Hi everyone!

I am very excited to announce that I have finally completed a massive #ME/CFS & #LongCOVID treatment survey entitled "TREAT ME"‼️🎉🤩

If enough people respond thoughtfully, I’m confident we may push research in the field forward!🏇
🧵1/3

surveymonkey.com/r/TREATMEANDLC
TREAT ME covers 150+ medications & supplements. Treatments were selected based on published trials, case reports, other relevant studies, results of earlier surveys I’ve written, direct patient accounts (incl lots of feedback from many of YOU🥰), and my own pharmacist intuition.
The survey has been granted IRB exemption.👍

Furthermore, @OpenMedF will be reviewing a summary of the survey results as they gather info for prospective research studies🤩😍

PLEASE join this effort to investigate #ME & #LongCOVID treatments!
Within less than 4 hours of posting the survey, I'm up to 400 responses! Amazing; I'm feeling so hopeful!

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More from @organichemusic

Jan 10
🚨When assessing cardiovascular risk, history of COVID should be considered a risk factor for cardiovascular disease.

Official treatment guidelines should be updated to account for frequent SARS-CoV-2 reinfections & Long COVID.🧵
jamanetwork.com/journals/jama/…
For example:

This atherosclerotic cardiovascular disease (ASCVD) risk calculator estimates the 10-year risk of ASCVD.

One problem: the tool does NOT consider history of COVID & thus likely underestimates risk in this enormous new population.
👇
tools.acc.org/ASCVD-Risk-Est…
The risk calculator is often used to help guide therapy decisions. For example, USPSTF determined that for primary ASCVD prevention, aspirin use has a small net benefit in those aged 40-59 with a ≥10% ten-year risk of ASCVD, but not in those age 60+.
👇
jamanetwork.com/journals/jama/…
Read 4 tweets
Dec 29, 2022
"I have COVID! What should my kids & I take to reduce chances of severe illness and Long COVID?"

This post covers my current best bets for speeding up COVID recovery and reducing the chances of Long Covid in adults & kids. I’m focusing on...🧵

pharmd.substack.com/p/i-have-covid…
...accessible evidence-based treatments w/ a good balance of safety, tolerability & efficacy.

I discuss:

3 sleep supplements w/ add'l antiviral benefits
5 best bets
4 hon. mentions

Also included:
Treatment & dosing schedule that optimizes efficacy & avoids drug interactions
I also discuss:

Dosing for both adults AND kids
How to optimize absorption w/ low bioavailable supps
When/how to take
Drug interactions when applicable
Brands
How one might combine all 12 of the treatments covered if desired
in vitro vs in vivo concentrations & calculations
etc
Read 7 tweets
Dec 20, 2022
Any #pwLC or #pwME tried CITOCOLINE?

Citocholine = cytidine + choline

Cytodine metabolizes quickly to uridine. Choline & uridine cross the blood brain barrier, promoting neuronal membrane phospholipid synthesis & reducing peroxidation.

ncbi.nlm.nih.gov/pmc/articles/P…
In COVID and perhaps ME, the blood brain barrier can become leaky, precipitating microglial activation and neuroinflammation.

In vitro studies have found that citocoline improves the endothelial barrier function impaired by hypoxia.

ncbi.nlm.nih.gov/pmc/articles/P…
Other potentially beneficial effects of citocoline:
-stimulates ACTH & may ⬆️ cortisol
-improves expression of SIRT1, thereby supporting nerve cells, ⬇️ NF-KB & ⬆️ autophagy
-enhances norepinephrine, serotonin, dopamine, & acetylcholine
-improves cerebral blood flow
Read 8 tweets
Dec 17, 2022
HIGH-DOSE EPA for LongCovid or ME/CFS?

Recently I spoke w/ an MD who has treated ~40 #pwLC with an Rx omega-3 fatty acid similar to EPA known as icosapent ethyl (IPE, brand name Vascepa) w/ promising results. Turns out, it may help #pwME too.

Details👇
pharmd.substack.com/p/high-dose-ep…
Even patients who had suffered from Long COVID for over two years reportedly experienced improvements in sense of taste & smell, fatigue, sleep, joint pain, brain fog, and hair/nail growth.
onlinescientificresearch.com/articles/propo…
This MD also treated ~140 acute COVID pts w/ IPE and reportedly none of them developed LC. The MITIGATE trial is currently investigating the ability of Vascepa (IPE) to reduce morbidity & mortality in a cohort of adults with URIs including SARS-CoV-2.
ncbi.nlm.nih.gov/pmc/articles/P…
Read 28 tweets
Nov 30, 2022
👏Good news for those with MCAS or histamine intolerance:

Serrapeptase (SP) inhibits release of histamine & thus it's plausible that SP may improve MCAS symptoms. Furthermore, co-administration of SP with nattokinase may improve tolerability & efficacy.

Update on lumbrokinase:

Some with MCAS were concerned that lumbrokinase production may involve fermentation. According to the VP of the company that manufactures Boluoke, their product does NOT involve fermentation.
Furthermore, Dr. Kwok confirms that lumbrokinase activity is reduced in acidic (gastric) pH; thus Boluoke includes acid resistant coating. This further supports my hypothesis that these proteolytic enzymes (NK, SP, LK) work better with enteric coatings.
Read 4 tweets
Nov 19, 2022
Hi!

I'm working on 4 LC/ME surveys. Which one interests you the most? See next few tweets for survey descriptions.

#1:
Covid & #LongCovid prevention: nasal sprays, probiotics, antivirals, & non-pharmacological measures that may ⬇️ infection or severity of/progression to LC.
Survey #2:

Anticoagulants/Anti-platelets (including aspirin) in #LongCovid & #MECFS - bleeding risk, what symptoms improved, how long did it take to see improvement, and do symptoms return with stopping? Compare those on triple therapy to those on monotherapy & aspirin, etc
Survey #3:

Investigates the top non-pharmacological measures from previous survey (vagal nerve stimulators, HBOT, craniosacral therapy, etc) in #LongCovid and #MECFS. Which symptoms did they help or hurt? May include sections for other post-viral illnesses if interest.
Read 4 tweets

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