LongCovidPharmD Profile picture
Aug 3, 2022 22 tweets 7 min read Read on X
SERRAPEPTASE, LACTOFERRIN, & THE POWER OF BIOFILM BUSTERS?⚔️🦠🤺

My surveys suggest serrapeptase added to NK or LK may improve #longcovid symptoms moreso than LK or NK alone.

Why?

One important factor may involve biofilm degradation.🧵
ncbi.nlm.nih.gov/pmc/articles/P…
Per NIH, 65% & 80% of all microbial and chronic infections, respectively, are associated with biofilms. Biofilms are microorganisms surrounded & protected by an external matrix. They help microbes hide out & evade the immune system. frontiersin.org/articles/10.33…
There’s also no denying that SARS-CoV-2 reactivates latent infections like EBV, HHV-6, CMV, et al. This “great awakening” could be another source of #LongCovid symptoms.
Biofilms are not limited to bacteria but can also be utilized by viruses. Some viruses can come into contact w/ pre-existing biofilms & colonize. Prelim evidence even suggests that SARS-CoV-2 virions may aggregate together into biofilm-like complexes!
pubmed.ncbi.nlm.nih.gov/24184317/
This preprint examined microscopic images of coronaviruses and found “clues pointing towards the occurrence of (possibly transient) SARS-Cov-2 aggregates, in which virions tend to be amassed in multiparticular complexes…that resemble bacterial biofilms.” preprints.org/manuscript/202…
Authors found that when SARS-CoV-2 particles stuck together, this induced a 3D conformational change that facilitated much tighter packing and ability to fit more virions into a given space. ImageImage
Serrapeptase is an intriguing proteolytic enzyme w/ a diverse range of activity including improved microcirculation, anti-inflammatory effects & biofilm degradation. Multiple studies suggest SP supplementation improves antibiotic efficacy. pubmed.ncbi.nlm.nih.gov/3525882/
This 👆🏼human trial found that SP significantly increased antibiotic concentration in desired tissues when compared to antibiotic monotherapy. Authors concluded, “the combined use of [antibiotic] & serrapeptase should stimulate permeation of the antibiotic into tissues"
Similarly, lactoferrin has also demonstrated the ability to improve antibiotic efficacy via anti-biofilm activity. In this study, lactoferrin also enhanced the dispersion of matured biofilms!
pubmed.ncbi.nlm.nih.gov/34454095/
Among other things, lactoferrin may also:
1) leach iron--an essential nutrient for microbes--from biofilms
2) enhance natural kill cell cytotoxicity, which has been shown to be impaired in both ME/CFS & Covid.
frontiersin.org/articles/10.33…
It's possible SARS-CoV-2 could be persisting in its own biofilm-like clumps, colonizing pre-existing biofilms, or activating latent infections.

Degrading these biofilms could release bad microbes from hiding so they are more vulnerable to attack, binding & removal.
Serrapeptase Dosing:
Human studies range from 20,000 SPU to 120,000 SPU total daily dose, with smaller doses at more frequent intervals preferred (i.e., 40,000 SPU three times daily on empty stomach). Enteric coating may improve efficacy.
Lactoferrin Dosing:
100-1000 mg typical range; up to 4.5 g w/ no apparent toxicity
32 mg 6 times daily of a special liposomal formulation + zinc showed efficacy in one small Covid study.
Jarrow Formulas 250 mg QD on empty stomach may be good starting dose.
ijrhs.org/article/2020/8…
NOTE:
With biofilm or amyloid clot breakdown may come a release of pro-inflammatory fragments or toxins ➡️ adverse effects ("Herxheimer"-like reaction). Concurrent supplementation w/ monolaurin, baicalin, EGCG, et al may help vanquish harmful debris & lesson side effects.
Binders like activated charcoal, bentonite, & chlorella may help detoxify further. An added benefit is heavy metal binding & removal--especially important when taking multiple supplements. Binders must be taken mindfully--separated from meds/food--and warrant their own thread.
TL;DR
1) Biofilms may play a role in Long Covid or post-viral ME.
2) Anti-biofilm supplements like serrapeptase and lactoferrin may help release microbes/toxins from hiding.
3) This release may facilitate ⬆️ efficacy of other supplements.
4) Side effects/"herxing" possible
This RCT evaluated the efficacy of two supplements in #LongCovid.
1) ImmunoSEB: enteric-coated serrapep, lactoferrin, bromelain, amylase, lysozyme, peptidase, catalase, papain, glucoamylase
2) ProbioSEB: Bacillus coagulans/subtilis/clausii ncbi.nlm.nih.gov/pmc/articles/P…
n=200 (100/100)
14-day trial
ImmunoSEB/placebo 2 caps BID daily, empty stomach
2 capsules ProbioSEB/placebo QD w/ lunch
Unfortunately authors used Chalder Fatigue Scale which is prone to skewing results. ImageImageImage
Authors concluded the supplements "significantly reduces the burden of both physical & mental fatigue [in early covid recovery]...many of whom continue to experience severe fatigue including muscle weakness and “brain fog” several months after initial infection."
While I am not impressed w Chalder scale, I do think the active ingredients in ImmunoSEB make sense. Note the ImmunoSEB included not only serrapeptase & lactoferrin but also bromelain, which shows anticoagulant, antiplatelet & immunomodulatory effects. ✅
The pair of supplements studied in the👆🏼RCT is available for purchase. While I don't typically start off with combo supplements--I prefer building monotherapies one-by-one to see how each affects me alone first--this looking intriguing.
(No affiliation)
amazon.com/ImmunoSEB-caps…
The trial serves as a reminder that when supplementing aggressively with proteolytic enzymes, biofilm busters +/- binders, probiotics are warranted to encourage & retain a healthy microbiome.

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More from @organichemusic

Nov 30, 2023
In a new version of my TREAT ME survey, I presented a list of health conditions and asked long haulers to indicate if they had each condition *before* or *after* COVID, if at all. The results suggest that MANY long haulers develop new & disabling conditions post-acute COVID.🧵 Health conditions before & after COVID in Long COVID patients (n = 214) - summarized in tweets below
For example:

👉5% reported immune dysfunction pre-COVID, while 21% developed it post-acute COVID.
👉1.9% had POTS pre-COVID, while 41% developed it post-acute COVID.
👉0% had ME/CFS pre-COVID, while 46% developed ME/CFS post-acute COVID.
⬇️
👉27% had migraines pre-COVID, while 24% developed migraines post-acute COVID.
👉2.8% had MCAS before COVID vs 16.4% post-acute COVID
👉1.4% had clotting disorders pre-COVID, while 11% developed clotting issues post-acute COVID.
⬇️
Read 6 tweets
Nov 19, 2023
People w MIGRAINES may be predisposed to develop ME/CFS or Long COVID.🧵

"Post-COVID headache" is well-known, and many w/ pre-existing migraines notice their migraines worsen post-COVID. This makes sense as both Long COVID & migraines can involve impaired neurovascular coupling.
Based on my survey data, it appears a disproportionately large % of pwME & pwLC had migraines before developing ME or LC:

In the general population, ~6% of men & 17% of women experience migraines. In those w/ LC, however, 11% of men and 31% of women reported pre-LC migraines.⬇️
It's nearly the same in the ME group w/ 12% of men & 31% of women reporting pre-ME migraines.

Another 24% & 21% of those w/ LC or ME reported experiencing new-onset migraines after developing LC or ME.

Migraines in ME & LC are a big deal & warrant further study!

Treatments⬇️
Read 7 tweets
Oct 4, 2023
More evidence supports the use of both GREEN TEA and BLACK TEA to battle COVID.

This further strengthens my past recommendation to swish, gargle and drink green (or black) tea for COVID mitigation and prevention.
nature.com/articles/s4159…
Study confirmed that EGCG in green tea & TFDG in black tea bind to the RBD of the spike protein & inactivate multiple SARS-CoV-2 variants to varying degrees.

Authors also found that the SALIVA in those who consumed black/green tea candies for 5 minutes reduced viral titers.👇 Figure illustrating that compared to dextrose 2% in water, sencha, matcha, black tea and bottled green tea beverage at final concentrations of 90% of original tea beverage significantly reduced viral titers of SARS-CoV-2.
Compared to placebo candies, the black & green tea candies reduced viral titers by ~1000 order of magnitude. The effects lasted for about 5 minutes, wearing off likely due to quick saliva flow rate.
Graphical depiction showing that green tea candy significant reduces viral titers ~1000x over a 5 minute timespan whereas placebo does not
Image
Read 8 tweets
Jul 4, 2023
Dear Friends,

How are you? I've been on a Twitter break, but I wanted to provide an update.

First, the main reason for my break was that I found a more covid-safe school out of state for my child, so I've been traveling and figuring out the logistics for relocating.⬇️
The school has very sophisticated HVAC system with 6-7 air changes per hour! Plus the classroom sizes & overall population are smaller. Overall I feel thrilled to have found this place, but as you all know, moving is incredibly stressful & exhausting even for a healthy person!⬇️
The school is expensive as is the cost of living in the area so I've been looking for a job to help cover tuition. However, retail pharmacies don't want masked pharmacists & remote jobs are hard to find, esp with so many disabled #pwLC competing for part-time remote positions⬇️
Read 6 tweets
May 4, 2023
Linked are articles #1 & 2 in a series of many detailing individual treatment results from #TREATME survey. At a later date, a comprehensive overview & analysis of pertinent data will be shared.🧵

#1: NK, LK, SP
pharmd.substack.com/p/treat-me-sur…
#2: Immunoglobulin
pharmd.substack.com/p/treat-me-sur…
OVERALL CONDITION
Over 81% on SCIG (n = 11) & 72% on IVIG (n=29) reported their overall condition improved. Strikingly, >52% reported feeling moderately to much better w/ >27% of the 38 respondents feeling “much better.” This is significantly better than most other surveyed txs! Survey result chart showing...Comments from survey respon...
TIME TO IMPROVEMENT
Responses varied substantially. 9 out of 25 (36%) respondents reported it took just 1 to 2 rounds of therapy before starting to feel better, while on the other extreme, 8 out of 25 (32%) respondents reported that over 10 rounds of IgG were required. Chart showing what was desc...
Read 10 tweets
Feb 19, 2023
#TREATME
Check out the charts for #longCOVID & #MECFS to see how enzymes like NK stacked up against aspirin, Plavix, DOACs (example: apixaban), and heparin. I won't do a deep dive until I gather more data & close the survey but wanted to share some data so far!🧵
Very Quick thoughts:
1) Oral anticoagulants alone looks subpar in #pwLC likely bc they only prevent clot formation & don't degrade existing microclots. Goal is to give body a break so it may clear clots on its own, but some may be too sick to achieve this.
1) cont..
Also note small sample size, so can't draw strong conclusions yet.

2) Many #pwLC may have hyperactivated platelets so it would stand to reason than antiplatelet meds would help. While just 38% reported aspirin ALONE helped, 60% benefited from dual antiplatelet therapy.
Read 10 tweets

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