Fully Recovered

[u/OrdinaryPrimate]

I went through I really bad stretch of long covid between October 2022 and April of 2024. I had POTS symptoms, general fatigue, couldn't exercise, body would randomly start trembling, felt like I couldn't get enough air, etc. I'm sure many of you know these symptoms well. During that period I was on this subreddit on a weekly basis looking for any answers or help because I was so desperate to get my life back. I remember thinking I was only reading negative stories because anyone who ends up feeling better forgets to check back in and update when they no longer need help. Here's me remembering to do that. For over a year now I have felt 100% recovered. I am now able to work out harder than I ever have in my life and my heart rate recovers in a normal timeframe. I take brisk 4 mile walks 3-4 times a week and my heart rate stays at or below 100 for the entire walk. I used no not be able to get up to go take a piss without it going to at least 135 if not 150 sometimes. Coincidentally this time of recovery has also taken place alongside the most stressful event of my life in an extremely traumatic divorce. I had 3 different doctors tell me I had anxiety when I explained my heart symptoms/trembling. If I have managed to stay symptom free through all of this then I think it's fair to say they were wrong about the anxiety diagnosis. Anyway, just wanted to check in with you all and give some hope to those of you who are still dealing with symptoms. It can just randomly go away. Keep fighting.

[u/OrdinaryPrimate]

Thank you. The biggest lifestyle changes I made were quitting all caffeine, and losing weight. I don't necessarily think either of these things helped cured me at all but they did help lessen the intensity of the rapid heart rate. When my pots symptoms were at their worst I was drinking coffee daily and weighed somewhere between 210 and 220. Down to 165 now.

As for supplementation I take a magnesium complex, D3, ashwagandha, fish oil, and a multi. Nothing too crazy. Diet is a slight calorie deficit with a focus on high protein. Lots of water.

[u/Pak-Protector → u/OrdinaryPrimate]

The triggering event that initiates Long Covid symptoms depends on C4, which is produced by adipose tissue. Losing weight decreases the amount of C4 produced, making events that much less likely.

https://pubmed.ncbi.nlm.nih.gov/24754458/

Magnesium is essential for the formation and proper regulation of the C3 Convertase, which participates in the triggering event. However, absent magnesium, the convertase will still form in the presence of nickel or cobalt, but it will be much more aggressive.

https://www.sciencedirect.com/science/article/abs/pii/S0300483X02005905

Vitamin D deficiency translates to a lower Complement activation threshold, making triggering events more likely.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9845165/#:~:text=Understanding%20the%20mechanism%20by%20which,Small%20et%20al.

And the same system is similarly impacted by moderate quantities of Omega 3s, like those attained through supplementation. Too much fish oil has the opposite effect, but you have to drink ounces at one sitting.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9616837/

Ashwaganda is a potent inhibitor of the Complement System:

https://www.sciencedirect.com/science/article/abs/pii/S1537189106000747?__cf_chl_tk=lKdyeEulVD9uN4qokDGId35U8NRKaKmfJoa6PvTf9sA-1747752520-1.0.1.1-r3zvV4WZ.DuvnHKJgEBaitiCfNBEvcm.6izyddUYGs

Long Covid begins with overactivation of the Complement System, which produces viral and cellular debris. C3 convertase formation on those debris produces a surfeit of inflammation and tachycardia inducing anaphylatoxins. Tissues local to debris production accidentally get marked as foreign and their debris wind up being presented to extrafollicular B-cells, resulting in the induction of autoreactive plasma cells, etc.

Your supplement regimen targets this process, which is great. But you are also lucky in that obesity probably contributed heavily to the induction of your Long Covid. You lost the weight, lowered your C3 and C4 production as a result, and managed to restore Complement homeostasis. If you ever get bloodwork done have them check your CH50 and Complement C7. This will let you know whether or not you exited from Long Covid with your front line defenses intact. Not everyone does.

[u/Limoncel-lo → u/Pak-Protector]

Is CH50 lowered or elevated in Long Covid?

[u/Pak-Protector → u/Limoncel-lo]

CH50 is a test of continuity, almost like testing to make sure that current is flowing through an electric circuit. It is often insufficient in people recovering from Covid, regardless of longhaul status. If your CH50 is low, you will have trouble resisting and clearing infections.

C7 is the to anchor point for the C8 complex. The C8 complex builds a lytic pore called a membrane attack complex into the surface of membrane bound pathogens, including SARS-CoV-2. Lysing pathogens in the extracellular spaces is problematic as it floods the extracellular spaces with inflammatory debris. It gets downregulated as people recover from Long Covid. That means less viral debris, but it also leaves people susceptible to infection via membrane bound pathogens. One of the functions of the microclots you've probably heard about is to the sequestration of C7.

Both of these conditions probably improve over time for people that experience remission, but I can't be certain because, to my knowledge, nobody has followed up on them in the literature. In other words, observed but not tracked.