Questions

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What else can I be doing to alleviate fatigue and PESE?

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The subtypes of LC are… correct?

• cardiac and renal
• respiratory, sleep and anxiety disorders
• skeleto-muscular and nervous disorders (ME!?)
• digestive and pulmonary dysfunctions

Are these connections correct? Can I try any of these therapies?

• Methylene Blue — does my SNRI contraindicate? • NAD+ — does my cancer contraindicate? | | | Autoimmune response —> Inflammation | Exacerbating hypermobility/connective tissue issues, fibromyalgia pain | • Myofascial release ✔️ • Collagen? • Red light therapy ✔️ | | | | Joint pain, skin issues | • Low dose naltrexone ✔️ • Duloxetine ✔️ • GLP1? • Metformin for anti-inflammatory? • Polymerised type I collagen as immunosuppressant? | | | | Mast cell activation —> Bloating & stomach pain | • Famotidine✔️ • Low histamine diet? | | | Metabolic dysfunction | Amino acid turnover —> | • Taurine supplements? • L-Tryptophan and L-Theanine? GABA? | | | Vascular/endothelial dysfunction | Bad circulation | • Stimulants/higher blood pressure ◦ Vyvanse ✔️ ◦ Nicotine? | | Autonomic nervous system dysfunction | Low HRV during repair stage of sleep cycle | Brain glucose (energy) consumption doesn’t drop —> Fatigue | Autonomic rehab ✔️ | | | Dysautonomia | Bad circulation/blood pooling | • Compression ✔️ • Electrolytes ✔️ • Should I be using more salt? | | | | Heat intolerance | • Hydration ✔️ • Fans, cold packs, etc. ✔️ |

Are any of my medication side effects making this worse? Cymbalta can increase heat intolerance, add to night sweats (dehydration, exhaustion) and lower blood pressure (which I needed from my stimulants, but also I feel better when my blood pressure is a bit higher…)

• https://www.idsociety.org/science-speaks-blog/2025/therapeutic-updates-on-long-covid-where-things-stand-5-years-later/

Symptoms: June 2025

• Low daily energy
• Brain fog
• Joint pain, constant and worse with activity
• Muscle pain & stiffness, constant and worse with activity
• Muscle weakness
• Nausea
• Lightheadedness/dizziness, occasional balance problems/falling
• Swelling in knees and feet upon standing for 20+ minutes
• Heat intolerance/extreme sweating
• Night sweats
• Post-exertion symptom exacerbation, of all of the above
• Raynaud’s phenomenon at cold/stress
• Frequent urge to urinate
• Dry eyes
• Occasional eczema & mouth sores

Other Issues

• Basal cell carcinoma (removed 2024)
• Recent mild concussion 5/5/25
• GERD
• ADHD
• Cystic acne
• Sun sensitivity/allergic reactions

Medication & Supplements

• Famotidine 40 mg, daily
• Vyvanse/lisdexamfetamine 20 mg, daily
• Low dose naltrexone 3mg, daily
• Lo loestrin fe, daily
• Cymbalta/duloxetine 80 mg, daily
• MitoQ CoQ10 20 mg, daily
• Protein shake 20 mg, daily
• Collagen 20 mg, ~3x a week
• Caffeine 2-5 cups of coffee, daily
• Electrolytes in water, daily

Current Treatments/Accommodations

• “Autonomic rehab” breathing exercises
• Energy
  • Pacing (avoiding activities I enjoy, exercise, standing, exertion of any kind…)
  • Using Visible heart rate monitor & Bearable app to track HRV & symptoms
  • Relying very heavily on stimulants to work
• Muscle/Joint Pain
  • Massage devices & foam rolling
  • Ice packs for temperature regulation and joint pain
  • Stretching frequently
  • Compression garments for knees and wrists (socks haven’t helped much)
• Taking frequent unplanned time off of work
• Relying heavily on memory supports at work
• Taking on less responsibility at work

What Hasn’t Worked: Celecoxib, Tylenol, Advil, heat for muscles

Crash Experience