🧵 Supplement #3 in Long COVID: N-Acetylcysteine (NAC)

Cheap, FDA-approved, widely available. And it may do something the other supplements don't: directly degrade the SARS-CoV-2 spike protein.

Evidence and mechanism below. 🔽 NAC is a precursor to glutathione, the master antioxidant.

In long COVID, oxidative stress is elevated, glutathione is depleted, and endothelial cells are generating excessive reactive oxygen species. NAC replenishes glutathione directly.

🧵 Supplement #2 in Long COVID: Creatine Monohydrate

Creatine has become a bit of a meme on X, I'll admit. However, two published trials now show it significantly reduces fatigue and improves symptoms in post-COVID fatigue syndrome.

Here's the mechanism and the evidence. 🔽 Why would creatine help long COVID?

Long COVID disrupts mitochondrial energy production. Creatine, as phosphocreatine, is an immediate energy reserve — it rapidly regenerates ATP during periods of high energy demand.

In a system where mitochondrial ATP production is already impaired, phosphocreatine buffering becomes critically important.

🧵 Starting a 10-part series on the supplements with the best evidence for Long COVID / PACVS.

Not wellness content, but published trials, mechanisms, and honest assessments of effect sizes. Starting with the strongest evidence and working through.

Follow for the full series. 🔽 🧵 Supplement #1 in Long COVID: L-Arginine + Vitamin C

This is the most robust evidence we have for any single supplement in long COVID. A published RCT, n=56, peer-reviewed in Nutrients (2022).

Let me walk through what it found and why it matters mechanistically. 🔽pubmed.ncbi.nlm.nih.gov/36501014/