
COVID Long haulers/ Post-Vac
The mask requirement and pandemic are over. Nevertheless, many people continue to suffer, namely those who continue to be plagued by long-term or post-Covid after contracting COVID-19 or those who have developed symptoms following a COVID-19 vaccination.
The clinical profile of post-Covid is very diverse. A patient with one group of symptoms can have completely different symptoms to another patient.
Symptoms of post-Covid/post-vac can include the following (although this is only a selection):
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Fatigue (constant, severe tiredness), also in the form of ME/CFS
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Physical weakness
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limited energy levels
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Post-exertional malaise (PEM for short - worsening of symptoms after physical, mental or emotional exertion)
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concentration difficultie
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impaired memor
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Muscle pain and joint pain
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Cough, breathlessness and difficulty breathing
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Cardiovascular system disorders
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Malfunctions of other organs (e.g. thyroid gland, pancreas)
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Sleep disorders (difficulty falling asleep / staying asleep)
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Depression or depressive tendencie
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and many more.
The variety of symptoms and combinations of symptoms reflects the individuality and metabolic weaknesses of each individual. Just as the symptoms can vary from person to person, so too must the therapy. There is no "one-size-fits-all" concept, i.e. not all patients can be treated in the same way if the therapy is to be successful.
Feel free to contact me to work together to find a therapy that is tailored to you.
There are mechanisms for the development and maintenance of post-Covid/post-vac that have been discussed and are often perceived in practice, which often occur in combination:
Circulatory disorders due to (micro)clots
Poorly circulated organs cannot perform their work optimally.
Inflammation of the vascular walls (endotheliitis)
Any inflammation of the vessel walls leads to an activation of the coagulation system and thus to (micro)clots with circulatory disorders.
Silent inflammation
This is not covered by the conventional laboratory markers that are regularly tested in general practitioners' practices. Other laboratory markers must therefore be used. The goal here is to interrupt the inflammatory process.
Inflammation of the nervous system (neuroinflammation)
The nervous system can also be affected by inflammation. Memory and concentration problems, lack of energy and sleep disorders can be the result.
Damaged mitochondria
Mitochondria are the power houses of our cells. They produce the majority of our energy in the form of adenosine triphosphate (ATP). If they do not function properly, not only our energy suffers, but also our immune system, the production of steroid hormones, our calcium homeostasis and programmed cell death (apoptosis), in which defective cells are removed from our body. Mitochondria need a sufficient supply of around 40 different micronutrients in order to function at their best. If they do not function properly, we simply lack the energy we need.
Disruption of the intestinal milieu, the microbiome (the bacterial colonization in our intestines), or the impermeability of the intestine
90% of our immune system is located in the gut. If the conditions here are not optimal, the immune system cannot function optimally either. If, for example, there is a permeability disorder (leakiness) in the intestine, food components that are too large and which our immune system does not recognize as such (because they would otherwise be absorbed as smaller components) reach our immune system. This interprets these unknown, too large food components as foreign and fights them. This happens anew every day, resulting in chronic inflammation.
Incorrect colonization with the wrong bacteria on its own can also lead to an inflammatory environment.
A misdirection of the immune system
As a result of COVID-19 disease, some patients experience too much immune activation, others too little and other patients have some parts of their immune system too active and other parts too inactive.
A chronically inflamed vagus nerve
In some patients, this manifests itself in reduced activity of the vagus nerve, which forms part of the autonomic nervous system in the form of the parasympathetic nervous system. These patients feel tense and tired at the same time and find it difficult to switch off and relax. In other patients, the inflammation of the vagus nerve manifests itself in overactivity. They are constantly tired because their body, controlled by the autonomic nervous system, is, to put it bluntly, far too relaxed.
Autoimmune processes
Autoimmunity is when the immune system mistakenly recognizes components of the body as foreign and fights them (and therefore itself). There has been a spike in autoimmune diseases after COVID-19 illnesses, that are responsible for a wide range of possible symptoms
Reactivated viruses
The best known form is the reactivation of the Ebstein-Barr virus (EBV). Many people know the initial infection with this virus as Infectious mononucleosis. Once the virus is in the body, it withdraws into niches in the body after the initial infection. If the immune condition is poor, the virus can reactivate, i.e. come out of hiding and become active in a chronic, latent form. This can lead to chronic exhaustion.
Serotonin deficiency due to chronic inflammation
Chronic inflammation can shift our body's own serotonin production system away from serotonin (happiness hormone) and subsequent melatonin production (sleep hormone) and towards a different metabolic pathway (kynurenine pathway). This has the task of slowing down the inflammation, but then sometimes slips out of balance itself and can have a toxic effect on nerve cells (neurotoxic) and mitochondria.
It is well known that depression or feelings of depression are caused by a lack of serotonin. However, the nutrient deficiencies and neurotransmitters produced as a result of the shift in metabolic pathways are in themselves also conducive to depressive symptoms. This metabolic pathway could therefore be the cause of depressive moods in some patients or intensify an existing depression. After a precise analysis of these metabolic pathways, it is possible to intervene therapeutically to reduce inflammation and increase serotonin (and thus feelings of happiness and well-being).
persistent SARS-CoV-2 viruses or viral antigens and RNA in tissues
Studies show that the gut can be a reservoir for the persistence of SARS-CoV-2 viruses. The persistence of the spike protein can also cause problems. In general, persistent virus components probably lead to a persistent inflammatory reaction.
Since COVID Long haulers or Post-Vac patients can become extremely exhausted by long conversations, I also offer the option of splitting appointments into several smaller appointments. Alternatively or in addition, relatives and family members are welcome to take over parts of the conversation or to participate in a supportive manner. Simply contact the practice to make an appointment so that we can find the best possible solution for you.