Extreme Fatigue and Brain Fog

Talk with your doctor about Low Dose Naltrexone. This has had the most consistent benefit for fatigue and brain fog of all interventions so far for many. Here is a link to some information:
https://www.rthm.com/resources/blogs/ldn-long-covid
Other things that I have found helpful include photobiomodulation,
Mineral baths, resonance breathing, pacing and anything that reduces stress.
Consider seeing an allergy/ immunology specialist that has an interest in Long Covid or post viral conditions as reducing all forms of inflammation can be very helpful including minor allergies and evaluation for Mast Cell Activation syndrome.

I am also getting great energy boosts from Low Dose Naltrexone. PM me if you want more info on how to use it and how to get it formulated.

How long did LDN take for most of you? I started a slow buildup 5 months ago, and have been at 4mg for 3 months. So far no benefits, but had two PEM crashes in last 5 weeks and still struggling. Heart rate has been hypersensitive since these crashes, and not just to any physical activity but cognitive ones too. I see my Covid clinic again in 3 weeks.

Hi Jeff. I've experienced extreme weakness since June 2020. After paying a small fortune for every test under the sun, in 2024 doctors finally diagnosed me with long-COVID.

I'm a full-time high school teacher (online now). My physician prescribes Armodafinil 150mg to combat extreme weakness. I experience zero side effects and still have weakness off and on. Yet it DOES help me. Please note, as a controlled substance, health insurance might not cover the cost of Armodafinil. Pharmacies that accept GoodRx cards will reduce the cost of Armodafinil.

I pray you find answers. Take care.

My symptoms and test results sound very similar, with extreme fatigue, post exertional malaise, and brain fog. I take a beta blocker to help even out my heart rate and blood pressure going from lying down to standing up (after a tilt table test). Low dose naltrexone helps a little with fatigue. What helped the most with fatigue: I started very slowly with building up exercise/activity, starting with only three minutes every day on a recumbent bike a year ago to now an hour three times a week. That slow build up kept me under my fatigue threshold and has built up my capacity for physical and cognitive activity.

The most that has helped me with brain fog is guanfacine and N acetyl cysteine at night (there's a published case study on this that I shared with my doctor), and the supplement lions mane. I participated in a clinical trial that helped, but the side effects were rough. I've found that all of these small things, including breathing exercises and reducing stress, have added up little by little and day by day to at least make all of these symptoms tolerable!

@bluesky6321 I have also found Guanfacine and NAC helpful. Also cut all gluten and inflammatory foods.

I was able to find a physical therapist that specializes specifically in Long COVID and she was very helpful in teaching me how to stay in energy envelope (though still not perfect with that).

I just returned from a weekend mini-outing,--Can't wait for that post malaise to kick in !--It usually takes a couple days.The big problem is, It's Summer and people expect me to be at the festivities. These people don't understand this stuff as neither do many doctors. -Just hoping they don't think I'm a hypo-chondriac. LOL

@thedreamingtree I'm so glad a physical therapist helped! My doctor recommended a speech therapist, and she has been the most helpful for me over the past year even though she didn't really have experience with long covid. I've been following a modified concussion protocol to help with brain fog and fatigue (including rest breaks, modifying activities to deal with cognitive and physical fatigue, and helping figure out triggers and patterns of symptoms).

If someone can't find a healthcare professional familiar with long covid, maybe asking about similar established protocols like concussion protocols can help. A year ago I wouldn't have been able to write these comments because of the brain fog, so it has definitely helped.

Jeff, Have you had the health of your immune system checked? This can be done with a blood draw. There is the T-Cell test which will give a very detailed test for each component that works to protect you; and, there is a very specific test for that looks at how you body handles inflammatory responses. That was an eye opener and it resulted in solutions. Who should get this test?

Individuals with suspected autoimmune diseases like lupus
Those experiencing chronic inflammation or persistent allergies
People being treated for Lyme disease or other tick-borne illnesses
Patients with symptoms of chronic inflammatory response syndrome (CIRS)
Anyone with unexplained fatigue, muscle aches, or joint pain
Those with recurrent or unresolved infections.
https://www.walkinlab.com/products/view/complement-c4a-plasma

@bluesky6321 This is very interesting, thank you. The fog/cognitive issues have moved to #1 for me since I was used to multitasking 24/7 before.

Do you mind if I ask what area you live in and what type of place you looked at for speech therapy for this?