BMC Clinic LONG COVID PROGRAM

In BMC Clinic we follow the guidelines of IFM (Institute for Functional Medicine) and FLCCC (Front Line Covid Critical Care) Alliance.

We know that a long Covid protocol should be dynamic, patient-centered, and adaptable as new information and treatments become available. This involves several steps to address the diverse and often persistent symptoms experienced by individuals, and leaves different types of sequels. Long COVID presents with a variety of persistent symptoms, including fatigue, cognitive issues, and respiratory and cardiac problems. We have a multidisciplinary protocol incorporating the innovating scientific and approved therapies and tailored to each patient. 


 

Assessment and Diagnosis

  • Initial Evaluation: Comprehensive functional medicine medical history, physical examination, along with relevant laboratory tests.

  • Diagnostic Criteria and Symptom Tracking: Clear criteria to diagnose long COVID, considering symptoms lasting more than 4 weeks post-infection.

Multidisciplinary Team

  • Primary Care Physicians: M.Ds. as a central role in coordinating care, along with a team of specialists;  Pulmonologists, internal medicine, cardiologists, neurologists, rheumatologists, mental health professionals, and physical therapists and Nutritionist and Health and Wellness Coach 

  • Nurses and Care Coordinators: Support in managing appointments, applying the therapies, follow-ups, and patient education.

​Designing a long COVID protocol within the framework of Functional Medicine involves a holistic and integrative approach. Functional medicine focuses on identifying and addressing the root causes of disease, emphasizing personalized care and the interconnection of body systems. 

1. Comprehensive Assessment

  • Detailed Medical History along with Functional Medicine Questionnaires:  In-depth patient interviews to understand the onset, duration, and nature of symptoms, as well as pre-existing health conditions.

  • Lifestyle Factors: Evaluation of diet, exercise, sleep patterns, stress levels, and environmental exposures.

  • Functional Lab Testing: Advanced diagnostics to assess inflammation factors, immune function, nutrient deficiencies, gut health, hormone levels, and mitochondrial function.

  • Food Allergy Test: To check food intolerances and sensitivities

  • Quantum Bioanalyzer (NLS Nonlinear Functional Resonance). Scans the body’s condition based on the resonance signals detected. The technology is able to provide information on the health of various organs and systems, may detect early signs of disease.

2. Personalized Treatment Plan

  • Root Cause Analysis: Identifying underlying factors contributing to long Covid symptoms, such as chronic inflammation, immune dysregulation, gut dysbiosis, and nutritional imbalances.

  • Individualized Approach: Tailoring treatment plans to the specific needs and conditions of each patient.

3. Personalized Suggested Therapies

  • Root Cause Analysis: Identifying underlying factors contributing to long Covid symptoms, such as chronic inflammation, immune dysregulation, gut dysbiosis, and nutritional imbalances.

  • Individualized Approach: Tailoring treatment plans to the specific needs and conditions of each patient.

Ozone therapy:

Ozone therapy is a form of complementary and integrative  medicine that involves administering ozone gas (O3) to the body for therapeutic purposes. Ozone is a molecule composed of three oxygen atoms, and it is known for its powerful oxidizing properties.

Potential Benefits for Long COVID:

  1. Reduction of Chronic Inflammation: Ozone therapy can modulate the immune system and reduce chronic inflammation, which is often elevated in long COVID patients.

  2. Improvement in Oxygenation: Enhancing oxygen delivery to tissues could help alleviate symptoms like fatigue and improve overall energy levels.

  3. Immune Support: By modulating the immune response, ozone therapy might help balance an overactive or dysregulated immune system.

  4. Antimicrobial Properties: Although the primary issue in long COVID is not active viral infection, the antimicrobial properties of ozone might help if there are lingering viral particles or secondary infections.

Hyperbaric therapy: 

HBOT involves breathing pure oxygen in a pressurized chamber. This environment allows the lungs to take in more oxygen than would be possible under normal atmospheric pressure, thereby increasing the amount of oxygen delivered to the body’s tissues.

Mechanisms of Action

  • Enhanced Oxygen Delivery: By increasing the amount of oxygen dissolved in the blood, HBOT can improve oxygen delivery to tissues and organs and has anti-Inflammatory effects, angiogenesis, cellular repair and antimicrobial action.

Potential Benefits for Long COVID

HBOT might help alleviate these symptoms through the following ways:

1. Improvement in Cognitive Function:

  • Enhanced oxygen delivery to the brain can improve cognitive function and reduce “brain fog.” Also triggers neuroplasticity in the brain and may reverse brain damage caused by COVID infection.

2. Reduction of Chronic Fatigue:

  • Increased tissue oxygenation and reduced inflammation can help alleviate fatigue.

3. Respiratory Improvement:

  • Improved oxygenation of lung tissues can aid in recovery from respiratory symptoms.

4. Pain Reduction:

  • Anti-inflammatory effects of HBOT can help in reducing chronic pain and discomfort.

5. Overall Immune Support:

  • HBOT can help modulate the immune response, potentially aiding in recovery from prolonged inflammatory states.

Haemo – Laser Therapy:

Haemo-Laser Therapy, also known as intravenous laser blood irradiation, involves the direct exposure of blood to low-level laser light. This is typically done using a fiber optic catheter inserted into a vein. The therapy is based on the principle that laser light can stimulate cellular and molecular processes, leading to various therapeutic effects.
 

Mechanisms of Action

  1. Improved Blood Flow: Laser light can enhance the rheological properties of blood, improving circulation and oxygen delivery to tissues.

  2. Anti-Inflammatory Effects: Laser irradiation can reduce inflammation by modulating cytokine production and immune response.

  3. Enhanced Cellular Function: Stimulates cellular metabolism, ATP production, and overall cellular energy.

  4. Antimicrobial Effects: Some studies suggest laser light can have antimicrobial properties, helping to control infections.

Potential Benefits for Long COVID

Haemo-Laser Therapy might help alleviate the symptoms through the following mechanisms:

  1. Reduction of Chronic Inflammation: By modulating the immune response and reducing inflammatory cytokines, the therapy may help in reducing systemic inflammation.

  2. Improved Oxygenation: Enhanced blood flow and oxygen delivery can potentially alleviate symptoms like fatigue and improve overall energy levels.

  3. Boosting Immune Function: The therapy may help balance an overactive or dysregulated immune system, aiding recovery.

  4. Cognitive Improvement: Improved circulation and cellular function can benefit cognitive symptoms such as brain fog.

  5. Respiratory Benefits: Better oxygenation and reduced inflammation can help improve respiratory symptoms.

IV DRIP Therapy: 

 

Intravenous (IV) drip therapy has gained attention as a potential supportive treatment for various conditions, including long COVID. IV drip therapy involves the administration of fluids, vitamins, minerals, and other nutrients directly into the bloodstream, ensuring rapid and efficient absorption (This method bypasses the digestive system, allowing for 100% absorption of the administered substances).

 

Common Components of IV Drip Therapy

  1. Hydration: Saline or lactated Ringer’s solution to rehydrate the body.

  2. Vitamins: Vitamin C, B-complex vitamins, and other essential vitamins.

  3. Minerals: Magnesium, zinc, and other trace minerals.

  4. Antioxidants: Glutathione, N-acetyl cysteine, alpha-lipoic acid, NAD+, Coenzyme Q10.

  5. Amino Acids: Essential and non-essential amino acids.

  6. Medications: As needed for specific symptoms (e.g., anti-inflammatory drugs, anti-nausea medications)

Potential Benefits for Long COVID

IV drip therapy might help alleviate these symptoms through the following mechanisms:

1.Rehydration and Electrolyte Balance:

  • IV fluids can help restore proper hydration and electrolyte balance, which can be disrupted in chronic conditions.

2. Nutrient Replenishment:

  • Direct delivery of vitamins and minerals can address deficiencies that may contribute to symptoms like fatigue and cognitive impairment.

3. Immune Support:

  • High doses of Vitamin C and zinc can boost the immune system and help reduce inflammation.

4. Antioxidant Effects:

  • Antioxidants like glutathione can help reduce oxidative stress, which is often elevated in chronic inflammatory conditions.

5. Enhanced Energy Levels:

  • Amino acids and B vitamins, NAD+ and Coenzyme Q10 play a crucial role in energy metabolism and can help combat fatigue.

6. Detoxification:

  • Certain components, such as glutathione, can support liver function and help detoxify the body.

IV Drip Formulations for Long COVID 

  1. Myers’ Cocktail:

  2. High-Dose Vitamin C:

  3. Glutathione Drip:

  4. NAD+ 

  5. Chelation Therapy

  6. Detox IV drips

  7. Immune Support 

Cell Therapy with Stem Cell: 

 

 Mesenchymal stem cells (MSCs) have shown promising results in treating severe COVID-19 patients and may also benefit those with long COVID. MSCs have immunomodulatory properties that can reduce inflammation and a cytokine storm. They also have regenerative capacity to help repair damaged lung tissue in COVID-19 patients.

Clinical trials have found that MSC treatment in severe COVID-19 patients led to:

•⁠  ⁠Improvement in clinical symptoms like weakness, fatigue, shortness of breath

•⁠  ⁠Reduced levels of inflammatory biomarkers like CRP, IL-6, TNF-α  

•⁠  ⁠Faster absorption of lung lesions and inflammation on imaging

•⁠  ⁠Higher survival rates

For long COVID patients specifically, MSCs may help address

•⁠  ⁠Organ tissue damage, including to the lungs and heart

•⁠  ⁠Excessive inflammation and immune system dysregulation 

•⁠  ⁠Disruption of the blood-brain barrier leading to neurological symptoms

​MSCs can differentiate into various cell types to potentially replace or repair damaged cells in organs. Their immunomodulatory effects may also help regulate the overactive immune response seen in long COVID.

IHHT THERAPY:

 

 Intermittent Hypoxic-Hyperoxic Training (IHHT) involves alternating between periods of breathing hypoxic (low oxygen) air and hyperoxic (high oxygen) air. This therapy is thought to stimulate various physiological adaptations that may help improve symptoms in Long COVID patients. The potential benefits of IHHT for Long COVID include:

​

  1. Improved Cardiovascular Health: Enhances blood circulation and oxygen delivery to tissues.

  2. Enhanced Cellular Function: Promotes mitochondrial health and energy production.

  3. Reduced Inflammation: May help decrease systemic inflammation, which is often elevated in Long COVID.

  4. Improved Respiratory Function: Supports lung function and efficiency.

 Diet. Nutrition and Gut Health

  • Intermittent daily fasting or periodic daily fast: along with:

  • Anti-Inflammatory Diet: Emphasizing whole, nutrient-dense foods, such as vegetables, fruits, lean proteins, healthy fats, and whole grains.

  • Elimination & Rotation Diets: Identifying and removing potential food sensitivities or allergens.

  • Microbiome Support: Probiotics, prebiotics, and dietary interventions to restore gut flora balance.

  • Digestive Support: Enzymes, herbs, and dietary changes to improve digestion and absorption.

  • Nutritional Supplementation: Targeted supplements to address deficiencies, lower chronic inflammation, boosting mitochondrial energy, etc.

6. Detoxification

  • Supporting Detox Pathways: Ensuring proper liver function and elimination pathways through  IV Drips, IV Ozone therapy SSO3, HBO Hyperbaric Chamber, diet and specific supplements.

  • Environmental Toxins: Identifying and reducing exposure to environmental toxins and pollutants.

7. Mitochondrial Energy Optimizers:

  • Energy Production: Personalize supplements and lifestyle changes to support mitochondrial function.

  • IV Drips with NAD+ and Coenzyme Q10 

  • IHHT Therapy:

  • Reducing Oxidative Stress: Antioxidants to protect and repair cellular damage.​

8. Hormonal Balance

  • Endocrine Support: Addressing adrenal fatigue, thyroid function, and sex hormone imbalances with Bio-Identical Hormone replacement therapy and other targeted therapies and lifestyle modifications.

9. Mental Health and Emotional Well-being

  • Psychological & Coaching Support: Counseling, cognitive behavioral therapy (CBT), and other mental health interventions.

  • Mind-Body Techniques & Stress Management: Techniques like mindfulness, yoga, meditation, deep breathing and relaxation exercises.

  • Sleep Hygiene: Strategies to improve sleep quality.

  • Stress Management: Techniques like mindfulness, meditation, and relaxation exercises.

10. Physical Activity and Rehabilitation

  • Personalized Exercise Plan and Physical Therapy: Tailored to the patient’s energy levels and physical capabilities, including gentle activities like walking, stretching, and yoga.

11. Monitoring and Follow-Up

  • Regular Check-Ins: Follow-ups to monitor progress, adjust treatments, and provide ongoing support.

  • Outcome Tracking: Using symptom trackers and functional lab tests to evaluate the effectiveness of interventions.

​

https://www.ifm.org/news-insights/the-functional-medicine-approach-to-covid-19-virus-specific-nutraceutical-and-botanical-agents/ 

https://www.ifm.org/news-insights/functional-medicine-approach-covid-19-additional-research-nutraceuticals-botanicals/

https://p.widencdn.net/kvdwlh/COVID-19_Nutraceutical-and-Botanical-Recommendations-for-Patients_v4

https://www.pharmacytimes.com/view/hyperbaric-oxygen-therapy-may-be-the-first-only-clinically-effective-treatment-for-long-covid

LABORATORY FOR LONG COVID PROGRAM

 

  • Standard blood chemistries, metabolic panel, including liver function tests

  • CBC with differential and platelet count / Erythrocyte sedimentation rate (ESR)

  • D-Dimer—as a marker of clotting activation, Fibrinogen

  • CRP Ultrasensitive —as a marker of ongoing inflammation also if were necessary Interluking-6 (IL-6), TNF-alfa  Tumor necrosis factor-alpha. Interleukin-1 Beta (IL -1B), Serum Amyloid A (SAA),  

  • Early morning cortisol—some patients develop autoimmune adrenal failure)

  • Thyroid panel test, female or male hormone panel

  • Homocysteine level

  • HbA1C—Vaccine-injured patients are at an increased risk of developing diabetes

  • Troponin and pro-BNP to exclude cardiac disease.

  • Vitamin D level (25OH Vitamin D)

  • Ferritin

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