Lasting Glymphatic Dysfuction after Long Covid

And Ambroxol neuroprotective effects

This may end up being short, or may end up being long, since it is an impromptu article. As a refresher, I presented the following argument in 2023, now backed by considerable evidence:

Misfolded protein build-up is not a problem, the body has multiple ways to tackle, dismantle, and get rid of them. The biggest hurdle is the clearance rate. Failure to clear the build-up efficiently is the core of the problem.

The reason the proteins build up, for example, the amyloid protein has antimicrobial properties, and tau has anti-herpes action. The body's last resort to tackle attackers in the brain, “when all else fails, enclose them in a proteic prison”…

Glymphatics and misfolded (protein) truths

In the article above, I covered, alongside many interesting papers a very important one. The researchers analyzed and demonstrated impaired waste clearance in the brain of Long Covid patients, pointing towards altered glymphatic function, likely impaired. This leads to waste build-up in the brain, misfolded protein accumulation (over a long enough time), neuroinflammation, and thus neurological symptoms, brain fog being the most common.

My recent Cognitive Strike series, where I cover, in-depth, the extensive effects SARS-CoV-2 has in the brain, is a way to understand not only the complexity, but the long-term consequences of “it’s just the flu bro” yearly infections. Severe Covid impacts the brain. Moderate. Mild. I stand by my analysis that SARS-CoV-2 was primarily a Neurological “weapon”, with the bone marrow targeting as a secondary mechanism, leading to spread through the lymphatic system. Lower lymphocytes contribute to a tilting in the immune system, and contribute to neurodegeneration.

Cognitive Strike - Part II

AI-generated podcast from my article above, as a refresher. Also a very long one.

If you are asking where part III is, it is open in another tab, and each paper I cover makes me do this, and I postpone lmao. Plus, a lot of advances in areas related to neurodegeneration, a

never-ending quest for knowledge.

I am also mainly writing what I feel like writing, my mental health says thank you.

Asymmetrical glymphatic dysfunction in patients with long Covid associated neurocognitive impairment- correlation with BBB disruption

Given the waste clearance impacts cognitive function at many timeframes, and glymphatic dysfunction is seen in SARS-CoV-2, testing and understanding if there is any level of dysfunction in Long Covid is incredibly important, given that waste accumulation will lead to neuroinflammation, activate the immune system in the brain, and cause a cascade of effects. Especially important if the Blood-Brain barrier is compromised, allowing external and foreign substances to enter the brain, contributing to neurodegeneration.

The authors followed 14 Long Covid patients over a period (longitudinal study), and one of their characteristics is anosmia (loss of smell), ageusia (loss of taste), fatigue, and, of course, cognitive impairment, with 10 healthy individuals as controls. They used advanced MRI at two time points, 3 months after initial infection, and 12 months after infection.

They also used DTI (Diffusion Tensor Imaging). As you recall from my Brain-focused articles, this test is sensitive to how water molecules move in the brain and useful for calculating how water efficiently moves in spaces around the blood vessels (perivascular spaces). Lower DTI-ALPS indicates reduced glymphatic function.

The other test was Dynamic Contrast Enhanced Perfusion MRI (DCE-MRI), which uses a contrast agent to track the movement of substances in and out of the brain tissue over time. This allows researchers to calculate K trans, which is used to measure capillary permeability of the BBB. High K means a weaker, porous BBB (thus compromised).

The findings were quite unique. Long Covid patients exhibited a significant reduction in the DTI-ALPS index, especially in the Left Hemisphere of the brain, meaning waste clearance is compromised more significantly in one side of the brain (more on this later in this article). There was no significant change over time in this index in the Long Covid group, meaning these changes and the cognitive impairment persisted over 12 months.

Using the BBB-K trans method allowed the authors to observe a strong inverse correlation between how they measure glymphatic function (DIT-ALPS) and how permeable the BBB was. Higher K Trans equated to decreased glymphatic function.

Why it matters

From a biological standpoint, Spike Proteins is to allow a virus to engage a specific receptor (a lego piece that opens the cell’s door) and thus hijack the cell to its purposes. From a synthetic perspective, the SARS-CoV-2 Spike Protein was designed upon a very precise scaffold to pierce through membranes. Not just engage, but “cut through it”. (Each of the following words is a paper in and on itself)

Besides papers, I analyzed myself, SARS-CoV-2's ability to damage, pierce through, and compromise the BBB is well-documented. Not only can SARS-CoV-2 use the nerves, especially optical nerves, to go through the brain, but the systemic inflammation and its response itself can progressively compromise the BBB, which is seen in Neuro-Long Covid and the few postmortem publications we have so far.

This allows toxins from outside the brain, with special significance from the gut, to travel through the body and get inside the brain, causing both damage and inducing inflammation, also allowing different pathogens, latent or chronic (Candida is one I specifically keep pointing out) to cross the barrier. It also allows the permanence, and especially the trafficking of viral fragments from the body, into the brain, creating an inflammatory feedback.

The Left Hemisphere Enigma

The most intriguing finding of this paper is the fact that the Left Hemisphere of the brain in this group of patients was significantly more affected. What is the Left Hemisphere responsible for ?

Language understanding, writing, memory recall, especially verbal memory, grammar, and syntax (language structure), semantics (the meaning of words). Language decay is one of the earliest signs of Alzheimer’s disease and other neurodegenerative conditions, it also impacts learning, communication.

This hemisphere is also responsible for Logical and Analytical thinking, thus essential for problem-solving, decision-making, and especially analyzing information step-by-step, breaking down complex problems into smaller parts. It also impacts information processing and complex motor tasks.

But the most terrifying for me is Mathematics, the Left Hemisphere is responsible for the symbolic math, which equations rely upon, also Calculation and Computation, both necessary for complex mathematical tasks.

How to address glymphatic dysfunction ?

Well, first and foremost, the “most boring” advice of all. Grounding (spending time with your feet or body literally on nature’s ground, 2 and a half hours per week for maximum effect…if possible, obviously), proper sleep, and especially exercise. These are all free, anyone can do them. Supplements.

Tianqi Pingchan Granule, traditional Chinese medicine, promotes the recovery of the glymphatic system.

• Taurine

• L-Carnitine

• Theanine

• Curmumin

• Reesveratrol

• Ginkgo biloba (one of my favorites, extract if you want more potent effects)

• Creatine (5+ grams + 3 grams of sugar, daily, over a long period)

• Whey Protein (enriched with Tryptophan if you have Long Covid or neurological symptoms)

If you can’t find Tryptophan-enriched Whey, just normal MILK Whey will do, never, ever, under no circumstances plant-based whey, even if you are vegan/vegetarian. Plant-based Whey uses crops that abuse glyphosate, and will harm your long-term health.

Red Light, and especially lately Blue Light therapy at 40 hertz, also helps improve. I also know from experience high-dose of Serrapeptase will drastically improve glymphatic function, especially over weeks, but you should not attempt high-dosage without experience, or deep awareness of your own body.


As a last addendum. If you search my Substack for the words “Bromhexine” and “Ambroxol” (they are the same thing), you will find I have recommended it at different times as an adjuvant treatment for SARS-CoV-2, with the precise wording of “avoiding long-term sequelae”. It acts as a minor inhibitor, not effective since Delta. Well…

Ambroxol regulates the expression of TLR4, and p-NFkB, which are neuroprotective, given that both of these are upstream and potent inflammatory initiators. It also stops TNF-α and IL-1β, very potent inflammatory proteins, with IL-1β being a contributor to multiple negative feedback loops. It also acted on the antioxidant master regulator of the body, NRF-2 (which is the first step to fail in glymphatic dysfunction btw), among other antioxidant regulators.

A reminder, if you take Ambroxol + antibiotics, it potentiates the effects of the antibiotics, enabling them to penetrate biofilms, and have a broader action. And given the presented evidence here, it also abrogates the effects of antibiotic usage, at least the overlooked and underspoken side of the influx of toxins in the body.

Ambroxol is OTC, and extremely cheap in the Third World. Rather… interesting if you ask me.


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Me coming this weekend