Like, what would be going on in me after I get over something that would make me, you know, have a post-viral illness that, you know, is seemingly almost worse than the virus that I dealt with initially? And then talk a little bit about what to do about it. Now, One of the things I'll just mention, because I know occasionally I'll have, you know, healthcare providers listening, etc. This particular topic I'm going to be doing in just about 2 weeks' time, a little under 2 weeks, on the 15th. I'm going to be doing a CME on it, a 2-hour continuing medical education update, and I'm going to go through those, you know, 80 Plus scientific papers and summarize them and talk about strategies for post-COVID syndrome, both from the point of view of what do you know from science right now, but also what do I see from what people are reporting. And, you know, what do I see as far as places to go looking for healthcare providers to try and help folks with that. So today is a little bit of an entree to that, but it's much more top-down because I know, in addition to healthcare providers. We have a lot of folks who are not healthcare providers, but they're interested in their health, or maybe they have COVID right now who listen to this. So today is a little bit more public-facing, and on the 15th is, is going to be a professional-facing, a little deeper dive. So the first thing is, you know, post-COVID syndrome. What is it? Well, it's under the category of post-viral syndrome. Post-viral syndrome is well known, although Many times you don't hear a lot about it unless you happen to have it. And like I used the example earlier, it's most commonly associated with things like something bad, like influenza, uh, or a, uh, bacterial or a viral pneumonia that knocks you down, or, you know, something else that's really a pretty significant illness. So post-viral or post-illness syndromes are well known. There are some things that come along with it that people will notice, and they are— one of them is that you can have random things that were part of your original illness pop up in the post-illness syndrome. And then you can actually have different things pop up afterwards, and we'll talk about why that might be a little bit later, but those are really common in post-viral or post-illness syndromes. The other thing is it has this lingering nature. And while there are outliers to this, people who have a post-viral or post-illness syndrome, usually it lasts more than 2 or 3 weeks and can last into 2 to 3 months or longer. Now, the majority of people start to get better somewhere around the 2, 3, maybe 4-month mark, depending on what they do about it. But the other thing is that the there are a small quantity of people who will have a post viral or post illness syndrome that will never get better, that will never be better since until they find a doctor who really do some diving in and helping them out. And so we'll talk about why that might be. But then there's also this group of people who go through and. Get through the end of COVID and they don't die from it, and they really don't have any post-COVID syndrome. So you have this very frustrating sort of distribution of no post-COVID syndrome, mild to moderate post-COVID syndrome, major post-COVID, and then, you know, lifelong post-COVID syndrome potentially. And it's frustrating to people who have it. I know from having post-whatever syndrome I had a year before COVID that lasted about 4 months that I didn't like that at all. And I didn't like living through it, but you do. And it taught me a lot of things, but it's real frustrating. So there's a couple of things that are said to people as a kind of a generalization. And like all generalizations, they're partly true and part not. One thing that is statistically more concerning is if you have somebody who lives through COVID, but they have a lot of underlying healthcare issues, you know, they have chronic, say, diabetes or cardiovascular or lung problems or other issues that were going on, or if they maybe had a chronic illness like autoimmunity or chronic fatigue syndrome or something like that. They are more likely to go into the mild to moderate or extreme post-COVID syndrome. So that sort of makes some logical sense, and people don't have a whole lot of, you know, beef with that other than if it happens to them, it's no fun. On the other hand, though, just like I've said before in other programs, there are people who are actually healthy And have no underlying diseases and nothing going on, and they still get really sick with COVID And I've seen and talked to some of them who wind up with post-COVID syndrome that's now gone on for 2, 3, 4 months. And this is especially frustrating for these folks because everybody— well, not everybody, but a lot of people will interact with them and kind of say, well, you know, you must have some illness that we don't know about, or you must have You know, something about you that you're not telling us, or, you know, whatever. And it's like a lot of these folks that I know who have made it to the other side of COVID only to have really bad post-COVID illness, you know, and still require respiratory support, and they feel crummy, and it comes and goes, all that stuff, truly don't have underlying problems. So you can't blame everything on underlying problems. Like, obviously, If you have them, you're more likely to have the trouble, but that doesn't mean if you don't have them, you're not going to get COVID and you're not going to have post-COVID syndrome. So I want to be really clear about that, even though it's maybe a smaller group of people. Again, you can't, you know, it's dangerous to make statements about things like that because we don't know the stats right now, but it's a group of people and it's enough people that I've talked to that it's very convincing. So there's a few things to consider about that. And so we don't really know numbers right now for the, for the CME thing I'm doing for healthcare providers in, I don't know, 11 or 12 days, whatever it is, on the 15th there. I'm going to go through some of the stats and some of the people that have looked at these in different countries, and it's, it's all educated guesswork at this point on the stats. So rather than focusing on, well, it's going to be, you know, 14% of people are going to fall in this category and 18% in this category and whatever, because those are just going to be stupid made-up numbers, you know, in 6 months anyway. What I want to focus on here is you or your loved ones will know if this is happening to you or not. And so it would be Good to know some of the reasons why it might happen. So I want to focus on why and then what to do about it from the top down. Now, obviously, I'm, you know, I'm a doctor, but I'm not anybody who's listening's doctor. And so I'm not giving you medical advice. I'm just giving you things to think about and talk to your own healthcare providers about. One of the frustrations, and this is very pervasive through if you read any published material about this or any, you know, interviews with people who have gone through this, one of the big frustrations, which I know I had, you know, 2 years ago when I went through all this stuff, was people don't understand. And if that's your doctor, You know, and they say, well, you know, you tested negative, you, you know, you don't have a fever anymore, whatever it is, you know, how bad can it be? And like a lot of chronic illness patients, what we're seeing is there's people reporting, well, they went into the emergency room or they went to their family doctor and they were referred to a psychiatrist. Well, you know, we all might need a psychiatrist, but the problem is not simply psychological or psychiatric. There's a lot of physical reasons why these things go on. Yeah. And so getting into the whys, it's helpful. And there's a huge effort right now trying to educate the medical community, which medical community is not a super quick uptake education group. But because COVID has been fairly disruptive and all of that, that people are trying the best they can, but trying to educate doctors and healthcare providers of what to watch for in people and what to look for. Now, one of the reasons that doctors are not quick to take up post-viral care and stuff like that is there's not really any good single or, you know, focused drug treatments for any of this. Whereas if you have respiratory problems and I can give you an inhaler and some oxygen and that helps you, that's a pretty clear pathway to helping your problem. If you're fatigued and you're, you know, you're having a few night sweats and we check some basic stuff and there's nothing seemingly quote unquote wrong going on, a lot of doctors are just gonna say, well, you know, there's nothing big here. You're over the illness. You're just having a post-illness syndrome and you just need to rest at home, right? And certainly resting at home is important, but that really doesn't gonna help A lot of people if they're like the people that I've talked to with this stuff going on. So you understand that the medical community, the majority of the medical community might recognize there's post-COVID syndrome, but they don't have any treatment for it particularly. So that's a problem. Now, talk about the why part first. And so there's a number of things. These aren't in any particular order, but The first thing, and this goes back to why COVID has so many different potential negative things it does to your body, is that the SARS-CoV-2 virus, when it gets inside of you, disrupts your immune system in a way that tends to become very pro-inflammatory. So then you have troubles not just breathing, but you can get clotting problems, you can get autoinflammatory disease, especially in children, all around the body, you know, all these these things that are basically the immune system's been, you know, jumbled up and it's not working correctly. And all of those can potentially kill you. So this is a big bad problem. Well, the other thing that happens is when you get this inflammatory and immune disruption going on, you get different organs affected. And so the organs are every organ you have potentially, but certainly the brain can be affected. Your eyes can be affected, your respiratory system, your digestive system, you know, your heart, Blood vessels, joints, everything is a possible target. None of those are things that you generally can live without. So if they get disrupted and inflamed, there's a chance that they're not going to heal quite the way that they ought to. And so in the statistics and the papers written about post-COVID problems, we see a lot of what we call constitutional symptoms, such as fatigue and night sweats and other things that linger on. Certainly. But then we see organ-based problems that go on with people where they still have bouts of respiratory insufficiency, difficulty breathing. They may have cardiac or heart problems that develop. There's a lot of pain, headaches, body aches, joint aches, muscle aches that can come and go. There's a lot of neuropsychiatric things. So you may not have been anxious or depressed previously, but you might have developed that. And there's a lot of reasons for that. But a lot A lot of them are sort of pawned off on being just a psychiatric manifestation when in many cases those are actually inflammatory problems with your brain. And once your brain is less inflamed, you have less of the psychiatric problem. So it's not simply like quote unquote all in your head. It's biologically a problem that your body is having. So there's also things though that go downstream and affect other organs in your body. One of them that's pretty huge that creates a lot of problems for people is reactivation or new activation of other infections. So if you consider you've been focused on, you know, COVID, and you had that, and that was bad enough, and, you know, you're trying to support yourself through it. Well, what if, what if during that time when you're immune guard is down, your body either reactivated old viruses or, or you were exposed to new bacteria, whatever, wouldn't that make you sicker longer? And has anyone looked at that? Well, indeed they have. There's a lot of research starting from the Shanghai expert panel in China, all the way through, you know, last week where people are publishing, geez, when we look at chronic other bad infections in COVID patients, we find them there. And the more infections they have, the sicker they are. Yeah. Well, this is not completely ignored by the medical community, but it's sort of like, oh gosh, you know, we're only going to go looking for other infections if they seem really bad or we have to rehospitalize you or something of that nature. What I can tell you from other post-viral patients and post-viral syndromes, when we look at people and what we're kind of seeing emerging from the work with people with COVID right now, is if you look for these chronic infectious problems, you will find them. Yeah. And they have to be treated. You can't just say, oh, well, you've got, you know, a chronic atypical pneumonia bacteria in your lungs, and you've got a couple of viruses. But, you know, those are self-limited, meaning we don't do anything about them, and you'll get better eventually. Well, no, you won't. You really do need to treat those things. So, and so what's the difference? And why would your doctor think one You know, we treat one, we don't, or whatever. The difference is if you're super healthy and you develop one of these atypical chronic things, you might feel sick for a week or 2 or 3, but your body may clear it because your immune system is working. That's what they mean by self-limited. But in a number of cases, and especially in people who are just recovering from a bad virus of any kind, whether it's influenza or SARS-CoV-2 or SARS or anything, you don't need those things and your body's not going to clear them normally. Right. So the first problem is you have to look for and test for these things, which most of the time when I review cases and protocols people are doing, they're not testing for other infections. So if you've been sick for longer than 3 or 4 weeks, this is something I would be asking for, that they test for other infections. And if the doctor or the healthcare provider you see thinks that that's a dumb idea, I would go to another doctor. It's, it's that important because here's the thing, these things might be self-limited in healthy people, but they're not self-limited in sick people. The other thing that happens is you wind up with potential aggravation of old illnesses that you may have had. So maybe you, you know, had some problems with a little, you know, some autoimmunity, or you had some problems, you know, 10 years ago with you know, you had chronic Lyme disease or some other problem like that, you can reactivate those things and become sick with them again because your immune system and inflammatory background is just all jumbled up. That really does happen. The other thing that's often not tested for beyond screening, and this is an area where there's a difference between screening and what you do with sick people, is it throws off your Your hormonal system in your body, the endocrine system, in a great way. Now, all chronic or acute infectious illnesses do this, and all inflammatory illnesses do this. It's just that something like SARS-CoV-2 is going to do it at a super high level. And so, in addition to testing for chronic infections that might be there, you also need to be not just screening that you know we did the screening tests. You're not anemic. You don't appear to have a thyroid problem. You, you know, everything else looks good. You actually need to look at the things that get thrown off when you have infectious inflammatory activity in the body. So again, if if I was post illness and it was longer than two or three weeks, I would also start to ask that the hormonal system be looked at. Now this includes a lot of things, and this is another reason like your average primary care doctor is generally not because they do screening. They're not thinking about things from the point of view of a post-viral illness or a post-COVID illness. But what we see happen is you get a derangement in a lot of the hormonal systems in the body. Why would you get that? Well, your hormonal system in your body is there to cross-communicate around your body for all sorts of things. So we think of hormones for reproduction, and certainly that's a big part of what some of them do, but they also keep everything operating. They keep your inflammatory world They help you with the management of certain minerals and electrolytes in your body. They deal with brain inflammation. They deal with other stuff. So it would kind of make sense if you've had this illness that's beat up your entire body in one way or the other, that your hormones might respond to that. Now, one of the things that we look at in chronically ill people, which would also carry over to post-COVID patients, is a broader look at their thyroid hormone function. Okay. In a healthy person, you can do 1 or 2 thyroid tests, and generally that would be sufficient if they're really healthy. In sick people, that's not sufficient. There are things that look at the inflammatory effect on the thyroid and its feedback. One of these is something called reverse T3, and that's something that is generally totally normal in people unless they've had a bad illness. Now, the problem is Reverse T3 is your body's way of slowing your metabolism down when you're really sick. When you're trying to get better, that's the last thing you need is to slow your metabolism down. So in people with their antibodies around the thyroid and reverse T3, there's stuff you don't normally check. Those things all get checked. The next thing is the balance between estrogen and progesterone and your androgens, which are the testosterone family. Now, what will happen a lot of times in men or women is during inflammation, the estrogen pool may rise for various reasons, and progesterone and androgens might be suppressed. Now, there may be good reasons for that to happen in the acute phase, but what happens long-term is in that situation, you tend to get more inflamed. Yeah. And you can have more brain inflammation like that. You can have more joint inflammation. A lot of things get inflamed. The other thing is whether you're a male or a female, you need the appropriate amount of testosterone in order to heal. And so in people that have chronic issues, especially when they come up after a big illness, rather than doing screening testing, we'll actually look male or female at the level of their estrogens, their androgens. Progesterone, while we're looking at their thyroid. And then the other one that's a really big thing that is affected because it's responding every time you get sick, and a lot of times it's not checked unless you have particular pretty extreme symptoms, is your output from your adrenal glands of your corticoids, cortisol. Now normally for screening, that's measured in the morning. Sometimes people will do multiple samples through the day, but somehow it should at least be screened because if you take And your cortisol has taken a hit, so it's not at disease low levels, but it's really low. And then you develop reverse T3, and your thyroid's all wonky. And then maybe you're inflamed because your estrogen balance is off. You know that's a trifecta of things that do not lead to robustly good health and you feeling well. Also, you're just not going to recover quickly from it. Your body doesn't bounce back from these things. Okay, so it's important to look at. We talked about the infections and inflammatory stuff to check on. We talked about the hormonal balance and hormonal things to check on. And those are critically, critically ill. Now, the other thing that happens, and this is listed in most of the research papers that I'm reading, and it's— most of the people I talk to with post-COVID syndrome talk about this. Yeah. And that is that to one degree or another, your digestive system gets thrown off, the balance of the digestive system. Now, some people have very overt digestive tract symptoms with COVID And if those are lasting, they might be symptomatically treated. But the biggest problem is when you have— maybe you didn't have a whole lot of digestive tract symptoms, but when you, you know, have these chronic inflammatory infectious things, especially if you had to take a lot of medicine for it, You may have thrown off the microbiome in your GI tract. And when you throw the microbiome off in the GI tract, you then throw off part of the immune system, a big part of it, your digestive system's immune system. Now, sometimes this is pretty straightforward. It's a matter of kind of healing up and repopulating the digestive system with good flora, you know, probiotics and eating prebiotics and all that stuff. So it can be that. But it can also be a lot of other things. Now, if you started COVID with other digestive problems, maybe you had some bacterial overgrowth or you already had a very inflamed GI tract or whatever, you may have more of that when you get out of the other end. But if you started with a seemingly healthy digestive tract, you want to know that on the other end, you can have some disruption there. So what we're looking at here is we've got We've got to back up and look at the areas of infection and inflammation, the hormonal areas, which help to balance things out. Then we're talking about the digestive system, which is super important and core. And then there's another group of things. And this is something where I would at least have it in the calculus of your assessment. And that is, if prior to getting COVID, you were dealing with some problems with Maybe clearing out some toxic things. Maybe you had a mold exposure, or you'd been exposed to some you know toxic metals or chemicals or something else. A lot of times your body will prioritize things. So while you're really sick with COVID you're not really working on detoxing those things, and that's fine. But sometimes you come out the other side and your detox is really slowed down. Your body's having trouble processing. So certainly if you had a history of that, you may want to revisit that and make sure that's being taken care of. But if somebody has, you know, we've looked at their hormonal milieu in their body and we've tested all that and we've looked at other potential infections that might be going on, we're working on their digestive tract and they're still not kind of crawling out of the hole, that would be a good time to check into some of these toxic things. And you can do screening in the urine for chemicals and mold toxins and other stuff and just see, you know, is it a no problem or is it a small, medium, or large problem? The reason those become important though is that those toxic influences actually lead to immune dysregulation. And if you're trying to get better and you have a post-viral illness, post-COVID syndrome in this particular case, Uh-huh. Your immune system needs to be getting back online and firing on all cylinders, so you can't have all these immune disruptors slowing you down. That just isn't going to work. Now, the other thing that I see with people when I talk to them who have this, and also being written about a lot in the in the data, are the idea of well, there's part of post COVID syndrome that's a lot like chronic fatigue syndrome. We had a whole radio program. on that little podcast we did about a month ago or so. And there's sort of two sides to that. So one of the sides is a lot of people with post-COVID syndrome don't want to be compared to people that have chronic fatigue or fibromyalgia because those are problems that are seen often in the medical system as just a chronic issue that you're never going to get over or get better from. The thing about that with chronic fatigue, fibromyalgia, and those sort of things is those are disorders where if these things that we're talking about for post-COVID syndrome are not assessed, like the hormonal and the inflammatory and the infectious and toxic and all that stuff in the gut, those things don't often get better. If you assess these things and treat the stuff that's wrong, often those folks do get better. So I think the important thing is a couple of things when it comes to fibromyalgia, chronic fatigue associations. If you had those disorders going into COVID, you need to crank up whatever you're doing for your fibro and chronic fatigue on the other end. That's sort of a no-brainer there. If you didn't have those things though, you might have symptoms that are similar on the other end in post-COVID syndrome, but they may not truly be chronic fatigue syndrome or fibro, et cetera, because both of those disorders have an exclusionary exclusionary part of their diagnosis, where if there is any other reason for the symptoms that you're seeing in the patient, you don't call it chronic fatigue or fibromyalgia or any of those other things. So if the person never had these problems and now they have post-COVID syndrome anywhere from 2 weeks to 3, 4, 5 months, if you can find out what is going on on the inside of the person that's throwing stuff off, and it might be one of everything I just talked Then you can actually do something about all those things on the other end. So I think here in the last little bit of time that we have, I want to talk about, okay, what do you do? Right? So the first thing is, if certainly, you know, if you're hitting 2, 3, 4 weeks and just not crawling out of the hole and you have residual symptoms, You definitely want to contact your healthcare provider and say, you know, I'm just not, you know, I know I'm not infectious anymore, but I'm not feeling good. What can we check into? If you have hit 2 months, 3 months, 4 months, and you are still feeling bad, then you, you do, you need to rest, you need to take care of yourself, all the stuff we always talk about, but you really need some medical workup to be done. And so So the areas that you need to look into then generally are going to require you working with whoever your primary care provider or some medical provider is. So as I said, there are some things that, you know, we might not test for unless they were a problem before, unless the person hits 3 or 4 months and nothing's budging and we've tested for other stuff. Those are sometimes things like the toxic end of the world and other stuff. Sure, that makes some sense. But the basic things, and this is something I've seen over and over in post-viral and other post-infectious illness, that you do need to look at are those big things that we talked about. So the first thing you're going to have to have is a doctor that's willing, or a healthcare provider that's willing, to step back and say, yeah, you've been sick Plenty long. You're not getting better. We should check into these things. So, what are they going to need to be open to looking into? And this is an area, and this is you know this is not intended to mean any disrespect to any other healthcare providers. But if if you're that sick and your healthcare provider will not even listen to looking into any of these things because they don't believe in it or they just don't. the experience or whatever. It might be great for you to see them for your other healthcare needs, but you really need to find somebody else to help you. And so the things that somebody is going to need to be open to checking into are going to be those big ones I talked about on the front end. So you're going to need to be looking at the infectious inflammatory leftovers. Okay. So the groups of things that I see the most coming up. And, you know, in different countries when they look at this, it's different infections. So if you're in North America, what I'm going to say is more likely a North American thing. If you're in China or you're in Italy or something, might be a little bit different. But the first thing are the atypical pneumonia organisms, because this is a respiratory disease and those things are all over the place. There's 2 bacteria that we always check for. The first, and they both end in pneumonia, So pneumonia organisms, right? The first is Mycoplasma, Mycoplasma pneumoniae, and the second is Chlamydia pneumoniae. Now some people hear of Chlamydia and they think of the sexually transmitted one. That's its cousin. But Chlamydia pneumoniae is one you can breathe in in the air. It's not sexually transmitted generally. So those 2 need to be checked for. There's— every lab has tests for those 2 because they're a problem. The others can be in the viral world. So you should be screened for things like Epstein-Barr virus. There are a cousin of Epstein-Barr called CMV, cytomegalovirus. Again, not usually a huge problem unless you're sick, and then it can get in and it can create all the same symptoms that Epstein-Barr virus can. There's some other viruses sometimes we'll look at. Normally in people where they've had that, especially if they've had any inflammatory You know respiratory problems, throat problems, etc. We'll do a check for some antibodies related to particular types of strep streptococcal illness. The ASO test is is for that. There's some other tests related to that. In some countries where people have been exposed, and certainly in North America too, you know people have. done tuberculosis screenings and other types of infections. But what I found more than not is it's the opportunistic infections that tend to flare up and create these problems. So the atypical pneumonias, Epstein-Barr, cytomegalovirus, some of those other viruses, ASO for the kind of recurrent streps and stuff like that. At the very least, those. Now, The next things are going to be the hormonal things. And these can really be, you know, things that your primary care doctor— it's just not something they test a lot and they don't get the connection that they're not doing screening now. They're actually looking for a derangement after your illness. But things like reverse T3 and then looking at the whole thyroid panel, so TSH, and T3 and T4, and then both of the primary thyroid antibodies, TPO and TG antibodies. Those are very important. At the very least, the morning cortisol. So you're gonna get your blood drawn in the morning. That's easy. Another one they're not likely to be wild about doing because they're thinking of screening, but we normally do whatever appropriate level of testosterone measurement, men and women, the test's a little bit different. In men, I do total estrogens. In women, we usually do estradiol and then progesterone levels. And that kind of gives you at least something to see if you're way out of balance one way or the other. Again, remember those are things that are going to either help with healing or perpetuate inflammation. Kind of like if your cortisol is low, that's either going to— if it's low, it's going to be a problem. If it's normal, you can leave it alone. Thyroid has got resistance because the reverse T3 is up or antibodies are up, you're going to need to do thing about that. So the hormonal things, so the infectious things, the hormonal things are very, very important. And then as far as your digestive tract goes, normally, unless you had a digestive disorder prior, in which case, like I said, if you had a bacterial overgrowth like SIBO or you had other digestive illness, just keep treating that afterwards. But if you didn't have any digestive problems before, you're just gonna have some derangement, you can kind of treat that in Usually what people will do is, in addition to kind of watching their diet, not having too much sugar and all those good things, looking at what are some prebiotic foods— internet's full of lists of these— that I tolerate, that I can eat, that helps rebuild the flora. A lot of people will take probiotics and all of that. And of course, there's all the other programs we've done about nutrients. Those are still useful. Yeah. But working on your gut a bit is helpful. And I just want to say, so whether you look at the newsletter that I have, we— the last one we did was about genomics and genetics and COVID, and one prior was about nutrients and COVID and all that stuff, or the other podcasts I've done about nutrients and COVID, there's a lot of of medical research around that. A lot of the really frustrated folks are saying, well, I'm in, you know, I've got this post-COVID thing going on, I don't feel well, and I'm taking, you know, I'm taking all of the right nutrients, right? You know, I mean, I'm taking my vitamins, I'm taking my glutathione, I'm doing all this stuff, and it's true, and I'm not getting better. Well, Well, the problem is not that you're taking those things. Those are a good base. But if you haven't looked into these other categories of issues, such as chronic infections, hormonal dysregulation, digestive system dysregulation, toxicity, all that other stuff, you can take all the nutrients and rest all you want, and you may eventually get better, but your body is just You know, it's sort of like making you walk every day with broken legs. You're just not going to do it very well. You have to get the legs set and let them heal up. Okay. Well, if you've got a bunch of chronic infections or toxicity stuff, or your gut's wrecked, or your hormonal system is imbalanced, or any of these other things, your post-anything syndrome, but especially post-COVID syndrome, is just going to last and last and last. It's— your body can't recover from that sort of So it's not only these very important nutrients and resting and eating correctly, but it's all this other stuff. And if you haven't tested for it, you can't say you don't have it or your patient doesn't have it. And I hear that a lot. Well, I don't think I have hormone— how would you know? Right? How would you know you don't have an infection or hormone problems or whatever? That makes no sense at all. Well, until you test, you don't know. And these are areas that are just statistically more deranged after people have illnesses. That's the most important part of it to consider. So in the last minutes that we have here together, I just want to go through a couple of big picture points. The first one is the one I just talked about, which is you can be doing all the right nutrients and diet and resting and all those good foundational things. That doesn't make them bad if you're not getting better. It means that you got other stuff that's wrong. So on top of that, you've got to do some diagnostics and figure out, How are the hormones doing in their balance, including reproductive hormones, thyroid, cortisol, all that stuff, and how they're talking to each other? You have to look broadly at infections that may or may not be there. You have to look at the digestive system. You have to, if you're still not getting better, look at toxicities and detoxification problems within the body, which you may have been totally asymptomatic before, All bets are off after COVID. You might have had infections before and you felt fine. All bets are off after COVID. Your body is not the same as it used to be. You got to fix these other things. The next thing is, and I said this a couple of times, is you have to find a healthcare provider who will listen to you about this. And that may take a little bit of work, but post-COVID syndrome is getting so much, you know, attention in the medical world and literature. Yeah. I would think and hope at least doctors are becoming more open to the idea of looking for answers, etc. You have to check all this stuff out. You can't just assume that you do or don't have things. Now, with some things like your digestive tract, you can assume it's not working like it did before. And you can generally, unless there's a contraindication, do prebiotic foods and eat correctly and take probiotics, you know, stuff like that you can kind of do no matter what. Everything else though, you really need to test. And investigate and look at. And then the next thing is you have to start a treatment plan that addresses all this stuff, and that can take time. And so you have to be a bit patient, but you're better off doing all of this stuff if you need to, rather than waiting 6 months and finally seeking the help of a chronic disease specialist who will then test all this stuff and say, yeah, you're really messed up and everything is wrong. We have to deal with all this. So So again, on the 15th, I'm doing a CE for healthcare providers. We're gonna get into the depths of this stuff, but that's the bottom line, kind of the punchline of all of it is we have to know where to look first. We have to then assess what's wrong. And then you have to treat these things to help the person crawl out of the hole after they've been sick with something very, very bad like COVID-19. Yeah. If indeed that they were sick and they had all those symptoms, they have to be able to get out. But we're out of time for this week. It's Dr. Paul Anderson with Medicine and Health, and today we've been talking about post-COVID syndrome. And next week we'll be back on the radio with another exciting topic. So I'll see you all on the radio in one week's time. Thank you.
