Antihistamines should be near the top of your list of things to try for #LongCovid.
Yes, allergy and heartburn medication have provided *substantial* relief for many.
How does it work, and how do you get started? 🧵
1/ How does it work?
Histamine is in all of us, and plays a role in:
- Regulating sleep-wake cycles, temperature, and blood pressure
- Stimulating production of mucus and gastric acid
- Inflammation
It's in food, and it's also produced by your body. Too much is bad.
In an allergic reaction, your immune system alerts your mast cells of an invader, and, among other things, they produce histamine to help clear things out.
Sometimes, they're too easily stimulated and flood the system with histamine.
Some #LongCovid symptoms, including tachycardia, low bp, flushing, shortness of breath, and congestion, overlap heavily with MCAS.
Another hint that MCAS could be at play: antihistamines can provide substantial relief.
2/ How to get started
There are some tangible things you can do today.
As always, this is not medical advice, and check with your doctor before making changes to your care.
2.1/ Avoid Triggers
Some potential culprits:
* Foods and additives (e.g. sausages, sulphites, corn syrup)
* Drinks (e.g. wine, cider)
* Artificial scents
Everyone can have different triggers. Pay close attention to try and identify yours.
Mast cells have H1 and H2 receptors, and you'll need to "block" both. You'll probably need some trial and error to find the right one for each. Based on the latest research, here are good starting points
- Zyrtec for H1
- Pepcid for H2
2.3/ Try a low-histamine diet
It's also important to lower the amount of histamine in your system ingested via food. Here are some to avoid:
- Packaged rice/pasta meals
- Fermented foods
- Strawberries
- Processed meats
Two giants of immunobiology and neuroscience, @virusesimmunity and @michelle_monje, just published a preprint that reviews the latest.
Here’s what you need to know 👇
First, it appears that multiple mechanisms conspire to cause Long Covid, and any given case might have its own particular combination.
Researchers are racing to confirm these mechanisms, so we can start working on cures.
1/ Respiratory inflammation --> central nervous system (CNS) inflammation
Some impacts:
a) Disrupted myelination: electrical impulses don’t fire as well
b) ⬇️ hippocampus cell growth: worse memory and mood
c) ⬆️ astrocyte reactivity: poor blood flow and reduced neurotransmitters
It's invaluable to know how your condition is changing and if new treatments are helping.
But after talking to over 200 patients, almost nobody sticks with it.
Here’s how we could do better 🧵
1/ They don't actually help you get better 🤷
Symptom tracking should help you get better. If the tool isn’t providing insight into how treatments are impacting you and how you can get better, of course you’ll eventually stop using it.
2/ The questions are too vague 😶🌫️
“mild, moderate, severe” isn’t enough. Answers drift over time, and it won’t capture important, small changes.
More patient-informed rubrics are needed to track more accurately and consistently.
🌬 Breathwork is a not-so-hidden secret within the #LongCovid and #MECFS community, and has been described as “game-changing” and “the number 1 intervention I’ve tried”.
But how could it possibly be so helpful? How does it work? Let’s dive in.
1/ How does it work?
First off, this is not just “thinking your symptoms away”. It creates substantial changes to your physiology that can counteract some of the harm caused by Long Covid.
1.1/ Vagus Nerve (VN) Stimulation.
A disrupted VN (e.g. via persistent virus) can contribute to dysautonomia. Breathwork stimulates the VN, activating a “rest and digest” mode, potentially mitigating these symptoms and even decreasing inflammation.
David Putrino runs a research group at Mt. Sinai, is a fierce patient advocate and a great science communicator. He makes sure patients are informed and involved in the latest research.
Amy Proal is a tour de force in Long Covid research, and is the CSO of a new @polybioRF initiative focusing on viral persistence. Follow her to stay up to speed on the latest Long Covid research (and we'd recommend her interviews on Youtube as well).