Covid and L-O-N-G Covid
COVID was not “just a lung infection.”
SARS-CoV-2 has an unusual ability to disrupt core regulatory systems in the body. In some people, those systems never fully reset or repair after the infection, even if the initial illness was mild.
Clinically, this shows up as dysfunction across six root mechanisms (people have different combinations and severity of each). It’s not single cause,so there is no single treatment. As soon as you realize this, you will be ready to get better the right way.
1. Dysautonomia
COVID can disrupt the autonomic nervous system, which controls heart rate, blood pressure, temperature regulation, breathing patterns, and gut motility. This explains palpitations, POTS, dizziness, heat intolerance, GI slowing, and adrenaline surges.
2. Mitochondrial dysfunction
The virus and the downstream inflammatory response can impair cellular energy production. This is why exertion feels disproportionately exhausting and why post-exertional crashes occur. The body’s energy “battery” does not recharge normally.
3. Endothelial dysfunction and microvascular injury
COVID inflames and destabilizes the lining of blood vessels. Impaired microcirculation means oxygen and nutrients are not delivered efficiently to the brain, nerves, muscles, and organs, contributing to brain fog, shortness of breath, pain, and exercise intolerance.
4. Hormone imbalance
COVID can disrupt the hypothalamic–pituitary–adrenal and gonadal axes, affecting cortisol, thyroid hormones, sex hormones, melatonin, and insulin signaling. Hormone instability worsens fatigue, sleep disturbance, anxiety-like symptoms, temperature intolerance, weight changes, and poor stress tolerance.
5. Mast cell activation and histamine excess
COVID can trigger abnormal mast cell behavior, leading to histamine intolerance, flushing, rashes, GI symptoms, tachycardia, air hunger, and exaggerated responses to foods, medications, heat, or stress.
6. Gut dysbiosis and barrier dysfunction
Changes in the gut microbiome and intestinal barrier perpetuate inflammation, immune signaling, nutrient malabsorption, and neurologic symptoms through the gut–brain axis.
This is why:
• Routine labs and imaging are often “normal”
• Symptoms worsen with exertion, stress, heat, or illness
• Previously healthy, high-functioning people are often affected
• One-size-fits-all treatments fail
Long COVID is not anxiety, not deconditioning, and not “just CFS”.
It is a post-viral multi-system disorder, driven by different combinations of these six mechanisms in different people.
SARS-CoV-2 has an unusual ability to disrupt core regulatory systems in the body. In some people, those systems never fully reset or repair after the infection, even if the initial illness was mild.
Clinically, this shows up as dysfunction across six root mechanisms (people have different combinations and severity of each). It’s not single cause,so there is no single treatment. As soon as you realize this, you will be ready to get better the right way.
1. Dysautonomia
COVID can disrupt the autonomic nervous system, which controls heart rate, blood pressure, temperature regulation, breathing patterns, and gut motility. This explains palpitations, POTS, dizziness, heat intolerance, GI slowing, and adrenaline surges.
2. Mitochondrial dysfunction
The virus and the downstream inflammatory response can impair cellular energy production. This is why exertion feels disproportionately exhausting and why post-exertional crashes occur. The body’s energy “battery” does not recharge normally.
3. Endothelial dysfunction and microvascular injury
COVID inflames and destabilizes the lining of blood vessels. Impaired microcirculation means oxygen and nutrients are not delivered efficiently to the brain, nerves, muscles, and organs, contributing to brain fog, shortness of breath, pain, and exercise intolerance.
4. Hormone imbalance
COVID can disrupt the hypothalamic–pituitary–adrenal and gonadal axes, affecting cortisol, thyroid hormones, sex hormones, melatonin, and insulin signaling. Hormone instability worsens fatigue, sleep disturbance, anxiety-like symptoms, temperature intolerance, weight changes, and poor stress tolerance.
5. Mast cell activation and histamine excess
COVID can trigger abnormal mast cell behavior, leading to histamine intolerance, flushing, rashes, GI symptoms, tachycardia, air hunger, and exaggerated responses to foods, medications, heat, or stress.
6. Gut dysbiosis and barrier dysfunction
Changes in the gut microbiome and intestinal barrier perpetuate inflammation, immune signaling, nutrient malabsorption, and neurologic symptoms through the gut–brain axis.
This is why:
• Routine labs and imaging are often “normal”
• Symptoms worsen with exertion, stress, heat, or illness
• Previously healthy, high-functioning people are often affected
• One-size-fits-all treatments fail
Long COVID is not anxiety, not deconditioning, and not “just CFS”.
It is a post-viral multi-system disorder, driven by different combinations of these six mechanisms in different people.
