Coach Mikki and Friends

Unveiling the Enigma: Understanding and Treating Long-Haul COVID with Dr. Melissa Mondala - S3E20

November 10, 2023 Coach Mikki
Coach Mikki and Friends
Unveiling the Enigma: Understanding and Treating Long-Haul COVID with Dr. Melissa Mondala - S3E20
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Are you feeling the lingering effects of COVID-19? Find out why you're not alone. Join us as we sit down with Dr. Melissa Mandala, an expert in family and lifestyle medicine, to bring light to the enigma of post-COVID symptoms. We discuss the ordeal that thousands are going through weeks, months, and sometimes years after their initial recovery. Dr. Mandala provides insights on how to deal with this issue using lifestyle measures and supplements, reminding us to always consult a medical professional before starting any treatment.

Don't let 'long COVID' remain a mystery. We venture into the maze of persistent post-COVID symptoms, with Dr. Mandala helping us identify their prevalence and potential long-term effects on our health. The conversation moves expertly between the significance of testing and quarantine, the persistent symptoms that continue to plague patients even after a positive test result, and the intriguing correlation between post-COVID symptoms, depression, and autoimmune disease.

As we draw our discussion to a close, Dr. Mandala shares her expertise on managing long COVID and fortifying our immunity. She doles out practical advice on staying healthy, especially during the holiday season. We express our gratitude for your continued support and implore you to be a part of our journey. Your comments, queries, and suggestions are the springboard for future podcast topics. So, lend us your ear and gain a newfound understanding of post-COVID health challenges, and the best ways to address them.

We look forward to seeing you succeed! - www.KeepOnSharing.com - Code - KOS

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Speaker 1:

Hey, I'm coach Mickey and I'm so glad that you've joined us, and if this is your first time joining us, come on in and make yourself comfortable, and for those of you that join us on a regular basis, I'm so glad that you do. Thank you so much for your support, not only with my YouTube channel, but with my podcast and reaching out to all my guests. I am thrilled that many of you actually take the time to connect with a lot of these guests. I know a lot of them have helped you through some of your Some of the situations, some of the things, maybe some of the stories that you've been able to identify and connect with. So Thank you so much and I am really Excited to have this guest backed on. You guys have heard her on my podcast, but now we're going to do the YouTube version of it and she is a plethora of information. Dr Melissa Mandala, how are you?

Speaker 2:

great. It's so good to be connected and Back into the groove, because a lot of people are sick in during the holidays and I just want to provide tools and help as many people as possible. So thank you for inviting me.

Speaker 1:

Well, I think what you have to offer is really exciting, because the subject we're going to cover today it's not just something that I think people need to hear, but either through my own experiences and my own family, my own friends are struggling with this, and I really felt this was very important for you to be able to share your insight and Information, I mean as a, as a health advocate, and your lifestyle and your way of eating and how healthy you know, everything that you bring when you do your lectures and and who you are Really is a plethora of information. So I I'm really excited, so I'm going to let you just jump right in and I'm going to stay back here and just absorb it like a sponge. So it's all yours today. Doctor, doctor, melissa, go for it.

Speaker 2:

Yeah, well, here I go. You know I'm talking about the post COVID Neuroimmunological connection. So a lot of people are unfortunately suffering from post COVID Not just days, weeks, months, years after and I'm going to go and dive deep and share the science and some stories, because this is maybe your family member. These are people who are slightly suffering Because there's not much treatment or actually no FDA approved treatment out there and the testing is still evolving and Unfortunately we're in year three of COVID and COVID is not going away. But also post COVID is Unfortunately one of those mystery cases, and so I want to provide tools and show you what it all means behind the scenes and what you Can do for your family and friends, and starting with simple lifestyle measures and also some supplements. So you're going to learn a lot today. You can. You know a lot of people like to take notes or replay this over and over, and that's okay. I'm here to walk you through this, so let me know if you can see my screen, coach Mickey, and then I'm going to start to Play this behind the scenes. Yeah, you're good, I can see it. Perfect, awesome. So Just medical disclosure. This is for educational purposes only. I do say you definitely know medical provider to walk you through any of the treatments I do discuss. This is something that you know you can potentially Learn from, but also you want to make sure you have guidance, because Post COVID is completely a black box, meaning you need someone experienced to that can treat post COVID. So just to give you a little bit about my background Thank you, coach Mickey, for just Sharing that family and lifestyle medicine trains. I'm double board certified in that and I completed a primary care psychiatry fellowship and also in certified and integrative psychiatry and I am an integrative medicine fellowship participant. And then, lastly, I Just have special training as an intensivist and a board member of the American College of Life Salmonison and founder in my clinic at Dr Lifestyle, where I see patients all over the nation and world. And A bit more background about me. I know coach Mickey has this all in her links about not only about me and my handle Dr Melissa's kitchen. I have all my YouTube and Instagram. I have my clinic website down below. And then the reason why this lecture is called neural Immune is because I learned a lot from my husband with autoimmune disease and we have a lot of patients in our clinic with autoimmune disease. So that's why I'm sharing his contact, in case anyone needs it, at my autoimmune MD. And then he's on social media, on TikTok, youtube, instagram, and he has a website as you can see there. So really, the objectives are for this entire experience is for you to understand a little bit of the newest Stats on post covid, some of the pathology behind it, some therapies that have been tested, and then what's the connection between Covid-19 and depression and Covid-19 and autoimmune disease. So let's go back in time. I know we've been having maybe some Recalls from our post covid times, or we had a socially distance and wear mask and all those things, and now things are in. We're trying to figure it out still, and my husband and I we've been working with covid patients from the very beginning, all the way from the hospital to ICU to the urgent care setting In the ER, and so not only have we seen Very sick people, but we've seen people get out of the hospital and you know I'm glad that a lot of us made it to the other side. But how can we prepare for the post covid symptoms? That's the talk that I'm going to share, and unfortunately, not only that. We had millions of people suffer from covid and also Pass away from it. But we have one in five American adults who still have long covid. So just soak that in right in the household one person has Post covid and sometimes those are of all ages, and it's not just the the household, it's the genetic Components. It's really hard to tease out why some people get covid and why others don't. It's people who are completely healthy can get covid, but also post covid. Overall, one in 13 adults have symptoms at least greater than three months or more. And then this is an interesting statistic Nearly three times as many people have post-COVID, long COVID, when they're in the age bracket 50s to 59. So I've seen this in my clinic where you get 30-year-olds, you get 20-year-olds, they'll have post-COVID, and 80-year-olds maybe. In this study they weren't necessarily tested or surveyed, so it's kind of hard to say that this is an exact study. But women are more likely to have more post-COVID. So just to clarify some of the terms you may hear long COVID, post-covid the official medical term by the NIH is called post-acute cell clay of SARS-CoV-2. So past PASC, and here's the process. So you may wonder you go on the plane, you, or go at a plot lock and you may wonder maybe the next night I might have some symptoms. Was it because of the night before you had to sleep over or something and you've caught a cold? But the studies have shown that COVID-2 exposure actually can happen as early as two weeks before the first symptom. So it's really this can happen two weeks before the first symptom, one week before the first symptom, and it can be up to how much the viral load was at that time. As you can see, it's a graph. So maybe the first exposure that person didn't have much of viral shedding. That means spewing out of the virus. But if you have an accumulation of viruses around you people that have COVID and maybe then the plane ride then eventually you may have the symptom. But usually it's not just one event, it's an accumulation of different events over time. And then now here comes the COVID test. A lot of people have questions like when to test, how often to test during the COVID, people who are testing nearly every day. But then we realize people are COVID positive for weeks and months. So COVID testing wasn't that necessary to do with that often. So the week one, week two I would say, is usually the most infectious. There are studies that say, oh, let's quarantine for two weeks, then 10 days, then five days, and, yes, week one is the most infectious rate or infectious time. Day three to day five is the best time to test, and then everyone else I would say it's very practitioner and patient dependent. And then by week three, week four, people still have symptoms and still may be positive. And that's where people get confused. They say, well, I may have a bronchitis or pneumonia or I just still have my brain fog and it's actually very normal to have that. That's when you go into this subacute, ongoing COVID-19 phase, where now it becomes more systemic. It's not necessarily the cold and cough. Most of the time people have the fatigue, the muscle weakness, the joint pain and they're not feeling their best. Some people, literally, are bedbound and I'll kind of share those, those sadder stories. But there are people who experience that. Some people have this ongoing cough and this difficulty breathing that just won't go away and that's because they require more oxygen. It's a hypostatic state because their lungs have not been able to adjust, and I'll explain that later. And then some who are completely happy and healthy suddenly have anxiety and depression and that's because of the virus itself and there are sleep disturbances. Some people have insomnia, ptsd, brain fog, headaches and then palpitations and chest pain. So people will go into the ER with completely normal labs, normal EKGs and echoes, but they still have this palpitation, chest pain, and that's because, once again, the post-COVID effect and then other people may be more prone to blood clots. So we have to be very careful and I'll describe that later. So just be very careful. And then, long term three months, six months, one year out people are experiencing hair loss. So hair loss is a real thing. More and more people have been complaining about that and I'm glad it's not only have gotten pressed but some science to it, because it's the stress effect from the virus itself and so people are having clumps of hair just fall out. That is a real thing. You are not crazy. I know people may have think you know what's wrong, it's fine, you'll get over it. But that's why I want people to understand this. The whole point of this talk is to bring a voice and bring more knowledge to you and to also maybe you have to share this with your provider, because this is something they may have not taken the extra time to study. So long COVID, just to give you the big picture again is that there is a process where in the very beginning, where people are having changes in not only their lungs, their brain, even their kidneys. So some people are not severely dehydrated and they go to renal failure and some people even have digestive changes. I've seen this time over and over where people have loose stools, nausea, vomiting and the whole type of abdominal pain and then other people may have dissonance headache spurt ago. So this is because of the whole COVID. I would say acute then goes into long COVID. So during this time, just a pearl, it's not a bad idea to take it. Aspirin during this time at least 81 milligrams, and turmeric because it can thin out your blood and avoid blood cuts and it's also turmeric is anti-inflammatory. So that's a pearl there. Chronic inflammation does happen because of that spike protein. So that spike protein, also with the AC2, goes in and gets swallowed by all the cells and then gets interpreted and then after that it spews out all these cytokines, which basically means the army of the immune system. So, as we know, we have our army, marines and Air Force. Somewhere to this we have our lymphocytes or neutrophils or macrophages. They all get spewed out and unfortunately this creates cytokines stormed in our body. Sometimes your body can fight it off, just find. Other times they can't, and it just stays longer and longer and it hits all organs. For some people they, as I mentioned before, they might have difficulty breathing. Some people actually get pulmonary embolisms and fibrosis in their lungs or hypertension in their lungs. So that's not just the normal hypertension, but that's where the vessels in their lungs are struggling to open and so, as you can see, this can be very detrimental and sometimes very subtle because they're not being tested. So I'm just going to present some cases. These are more hospital cases, so I'm going to give some of the severe cases and then the maybe not severe cases, and the severe ones are the people who actually get hospitalized and for pneumonia. There are people who walk and stay home when they have pneumonia. Other people get help and they need to get antibiotics and other things. So this person needs had persistent shortness of breath after eight weeks. As you can see from his lungs, his lungs are not looking too good. That's where all the spots are. You want the lungs to actually be all black and nice, full of air, but he has some glass opacities and bronchiocytosis, which basically means some inflammation and scarring and unable to open. So imagine his lungs are suffering. And that happens after COVID, even eight weeks after. And then there are cardiovascular changes. So not only people are worried about cardiovascular changes from COVID or the vaccine, but actually from the various too. So this has happened in a female patient's, 45 year old. At five weeks after discharge you see myocarditis. So that's when the heart becomes thickened and inflamed, sometimes becomes even injury, to the point where it almost presents like a heart attack. So this is a volatile time for some patients. So that's why it's so important to keep a strong immune system. Be prepared with tools, supplements and close care. Don't ignore your symptoms. So here are the neurological changes. Not many people know that not only can you have brain fog, but if you actually test on MRI, such as this patient, he was in the ICU, he had lung issues but he had micro bleeds in the brain, so very small white spots, as you can see. There's white spots, there's black spots, so basically that just shows grain white matter changes and these are micro bleeds. And that's why people come out feeling as if not only they have trouble concentrating, but sometimes they kind of have a hard time remembering things as well. So unfortunately, covid-19 took advantage of our weakness. It showed us not only that we need a coordinated healthcare system and we need public health awareness, but also we have chronic diseases such as heart disease, type two diabetes, cancer, lung diseases that weren't necessarily treated and these chronic diseases have really driven the immune dysfunction and those people have higher risks. There are still significant studies that those people are more likely to be hospitalized and struggle from COVID and post COVID. So I'm always for the proponent is make sure you're healthy and treating those other diseases so that you can have a better immune system. And we know that immune dysfunction also increases inflammation and that's been also been linked to worse depression and recovery from post COVID. So what's the first step we can do to prevent from long COVID? Literally, first prevent an infection those who have had more plants, so fruits, vegetables, beans, nuts and seeds, even pescetarian diets for study. So these are studying six different countries and healthcare workers and you can see that about over 500 cases, those who ate more plant-based diets were less likely to have worsening COVID symptoms. So they had just mild to moderate COVID symptoms. So do your best to not get infected. Number one, number two do your best to eat a variety of fruits and vegetables, cause that's where the antioxidants comes. That's what decreases inflammation and decreases the risk of even clots and depression. Also, number one to preventing COVID-19 is really reducing the chronic disease. Unfortunately, hospitalizations were six times higher and for deaths 12 times higher with those with chronic disease. So really get screened for this, people with even asthma. So you may think you know it's just asthma, or it's just I just have eczema or I just have pre-diabetes, or please don't ignore those things. Those are signs from your body to say let's get ahead and let's overcome our risk for COVID and long COVID. And that's I wanted to show. Even the CDC is showing a preventing chronic disease campaign, so they have a whole campaign now. So we need to get ahead. Saying active and seeking supervised guided exercises is important. So those who have a balance of exercise, at least 150 minutes per week is ideal. When you're going through COVID, you wanna be resting, by the way, and if you're having post-COVID you really wanna be careful, because there's a balance between over-inserting yourself. I have patients who are PE teachers and they were active but unfortunately they didn't do well during COVID or post-COVID and they jumped too soon into work and they ended up having to stay home because they had flu-like symptoms again once a month, to the point where they had to take some time off. So really pay attention, don't rush into work until you're cleared by your physician or a medical provider. And if you do get into the exercise world again, make sure it's supervised and guided, because maybe your lungs may not be able to tolerate it or your heart, especially if you're feeling symptoms, because you can reactivate the immune dysfunction if you're not totally well. So sleep well and stress less is another important tip. So those who have suffered from COVID, as you can see from this diagram, not only did it hit all their organs, there's a glial cell activation, so that's your immune system in your brain. And there's been studies that new and old depression has come up bipolar, ptsd, psychosis, ocd, even seizures. So it's just epilepsy and Alzheimer's. So there's a form of dementia there. So we have to be very careful because we wanna know that we can protect our sleep, because that is our biggest immune defense. That's when you know when you sleep you're cleaning up the brain, cleaning up the debris from the stress and the toxins and finding ways to stress less. Try to find ways to laugh more and not overwork ourselves is really important. So here's the multiple proposed potential mechanisms for why we get post COVID. So not only have there been more and more studies, cdc, everyone's trying to figure it out. The proposed mechanism is something called viral persistence. So that's been shown to. We're trying to understand because we see the infection like symptoms happen not only weeks but months after. So there are studies that show that maybe the virus is still. It's called virulence, it's still active in the blood. So that's what we have to determine. And is there still systemic and tissue inflammation? And then autoimmunity. Autoimmunity just means it's kind of like micro I'm gonna simplify it but basically where the body feels like the immune system is still activated, even though the virus is at bay, it'll still be on. It's almost like an autoimmune disease where the body thinks there's a foreign body and everything. All the alarms are turning on. So they'll have symptoms, they'll have all these spews of the cytokines and then the microvascular dysfunction is once again people feeling more as if they're getting thicker blood and other dysfunction. So the mechanisms is still being determined and really we've seen a reactivation on many levels of even other viruses. So we have to be very careful. It's been shown that this may be a new pandemic. There's a certain chaos into it because it hasn't been clearly defined and we need to find a way to make it structured and understand this post acute version, because there are up to 50 long-term effects. As you can see, it's pretty wild right how the potential 50 symptoms 50% of people that's significant have fatigue, 44% have headache and that are reporting it from post COVID, 15% still have the sense of hearing loss and tinnitus and 25% have hair loss, 19% have joint pain and 23% are still struggling from loss of taste and smell. As you can see, even on the side here, people are still struggling with nausea. That's uncomfortable 16% still have nausea, 11% with sleep disorder and some people feel a flush of feeling warm. That's the fever coming back in. As you can see, the depression inside are quite high over the teens and there is that I would say, dysbiosis. That happens, so we have to do something differently. Some people are still coughing 19% of people are still coughing. Unfortunately, it's not just our adults, but it's also children in our teens, so we can't ignore them. This is a study published in June of 2022 where they've seen that at least 25% of our children are still experiencing some respiratory symptoms. So that's nasal congestion, respiratory issues, difficulty getting back to their full exercise, 4% having some chest pain, cough, 2% having sore throat and some people having that chest tightness that I wanna not ignore, once again in palpitation. So it's a very uncomfortable feeling for our kiddos and so I would say let's not dismiss our kids if they're feeling any of these symptoms. And you can see, even the neuropsychiatric symptoms are pretty high 16%. How are feeling sad, angry and depressed in our kids, 8% within some in poor sleep and they're having difficulty concentrating in classes. Up to 6%, and there's also having 4% of dizziness. So when it comes to our kids, once again, they're not immune to it, meaning they are still, even though they're young and strong and healthy. We gotta pay attention when our kiddos are complaining of similar symptoms and ask the questions is it because of post COVID? Some of the things that happen after post-COVID are what I'm going to discuss. I literally need another lecture for this. This is like a six-part series. So a mast cell activation syndrome and COVID has been shown. This is a study in 2022. And mast cell is nothing new. It usually happens after viruses or after allergies. It's basically when the mast cells release histamine and people have difficulty with abdominal pain after eating. They have not only nausea but also they have rashes, they're feeling lightheaded and they're also having a sense of vertigo. So it's a very complicated condition. Not everyone can treat it Rheumatologists, maybe, some allergists. We treat it a lot in our clinic. It's often under-recognized and then dysautonomia and POTS has been shown in COVID. So some people have experienced fast heart rate despite them not doing anything and it's a very scary feeling. I have a lot of my athletes and teens, once again, who suffer from this, but once they do get diagnosed and do get the proper treatment, they're able to go back to the gym. I have one, I would say, runner, and another one who is a Jiu-Jitsu player and he was finally able to get the proper diagnosis and treatment, because what was happening is he felt like he was having a heart attack every single time and really you want to be able to recognize this and find ways to lower the heart rate because it's very uncomfortable and that's because of the long COVID. So chronically long COVID therapies. There's no proven therapies out there, as I mentioned, so there's still clinical trials being done for treatment Right now, there has been not only integrative and lifestyle as the foundation. We're trying to come together as a community. What can we do to prevent it? What supplements can we do to help support this? And so what if lifestyle changes is enough? Is it enough, right? I always promote plant-based eating, fruits, vegetables, stressing less, exercising more, avoiding toxins, but sometimes it's not enough. I have really healthy people trying. So here's what you can do. These are kind of my pearls. I just wanted to share this because there has been data that intermittent fasting has been shown with post-COVID, and so that's hopeful, right? Because when you fast intermittently, not only are you decreasing your insulin and your sugars, but you're also activating the mTOR pathway, which is a scientific term for the anti-inflammatory pathway. It's the anti-aging pathway, so you're giving your body some time to rest and heal. So that's eating twice a day, if you can. Nac and glutathione these are great supplements to help. These are strong antioxidants. These can be found in broccoli and pumpkin seeds and microgreens. But really you want high enough doses. Of course. I say put it in your green smoothies, but when you're dealing with post-COVID, you need to make sure you have someone to guide you through this, but this is a starting point. And then vitamin D is excellent. There's vitamin D receptors everywhere in our brain, in our guts, in our bones, so we want to make sure that we are getting adequate vitamin D. And then omega-3 is definitely one of those subliminal sets anti-inflammatory at least one gram of that. And quercetin is an antihistamine, so that can potentially help with a mast cell activation syndrome and I've seen this help my patients even with allergies and other cough nasal congestion, so that can help. Melatonin has been studying, not only for chronic insomnia and post-COVID, but also during COVID. So there's a study of 50 participants who said that they had decreased symptoms by at least 50% just by higher doses of melatonin. And I would say that's like a 5 or 10 milligrams If you're okay, if you don't get druggy in the morning, so get guidance. A higher melatonin dose can really be a strong antioxidant and that's what the study has shown. And then coenzyme Q10 is great for the brain, the heart, but also for post-COVID. And then low dose. Nopchoxone is a compound in medication that I prescribe in my clinic and I just want to bring education to this because a lot of traditional doctors don't know about this. It's not necessarily studied in the traditional world but in the great integrative realm. It has been well studied to be anti-inflammatory and has shown not only through a lot of autoimmune diseases but also with post-COVID. So get some support with you because these can be novel treatments and, as I mentioned, there's multiple things that we can try. It's not one size fits all, it's not one supplement or one medication. I have patients I've been with them for months and up to a year because it's so complex, but they were bed bound and eventually now they're back and active and walking. But it does take some dedication and self-care. So with the Masal hyperactivation symptom, as I mentioned, antihistamines can help with the disautonomine Plot. Salt is important, so some people are scared of salt but you can use salt in this case and making sure you're hydrated, compression stockings all of those things are important to get blood back to the brain so that you don't feel like your heart is being so fast and where you feel like you're going to faint. And then cognitive behavioral therapy is something I really appreciate because mental health is everything and a lot of people think that they're not acknowledged and they need the support to make sure that they're not catastrophizing in their head or over-generalizing, because it is an important time where people are in deep depression. I have patients who were near suicide, unfortunately, and I have another doctor colleague who had a best friend, where the person went to the ER many times, saw all the care, but they just couldn't get the care they wanted and they committed suicide, unfortunately. And so I don't want anyone to be dismissed by the medical system. I want people to know that there is help, and by getting a mental health professional on your side can really help you get through and in practice, deep breathing, literally simple tools of opening, expanding the lungs. Not only do they do this in pulmonary rehab, but also this can help regulate your immune system, your nervous system and just process things because you will be okay. I just want to encourage you. You will be a get through this, as long as you get the help and get the guidance. Once again, depression is prevalent. It's three times higher in those with people who have basically depression, or three times higher likely to get COVID. So that's as tremendous amount. Nearly 350 million people have COVID. It starts in their 20s, but I see them in the youth, the teens. 60% of people who have depression are inadequately treated. So we definitely want to treat depression soon as well, either by lifestyle and supplements or through medications. So the reason why I bought this app is because early studies of flu vaccine, which is an antidepressant, was trialed in COVID patients. So they were trying to understand is this a possibility, is there a pathway here? Because there's a cytokine storm in the brain where the immune system is spitting out all the cytokines and they've shown that it potentially can be as useful anti-inflammatory to culture scene and steroids. So it's fairly new. I would say I haven't seen that much of a benefit. I think there needs to be more studies because this is a stronger antidepressant and some people may have more suppression and anxiety. So they're trying, they're trying to find the missing medication here, but it is hard. And then there's a connection to psychology, as I mentioned this the IL-6 acute phase reactants. They basically that means in the in our brain we have the access, hypothalamic, paternity, adrenal access. Those would severe to passion. So they studied this in 1993, so a while ago but showing that the immune system does release these, I would say, factors. And so these are the things that I check in my clinic. So I'm not trying to go too scientific here, but there are some labs and testing that you can do. Some people have shown that even when I say people, these are studies. You can see down below that there are anti-inflammatory therapies such as TNF alpha blockers, nsaids and minocycline, so that's a form of antibiotic that can reduce depression. So there is definitely clear evidence that there is a psycho-neuro-immunological connection here, and so we can finally find that connection and finally find a way to open the door. Because when it comes to the immune system, it's new, it's evolving, but we need to try something different. And one of the things that I like to look at is just knowing that our brain is very dynamic. We call this neuroplasticity, neurogenesis. Can you imagine our brain to have the ability to rebuild? And really, when there are some deficiencies in the immune system or the neurochemical, so the happy hormone? So just imagine this on a sad day, like daylight savings times, we can feel it in our brain. We can feel the sadness and the soreness in our brain. It's because there are deficiencies in light and also deficiencies of the happy hormones like serotonin and neuroepinephrine. So we wanna be very careful because when people have changes in their brain, if it's because of brain changes, structural brain changes from previous strokes or head trauma or concussions that can increase risk of depression. Or there's vascular changes because of cholesterol, increased cholesterol or stress. Or there's even metabolic dysfunction because some women have hormone deficiencies when they go into menopause. Even men, when they increase in age to testosterone, they can feel more depression and more anxiety. So all in all, I'm going to just kind of run through these slides, but basically the reason why that there's a long COVID connection to the brain is because the immune cells travel, it crosses the blood brain barrier and it leaks in there and that's where you have the system being dysfunction. And so these two show us that the reason why we have this imbalance of the immune system is one there's poor diet, we're not eating healthy enough, we're not walking enough, so that's the sedentary behavior. We need to get active as much as possible and we are stressing too much, and all of that is really the push towards the immune dysfunction in the imbalance, and so we need to be better at having healthier lifestyles. Once again, you can see this whole pathway of stress on the body where there's a lack of the serotonin and the tryptophan and tryptophan, by the way, is from pumpkin seeds. It's from your flax seeds and your chia seeds your body can make natural serotonin. And even I would say pistachio comes actually has a little melatonin compounds in there. So that's why I say so, your seeds and your nuts. And then this is really important because there's scientific literature linking COVID and not only immunity and depression, but we've seen that there's complementary medicine. So if there's traditional Chinese medicine being studied, so I love my acupuncturists. They have practiced Qigong, which is a relaxation technique. We can have more omega-3 and turmeric, but Ayurveda practices have been studied, so their types of eating healthy and herbs potentially can be helpful. And then the pharmaceuticals they're working on. The oxytocin is one of those things where it's like the happy hormone when females breastfeed or when people engage in sexual activities. That's what actually increases their immunity. So we want to stay happy. And now the brain, once again, is important for memory and plasticity. So what can we do differently? So I know there's a lot of words on this, but the big picture is that we need to explore gut health. We really need to find out what are we feeding the microbiome? Not only omega-3s is what's necessary. Diversity of polyphenols, but we know that studies have shown that the less diverse of a diet, the more of a leaky gut that you have. Then you're more likely to have depression and likely to suffer from post-COVID too. So food scarcity is important to know in our population. So we know that it's not easily accessible. A lot of patients ask me well, how can I eat healthy when everything's over-inflated and we're on this tight budget? We know that it's hard to get access to healthy foods, but I would say that there are. You know, black beans and rice is simple and fruits from the dollar store and just shopping for things that are seasonal or on sale. I have my college students who are still kind of overspending because they never learned to grocery shop, so they need to come together in communities. So I would say, reach out to your family members, your friends, and maybe get more experience in shopping on a budget, because there are tons of researches where you can shop even $5 per day on a plant-based eating, on a plant-based nutritional diet. So, all in all, it's important. Once again, covid and autoimmune disease. So let's talk about this. So, as I mentioned before, not only has COVID been shown to increase autoimmune disease, but mono, ebv, cmv, curfews and even the flu. So COVID-19 has really contributed to the evolving of new diagnoses of autoimmune disease or worsening autoimmune disease. So we see this not only in our rheumatoid arthritis patients, our lupus patients. We have vascularitis patients and this is like head to toe. People not only experience joint pain, but also muscle pain and even changes in their vision. So if you have any of these, make sure you see a rheumatologist. So there is now more advancing studies that explores the link between COVID-19 and autoimmunity. How can we make sense of this? Because my husband and I at our clinic at Dr Lifesale have really seen this push towards new autoimmune disease and long-haul COVID presenting similar to an autoimmune disease. So be very careful and I said, get some help. You can see through this complicated but lovely diagram that this is not only shown in all organs here, but there's just an invasion that happens and that stays throughout the entire system, and so we need to find ways to capture it. Here is just another way to show that that spike protein becomes what we call the superantigen. It's the superantigen. If you hear that term, it's because it locks in, it's staying there and it's not going away. That's why my goals is to just educate you through this process here in 2021, they studied that. You know it's important to see first your primary care doctor. They need to be involved in your care and sometimes they can offer rehab or send you to a COVID-19 clinic. Those are hard to find, some already shutting down. You can find them at academic centers. There are some patient advocacy groups online through not only Facebook but alliances, so hopefully they can share those resources. Some people have chronic coughs that they're getting chest x-rays and pulmonary function tests and maybe even be seen by a pulmonologist, and so you can see here are real people that need to see multiple specialists. So other times they need to go into pulmonary rehab, get an echocardium by a cardiologist and EKGs. So make sure you see a specialist if you have certain persistent symptoms. Hematologists, too, are important, especially if there's concern for clotting and then kidney changes. As I said, it's sad to see people who have completely healthy kidneys, but if you have hypertension, diabetes, you add COVID in there and their kidneys are get a hit, and if you're not testing, you won't know. So testing is important. And then neuropsychiatrics. So psychologists, psychiatrists, are important to screen for anxiety, depression, ptsd, sleep disturbances or even get a sleep study. So in our clinic we really emphasize seeing, getting seen frequently and testing, getting referrals, and really consider getting seen by a rheumatologist, because they are the autoimmune specialists, and so consider a cardio or pulmonary rehab. As I mentioned, I've seen patients do really well. They actually get monitored, with them going to the treadmill and get seeing their oxygen and their peak flows, and this is an opportunity to understand why they're having difficulty breathing. And then over time, you're basically exercising the heart, exercising the lung, so that they can go back on their feet and go back into normal life. So what I practice is really root cause medicine. We're really trying to understand what happens, even not only downstream when people are feeling horrible, but upstream, why things happen. It's like the iceberg. So there are truly root causes of why there are all these dysfunctions. So anything from how we eat, sleep, move, that we need more relaxation and really figuring out the toxins in our environment, from plastics to heavy metals, and really finding that mind body connection. And really I know it's the holidays, I want to end on a happy note. So you know we really need to bring back joy, fun, passion, purpose, because that's what keeps us alive, keeps us going, that's our motivation to even try these lifestyle changes to show up for our doctors, because then you want to live long and be there and make memories and so paying attention to not only these daily things. And then when you go to your doctors at Dr Lifestyle Clinic, I test for these things this biosis, inflammation, hormone imbalance. Let's check the immune system and nutrient deficiencies and metabolic dysfunction so that we can capture the disease earlier and put a stop to, if it's long, covid, immune, cancer, diabetes, fatigue or pain. And once again, really my goal is really to stop the pandemic with depression anxiety. My proposed goal is we need to find a way to have suicide prevention in the way we take care of our patients and in our world today. So thank you again for your time and that's my conclusion. I just want to wrap it up. As you can see, it's post COVID lingers around. Let's pay attention to that. Get tested for either the chronic fatigue, dysautonomia, mast cell activation syndrome and find an integrative approach, because this is likely going to be some audio immune array of what's to come and we want to get ahead. This is where you can find us at Dr Lifestyle. I'm in Newport Beach and accepting patients throughout the US, and so is my husband. He has tons of state licenses. So this is me. I forgot to put my special QR code, but I have a plant powered mind master course to that really teaches us how to eat healthy, how to overcome those mood swings, those negative thoughts, how to incorporate healthy lifestyle habits, because it's it takes time, right, it's not, it's not going to happen every night, but it does. Those little changes make a big difference. So please don't underestimate the power of habits. And then I'll probably share with coach making my special discount $150 off, so I'm happy to give that to you for the holidays and happy to be here with you.

Speaker 1:

Well, you were a plethora of information, but I have to say it's. I have got so many questions and I know for a fact there is a lot of people that are listening and who's it. And for those of you that are watching this, this presentation, I know the questions are just in abundance at the moment and we've got a few minutes, so there's a couple of things. I mean, if you wouldn't mind, I wouldn't mind going over and ask it. So, because I personally I do know people that are dealing from long term COVID and long haul COVID, and someone very close to me has been struggling with vertigo for almost a year and I have done everything to go through every kind of testing and everything. Everything has come back negative and I just it came back over and over and over again as we went down the road saying, well, we've heard, we're hearing about this long, long haul COVID and I have to ask how many in the medical field are actually open? And we'll start discussing this long term COVID because in my experience I have gotten a lot of what to tell you. I'm sorry this, you know we don't have an answer and this is where the struggle and the you know it's difficult to be tell somebody sorry, there's nothing we can do for you because we don't have an answer, and to me I'm sorry, that's an unacceptable answer and that's why it was kind of exciting to find you, because you're open it, you're opening you know about, you're open about this and you're talking about it, and I've got friends that are struggling physically, that are like getting no answers. So I guess my first question would be when someone is suffering from long term, covid, do they have a timeframe where your body will finally cleanse it and get through this and get rid of it? Is there a? Have you finding any timeframes on this?

Speaker 2:

Great question, thank you, and I know sadly people are kind of going in and out trying to find help after like five, 10 opinions, I would say. Right now the studies are unclear, as I say, like one year up to one year. I've seen some studies, my patients, sometimes it's one year, two years, especially if they're not doing anything, meaning I know people are asking for help and trying things at home. But I really think with Turin, I would say testing, supplements and diagnoses, you can shorten that a little bit more. Some people get really lucky where it's only three months or six months or it starts to diminish it over time spontaneously. It's really keeping the immune system strong the entire time. I say until not only that you feel back to your best, like as best as you can. Even if your best is 50%, that's still going to be something you want to maintain so that you're not really putting more holes in your immune system. Pretty much so you want to patch up those holes and seal it so that when, in case, there's any other stressors, you have that protection.

Speaker 1:

So I guess my next question will be because we're coming up on flu season and again, you know, covid still lingering thing that we have. You know it didn't never really went away. For those that are maybe already struggling with long haul COVID, I mean, what's the best course of action so they, you know, in the event that they get it again, that it doesn't exasperate the symptoms that they already have? Or, you know, is this, I guess increasing your immune system is always a good, good thing to do, but what's the best course of action for those that might still be struggling and then get it again?

Speaker 2:

Yeah, you know, I've seen some of my patients unfortunately with patients with all immune disease sometime, or they're frequently traveling. I've seen people get COVID like within two months right, you hear those stories, it happens or within three months, or or they get the flu in the next phase. So really, as I had those supplements I mentioned before, vitamin C, you know it's still like very powerful, like I didn't put that on there, but that's really important to try and and really getting the, the rest that you need. There's just I, time and time again, we just overwork ourselves during the holidays. We like get really excited and we want to, you know, get all the gifts and make the home really nice and fun. But really my best advice is kind of lay low, give the gift to yourself first and treasure that, because you want to put that action in on your, on your, on your mouth and you'll just be better. What I did, my short cut answer is I even me as a guy, I'm just going to do gift cards and sentimental cards. Just that's kind of just for this year, and then next year I'll I'll go back to getting the the fun, fancy gifts. But I would say, in general, though I the list of supplements I gave. Those are really powerful. I would say that's a good enough list and I hope that people can try that and to get through with really just washing hands. People forget to wash your hands. You know simple things like when you're at politics Stay geared up and keep yourself equipped with supplements, because people feel the fact even the next thing or the weeks before or weeks after.

Speaker 1:

And that's, that's good advice, and we definitely need more time to go over some of this. So and I know you're going to be back because you've got some great information like he, as you said, the holidays how do we get through the stressful holidays, you know? And keeping our immune system on. But I want to thank you for all the information and the research and the time, and I know even what you do, as in your clinics, and who you are as a person. I know that people can reach out to you and and get the help that they need based on what you, what you teach and what you have to offer. I really appreciate you, dr Melissa. I mean, you really have taken something that people have a lot of questions about and you, you, I know you you're thriving every day to just get those answers and help people along the way, you know, as you discover them. So thank you so much for yeah no, from the bottom of my heart.

Speaker 2:

It's literally these things. My patients come I, they know I love them and I I spend night and day and sometimes like lose a little sleep just because I know that we have to go the extra mile. And it's totally worth it when I see patients just back up on their feet and and getting to their goals or really, you know, overcoming and it happens. Once you find it, it's not that hard like it's. It's because people don't have that diagnosis and once, once you get the key and here's your healing. And so I just want to give people the, the hope, the gift of hope.

Speaker 1:

So well you, you definitely do that and I appreciate you. So, again, as you guys know, the links will be in the bottom of the podcast and the YouTube channel, so you'll have ways to be able to reach out to Dr Melissa, and she does things virtually. So if it's not something you have wherever you live in the world, this is something that you need. I'm sure she'll be happy to to help you out in that aspect too, no matter where you are. Thank you so much and I cannot wait to have you back on with us again.

Speaker 2:

Thank you, enjoy your day. Thank you all everyone.

Speaker 1:

Thank you guys. I'm coach Mickey. Please connect with all of my guests and I look forward to hearing your comments or questions and your suggestions for a lot of people that you'd like to have on. And remember the most courageous thing you can do is be yourself. I love you, guys. I'll look forward to seeing you again. Okay, bye.

Post COVID Neuroimmunological Connection
Understanding Post-Covid Symptoms and Long Covid
Post-Covid Symptoms and Treatment Options
Depression, COVID, and Autoimmune Disease Connection
Managing Long-Haul COVID and Boosting Immunity
Appreciation and Call for Engagement