PEM Recovery Protocol

Here are the 3 main pillars of the treatment protocol that cured my physical PEM:

I designed this protocol with the idea of clearing persistent SARS-CoV-2 virus.

My goal was to do everything I could to both fight the virus directly, as well as optimize my immune response to give my body the best possible chance of fighting it off.

Each piece of the protocol is meant to work synergistically - it all fits together.

left: selfie of me, wearing a gray KN95 masks. Right: Photo of the evening sky. You can see the moon. The sky is still light blue, and the clouds are lit up pink by the sunset. — The view from my studio apartment

My plan has 3 main pillars:

1. Mitochondrial & Metabolic Support (began Feb. 2024)

I considered this pillar to be the foundation. Before I added in any specific antiviral interventions, I wanted to do everything possible that I could in a broad sense, to help my body fight off the virus.

As I researched, I found there were nutritional antivirals you can take/eat that make your body less hospitable to the virus.

I looked at supplements to boost the health of the immune system, helping to give my T-cells and natural killer cells the energy needed to do their job.

left image is an illustration of a T cell. It's a circular orange colored blob with what looks like clear blue bubbles surrounding it. To the right is an illustration of a glutathione molecule. It features a black backbone with white, red and yellow atoms attached to it. — T cell (left) and glutathione molecule (right)

In particular, I targeted the glutathione pathway, after finding evidence that this endogenous antioxidant is often depleted in other chronic infections such as Hepatitis C and HIV.

I began everything in this pillar in Feb. 2024, several months before the antivirals and peptides. Although I’ll never know for sure exactly what role these interventions played, within a few weeks I was able to fully stop the anticoagulants I’d been tapering off of since the previous fall. (See my full Timeline post for more!).

2. Antivirals (began June 2024)

While it’s not clear that SARS-CoV-2 is actively replicating in all Long COVID patients, I decided the evidence from several preliminary papers was compelling enough that I didn’t want to overlook the very strong possibility. So I included an antiviral that’s known to fight SARS-CoV-2.

I was heavily influenced by this work by Johan Van Weyenbergh, PhD, and team. They found that Long COVID patients had SARS-CoV-2 RNA in their bloodstream - and that these amounts decreased or even vanished while the patients took a 15-day course of the antiviral drug Paxlovid:

3. Immune Stimulant Peptides (began June 2024)

I took note from leading researchers who hypothesized that antivirals alone may not be enough to clear persistent virus in Long COVID. That’s because while an antiviral can halt viral replication, we still need our immune system to clear out infected cells - and that process is likely not happening as needed in Long COVID.

I used what are called “thymic peptides” - they are signalling molecules produced by our own thymus gland and play important roles in immune function.

Chemical Structure of Thymosin Alpha 1 - Credit MedioPT

I took two different peptides, which are very closely related. They are:

Thymogen alpha 1 (a combination of two smaller peptides, Glu-Tryp (thymogen) and Immune Peptide A2 (Lys-Glu)
Thymosin Alpha 1 (studied in other viral diseases like Hep B and C and HIV)

Essentially, these peptides increase the virus-fighting ability of our immune cells, and also make it easier for our immune system to see which cells in our body have been infected, and need to be cleared.

By October 2024, my physical PEM was gone.

photo of me standing in a nature preserve. I'm wearing a black tank top and a black baseball cap, and my hair is in a braid. i'm squinting towards the camera as the sun is in my eyes. behind me is a path of mowed grass, with long brown grass on either side. the path leads up a hill. — The day I realized my PEM was gone!

You can see my full Timeline for all of the details of my story :)

I believe my PEM was caused by the persistence of the SARS-CoV-2 virus.

I am still stable now, over a year later. The chemical reactions in my cells feel normal. I no longer get that sick, horrible, exhausted feeling from doing practically nothing.

I don’t have to plan my days around the most basic of energy expenditure. If I overdo things and lift something heavy, I don’t need the next 3-4 days to recover - I can basically forget about it, knowing my muscles will repair normally.

I can exercise - with one major caveat, that I may have developed damage to my leg veins called an iliac vein compression as part of Long COVID. I’m working on figuring that out now.

However, my energy levels are stable, and I can live a normal life without having to factor in PEM recovery time.

I never thought I’d get free of this symptom - and yet here I am!

Note: Anticoagulant Therapy for Microclots contributed to my recovery as well.

I started this treatment in June 2023, about a year before starting the antiviral protocol. It significantly raised my baseline, although it wasn’t a cure in itself.

I chose to include it here, as I’m not sure how the protocol would have affected me if I hadn’t done the anticoagulant treatment first. I believe Long COVID microclots are downstream of SARS-CoV-2 persistence. It’s possible it wasn’t necessary to treat them specifically, and that all I needed was to focus on clearing the virus.

However, I think it’s highly possible that treatment actually helped me clear some virus in and of itself, based on how much I improved. I think it’s possible that interrupting the microclotting process may have somehow inhibited viral replication or spread within the body. In addition, perhaps the increased blood flow would have allowed my body to fight back better.

So I thought it was important to mention here, so everyone reading this gets the full story. If I’m ever reinfected, I plan to these medications too, just to be safe.

I’ll be explaining in more detail!

In future posts, I’ll be explaining more about the nitty-gritty of each step of the protocol - why I did what, and which specific mechanisms I was targeting.

Long Covid Be Gone