Hi Everyone! Welcome back to another Friday blog. Today I wanted to take a look at “long-Covid” - symptoms - and strategies that we can implement to improve and restore vitality and quality of life. The CDC began collecting data in June 2022 on symptoms of Covid-19 that lasted > 3mo and reduced ability to perform day-to-day activities. Of note - incidence is nearly double in women 😳 Let’s delve in.

Did you know roughly 20 million people are suffering from prolonged symptoms following SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection or exposure to the spike protein? (Check out blog # 52 on prevention). It is characterized by severe vascular damage - inflammation and clotting - as well as perivascular (around the blood vessels) inflammation - that leads to organ damage and the plethora of symptoms affecting all organ systems. In fact, morticians are pulling long clumps of viral spike proteins from the blood vessels of deceased individuals. WHAT?!!!! Using scanning electron and fluorescence microscopy as well as mass spectrometry they found that presence of spike protein in circulation contributes to “hypercoagulation” (large clots) where there is also impairment of fibrinolysis (clot destruction). Further, they see “a massive load of preformed amyloid clots” (Alzheimer’s) - as well as damage to erythrocytes and platelets - and dysregulated inflammation. Researchers report the “spike protein does indeed play a major role in hypercoagulability seen in COVID-19 patients.” Normal clotting is more net-like. “In the presence of spike protein, the structure changed to form dense clot deposits.” 😳 This is terrifying - 

“Research suggests that between one month and one year after having COVID-19, 1 in 5 people ages 18 to 64 has at least one medical condition that might be due to COVID-19. Among people age 65 and older, 1 in 4 has at least one medical condition that might be due to COVID-19.” How is this possible? It must be hiding covertly in the body - Many people find that their body behaves differently after having a Covid infection - even a mild case - weeks to months later something else happens that may or may not be related to Covid: fatigue, SOB (shortness of breath) that wasn’t there before, brain fog and digestive issues are common. Symptoms can vary in intensity - and can even become disabling -

• Fatigue/chronic fatigue syndrome
• body aches
• Symptoms that get worse after physical or mental effort
• Fever
• Loss of taste or smell
• Lung (respiratory) symptoms, including difficulty breathing or shortness of breath and/or cough
• POTS (postural orthostatic tachycardia syndrome) - neurological - ANS (autonomic nervous system) - due to reduced blood flow/O2 to the brain and peri-vascular inflammation. The brain is super-sensitive to inflammation. 
• Neurological symptoms or mental health conditions, including difficulty thinking or concentrating, brain fog, headache, sleep problems, dizziness or lightheadedness on standing, pins-and-needles, loss of smell or taste, and depression or anxiety
• Joint or muscle pain
• Heart symptoms or conditions, including chest pain and fast or pounding heartbeat, HTN (hypertension)
• Digestive symptoms, including diarrhea, constipation, vomiting and stomach pain
• Metabolic issues - progression to T2D (type 2 diabetes) or obesity
• Blood clots and blood vessel (vascular) issues, including a blood clot that travels to the lungs from deep veins in the legs and blocks blood flow to the lungs (pulmonary embolism)
• Other symptoms, such as a rash
• Changes in the menstrual cycle

Whatever mild disease process you may have had previous to Covid  - your risk of that problem progressing into full-blown disease is roughly doubled! Why? The loss of microcirculation to all organ systems!! 😳 This is very bad. For example, one year after Covid infection, you see a doubling of CVA (stroke), MI (heart attack), GI disorders, HTN, T2D, heart problems and increase in micro-blood clots. So, how is this virus able to exert such a wide-range of health issues and literally take us down? To understand this, we must understand how it gets into our body - where it attaches - how it gains entry into the cell to replicate - and where it travels to exert its damage.

SARS-CoV-2 (Covid-19) enters the body primarily through the respiratory tract - nose, mouth, lungs -where it attaches to ACE2 (Angiotensin-converting enzyme 2) - like a key in a lock. [“ACE2 is highly abundant on type 2 pneumocytes, an important cell type present in chambers within the lung called alveoli, where oxygen is absorbed and waste carbon dioxide is released” - (transmission can also occur via the fecal-oral route)].

ACE2 is abundant in cells that line the nose, pharynx and lungs - all the way down to the tiny alveoli - like an army of guards like border-patrol agents trying to prevent “bad guys” from entering the body -acting as part of our immune defense. The problem, is that Covid’s spike protein fits perfectly into ACE2 - like a lock and key - literally facilitating viral entry! How? ACE2 is a trans-membrane protein - structurally crossing from outside to inside the cell - due to its function in protein transport. This allows the virus/spike protein to bind - disable it - then, enter and infect the cell - activating viral replication. Loss of ACE2 causes damage to blood vessels, heart, lungs - driving up inflammation - inducing clotting and blood vessel death - impairing circulation to all organ systems. ACE2 deficits and mitochondrial dysfunction can persist for weeks to months after a person recovers from Covid-19.

A few of ACE2’s functions:

• Regulates homeostasis - found in high numbers lining the nose, pharynx, blood vessels and gastrointestinal tract.
• Regulates renal (kidney) amino acid (protein) transport and pancreatic insulin secretion
• Regulates transport of intestinal neutral amino acid transporters
• Regulates intestinal inflammation and diarrhea, hence modulating the gut microbiome
• Serendipitous function as the cell-surface receptor for the virus facilitating viral RNA entry in the lungs. The consequent downregulation of surface ACE2 levels leads to increased local levels of Ang II, which probably contribute to the significant mortality rates resulting from the acute lung injury and fibrosis caused by SARS.
• Inactivates angiotensin in the brain to prevent amyloid plaque formation in Alzheimer’s
• ACE2 may also be protective against liver fibrosis and other fibrotic diseases, again through reduction in Ang II (angiotensin II) levels (or elevated Ang-(1-7) levels).

When Covid attaches to ACE2, it damages it - depleting these enzymes - inhibiting their protective function - and damaging the mitochondria. This down-regulation of ACE2 results in loss of its protective function. “Concomitantly with the onset of SARS-CoV-2 viral infection, the downregulation of the ACE2 receptor action occurs, with a subsequent local increase in angiotensin II levels and, thus, the dysregulation of the renin–angiotensin–aldosterone system (RAAS).” We get massive vascular damage through a cascade of events - we get perivascular inflammation that affects the brain and nervous system - Let’s look at what happens with the loss of ACE2:

• Endothelitis - (inflammation of the lining of the blood vessels) The SARS Co-V2 spike protein binds up ACE2 and goes straight to the lining of the blood vessels (endothelium) as well as the lining of the intestines- Inflammation triggers clotting factors causing platelets to clump together.
• Microthrombosis - (microscopic clotting) along the lining that was triggered by inflammation along the endothelium - activates clotting factors that cause fragments to aggregate or clump together.
• Mitochondrial Dysfunction - “COVID-19 highjacks mitochondria of immune cells, replicates within mitochondrial structures, and impairs mitochondrial dynamics leading to cell death. Mitochondria are the powerhouses of the cell and are largely involved in maintaining cell immunity, homeostasis, and cell survival/death.” We experience a host of symptoms, including fatigue - we are unable to survive without our mitochondria.
• Visceral Hypoxia - (low O2 supply to the organs). The microscopic clots lodge in the tiniest blood vessels and capillaries and impair circulation to our organs. We lose blood flow to the lungs (for example) and experience SOB - in the brain we get brain fog and memory deficits.
• T-Lymphocyte Dysfunction - (generals of our immune system). T-cells are high-energy immune cells. They require high amounts of ATP to work - which requires optimal mitochondrial function. They run on FAO (fatty acid oxidation) that produces nearly 3.5x the ATP compared to glucose - they cannot survive on sugar/glucose. Our TEM (T-effector memory) cells become damaged - these cells remember whatever past infections we’ve had (such as viral/bacterial) and go after the cells that harbor them - When our T-lymphocytes are disabled and can’t perform their functions - things run amuck. When we eat too much sugar and don’t feed them good fat that they require - they begin acting like cancer cells - fermenting glucose. We lose balanced immune-defense function - the immune system goes haywire.
• B-Lymphocytes - (make antibodies) typically controlled by the TEM cells,  come out to fight. They fight from afar - throwing antibodies like “grenades” at Covid’s spike protein - damaging surrounding tissue and driving inflammation. This allows certain dormant viruses - like EBV (Epstein Barr Virus) - to come out of hiding. (EBV hides in our B lymphocytes). Other viruses can come out of hiding as well, like Herpes Simplex Virus (hides in our neurons). 
• Autoimmune - Our immune system - now without generals - and out-of-control B-Lymphocytes - sets the stage for autoimmune disorders to get started. FYI - they have risen by ~500% 😲 The immune system sees an altered form of ACE2 (due to damage) and makes antibodies against it (mast cell activation syndrome) and we get immune dysfunction. Mast cells inside the blood vessels and GI tract behave differently than mast cells in the skin (hives) - and react to blood platelets - you can get antibodies to your antibodies - and the proverbial cytokine storm.
• Microbiome Dysbiosis - Covid -19 also goes to the lining of the GI tract - causing inflammation and dysbiosis (altered balance of gut microbes). We lose beneficial bacteria - that make good products for us -  while pathogenic bacteria proliferate - making toxins and inflammatory molecules. We now know that SARS-CoV-2 can become a bacteriophage (virus that infects/kills bacteria) - It infects and effectively wipes out 2 keystone species in our microbiome: 1) Faecalibacterium prausnitzii - a major butyrate producer - eats indigestible fiber (GOS) galactooligosaccharides - 70% of our enterocytes’ diet is butyrate - and 2) Lactobacillus Plantarum - L. plantarum has significant antioxidant activities and also helps to maintain intestinal permeability. It is able to suppress the growth of gas-producing bacteria in the intestines and may benefit some patients who suffer from IBS. It helps to create microbe balance and stabilize digestive enzyme patterns. Lactiplantibacillus plantarum has been found in experiments to increase hippocampal brain derived neurotrophic factor, which means L. plantarum may have a beneficial role in the treatment of depression.   - found in sauerkraut and fermented vegetables -  When they don’t eat, our enterocytes get weak - we get leaky gut - microbial translocation -proliferation of pathogenic microbes.

Okay - Covid depletes our ACE2, damages our mitochondria, wipes out our T-cells, drives up inflammation, damages our blood vessels, causes micro-clots along the lining of our blood vessels, damages our organs by preventing O2 supply, creates dysbiosis of the microbiome and hides in our gut - wiping out keystone species - for a year or longer after exposure to the virus or spike protein. Dr. Leo Galland may be the world leading expert on long covid. He proposes a “web of long-covid” - problems resulting from exposure to the virus or spike protein.

So - to fix this problem, we must restore ACE2, T-cells, mitochondrial function, activate autophagy, heal our blood vessels and balance our microbiome - Let’s look at some strategies - 

• Vitamin D3 - hormone highly involved in immune response. Want blood levels to be 70-100. You can’t get enough in food - low levels are in pastured eggs and wild mushrooms (particularly shiitake). We aren’t getting enough through sunshine - due to winter, working indoors, sunblock/sunscreen, older skin or higher melanin levels. Unless you are outside all day with most of your skin exposed to the sun, you aren’t getting enough exposure to sunlight - many us have genetically poorly-functioning vitamin D receptors to complicate the problem even further - AND, if you are low in magnesium they don’t function as well either - or your body may not convert vit D to its active form - You may need to supplement from 10,000IUs-40,000IUs/day to get your levels where they need to be.
• Vitamin K2 - works with D3 to remove calcium from arterial plaques and place it into bone. Ideal ratio of D3:K2 is 10,000IUs:100mcg
• Kill virus - black cumin seed oil kills a host of pathogens, including EBV, cytomegalovirus, HIV, HSV, SARS, MRSA and is being used to prevent and treat covid infections. Many other compounds have antimicrobial properties as well - garlic, EVOO, curcumin, parsley, rosemary, oregano…
• Autophagy - (self-devour) your body’s demolition and recycling function - your body’s natural defense to kill and remove pathogens. SARS-CoV-2 inhibits autophagy. You can stimulate autophagy by time-restricted eating - give your body 18 hours without food daily to enhance autophagy, kill virus and repair damage. EVOO stimulates autophagy.
• Antioxidants -  Lower arterial inflammation - Vitamin E - delta and gamma tocotrienols are significantly better than tocopherols, HP-EVOO, curcumin (turmeric), quercetin, resveratrol
• GOS - galactooligosaccharides - indigestible fiber that F. Prausnitzii loves to eat! Some research reports taking GOS for 3 months increased T-cells by 70%!
• Zinc - ACE2 is a zinc metalloenzyme - It requires zinc as a cofactor to function. Vit, D3, curcumin, resveratrol, alpha-lipoid acid (nervous system), NAC (lungs) all help to restore ACE2 activity. You want ~ 50mg/day.
• Magnesium - Cofactor for >300 enzymes. Required to activate ATP. Crucial in metabolic processes. You want around 400mg/day
• Mineral Water - Drink carbonated mineral water!! “ Intake of mineral water with a high content of hydrocarbonate ions, magnesium, sodium, and carbon dioxide saturation with general water mineralization from between 5 and 6 to between 11 and 13 g/L has the maximum effect.” The CO2 (carbon dioxide) in carbonated mineral water enhances oxygenation of tissues - this is due to the Bohr effect - creating a slight acidification to allow O2 uptake into tissues.
• Eliminate highly processed foods/grains/sugar - “As a result of food refining and processing, the Western diet is often low in Mg.”
• Restore T-cells - T-cells run on FAO (fatty acid oxidation) - they eat FAT due to their high energy demand - they don’t do well with sugar. FAO produces nearly 3.5x as much energy as glucose metabolism. 
• Omega 3s (DHA,EPA) - animal sources - “DHA and EPA, the main dietary n-3 fatty acids present in fatty fish, have shown positive effects on health and diseases, such as cardiovascular diseases, dyslipidemia, hypertension, atherosclerosis, diabetes, obesity, gastrointestinal disorders, arthritis, and neurological disorders” as well as enhance immune function, T-cell function, macrophages and neutrophils. Ideally, you need roughly 3,600mg/day to restore function - as well as in the brain. Best source is Alaskan Cod Liver Oil infused with lemon (it doesn’t smell or taste fishy because it’s primarily DHA) you get 1,000mg/T. I take 2T daily plus eat fish.
• Restore mitochondrial function - coQ-10, alpha-lipoid acid, NAC, Magnesium, B vitamins - and restore your energy. 
• Exercise - Extremely beneficial -  impacts systemically to help prevent Covid in the first place - But, if you do get sick or have SOB, you have to go slow. Start with exercises in sitting or lying on your bed - add resistance bands - progress to standing and going for walks - Gradually build up strengthening exercises before adding high intensity interval training. 
• Restore Microbiome species -  F. prausnitzii - likes indigestible fiber (GOS) -galactooligosaccharides, avocados, chickpeas, Konjac root, Daikon radish, Jicama…L. Plantarum - found in raw fermented sauerkraut, kefir, aged cheeses and fermented vegetables. Take a good probiotic - the best I’ve found is Seed (I have no affiliation with any products). It has the most extensive research and outcomes. 
• HP-EVOO - (High polyphenol extra virgin olive oil) Oleic Acid in EVOO helps to restore T-cell FAO, heal the lining of blood vessels and intestines - polyphenols feed the microbiome and the mitochondria - signals them to “uncouple” and make more mitochondria - feeds the microbiome - scavenges ROS (reactive oxygen species) to lower inflammation - triggers FAO to feed T cells - is selectively antimicrobial against pathogens - triggers autophagy - anti-aging epigenetic factors -  protects organs: brain, heart, liver, pancreas…and much more we haven’t even discovered yet. 

So, until next time my friends…Drink, Drizzle, Digest HP-EVOO at least 4T raw daily, - use more for cooking and drizzling onto your food - eat the rainbow of organic or wild-sourced or organic veggies (7-9 C) and low-glycemic fruits (to get the rainbow of gut microbes!) - eat wild-caught, pasture-raised, grass-fed - get plenty of sunshine - supplement magnesium, zinc, vitamin D3 + K2 - get your trace minerals and electrolytes with good sea salt - Celtic is hand-harvested and Himalayan was formed before plastics - eat foods high in lutein - drink your body weight in oz of water - get a good pre/probiotic - consume digestible and indigestible fiber for your gut microbes - adaptogens (such as mushrooms) and methylation donors (kale, beets, spinach, cruciferous, lion’s mane…), marjoram, rosemary, oregano, parsley and other herbs to detox, enhance overall health and reverse aging and disease - exercise your body and mind - add a few minutes of mindful meditation to your day to combat stress - take a hot Epsom salt bath and follow with a cold shower/ice plunge - practice “earthing” as an anti-inflammatory - remove EMF (electromagnetic frequency) devices and blue light - use IR (infrared) from incandescent lighting, non-toxic candle or light a fire to enhance sleep and...turn off the light!!   #HP-EVOO