You don't have to wait out Long COVID
While there are currently no FDA-approved medications for Long COVID, many patients have seen significant symptom improvements with off-label, low-risk, research-backed treatments.
At RTHM, we’re here to help you regain control of your life.
Theories behind Long COVID
Long COVID is a complex condition with puzzling symptoms, and researchers are still uncovering its causes. Here are some of the leading theories:
Autonomic dysfunction
Fatigue
Post-exertional malaise
Sleep disruption
Pain
Brain Fog
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The SARS-CoV-2 virus may linger or reactivate in certain tissues, continuing to cause symptoms. This theory draws parallels with other chronic infections where the virus remains latent and can periodically reactivate, contributing to ongoing health issues. Studies, such as this one, show that remnants of the virus, such as RNA or antigens, may persist in certain tissues, potentially triggering ongoing immune responses. Additionally, reactivation of latent viruses, like Epstein-Barr virus, could contribute to the complex symptomatology of Long COVID. Learn more about viral persistence (HERE) and reactivation (HERE).
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One emerging theory suggests that microclots play a significant role in these prolonged symptoms. Research has shown that individuals with Long COVID often have microclots in their blood, which can trap inflammatory molecules and impair blood flow, potentially leading to symptoms like fatigue, brain fog, and shortness of breath. These microclots are difficult to detect with standard tests, making diagnosis and treatment challenging. Learn more about microclots HERE.
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Dysautonomia, specifically Postural Orthostatic Tachycardia Syndrome (POTS), is a condition characterized by an abnormal increase in heart rate upon standing, often accompanied by symptoms like dizziness, fatigue, and brain fog. Recent studies have found that a significant proportion of Long COVID patients, approximately 79%, meet the criteria for POTS. This suggests a strong link between SARS-CoV-2 infection and the development of autonomic nervous system dysfunction. Learn more about dysautonomia (HERE) and POTS (HERE).
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Mast cell activation syndrome (MCAS) involves the hyperactivation of mast cells, leading to the excessive release of chemical mediators that can cause a range of symptoms, including fatigue, cognitive issues, and respiratory problems. Additionally, immune system dysfunction, such as abnormal immune-cell activation and autoantibodies, has been observed in Long COVID patients. These immune irregularities can contribute to ongoing inflammation and tissue damage, exacerbating the condition. Learn more about MCAS (HERE) and immune system dysfunction (HERE).
Explore our range of Long COVID treatments
RTHM Direct connects you to the latest treatments for managing Long COVID.
Guanfacine
Used to improve cognitive function and reduce brain fog. By regulating norepinephrine levels in the brain, guanfacine helps with attention, memory, and cognitive clarity, providing relief for those struggling with mental fatigue.
Low Dose Naltrexone
LDN modulates the immune system and reduces chronic inflammation, which may alleviate symptoms like fatigue, pain, and brain fog. It offers a promising approach for patients struggling with persistent symptoms by potentially balancing immune responses.
Pyridostigmine
Pyridostigmine improves autonomic function, particularly in patients experiencing dysautonomia. It enhances communication between nerves and muscles, helping alleviate symptoms like dizziness, fatigue, and exercise intolerance.
Propranolol
A beta-blocker that helps manage symptoms related to dysautonomia, such as elevated heart rate and anxiety. By reducing heart rate and controlling blood pressure, propranolol stabilizes the autonomic nervous system.
Ivabradine
Lowers heart rate without affecting blood pressure, making it ideal for patients with autonomic issues like postural orthostatic tachycardia syndrome (POTS). It helps reduce symptoms such as palpitations, fatigue, and exercise intolerance.
Midodrine
Supports blood pressure regulation, particularly in patients experiencing orthostatic hypotension or lightheadedness. By constricting blood vessels and increasing blood pressure, midodrine reduces dizziness and improves daily functioning.
Ketotifen
An antihistamine that targets histamine-related symptoms, often associated with mast cell activation syndrome (MCAS). By stabilizing mast cells, ketotifen helps reduce allergic-type reactions, providing relief to those with hypersensitivity issues.
Metformin
Metformin is a proven treatment for type II diabetes, which has seen an increase in those with Long COVID. In addition, studies show metformin may reduce the risk of developing Long COVID.
Explore our range of Long COVID treatments
RTHM Direct connects you to the latest treatments for managing Long COVID.
Guanfacine
Used to improve cognitive function and reduce brain fog. By regulating norepinephrine levels in the brain, guanfacine helps with attention, memory, and cognitive clarity, providing relief for those struggling with mental fatigue.
Low Dose Naltrexone
LDN modulates the immune system and reduces chronic inflammation, which may alleviate symptoms like fatigue, pain, and brain fog. It offers a promising approach for patients struggling with persistent symptoms by potentially balancing immune responses.
Pyridostigmine
Pyridostigmine improves autonomic function, particularly in patients experiencing dysautonomia. It enhances communication between nerves and muscles, helping alleviate symptoms like dizziness, fatigue, and exercise intolerance.
Propranolol
A beta-blocker that helps manage symptoms related to dysautonomia, such as elevated heart rate and anxiety. By reducing heart rate and controlling blood pressure, propranolol stabilizes the autonomic nervous system.
Ivabradine
Lowers heart rate without affecting blood pressure, making it ideal for patients with autonomic issues like postural orthostatic tachycardia syndrome (POTS). It helps reduce symptoms such as palpitations, fatigue, and exercise intolerance.
Midodrine
Supports blood pressure regulation, particularly in patients experiencing orthostatic hypotension or lightheadedness. By constricting blood vessels and increasing blood pressure, midodrine reduces dizziness and improves daily functioning.
Ketotifen
An antihistamine that targets histamine-related symptoms, often associated with mast cell activation syndrome (MCAS). By stabilizing mast cells, ketotifen helps reduce allergic-type reactions, providing relief to those with hypersensitivity issues.
Metformin
Metformin is a proven treatment for type II diabetes, which has seen an increase in those with Long COVID. In addition, studies show metformin may reduce the risk of developing Long COVID.
Didn’t find a treatment?
We are continuously vetting and adding new treatments based on the latest research and treatment profile. Let us know what you are looking for and we will take it into account for future developments.
Do you have Long COVID? We have options.
Although there are no FDA-approved treatments for Long COVID, there are low-risk and research-backed medications that help patients reclaim their lives.
Our treatment discovery tool takes in your symptoms and their severity levels and provides a tailored list of medications that may support your journey back to health.
Get personalized suggestions based on your specific symptoms and conditions and save time sifting through countless research papers.
Read the latest about Long COVID from the RTHM team
RTHM Patient Voices
RTHM has given me hope. After struggling with Long COVID for two years, even with the help of a Long COVID clinic, I was still doing all of my own research and trying to keep my doctors advised of the state of the art in treatments.”
— Stuart
And in case you missed anything.
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Long COVID is a complex and evolving condition that refers to many symptoms and health conditions that persist or develop after an acute COVID-19 infection. Also known as Post-Acute Sequelae of SARS-CoV-2 (PASC), Long COVID is often a debilitating condition that requires comprehensive care.
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Currently, there are more than 200 symptoms tied to Long COVID. Some of the most common symptoms experienced by patients can include:
Fatigue
Brain fog
Shortness of breath
Headaches
Fast heart rate
Loss of taste and smell
Difficulty sleeping
Gastrointestinal upset
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At this time, the exact cause of Long COVID is unknown. Current theories being investigated include immune dysregulation, viral persistence, microbiota disruption, micro-blood clots, endothelial abnormalities, autoimmunity, and dysfunctional neurological signaling.
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No medications are currently FDA-Approved for the treatment of Long COVID. However, clinicians and researchers are seeing treatment benefits from many off-label prescription medications, such as those offered through RTHM Direct.
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At this time, RTHM Direct offers low-dose naltrexone, guanfacine, midodrine, ivabradine, propranolol, metformin, ketotifen, and pyridostigmine that can help address many of the symptoms you may be experiencing with Long COVID. Some of the medications are coming soon.
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At this time, RTHM Direct requires a diagnosis from a primary clinician or specialist.