As a user of Low Dose Naltrexone (LDN) of 1 year (and someone who knows a Long Covid setback is coming by ominous increase in gas) this is very interesting. Toxins in the gut make sense to me.
I'm also struck by the effects of LDN on the adrenal system releasing cortisol and adrenalin. I used to feel quite anxious in the morning (and a peak of other Long Covid symptoms) for no obvious reason and I think this was the production of cortisol and adrenalin triggering fight or flight. LDN seems to have helped with this - and certainly has increased my sleep so presumably improving parasympathetic function. I've recently noticed that my blood pressure has been borderline low around 90/60 in the morning and I gather that this too can trigger the release of cortisol and adrenaline to boost the pressure as soon as I start getting active. Having listened to Dr Boon Lin, Cardiologist, on autonomic dysfunction in Long Covid I've taken more salt in the morning raising my blood pressure by about 10 bpm and this too, alongside diaphragm breathing, seems to be helping.
Thanks for laying that out David. I'm a research scientist, not a clinician, so I was not familiar with this intervention. I'm curious about the 'toxins in the gut' connection. Any thoughts?
The paper quoted by Dr McMillan and the one below covers Dr Brogna and colleagues' work on toxin-like peptides. There are some video presentations in which he has shown some fairly convincing images of the virus inside gut bacteria and some reported success with antibiotics. I know Dr McMillan is interested in that work, as he explains. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9855837/
Interesting, but could you lay out data on the use of Naltrexone in Long COVID? What have clinical trials revealed? What are the benefits to Long COVID patients of treating with Naltrexone?
I doubt there have been clinical trials but Low Dose Naltrexone is emerging as one of the first-line treatments for FLCCC doctors simply through the numbers of Long Covid patients who respond positively. It is described as an immune modulator although the finer grain of that mechanism still seems unclear but the idea of the blocking of toxins looks interesting. I take Dr M's point about it not addressing primary pathophysiology but one rationale is that calming the immune system buys time for the body to heal itself. Many non-pharmacological approaches in treating Long Covid (rest, meditation, diaphragmatic breathing, brain retraining, careful pacing to avoid post-exertional malaise etc) are aimed at reducing reactivity of the ANS and these do seem to help over time.
Interesting. I write about Long COVID because of my own 2+ years experience, following the acute infection. I agree wholeheartedly about the need for buying time to heal. My hypothesis is that mitochondrial dysfunction is causal and that until mitochondria have time to repair and replicate, that recuperation from LC is difficult to impossible. Mitochondria are key players in innate immune responses to viral infection, beyond their role in making ATP, so viral infection within the mitochondria is a double whammy.
Analysis of Bacteriophage Behavior of a Human RNA Virus, SARS-CoV-2, through the Integrated Approach of Immunofluorescence Microscopy, Proteomics and D-Amino Acid Quantification
More points. Dr. Shankara Chetty has considered and treated successfully long covid issues as a persistent auto immune condition that waxes and wanes. Would opioid receptor mechanism dovetail into the auto immune path, at least for the neurological presentations of long covid ? For the experts to explain. If my basic explanation about molecules like Naltrexone is correct, its work is on the pathophysiology of the disease too, as well as on the symptoms. One could also look at long covid as a more persistent symptomatic disease rather than a pathological one. At least certain presentations of it. And how about Pregabalin or Gabapentin from the neurological angle of long covid ? These molecules also have strong amine structural features. And I recall that some 12 years ago, I was on a six month course of Gabapentin to slowly get rid of symptoms like pain, irritation and tingling sensation after a severe attack of herpes even though the infection itself was contained in three weeks. And herpes has been one bug bear in long covid.
The presentation is an interesting new insight into long covid provided by the intrepid Dr. McMillan, followed by the thoughtful comments exchange from the two specialists Dr. Pocock and Dr. Mardi Crane-Godreau. As an old time organic chemist (PhD) with reading interests in medicinal chemistry in retirement, I have my perspective. Naltrexone is a strongly basic amine with a pKa in the region of 9. Its structure would clearly put it in the class of CADs (Cationic Amphilic Drugs). As a result, it can be a powerful anti viral ( against RNA viruses), anti inflammatory, immuno modulatory even anti histaminic. These are roles needed to fight the virus both in primary infection and in long covid conditions. It is a different matter that people did not find contexts in the past to study the drug’s multiple roles. If spike protein, from virus or vaccine remnants, is implicated, this molecule can prevent it from binding it to opioid receptor cells or dislodge it if already bound, by its own chemical (electro static) affinity to the spike protein structure. Dr. McMillan knows that I have been mentioning about this chemistry for over two years in many contexts. It is this chemistry why Azithromycin, Montelukast and Levocetrizine have worked powerfully in covid. He is also aware of my line that there are hundreds of drugs from many different indications that have this chemical structure feature capable of such interventions.
Dr Balakrishnan, I'm curious if you might have an opinion about GABA (gamma-amino-buteric-acid) in the form that can be purchased as a supplement in the US. I'm aware of individuals who are finding relief from anxiety, depression and brain fog. These conditions may or, may not be related to COVID/Long COVID. Many thanks for your insights.
Sorry for the delayed response. I have no idea of GABA supplements freely available in the USA, but I note that they have low blood brain barrier. Structurally, the derivatives like Gabapentin and Pregabalin would be more organophilic and I presume that would make them more effective/ in smaller doses. I hope they are also suitable for long courses, a prescription need in long covid. Through your professional research contacts, is it possible that you could get their other potential properties quickly checked out - anti viral, anti inflammatory, immuno modulating, even anti histaminic ? From an organic chemistry perspective, I feel that in any adverse situation where spike proteins ( from the vaccine, in particular) binding to cell walls is implicated, these drugs can disarm spike protein for such bindings. The possible versatility of some these drugs need to be established, they have profound bearing on therapeutic options. Someone like you or Dr. McMillan are placed well to coordinate such effort. As the windows for researchon direct covid issues slowly close, this related research can be of immense value.
I personally developed a COVID infection in March 2020 and never did regain my health until I began to take steps to change my diet and to support my mitochondria. That process took a little over 2 years. So, my Long COVID began (technically) in the summer of 2020. If your question relates to vaccines, they were not available in the US until early in 2021.
I went onto the "Plant Paradox" diet designed by Dr Steven Gundry. I'm a mucosal immunologist who was eating what I considered to be a very healthy diet. What had happened to me is apparently that the virus had attacked my gut epithelial cells and caused leaky gut. I had become sensitive to a number of foods that are normally nutritious in healthy people. Many of these were foods high in lectins. Once I stopped ingesting lectins and nightshade family vegetables, eliminated refined sugars and starches and began using only olive, avacado and LIQUID coconut oil, my situation changed radically. I lost a little weight, but gained muscle. All signs of inflammation stopped. It took several months for my gut to heal, but now, after nearly a year, I am slowly able to reintroduce foods that were making me sick. If you should want to check out my Substack, I go into considerable detail about diet and the supplements that I've used to regain my health. My biggest residual issue with Long COVID now is occasional post exertional malaise brought on by stressful situations.
Dr….you had very early covid. I am curious to know the kind of symptoms you had in the initial days, the medications you took in those first days ( or was it just acetaminophen and waiting out), whether you went into the auto immune phase around 8 th-10th day including drop in saturation etc and the treatment given to you. I will come back with further comments if you can post these details. Please note that despite my acquired interest in medicines, I am not a medical doctor. In June 2021, I discussed two case studies with Dr. McMillian….my 85 year old brother twice vaccinated then and a 60 year old friend, unvaccinated, which he appreciated. You might find that report interesting and I request your mail id to enable me to send that report to you. Did all these GI issues follow your infection in early 2020 itself ? And what were the medications you were taking then ? Strange it may sound, I am interested to consider you as a case study. On GABA, I am not aware in what form it is available in the USA ? I am from India.
Begin by reading the posts in chronological order, beginning last fall (2022). You can also reach me directly by responding to any email that comes to you from the blog.
In brief, my acute COVID illness was moderate and I received no medical support. As a professional with considerable understanding of mucosal disease, I increased some of my regular supplements, especially Vitamin D and C. (If you read my blogs you will see that there are many others that I have added in the interim and that were necessary for my recovery.) In the first year, prior to vaccination, the profound symptoms were primarily metabolic and neurological, manifest as 'brain fog' and waves of extreme fatigue. There is more to tell. Please have a good read and let's move this conversation forward.
More points. Since following Dr. McMillan’s presentations, we have come to know so much about the lingering effects of vaccine. Your vaccination history is also an important factor, though you began as a classical long covid patient, being unvaccinated when it began in summer 2020. What was your condition like post vaccinations in 2021 ?
Hope you have fully recovered from your long (really long) covid conditions now. As a patient you may have ignored two key points, but as a researcher you shouldn’t ignore. First, you didn’t seem to have taken any early medications, as the symptoms were mild, but mention that your infection was strong. You may have rightly concluded so, because the long symptoms quickly followed. There is every possibility that this would not have happened if you had taken early medications, particularly the classical drugs. The viral load had a free road to build up. It is a relief that it didn’t lead to severe lung conditions as the common occurrence those days. Second, from 2021, you may have gone through your rounds of vaccinations, including in 2022. The official response could be different, but the downsides of vaccine are now in the realms of serious science research. You cannot discount the fact that the repeat vaccines have unnecessarily extended your recovery by atleast a year, even by the mitochondrial mechanisms.
As a user of Low Dose Naltrexone (LDN) of 1 year (and someone who knows a Long Covid setback is coming by ominous increase in gas) this is very interesting. Toxins in the gut make sense to me.
I'm also struck by the effects of LDN on the adrenal system releasing cortisol and adrenalin. I used to feel quite anxious in the morning (and a peak of other Long Covid symptoms) for no obvious reason and I think this was the production of cortisol and adrenalin triggering fight or flight. LDN seems to have helped with this - and certainly has increased my sleep so presumably improving parasympathetic function. I've recently noticed that my blood pressure has been borderline low around 90/60 in the morning and I gather that this too can trigger the release of cortisol and adrenaline to boost the pressure as soon as I start getting active. Having listened to Dr Boon Lin, Cardiologist, on autonomic dysfunction in Long Covid I've taken more salt in the morning raising my blood pressure by about 10 bpm and this too, alongside diaphragm breathing, seems to be helping.
Thanks for laying that out David. I'm a research scientist, not a clinician, so I was not familiar with this intervention. I'm curious about the 'toxins in the gut' connection. Any thoughts?
The paper quoted by Dr McMillan and the one below covers Dr Brogna and colleagues' work on toxin-like peptides. There are some video presentations in which he has shown some fairly convincing images of the virus inside gut bacteria and some reported success with antibiotics. I know Dr McMillan is interested in that work, as he explains. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9855837/
Interesting, but could you lay out data on the use of Naltrexone in Long COVID? What have clinical trials revealed? What are the benefits to Long COVID patients of treating with Naltrexone?
I doubt there have been clinical trials but Low Dose Naltrexone is emerging as one of the first-line treatments for FLCCC doctors simply through the numbers of Long Covid patients who respond positively. It is described as an immune modulator although the finer grain of that mechanism still seems unclear but the idea of the blocking of toxins looks interesting. I take Dr M's point about it not addressing primary pathophysiology but one rationale is that calming the immune system buys time for the body to heal itself. Many non-pharmacological approaches in treating Long Covid (rest, meditation, diaphragmatic breathing, brain retraining, careful pacing to avoid post-exertional malaise etc) are aimed at reducing reactivity of the ANS and these do seem to help over time.
Interesting. I write about Long COVID because of my own 2+ years experience, following the acute infection. I agree wholeheartedly about the need for buying time to heal. My hypothesis is that mitochondrial dysfunction is causal and that until mitochondria have time to repair and replicate, that recuperation from LC is difficult to impossible. Mitochondria are key players in innate immune responses to viral infection, beyond their role in making ATP, so viral infection within the mitochondria is a double whammy.
Analysis of Bacteriophage Behavior of a Human RNA Virus, SARS-CoV-2, through the Integrated Approach of Immunofluorescence Microscopy, Proteomics and D-Amino Acid Quantification
https://www.mdpi.com/1422-0067/24/4/3929
PDF ⬇️
https://mdpi-res.com/d_attachment/ijms/ijms-24-03929/article_deploy/ijms-24-03929-v2.pdf?version=1676618465
Thanks Dr. McM. Fascinating indeed. Beyond intriguing that yet another venom is involved in the injections.
More points. Dr. Shankara Chetty has considered and treated successfully long covid issues as a persistent auto immune condition that waxes and wanes. Would opioid receptor mechanism dovetail into the auto immune path, at least for the neurological presentations of long covid ? For the experts to explain. If my basic explanation about molecules like Naltrexone is correct, its work is on the pathophysiology of the disease too, as well as on the symptoms. One could also look at long covid as a more persistent symptomatic disease rather than a pathological one. At least certain presentations of it. And how about Pregabalin or Gabapentin from the neurological angle of long covid ? These molecules also have strong amine structural features. And I recall that some 12 years ago, I was on a six month course of Gabapentin to slowly get rid of symptoms like pain, irritation and tingling sensation after a severe attack of herpes even though the infection itself was contained in three weeks. And herpes has been one bug bear in long covid.
The presentation is an interesting new insight into long covid provided by the intrepid Dr. McMillan, followed by the thoughtful comments exchange from the two specialists Dr. Pocock and Dr. Mardi Crane-Godreau. As an old time organic chemist (PhD) with reading interests in medicinal chemistry in retirement, I have my perspective. Naltrexone is a strongly basic amine with a pKa in the region of 9. Its structure would clearly put it in the class of CADs (Cationic Amphilic Drugs). As a result, it can be a powerful anti viral ( against RNA viruses), anti inflammatory, immuno modulatory even anti histaminic. These are roles needed to fight the virus both in primary infection and in long covid conditions. It is a different matter that people did not find contexts in the past to study the drug’s multiple roles. If spike protein, from virus or vaccine remnants, is implicated, this molecule can prevent it from binding it to opioid receptor cells or dislodge it if already bound, by its own chemical (electro static) affinity to the spike protein structure. Dr. McMillan knows that I have been mentioning about this chemistry for over two years in many contexts. It is this chemistry why Azithromycin, Montelukast and Levocetrizine have worked powerfully in covid. He is also aware of my line that there are hundreds of drugs from many different indications that have this chemical structure feature capable of such interventions.
Dr Balakrishnan, I'm curious if you might have an opinion about GABA (gamma-amino-buteric-acid) in the form that can be purchased as a supplement in the US. I'm aware of individuals who are finding relief from anxiety, depression and brain fog. These conditions may or, may not be related to COVID/Long COVID. Many thanks for your insights.
Many herbal remedies like Chinese skullcap work on GABA
Sorry for the delayed response. I have no idea of GABA supplements freely available in the USA, but I note that they have low blood brain barrier. Structurally, the derivatives like Gabapentin and Pregabalin would be more organophilic and I presume that would make them more effective/ in smaller doses. I hope they are also suitable for long courses, a prescription need in long covid. Through your professional research contacts, is it possible that you could get their other potential properties quickly checked out - anti viral, anti inflammatory, immuno modulating, even anti histaminic ? From an organic chemistry perspective, I feel that in any adverse situation where spike proteins ( from the vaccine, in particular) binding to cell walls is implicated, these drugs can disarm spike protein for such bindings. The possible versatility of some these drugs need to be established, they have profound bearing on therapeutic options. Someone like you or Dr. McMillan are placed well to coordinate such effort. As the windows for researchon direct covid issues slowly close, this related research can be of immense value.
Fascinating... so how is it (long COVID/ COVID itself) being distributed to the population?
Hello Rena,
I personally developed a COVID infection in March 2020 and never did regain my health until I began to take steps to change my diet and to support my mitochondria. That process took a little over 2 years. So, my Long COVID began (technically) in the summer of 2020. If your question relates to vaccines, they were not available in the US until early in 2021.
What diet did you implement to help you recover? Thanks
Hi David,
I went onto the "Plant Paradox" diet designed by Dr Steven Gundry. I'm a mucosal immunologist who was eating what I considered to be a very healthy diet. What had happened to me is apparently that the virus had attacked my gut epithelial cells and caused leaky gut. I had become sensitive to a number of foods that are normally nutritious in healthy people. Many of these were foods high in lectins. Once I stopped ingesting lectins and nightshade family vegetables, eliminated refined sugars and starches and began using only olive, avacado and LIQUID coconut oil, my situation changed radically. I lost a little weight, but gained muscle. All signs of inflammation stopped. It took several months for my gut to heal, but now, after nearly a year, I am slowly able to reintroduce foods that were making me sick. If you should want to check out my Substack, I go into considerable detail about diet and the supplements that I've used to regain my health. My biggest residual issue with Long COVID now is occasional post exertional malaise brought on by stressful situations.
Dr….you had very early covid. I am curious to know the kind of symptoms you had in the initial days, the medications you took in those first days ( or was it just acetaminophen and waiting out), whether you went into the auto immune phase around 8 th-10th day including drop in saturation etc and the treatment given to you. I will come back with further comments if you can post these details. Please note that despite my acquired interest in medicines, I am not a medical doctor. In June 2021, I discussed two case studies with Dr. McMillian….my 85 year old brother twice vaccinated then and a 60 year old friend, unvaccinated, which he appreciated. You might find that report interesting and I request your mail id to enable me to send that report to you. Did all these GI issues follow your infection in early 2020 itself ? And what were the medications you were taking then ? Strange it may sound, I am interested to consider you as a case study. On GABA, I am not aware in what form it is available in the USA ? I am from India.
Many of your questions can be answered by reading my Substack blog. I suggest that you subscribe. It's free and open to all. https://longcovidjourney2wellness.substack.com/
Begin by reading the posts in chronological order, beginning last fall (2022). You can also reach me directly by responding to any email that comes to you from the blog.
In brief, my acute COVID illness was moderate and I received no medical support. As a professional with considerable understanding of mucosal disease, I increased some of my regular supplements, especially Vitamin D and C. (If you read my blogs you will see that there are many others that I have added in the interim and that were necessary for my recovery.) In the first year, prior to vaccination, the profound symptoms were primarily metabolic and neurological, manifest as 'brain fog' and waves of extreme fatigue. There is more to tell. Please have a good read and let's move this conversation forward.
Kind regards, Mardi
More points. Since following Dr. McMillan’s presentations, we have come to know so much about the lingering effects of vaccine. Your vaccination history is also an important factor, though you began as a classical long covid patient, being unvaccinated when it began in summer 2020. What was your condition like post vaccinations in 2021 ?
If you would go to my Substack and subscribe (this is free and open to all) I have laid out answers to many of the questions that you pose. https://longcovidjourney2wellness.substack.com/
Hope you have fully recovered from your long (really long) covid conditions now. As a patient you may have ignored two key points, but as a researcher you shouldn’t ignore. First, you didn’t seem to have taken any early medications, as the symptoms were mild, but mention that your infection was strong. You may have rightly concluded so, because the long symptoms quickly followed. There is every possibility that this would not have happened if you had taken early medications, particularly the classical drugs. The viral load had a free road to build up. It is a relief that it didn’t lead to severe lung conditions as the common occurrence those days. Second, from 2021, you may have gone through your rounds of vaccinations, including in 2022. The official response could be different, but the downsides of vaccine are now in the realms of serious science research. You cannot discount the fact that the repeat vaccines have unnecessarily extended your recovery by atleast a year, even by the mitochondrial mechanisms.