I am not very fond of short, “unimportant” articles, it feels intellectually lazy, so I will do what I usually do, a complexity-framed analysis. Good news first, and the background for this is the last article I published on Ketogenic Diet.
Long Covid, or any post-viral syndrome for that matter are incredibly complex conditions, multifaceted, often a byproduct of not one, or even two interactions, but a multitude of changes in the body. And as Hippocrates said “Everything begins in the gut” and almost all healing may start from the same place. I have suggested fasting as a no-cost, potent Covid/Long Covid/mRNA damage since late 2020, followed by the same proposition from many researchers.
Improvements during long-term fasting in patients with long COVID – a case series and literature review
Case description: We present a case series of 14 COVID-19 patients with post-acute symptoms who underwent medically supervised long-term fasting (6 to 16 days) according to the peer-reviewed Buchinger Wilhelmi protocol. The EQ-5D-5L questionnaire and visual scales were used to evaluate the intensity of the symptoms, retrospectively during the acute phase, and prospectively before and after long-term fasting. Blood tests were also performed before and after fasting. Thirteen patients reported that fasting caused an enhancement in their perceived overall health. Only one patient had no improvement. Both frequent (fatigue, breathlessness, muscle and joint pains) and less frequent (cognitive impairment, smell and taste disorders) sequelae ameliorated. Body weight and other risk factors for cardiometabolic diseases like blood pressure, blood glucose, total cholesterol, low-density-lipoprotein cholesterol, and triglycerides were reduced. No severe side effects occurred.
Discussion: This case series reports beneficial changes in self-perceived symptoms in patients with long COVID after long-term fasting. This highlights the potential of long-term fasting as an effective intervention for managing and treating long COVID.
While light on my favored type of data, biological markers, and all those complicated protein-network “thingies”, it is a solid step in the right direction. It is straightforward per the description. A small group of patients supervised by doctors fasted between 6 to 16 days and experienced improvement in different symptoms.
The Discussion section of the paper brings up how and perhaps why the patients experienced an improvement in their symptoms, and it is because of the systemic modulatory effects of BHB (Beta-Hydroxybutyrate), the most abundant ketone when you either go into a ketogenic diet or fast over an average of 24 hours. Because that is what a keto diet is, a state that mimics fasting.
Fast will remain the primary and most significant adjuvant treatment option (adjuvant means together with something else) for a sizable portion of Long Covid patients, but here is a caveat and a colossal disclaimer.
Long-term fasting, over 5 days has profound effects on human physiology, I have observed people who developed rashes all over the body on days 5, and 6 because your body is breaking down everything. Including biofilms, bacteria, and fungi, it is “deep cleaning” the house. Coming out of a long-term fast by eating large, calorie-dense meals can lead to Refeeding syndrome, which can be dangerous.
My advice if you can’t get medical supervision to execute long-term fasting, is to slowly build towards it. Week 1 - Fast 24 hours, Week 2 - Fast for 48 hours, and such. The trick to handle long-term fasting is ingesting sufficient amounts of magnesium, potassium, and sodium. Do not under no fucking circumstances get out of long-term fasting by eating a carbohydrate-heavy meal.
Now here is where we diverge from the current paradigm, and currently, there isn’t much published evidence on this. One way to hack your metabolism into mimicking a long-term fasting state is by adopting a low-carbohydrate diet + supplementing with exogenous BHB. Some of the most complex cases I have dealt with had great success with this approach, but there are individual differences, and for some, there was no end-point (autoantibodies make everything harder to treat, so far).
Leading us to the next section of this piece. I have waited for quite a while but the following paper is behind quite an annoying paywall, so we will need to rely on other sources of information to build into the subject. A rare occasion, but the paper is quite significant.
Gastrointestinal fungal dysbiosis is a hallmark of several diseases marked by systemic immune activation. Whether persistent pathobiont colonization during immune alterations and impaired gut barrier function has a durable impact on host immunity is unknown. We found that elevated levels of Candida albicans immunoglobulin G (IgG) antibodies marked patients with severe COVID-19 (sCOVID-19) who had intestinal Candida overgrowth, mycobiota dysbiosis and systemic neutrophilia. Analysis of hematopoietic stem cell progenitors in sCOVID-19 revealed transcriptional changes in antifungal immunity pathways and reprogramming of granulocyte myeloid progenitors (GMPs) for up to a year. Mice colonized with C. albicans patient isolates experienced increased lung neutrophilia and pulmonary NETosis during severe acute respiratory syndrome coronavirus-2 infection, which were partially resolved with antifungal treatment or by interleukin-6 receptor blockade. sCOVID-19 patients treated with tocilizumab experienced sustained reductions in C. albicans IgG antibodies titers and GMP transcriptional changes. These findings suggest that gut fungal pathobionts may contribute to immune activation during inflammatory diseases, offering potential mycobiota-immune therapeutic strategies for sCOVID-19 with prolonged symptoms.
Fungal infections at any stage of Covid infection have been a large interest of mine since early 2021, for two main reasons. First, fungal infections are pernicious at best and often hard to deal with, it is an uphill battle. Two, they often follow something else, a common secondary infection after aggressive viral infection being the primary example here, other reasons also play a role, but these are the ones easier to understand.
At this point, and as a trend in regard to papers with these perplexing findings, researchers here also used samples from patients who suffered severe Covid infection, as a very simplified rule of thumb, the massive viral load of a severe infection is usually what sets off Long Covid (again, extremely simplified).
After analyzing the samples of many patients from a hospital in New York the researchers found that certain fungi (yeast is the correct term here) are increased in the gut of these patients, especially Candida Albicans.
After culturing Candida from these patients and transplanting it to mice, they observed the very same similar trend found in the severe patients, higher levels of neutrophils, your primary cells to fight and clean off fungal infections, both in blood and lungs of the animals, and signs of heightened inflammation. Testing the blood of the patients up to a year after the severe infection, they still found high levels of antifungal antibodies.
When looking into the cells (stem cells) that can become neutrophils, the cells were hardwired to respond aggressively to fungi, by producing more IL-6, a master inflammatory protein. Blocking IL-6 or using antifungal treatment helps mitigate all these effects. “Ok, why this is so important, even after so long ?”.
Well, it is complicated, there are many variables, and many different interactions between different viruses, bacteria, and fungi/yeast, but it is very simple to explain with just one single aspect. In 2021 a now widely known paper found evidence of drastic change in immune responses after mRNA vaccination to different bacteria and fungi (and a recent paper basically reproduced the findings, which I intend to write about but our friend DoorlessCarp wrote about it recently), with one of the most significant ones being Candida.
A common misconception, is “responding with more inflammation = more protection” which is not the case with any pathogen, but especially with Candida Albicans. A more inflammatory response here can lead to Candida using different measures to escape the immune system, which creates long-term effects, such as the pathogen creating biofilms.
Higher levels of IL-6 allied with high levels of Neutrophils will invariably lead to NETosis, the “neutrophil trap” your body uses to trap and kill invading pathogens, and this leads to clotting, it can aid neurodegeneration, autoimmunity, fibrosis, fuel cancer (I wrote how to deal with NETosis here), it will fuel the deposition of misfolded proteins such as amyloid beta. This is outside the scope of what the authors intended in their paper, but the “stalk” of the Spike Protein directly interferes with the Cholinergic system and directly interferes with how the body may respond to Candida.
This is important for manyfold reasons. Candida is opportunistic, it sticks around for a long, it is “besties” with Herpes Simplex, by both making Candida adhere and create biofilms and using the biofilms to escape the immune system and incite inflammation (imagine this interaction as a sniper hidden from enemy forces), all these complex interactions leads to more inflammation, more HERV expression, therefore creating not one, but many different feedback loops that can lead to both neurodegeneration or cancer.
All the information presented and referred to here is necessary to help the most amount of people we can. Vaccinated or not, but they need more of our help than others for now.
Fasting, and the ketogenic diet/BHB are able to deal with Candida infection, viral infections, inflammatory responses, and all these complex interactions. It is a very helpful tool in the toolset. I can’t emphasize enough how helpful these are, so I will repeat myself sometimes.
The article above is highly complex, but I would highly recommend you read it if you missed it. This one is much shorter, but as significant, on how SARS-CoV-2 Infection and corticosteroid usage both disrupt the “immune memory” and your cells don’t fight fungal infections as they should. I will leave you with two visualizations to hopefully help you understand the complexity and how the pieces fit together.
Click on the image or open in a new tab for the full high-resolution map.
The internet is filled with different methods on how to deal with fungal infections, and doctors can easily help you by prescribing antifungals if necessary, but for the “I prefer a completely natural approach” here is a fairly extensive review on herbal extracts with antifungal activity against Candida albicans. You must download the paper to read it, it is completely free.
Many of the supplements I suggest help clean, and actively fight Candida too, and both Berberine and Metformin have strong anti-fungal and anti-candida properties, especially when the yeast resists treatment.
From a healthcare perspective, special attention to Candida is necessary, because it contributes to many diseases, it disrupts normal immunological function on its own, but when you add SARS-CoV-2 and latent viruses, it can create easy-to-miss but important and complex interactions that can disrupt and degrade quality of life at a minimum.
I hope this helps you understand these complex interactions and their potential consequences better, and how you can address them if it ever becomes a problem for you or someone you know. At some point in the near future, I need to just “clean house”, and summarize and contextualize many of my articles, given how much information and how extensively linked they are.
I appreciate your support !
While dense in further reading material, and in references, I decided not to overcomplicate this one. Galectin-3 plays a SIGNIFICANT AND CENTRAL ROLE on all of this. I may come back to Galectins in 2024, maybe.
Also, primary exposure to endotoxins/LPS vehemently dictate how your body responds to secondary exposure to different fungi, including Candida. Another complex angle to further investigate, and another angle it is referred in one of my other articles.
I wish everyone a great week ahead.
This east confirms all my instincts on my sons’ mysterious issues. Inflammatory responses that cause irregular heartbeats and rashes and anaphylaxis with no known causes or “allergens” in two boys... they are both offered corticosteroid steroids that I always instinctively reject using... and we try our best to fight off fungal growth etc. But when dealing with kids who just want to be normal and eat the normal foods teens eat (absolute crap and junk) it is so difficult to get them to undertake a diet that they feel is restrictive and “weird” even if it means that it will help them heal and he be well. Ugh.
Adults will pursue these things because they value their health and are willing to sacrifice in order to achieve those ends. Convincing teens to do this is a giant hurdle. Also because none of the doctors or specialists ever suggest fasting or ketogenic diet as a remedy I’m just the weird mom who reads the stuff compiled by a guy named JP on substack 😂. But it’s not funny really.
No matter how much science supports this when mainstream medicine does not follow the science they undermine the very remedies that are needed by so many people! It’s beyond frustrating.