[HN Gopher] A Mechanism for Long Covid
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       A Mechanism for Long Covid
        
       Author : pera
       Score  : 89 points
       Date   : 2023-04-15 13:56 UTC (9 hours ago)
        
 (HTM) web link (mastodon.nl)
 (TXT) w3m dump (mastodon.nl)
        
       | dTal wrote:
       | >Meanwhile, I decided to put the hypothesis to the test and came
       | up with a treatment consisting of multiple components that would,
       | in theory, enable me to rebalance my acid-base levels. After
       | trying this treatment for a couple of days I started to see
       | significant improvements in my full range of #LongCovid symptoms.
       | 
       | "I have discovered a truly marvelous treatment for Long Covid,
       | which, however, this margin is not large enough to contain."
        
         | viraptor wrote:
         | It's described in a separate thread
         | https://mastodon.nl/@vickyvdtogt/110202237846457614
        
       | csdvrx wrote:
       | Paper on
       | https://www.frontiersin.org/articles/10.3389/fimmu.2023.1150...
        
         | Animats wrote:
         | It's a hypothesis supposedly testable in a month. Now what?
        
           | csdvrx wrote:
           | > It's a hypothesis supposedly testable in a month. Now what?
           | 
           | Your guess is as good as mine.
           | 
           | There's a lot of politics embedded in science now: I learned
           | on the tinnitus thread posted here a few days ago that the
           | side effect of tinnitus after vaccination was very likely to
           | be real, but that research had been suppressed to help with
           | vaccine adoption. It's possible it's a psyops, but here, on
           | HN? By several people with a valid post history? Extremely
           | unlikely.
           | 
           | For this, given how simple the confirmation is (test lactate
           | levels), I hope sufferers of long covid will measure their
           | levels and try the simple suggested approach, for which there
           | should be very little risks of drawbacks (supplementing in a
           | few amino acids and carnitine, taking some sodium
           | bicarbonate)
           | 
           | Hopefully, enough of a critical mass of confirmation for both
           | the proposed confirmation test + simple treatment option will
           | lead to actual research, but what a shame it didn't come from
           | mainstream science, and what a shame independant researchers
           | are being put on the defensive: as the author said in a link
           | just posted:
           | https://mastodon.nl/@vickyvdtogt/110202251308724694
           | 
           | > I want to state again: this is not a suggestion to what
           | people should do, as it needs to be studied and clinically
           | tested first.
           | 
           | Well, maybe it should be, I don't see the risks of people
           | trying stretching exercices, breathing exercices,
           | supplementing in a few amino acids or drinking alkaline
           | water.
           | 
           | I can already imagine comments "BUT WHAT IF PEOPLE DRINK
           | GALLONS OF PH BUFFERS???" Well, it's not what's suggested,
           | and even water can kill if drinking too much of it.
           | 
           | The real shame is how many people have learned to distrust
           | science and how the political takeover has damaged the trust
           | network necessary for society to work.
        
       | yafbum wrote:
       | > After continuing this makeshift treatment for a couple of
       | weeks, I improved to a point where I was completely and stably
       | symptom free.Since then I've been working with Dr. Jeremy Rossman
       | to put this mechanism on paper, so that it can be shared and
       | further researched, tested, and proven.
       | 
       | Counting down seconds to articles spinning this as "CURE FOR LONG
       | COVID MAY HAVE BEEN FOUND", someone who thinks they have long
       | COVID "does their own research" and starts drinking gallons of pH
       | buffering solution. I'm excited and happy for the researcher but
       | if we've learned anything about COVID treatments in the past few
       | years, it's that desperate people will do desperate things (eg
       | hydrochloroquine) well after they've been shown to be harmful. I
       | think it'd be nice to not get too many people's hopes up yet.
        
         | [deleted]
        
       | Mildlypolite wrote:
       | I can confirm that, after having ME for more than ten years, this
       | researcher seem to have understood the underlying mechanisms.
       | I've got better with a similar treatment and I will persevere now
       | that I know more precisely what to do.
        
       | labrador wrote:
       | I managed to avoid Covid for three years but finally got it. I
       | suspect it is one of the new more transmissible strains from
       | China after they opened up and 230 million Chinese got sick,
       | because I got it at the Trader Joe's next to the San Jose airport
       | and live in an Asian neighborhood. I've been sick for 6 weeks
       | now, so I don't know if that qualifies as long Covid.
       | 
       | After years of hearing it was "just a flu" I didn't think much of
       | it interacting with my bipolar type II disorder, but I noticed I
       | was hypomanic with Covid in a strange sort of way and my
       | quetiapine no longer seemed to work. Other strange things have
       | happened, such as I am a vegetarian now because eating meat
       | tastes repulsive to me. Dairy is ok. I also can't stand using
       | cannabis anymore. The high feels different, much harsher and
       | weirder.
       | 
       | Not much research has been done in the areas of Covid interaction
       | with psychiatric disorders, psyche meds and interactions with
       | recreational drugs but I'm hoping things get back to normal so I
       | don't have to keep researching it. All except for the meat part,
       | because I'm happy being a vegetarian. And I'll save money at the
       | cannabis store.
       | 
       | Full disclosure: I'm fully vaxxed and boosted with bivalent
       | formulations of the Moderna and Pfizer-BioNTech in November 2022
       | 
       | Edit: I'm not making up wild theories of new mutations. There are
       | multiple credible sources. This is just one
       | 
       | https://www.voanews.com/a/experts-weigh-risk-of-new-covid-mu...
       | 
       | I'm surprised there is any negative reaction to this comment. I
       | would love if someone with such a reaction would explain
       | themselves
        
         | MengerSponge wrote:
         | > years of hearing it was "just a flu"
         | 
         | "Just a flu" was always bullshit on two fronts: influenza is a
         | terrible disease that has killed millions, and everyone serious
         | knew COVID was worse.
         | 
         | But of course: "If you tell a lie big enough and keep repeating
         | it, people will eventually come to believe it. The lie can be
         | maintained only for such time as the State can shield the
         | people from the political, economic and/or military
         | consequences of the lie."
        
           | [deleted]
        
           | goatlover wrote:
           | Wait, how has Covid been worse than Influenza? Infuenza
           | killed around 50 million people in 1918. There were far less
           | people back then, and travel was slower.
        
             | azeirah wrote:
             | Influenza is a virus that is constantly mutating. I think
             | the comparison means to the variants colloquially known as
             | "the flu", which are the ones that make you sick for a week
             | or maybe two. They're not comparing to all influenza
             | variants ever.
        
               | MengerSponge wrote:
               | Exactly. It's still a serious infection! It makes
               | otherwise healthy young adults super ill for a week or
               | two, and kill the elderly and the very young.
        
             | terminatornet wrote:
             | > This finding should be interpreted in the context of a 2
             | to 3 times greater number of people being hospitalized for
             | COVID-19 vs influenza in the US in this period.
             | 
             | > However, the difference in mortality rates between
             | COVID-19 and influenza appears to have decreased since
             | early in the pandemic; death rates among people
             | hospitalized for COVID-19 were 17% to 21% in 2020 vs 6% in
             | this study, while death rates for those hospitalized for
             | influenza were 3.8% in 2020 vs 3.7% in this study.
             | 
             | The gap between mortality rates for covid and the flu has
             | decreased, but covid is still clearly worse.
             | 
             | https://jamanetwork.com/journals/jama/fullarticle/2803749
        
             | LorenPechtel wrote:
             | While you're right that then 1918 flu was worse than any
             | variant of Covid that was more than 100 years ago, not now.
             | Covid is now, and considerably more deadly than current flu
             | strains.
        
             | MengerSponge wrote:
             | The original strain of covid was not worse than the
             | deadliest strains of influenza, but "common" circulating
             | strains of influenza kill tens of thousands almost every
             | year. I would say every year, except deaths from influenza
             | plummeted in 2020/2021 due to masking and social
             | distancing.
             | 
             | 2020 and 2021 are the root of my claim that Covid is
             | "worse". Millions died of covid during this time, but
             | deaths from influenza dropped to minuscule levels. Some
             | strains of influenza may have gone extinct.
             | 
             | Influenza that makes you sick for a week or two isn't a
             | trivial thing either! If you're lucky, you'll just feel
             | awful for a week. If you're unlucky, you're part of the
             | chain of transmission that kills someone's grandparents.
             | Get your flu shots.
        
         | Qellion wrote:
         | The flu comment was some fake news. I'm surprised that you
         | repeated that blindly.
         | 
         | Also your assumption why you have COVID now is just racist or
         | stupid.
         | 
         | COVID is still out there, people still get COVID.
         | 
         | The simplest explainatiom why you got COVID: because someone
         | was infected and now you were unlucky in comparison to before.
         | 
         | COVID did not disappear.
        
           | gadders wrote:
           | If you have no underlying conditions and under 70 or so then
           | it is just like flu/a bad cold in 99% of cases.
        
       | Jamesbeam wrote:
       | She has done research on herself...with cheap electronic home
       | monitoring devices that were not calibrated to any proper
       | laboratory standards, without any kind of proper blinding or any
       | other globally accepted research standards.
       | 
       | I can't. I can't do this any longer.
       | 
       | This is as professional as a certain former US president
       | suggesting we should shine strong light into the body or inject
       | people's lungs with disinfectant. It's not a "hypothesis" it's
       | just you being stupid.
       | 
       | I'm not a scientist, but I beg people to not test wild stuff on
       | themselves and instead let the people do their job who dedicated
       | most of their lives into figuring out problems the proper
       | scientific way. You are not a scientist because you read some
       | research papers and stretched a bit at home and changed your diet
       | and magically feel better now.
       | 
       | Long-Covid for many people is the first time they have to deal
       | with a life-altering illness that we do not have a treatment for
       | yet.
       | 
       | So unless you have prior experience with that kind of situation,
       | I get it, it's scary and hard to understand that there might
       | never be a cure.
       | 
       | I have the "luxury" as someone with a lifelong autoimmune disease
       | that cost me a vital organ along the way and can only live
       | because of science and popping a pill each day, plus surviving
       | cancer, that sometimes all you can do is make the best out of the
       | situation as is while real scientists and doctors figure stuff
       | out.
       | 
       | Accept that at this time you might not be going to get back to
       | what you were capable of before the illness. Build psychological
       | resilience and find mechanisms that help you get back to an
       | acceptable level of life quality. It's not worth it chasing DIY
       | treatments if you have no fucking idea what you are doing, like
       | this girl. Desperation is not a good guide in life decisions.
        
       | ekianjo wrote:
       | TLDR: increase of lactate levels may be a pathway to explain long
       | covid
        
         | wahnfrieden wrote:
         | There was so much culture war discourse on this...
        
         | mitjam wrote:
         | Maybe a too short summary; my tldr would be: self-help research
         | led to the hypothesis that acid-base balance disruption may
         | underpin Long Covid. The hypothesis was published as a paper,
         | the author's successful self-treatment is described here:
         | https://mastodon.nl/@vickyvdtogt/110202237846457614 high
         | lactate levels were an indicator that helped finding a
         | hypothesis which could explain the diverse symptoms of Long
         | Covid.
        
           | csdvrx wrote:
           | I didn't see any description of her self treatment, but I'd
           | assume that to be taking bicarbonate or anything else that
           | say marathoners take like L Carnitine, Carnosine, Beta
           | Alanine, Leucine, Iso Leucine, and Valine.
           | 
           | https://www.runnersworld.com/training/a20860259/does-
           | baking-...
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867441/
           | https://www.mbsf.org/the-best-vitamins-and-supplements-
           | for-r...
        
             | mitjam wrote:
             | Yes, I only found it after looking at her Mastodon channel,
             | it ist not a true tldr, but I think still worthwhile to
             | mention. Maybe I should have given this as additional
             | context at the end. Thank you for the feedback and the
             | additional links.
        
             | PaulDavisThe1st wrote:
             | Recent research has cast doubt on lactate levels as an
             | issue for fatigue during endurance sports.
             | 
             | https://www.january.ai/blog/what-is-blood-lactate-vs-
             | lactic-...
        
             | infl8ed wrote:
             | She has posted another thread discussing her treatment
             | https://mastodon.nl/@vickyvdtogt/110202251308724694
        
       | civilized wrote:
       | Any connection of this mechanism to cognitive symptoms, brain
       | fog, or sleep difficulties?
        
       | gadders wrote:
       | Long COVID is similar to ME in that the cause is likely
       | psychiatric (although real to the sufferer) rather than physical.
       | 
       | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870488/
       | 
       | "Conclusions: Our study shows higher levels of neuroticism in
       | patients with post-COVID syndrome."
        
         | Mildlypolite wrote:
         | Higher neuroticism? I am a psychologist and this means nothing.
         | 
         | This "believes" were entertained for a long time about ME but
         | we have enough scientifical evidence that they were false.
         | 
         | Historically, this happened with multiple sclerosis, people
         | with ms were labelled as fakers and ms was called "faker's
         | disease".
         | 
         | Let's not go again to those horrible times today.
         | 
         | For an ample literature about ME I Invite you to visit the open
         | medicine foundation website (the centre that studies ME at
         | Stanford).
        
         | nequo wrote:
         | Are you saying that if neuroticism is a cause then neuroticism
         | is the only cause? I'm not an expert but it seems that the
         | causes are pretty much unknown:
         | 
         | https://en.wikipedia.org/wiki/Chronic_fatigue_syndrome#Cause
        
       | thenerdhead wrote:
       | > The cause of PASC is currently debated but likely involves
       | several different components, including: viral dissemination and
       | persistence, immune activation and dysregulation (e.g. clotting,
       | autoantibodies and reactivation of pre-existing latent viruses),
       | cell death and tissue damage, and long-lasting cellular changes
       | (e.g. epigenetic changes, senescence, fibroproliferation,
       | metabolism alterations) (3). However, at present we lack an
       | integrative understanding of how these disease components
       | interact to cause the variable symptomology of PASC. Based on
       | studies on acute COVID-19, PASC and the related myalgic
       | encephalomyelitis (ME; chronic fatigue syndrome), we hypothesize
       | that an inflammatory acid-base disruption underpins PASC and that
       | viral proteins, both acutely and persistently-expressed, cause
       | disease symptomology through disseminated tissue damage and
       | inflammatory acid-base disruptions.
       | 
       | Seems like an explanation for the body compensating for hypoxic-
       | environments by changing its acid-base. But what is fundamentally
       | causing these environments?
       | 
       | Focusing on sleep, diet/hydration, and exercise are your three
       | major ways to combat long covid. The latter (exercise) is heavily
       | controversial in the long covid / ME/CFS communities, but would
       | help moderate your acid-base over the long term if you can push
       | through the pain/fatigue/etc.
       | 
       | The author suggests a few things helped them. Deep breathing,
       | diet changes surrounding acidic foods, and stretching.
       | 
       | My personal experience with two bouts of long covid (14 months
       | and 7 months) has me still believing that microclots and nitric
       | oxide deficiency being the key factors in my recovery. I've
       | recovered twice now and back to pre-covid ability. It took me two
       | years of constant exercise to build back to where I was. A modern
       | Sisyphean task at that.
       | 
       | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9212559/
        
         | starkparker wrote:
         | > But what is fundamentally causing these environments?
         | 
         | With the caveat that this doesn't contain an answer, cf. cited
         | studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8469745/
         | ("inflammation, difficulty in gas exchange in the lungs and
         | thrombosis" during early infection causes a self-reinforcing
         | cycle of metabolic acidosis: decrease in blood pH leads to
         | decrease in oxygen saturation, which exacerbates the acidosis)
         | and https://pubmed.ncbi.nlm.nih.gov/32738466/ (increased
         | general COVID-19 vulnerability correlating with increased
         | lactate dehydrogenase levels).
         | 
         | The OP study suggests in the broader context that a person more
         | prone to acidosis is more likely to have a _much_ longer and
         | worse experience with COVID. This isn 't necessarily news
         | because acidosis was already well correlated with worse short-
         | term COVID outcomes, but if treating the acidosis can
         | substantially treat the symptoms of PASC/long COVID - which one
         | of the authors attempts to experimentally prove on the smallest
         | meaningful sample size of herself - then identifying and
         | treating the cause of _pre-infection_ acidosis risk factors
         | _might_ reduce the likelihood and potency of long COVID.
         | 
         | COVID's already been shown to have a harmful effect on renal
         | health post-illness: https://journals.lww.com/jasn/fulltext/202
         | 1/11000/kidney_out...,
         | https://www.nature.com/articles/s41581-021-00487-3
         | 
         | And a strong correlation to both complications in diabetic
         | patients and as a potential cause of diabetes:
         | https://www.cdc.gov/diabetes/library/reports/reportcard/diab...
         | 
         | And since two of the strongest causes of metabolic acidosis are
         | poor renal health and poorly managed diabetes, it feels like
         | there's a case for at least experimentally trying to treat long
         | COVID with a combination of renal nutrition (low-acid/high-
         | alkaline diet, more alkaline-forming foods, alkaline water,
         | less alcohol, more sodium citrate or bicarbonate) and pre-
         | diabetic treatment (stop smoking, exercise, increase low-starch
         | vegetable intake, treat high blood pressure).
         | 
         | Or tl;dr: eat all brussels sprouts and carrots, go play outside
         | more, and stop eating and drinking so much crap. Preferably
         | _before_ you get COVID, but _especially_ after.
        
           | thenerdhead wrote:
           | Brussels sprouts are a great way to get nitric oxide.
        
             | jaggederest wrote:
             | Unironically my first thought was sildenafil. The little
             | blue pill works by increasing nitric oxide production and
             | was originally designed for vascular heart issues iirc
        
               | thenerdhead wrote:
               | I've heard of that as a wonder drug. It signals for blood
               | flow and dilate blood vessels. There's other supplements
               | like l-arginine + citrulline that has similar effects but
               | different mechanisms.
        
         | prox wrote:
         | Can you place the article? Who is the author in a wider
         | context?
         | 
         | I have to ask because sometimes you don't know the credentials
         | and there is a lot of fluff articles and information around.
         | 
         | Pretty interesting that you were able to beat long covid, so
         | you think your regimen helped speed up recovery?
        
           | thenerdhead wrote:
           | The author has a link in the mastodon post. I was simply
           | quoting the article and some of their other threads.
           | 
           | There is a lot of fluff in general, but experience is the
           | best teacher. I'm convinced personally that it helped speed
           | up my recovery, but then again who knows if it is gone for
           | good. That's the vicissitudes of life for ya.
        
             | Mildlypolite wrote:
             | I can confirm that I had ME for 10 years and the treatments
             | which the author discusses helped me too, I had to discover
             | them through experience but it has always been clear that
             | my lactate levels were sky high, I've always felt as I was
             | feeling after an all out rowing competition when I was
             | healthy. The condition is terrible.
        
         | mancerayder wrote:
         | > nitric oxide deficiency
         | 
         | Wasn't there something around Cialis / Viagra being explored
         | for covid recovery? Since those drugs act on that, maybe
         | there's a potential connection?
        
         | csdvrx wrote:
         | > Seems like an explanation for the body compensating for
         | hypoxic-environments by changing its acid-base. But what is
         | fundamentally causing these environments?
         | 
         | Damage to the lung tissue!
        
           | jaggederest wrote:
           | Or damage to microvasculature, whether in the lungs or
           | elsewhere
        
             | agumonkey wrote:
             | I had weird cardiovascular issues (stuff that feels like
             | microclotting after various type of efforts) and \i'm
             | really curious about how to improve microvasculature (I
             | altered my diet a lot but that's a bit of a blind shot). I
             | thought it was out of reach of people today.
        
               | thenerdhead wrote:
               | What has helped me is nattokinase, occasional aspirin,
               | and plenty of nitric oxide foods / supplements. Very low
               | risk and are generally found in natural foods. But I take
               | these because I suspect I've had long Covid post my two
               | infections.
               | 
               | There is also a triple anticoagulant therapy of
               | clopidogrel, aspiring, and apixaban. Those studies are
               | popular in South Africa.
        
               | agumonkey wrote:
               | Thanks, I'm gonna read about this. I didn't try
               | microdosing aspirin, even though it's well known, because
               | i'm too weak on biochemistry to avoid bleeding.
               | 
               | Really, thanks a lot, it's a damn burden when your
               | cardiovascular system is feeble, you're constantly on the
               | edge of a problem and have to monitor every effort
               | (almost requiring a car for groceries because i'm not
               | sure I can walk with a backpack multiple times a week).
               | 
               | ps: I've recently learned about the blood viscosity
               | aspect and also red blood cell renewal through "blood
               | donation", you red blood cells being more elastic, it's
               | supposed to ensure better flow in microvasculature.
        
           | thenerdhead wrote:
           | No idea. I've read stories about people getting CTs showing
           | damage and others showing absolutely none. A very, very
           | strange virus.
        
           | [deleted]
        
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