Dr Peter McCullough: Prescription and Over-the-Counter Treatments for Long COVID Syndrome (2023)
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Over three years into the pandemic with nearly the entire country having become
sick with SARS-CoV-2, a virus engineered to invade the body, there are millions
suffering with long-hauler syndrome. Approximately half of patients admitted to
the ICU with COVID-19 will have post-COVID syndrome which is now understood to
be due to persistence of the SARS-CoV-2 Spike protein within cells, tissues, and
organs. Those vaccinated have been additionally loaded with Spike, so may have
even a worse course with prolonged symptoms including fatigue, lethargy, brain
fog, muscle loss, skin and hair changes, sleeplessness, and effort intolerance.
The magnitude of the problem has driven an all-encompassing search for
management strategies to resolve the syndrome(s).
Hope is on the
horizon with a preprint paper published by Halma et al summarizing the
prescription drug and over-the-counter candidates for therapy. In my practice, I
stylize the approach based on the patient and how recent the COVID-19 infection
was in their history. If there are lingering signs of infection, then a course
of full dose ivermectin can be considered. Aspirin is reasonable given increased
rates of heart attack and stroke after the illness. I have found the colchicine
appears to have an important role in pleurodynia or chest wall discomfort.
Additionally it is used with corticosteroids in vaccine-induced myopericarditis.
Low-dose naltrexone has been reported to ameliorate fatigue and inanition.
Metformin has supportive data and would be appropriate in pre-diabetes and those
with diabetes mellitus.
Halma, M.T.; Plothe, C.; Lawrie, T. Strategies for the
Management of Spike Protein-Related Pathology. Preprints 2023,
2023030344. https://doi.org/10.20944/preprints202303.0344.v1.
From the OTC list, I have found nattokinase, the Japanese product derived
from natto (a traditionalJapanese food made from whole soybeans that have been fermented with Bacillus subtilis var. natto.) to be the most compelling and scientifically supported approach to
clear Spike protein out of the body via proteolytic degradation. A host of
cellular protective, anti-oxidant approaches are listed with vitamin C and
NAC being readily available and widely used.
Nattokinase and Spike Protein
Tanikawa et al. examined the effect of nattokinase on the spike protein of SARS-CoV-2. In
the first experiment, they demonstrated that spike was degraded in a time
and dose-dependent manner in a cell lysate preparation that could be
analogous to a vaccine recipient. The second experiment demonstrated that
nattokinase degraded the spike protein in SARS-CoV-2 infected cells. This
was reproduced in a similar study done by Oba and colleagues in 2021.
Tanikawa T, Kiba Y, Yu J, Hsu K, Chen S, Ishii A, Yokogawa T, Suzuki R,
Inoue Y, Kitamura M. Degradative Effect of Nattokinase on Spike Protein of
SARS-CoV-2. Molecules. 2022 Aug 24;27(17):5405. doi:
10.3390/molecules27175405. PMID: 36080170; PMCID: PMC9458005.
Nattokinase is dosed in fibrinolytic units (FU) per gram and can vary
according to purity. Kurosawa and colleagues have shown in humans that after
a single oral dose of 2000 FU D-dimer concentrations at six, and
eight hours, and blood fibrin/fibrinogen degradation products at four hours
after administration elevated significantly (p < 0.05, respectively).
Thus
an empiric starting dose could be 2000 FU twice a day. Full pharmacokinetic
and pharmacodynamic studies have not been completed, but several years of
market use as an over-the-counter supplement suggests nattokinase is safe
with the main caveat being excessive bleeding and cautions with concurrent
antiplatelet and anticoagulant drugs.
Ivermectin and Spike Protein
Former NIH researcher David Scheim, PhD, early in the pandemic proposed that
SARS-CoV-2 Spike protein was acting like a grappling hook pulling together
circulating red blood cells (RBSc) into long chains and clumps in a process
called hemagglutination (HA). This explained why the red blood cells could
not carry oxygen normally and was congruent with the finding of micro blood
clots in the lungs. Recently, Boschi et al have provided additional support
for this mechanism (source).
According to the authors: “Ivermectin blocked HA when
added to RBCs prior to spike protein and reversed HA when added
afterwards.”
In another spectacular publication, Stone et al,
describes the prompt improvement of oxygenation in patients with ivermectin
(source).
The published oxygenation curves from multiple studies clearly
show this physiological effect of ivermectin occurs so rapidly, it must be
explained by a direct anti-Spike protein effect of ivermectin. An
anonymous video of a critically ill man
demonstrates the very effect that Scheim, Stone, Hazan, and Babalola have
described in the Figure above. So for the next critically ill patient with
COVID-19, if the opportunity presents itself, push for the administration of
ivermectin. This is the only published therapy for COVID-19 that improves
oxygen saturation while the patient mounts a recovery. As in this man, it
may be the critical factor for a turnaround and a chance to walk out of the
hospital.
Key Takeaway
Patients should push their doctors to refer them to clinical trials, and
when that is not feasible, then empiric therapy can be pursued. It is
important to realize that in the absence of completed large randomized
placebo controlled randomized trials, which are easily 5 or more years away
in the future, no therapeutic claims can be made. In the meantime we must be
perceptive as patients and open-minded as clinicians to come up with
reasonable approaches that can be used to help those sick now with
post-COVID syndromes.
Though there are many long haulers treatment protocols out there, we
consider and recommend the I-Recover protocol as one of the best.
Given the lack of clinical trials of long-haul COVID-19 syndrome,
these recommendations are based on the abnormal changes within the
body associated with the COVID-19 disease and post viral illnesses
along with the collective experience of FLCCC members.
This protocol has also been used to treat post-vaccine inflammatory
syndromes with similar success. As with all FLCCC Alliance protocols,
the components, doses, and durations will evolve as more clinical data
accumulates.
Due to the marked overlap between long COVID and post-vaccine syndrome,
please refer to the I-RECOVER Post-Vaccine Treatment protocol for detailed treatment strategies.
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The Front Line COVID-19 Critical Care (FLCCC) Alliance was initially formed as a working group under “emergency” conditions of the early COVID-19 pandemic in response to multiple early reports of COVID patients with an inexplicably high need for prolonged mechanical ventilation and an excessive mortality associated with the prevailing “supportive care only” recommendations disseminated by the majority of national and international health care organizations. Early treatment is critical and the most important factor in managing this disease. COVID-19 is a clinical diagnosis; a confirmed antigen or PCR test is not required. Treatment should be initiated immediately after the onset of flu-like symptoms. The multiple therapies and drugs in this protocol have different mechanisms of action and work synergistically during various phases of the disease. About this Protocol The information in this document is our recommended approach to COVID-19 based on the best (and most recent) literature. I
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