The Cause of Post-Exertional Malaise (PEM) in Long-COVID

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Did you ever wonder if fatigue and PEM are the same or different?

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00:00 Introduction
00:21 Review of study methodology and findings from recently published paper by Rob Wüst, et al in Nature Communications
07:06 Conclusions from the study
09:00 Why this research is exciting

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Dr. Stein retired from medical practice at the end of 2022 to bring everything that she learned, over 33 years, about Myalgic Encephalomyelitis, Chronic Fatigue Syndrome (ME, CFS), Fibromyalgia (FM) and Environmental Sensitivities (ES), Long COVID, and chronic pain to anyone worldwide wanting to take charge of their health and improve their quality of life.
She became ill with ME/CFS, FM, and ES in 1989. Since then, she learned that she has the full alphabet of related conditions including joint hypermobility, orthostatic dysfunction, and Mast Cell Activation Syndrome (MCAS). Her passion is to help others with these conditions and to make their journey to healing easier and faster than hers was.

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Access many free and paid resources on her website:
Find her on social media:
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#longcovid #chronicillness #longcovidrecovery #pacing #postexertionalmalaise #dreleanorstein #covid_19 #covidresearch #learning #education

[aprilgarnett]

This majes so much sense, i have been saying for years now that i feel like im not getting oxygen, even when im taking deep breaths! Like, i can feel like my tissues are starving for air, i don't know how to explain it. Long covid for 4 years, march 2020. Used to be an athletic, super fit, active person. Now, bed or couch most days, but try to exercise any day i feel good enough to try. Then feel like absolute garbage after for days. This is crazy

[Zeepjeliefs]

After covid I got vestibular neuritis, than the flu. I'm still recovering two years later. Last summer I was still housebound and at times bed ridden for a couple of weeks. I was super scared at my worst, mostly of worry about my future and because I had become slowly worse in this period. I watched a lot of video's from people who have gotten better from ME and CVS. I tried to stay calm and kept saying to myself I can't predict the future. Now December '24 Im doing better. I'm can feel myself getting stronger and feel good when I wake up. I'm not at my old activity level at all. But more out of the house nowadays. I see this as a sign that I'm doing better. One day I even walked 3 km. Take care people I had so many setbacks I know what it feels like. But please don't ever give up on hope!

[georgjrgensen]

Thank you so much. As a relatively mildly affected LC patient I sincerely hope that medical science will find a way to (partially?) cure LC. Literally millions of people would be hugely grateful!

[Blackpool]

Doctor Stein - you have a new subscriber. I'd found you on Raelans channel and the advice that stuck with me as a 21 month long hauler is that if the 17th thing didn't work, try the 18th. If i didn't have MCAS/anaphylaxis reactions, id be wiling to try the 200th thing.

But this video is a gem. I needed to hear what I deep down believed to be the case right since the 2nd month of my long haul journey about the impact of the virus on oxidative phosphorylation.

I think viral persistence in the form of viral debris or intact spike proteins in huge sludge-like quantities that has shifted the body from normal oxidative phosphorylation to lactic or glycolysis type of energy delivery system.

I also think that viral persistence in the form of debris or intact spike protein in difficult to reach areas such as the CNS/Brain/ Brain stem is reason behind why patients are forced to stay with this illness longer than they would have. Nerves they say take longer to heal thus affecting the functioning of the Autonomic Nervous systems ability to cope with stress and rest and digest.

Also, are those amyloids/misfolded proteins the root cause behind microclots in the blood?

Id love to learn more from some like you who knows what we're going through and has gone through an eternal suffering for decades.

Thank you Dr Stein :).

[garethmorgan]

Thank you for this clear explanation of very important research. I also think it's wonderful how you kindly respond to the people leaving comments. Best of luck with your channel. Subscribed !

[SarahScottLifeCoach]

Thank you so much for summarising this research; it’s near impossible to read research papers with LC brain fog. Do you have any suggestions as to potential implications of this research for treatment or self-management? How do we as patients support our metabolic function?

[jodithomas]

Excellent presentation, concise with lots of information. The question now is how do we turn back from a state of glycolysis to oxidative metabolism??? Any response would be appreciated!

[rbdesigner]

This rings true to my experience. Dr Patterson’s work agrees with this as far as viral remnants

[JennsCorner]

I got severe Long Covid symptoms after catching covid-19 three times and having several comorbilities. My most worse symptoms are breathing difficulty, GI problems & fatigue. I’m mainly bed bound. I hate covid-19 & LC!

[renaissance]

dr stein I struck gold when I found you just subscribed thank-you

[alisonbamford]

B vitamins are crucial for Nervous System functioning, energy (ATP) generation & digestive function, especially B1 & B12. They all directly or indirectly play a role & all support each other, however these two are major players, but many people are very deficient.

Thiamine is often lacking because the modern highly refined & processed wheat & sugar-laden diet places demands for a far higher amount of it in the body than it supplies. So, many have gone into CV already deplete. B12 can be deficient because many lack the biome microbes that metabolise & synthesise B vitamins. Even if they get enough in their diet & can absorb it, the process that converts it from inactive to active for use at cellular level may be failing at some point. And if it cannot get into the cells, it doesn’t matter how much shows in the serum test - which does not determine how much is active or inactive, only the total.

B Vitamins, along with other nutrients like Magnesium, are part of the body’s ‘stress-management’ armoury. Any stress or trauma, whatever form it takes, can rapidly deplete these crucial nutrients. We’ve all gone through a hugely stressful & traumatic period. If people were already deplete in these vital nutrients, it’s pretty inevitable that they could come out the other side in abject deficiency along with all the issues that go with that depletion.

Modern Thiamine deficiency is a whole different animal to the historic textbook versions.

This article penned by Dr. Derrick Lonsdale & Chandler Marrs who wrote the tome ‘Thiamine Deficiency Disease, Dysautonomia & High Calorie Malnutrition’ is extremely interesting.

[Awesomes]

Thank you for your work here. This disease is hell.

[garnerblair]

Excellent comments here . I recall a study not long ago about iron anemia in some long-covid/vax patients. Knowing the function of hepcidin would be helpful as you would not want to supplement iron in this situation. So i see several things when trying to recover ; restoring the gut biome, repair/replace mitochondria, reduce inflammation, chelate iron stores/reduce hepcidin.

[davec]

I think anything you can do to lower stress of any kind helps, and the root cause is an irritated nervous system that won't return to normal due to stress, forming a feedback loop. This is why so many different things both physical and mental can help, and any of them can be "the straw that broke the camels back", but in this case the straw that finally allowed recovery. There's tons of accounts of this issue, along with the myriad of other LC symptoms, resolving... recovery is definitely possible. A holistic mind/body approach will, imo, prove to be most effective, but nobody is an expert in all aspects of this condition.

[garnerblair]

It is interesting to note that when neutrophils acted on spike protein with neutrophil elastase formation of amyloid fibrils was observed .

[duneideann]

I have started taking CoQ10 supposedly it repairs / boosts the mitochondria
I don’t feel so Potsy standing up now but still suffer severe PEM
I will keep trying it for a while and see how it goes
Anyone had good results with CoQ10 ?
I am only taking 100mg

[josephkrehel]

So is this mitochondrial change reversible and how?

[carmensaez]

Móviles en la primera fase cree que es mejor mover el cuerpo poco a poco?

[rohinihyde]

In people who are vaxed and also get covid infections how would you know for sure which of the two are causing the symptoms. Has research been done to find out?

[sallyweiner]

Ugh. Its been a year now and in some ways I’m much worse with post exertional malaise