“When you have exhausted all possibilities, remember this: you haven’t.”
― Thomas Edison
|Lincoln Stoller, PhD, 2020. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (CC BY-NC-ND 4.0)
When COVID-19 first appeared, all attention was on the fear of death and the lack of immunity. Only slowly did attention turn to remaining healthy and understanding transmission. In general, it seems, attention is focused on the sensational. This is a bad way to approach a risky situation.
The pandemic has progressed much as epidemiologists predicted. The symptoms are not as clear as originally thought. Those at risk are more specific in their vulnerabilities, and the virus’s transmission is more subtle. Because of these factors—which are not only different from what was presumed but have changed over time—the mortality rate is lower than was originally feared, though still five to ten times higher than influenza.
Now, three months into the official pandemic, measuring from March 11th when the WHO assigned that designation—three months after it first appeared—the public understanding is still thin and the political discussions shallow. This is in spite of plenty of expertise and past experience.
We know the virus is still present and that widespread infection will reappear once the population again begins to intermingle. We know we need to monitor infection levels to navigate the near-term and that this requires widespread testing. In spite of this, little testing is being done or planned. As a result, we can expect there will be a resurgence of infection which could exceed initial levels, judging from past pandemics. This is only one of many issues not part of the political dialog.
Discussions of cures, treatments, and preventatives—including the prospect of vaccination—erupt daily in the mainstream press. These come to a head, spill dire warnings or hopeful promises, and then fade away. In spite of this, there has been no interest in becoming educated in these issues. The vaccine/anti-vaccine diatribe remains sophomoric, issues pertaining to strengthening immunity remain anecdotal, and treatments are no better understood than the symptoms of the disease, which are widely varied.
Even less discussed is what happens after one gets COVID-19. There seems to be a general and ignorant avoidance of the inconvenient fact that just as COVID-19 is not a particular illness—it can and often does affect multiple systems in different ways—it is not something that one simply “recovers” from.
In this, SARS-CoV-2 is not that unique. Viral afflictions, in general, are not simple diseases, though this one seems particularly complex. One of the consequences of many viral infections—and we can presume this will be a consequence of SARS-CoV-2—is something called Post Viral Fatigue Syndrome, or PVFS.
It’s not clear what PVFS is, but it seems to develop as a consequence of many viral illnesses. Its symptom is similar to CFS, Chronic Fatigue Syndrome, characterized by extreme and long-lasting fatigue. In spite of the similarity in name and symptoms, CFS has a method for diagnosis, though it is in dispute, while PVFS does not. The diagnosis is said to involve extensive tests and medical history which makes for a complicated but not necessarily accurate process. Suffice it to say that neither PVFS nor CFS is well understood.
It’s estimated that 20% of those who recover from serious viral illnesses experience some form of PVFS, but PVFS often goes undiagnosed. Many of us have experienced a slow recovery from an illness, and it’s not clear whether or not this is to be expected; nor is it clear when a recovery is so slow that it’s not really a recovery from the original illness, but a secondary illness. This seems to be especially true with COVID-19, whose infection causes enduring symptoms.
My first suspected symptoms of COVID-19 were mild. They appeared on March 17th and lasted for five days. Because I’d already had what I believed to be the seasonal flu, and because these symptoms were unusual, I considered COVID-19 a likely cause. Two weeks later I had a serious gastro-intestinal infection that developed within hours, affected my whole G.I. tract, and disappeared 48 hours later. This also fit the COVID-19 profile.
Seven weeks have now passed since the G.I. infection, and my night sweats, lassitude, and malaise reoccur on a regular schedule. In addition, I found myself drawn to carbohydrates and proteins, and experienced newfound difficulty with sugar and egg products.
Fatigue is Common
In a proposed study on COVID-19 I read:
“Chronic fatigue is the most common and debilitating symptom in intensive care unit (ICU) survivors. Indeed, it has been widely reported that patients who stayed in ICU for prolonged periods report a feeling of tiredness for months to years after ICU discharge. This symptom seems particularly pronounced in Covid-19 patients and may affect their quality of life by decreasing their capacity to perform simple tasks of daily life.”
— from “Chronic Fatigue Etiology and Recovery in Covid-19 Patients: the Role of Fatigability (FatCovid-19),” retrieved May 23, 2020, from: https://clinicaltrials.gov/ct2/show/NCT04363606
While I have not been hospitalized, it is not the hospitalization that causes the disturbance. I suspect my gut flora has been disturbed by the infection. Taking a low dose probiotic, which seemed to have an initial positive effect, was not restoring my vitality. This was when I researched post-viral syndromes and found that CFS appears to have a substantial relationship to gut health, and that efforts to repopulate the gut biota had long-term success in 30-50% of diagnosed cases (Roman 2018, Venturini 2019).
“While most people with post-infection fatigue will improve and return to normal health, good management during the very early stage is an important factor in trying to help any natural recovery process take place. And patient evidence also indicates that good initial management of post-infection fatigue lessens the chances of this turning into an ME/CFS-like illness.”
— Dr. Charles Shepherd, “Covid-19 and Post-viral Fatigue Syndrome,” ME Association, retrieved from:https://www.meassociation.org.uk/2020/04/covid-19-and-post-viral-fatigue-syndrome-by-dr-charles-shepherd-30-april-2020/
The gut is an essential part of your immune system. It’s where your leukocytes get their chemical education. Your blood is both the source of your body’s nutrition and the vehicle for your immune defense, and both functions are largely empowered in your gut. For more detail, read the 2018 article at medicalxpress.com titled, “Why Gut Bacteria are Essential for a Healthy Immune System,” cited below.
Taking matters into my own hands, and having success with past fasts, I decided to repopulate my G.I. tract. Because I was experiencing difficulty with sugar, which is implicated with flair-ups of gut candida, and because of other contra-indications against sugars such as found in most juice, I limited myself to water, vitamins, and mild laxatives for the duration of a 3-day fast.
Each day I mixed filtered water with a package of Emergen-C powder—which includes a minor spectrum of vitamins in addition to 1 gram of vitamin C (the recommended daily allowance (RDA) is 0.1 grams)—and a chewable multivitamin. I also took 2,000 UIs of vitamin D (twice the RDA), 100 mg of zinc (ten times the RDA for zinc), and 500 mg of Quercetin—a bioflavonoid for which there is no RDA, but this was half the typical dose.
With this I consumed over the course of each day: two 8 oz glasses of water mixed with Metamucil (psyllium husks), several cups of senna leaf tea (a laxative), two cups of organic prune juice—which provide quite a bit of natural sugar—and as much water as I could, which I mixed with a pinch of salt.
On the first day I felt weak and slept for several hours in the afternoon. On the second day my energy stabilized and I went for a 2-hour walk. I ended the third day feeling well-slept and took a 90-minute hike up a 200-meter hill. I was never hungry over the course of the fast, but after three days I planned to break the fast by reintroducing first bioflora, then prebiotics, and finally food. It’s important to break a fast carefully.
Before bed on the third day, I mixed my first dose of probiotic powder with a few tablespoons of sauerkraut, a cup of water, and a few tablespoons of yogurt whey. I drank two cups of water through the night, and in the morning of the fourth day took my second dose of probiotics with similar hydration.
A few hours later I ate my first meal: a large plate of well-cooked shredded cabbage and carrot. I continued a diet of cooked, low-sugar, unspiced, low-fat, high-roughage foods and herbal teas until returning to my normal, carnivorous, healthy diet by the fifth day.
Since the point of this effort was to repopulate my digestive tract, I was particularly interested in the contents of the many different probiotic capsules available and in comparing these to what were used in variously reported investigations.
An article in The Journal of Food and Drug Analysis (Kerry 2018) says:
“Research in probiotics has progressed considerably in the past two decades and significant advances have been made in the selection and characterization of specific probiotic cultures along with substantial health benefits upon consumption.”
— Kerry, R., Patrab, J., Gouda, S., et al. (2018). “Benefaction of probiotics for human health: A review,” Journal of Food and Drug Analysis, 26 (3). 927-939. https://doi.org/10.1016/j.jfda.2018.01.002. Retrieved from: https://www.sciencedirect.com/science/article/pii/S1021949818300309
In spite of this, I found no useful recommendations for what specific probiotic cultures to use in repopulating my digestive tract. Instead, I followed the general suggestions provided by Carol Wolf in a personal report titled “Did Probiotics Cure My Chronic Fatigue Syndrome?” which she published online in 2016 at the Health Rising website for ME/CFS, at: https://www.healthrising.org/blog/2016/01/07/probiotics-cure-my-chronic-fatigue-syndrome/
Finding herself in the same situation as I, she suggests using as high a bacterial count as one can take, and the widest range of different bacteria that one can find. Not feeling the need to go overboard, as she admitted that she did, I settled on taking 300 billion bacteria per day, spread out through the day, which is roughly three times the maximum recommended amount. The chance of anything like an overdose seemed remote for me, and its consequence of irritation or diarrhea could be easily countered by lowering the dose.
Probiotics can trigger adverse reactions in immune-compromised individuals, so before you experiment with them, do some research. If you have not taken them before and you’d like to, then start slowly. See the 2017 article, “Can You Overdose on Probiotics?”, at https://magazine.labdoor.com/can-you-overdose-on-probiotics.
Be aware the gut bacteria of men and women differ significantly. It’s important to add the right bacteria. For more information, see Scott Anderson’s “Sex and the Microbiome,” posted in February of 2020 in Psychology Today, at: https://www.psychologytoday.com/ca/blog/mood-microbe/202002/sex-and-the-microbiome
The bacterial ingredients in most of the wide-spectrum probiotics I reviewed in the refrigerated section of my local Whole Foods store—which I compared to a half dozen alternatives listed on the VitaCost.com website—contained many of the same bacteria. I settled on a broad-spectrum, 90 billion Colony Forming Units (CFU), 23-strain active cell count product sold by New Roots and labeled as “Colon Care Probiotics.”
I could have purchased any of the various other products but found this gave me the largest number and the widest variety of bacteria for the lowest price: roughly 15 strains of Lactobacillus, 7 strains of Bifidobacterium, and one strain of Streptococcus.
Your gut is deeply involved in the health of your immune system, and unbalanced gut biota generate a wide variety of negative health conditions. In addition, gut health affects your moods, which you can notice as wide mood swings while fasting.
If you take probiotics, you will also notice that the probiotics precipitate mood swings. This should really set off alarms: if you can change your state of mind by adding live bacteria to your gut, just where is your state of mind located? I don’t take this question lightly, and I don’t think you should, either.
For more information, see Peter Bongiorno’s 2014 article in Psychology Today titled, “The Gut Microbiome, Anxiety and Depression: 6 Steps to Take, How balancing your intestinal bugs brings balanced mood,” at: https://www.psychologytoday.com/ca/blog/inner-source/201411/the-gut-microbiome-anxiety-and-depression-6-steps-take
It’s too early to judge the success of my effort to rebalance my gut. Some people report rapid improvement, but the research studies span months of probiotic treatment. In general, changing one’s gut biota takes months. My own effort may take weeks or months to settle. So far, however, after only a few days, I’m feeling better. The night sweats have ended, but I’m still low on energy.
Hypnosis and the Gut
You will not be surprised that I propose to use hypnosis to address gut conditions, since I’ve used it to address everything else. You may be surprised that psychological methods have been tested in this context and demonstrated a robust, positive effect.
“Cognitive-behavioral therapy (CBT) has been tested most rigorously in multiple randomized controlled trials and consistently demonstrates significant and durable effects on Irritable Bowel Syndrome (IBS) symptoms and quality of life… Despite the well-documented advantages of CBT for IBS, it has been poorly disseminated and few patients have access to this treatment… the American Gastroenterological Association recommends psychological interventions for patients with moderate-to-severe IBS.”
— Sarah Kinsinger (2017). “Cognitive-behavioral therapy for patients with irritable bowel syndrome: Current insights,” Psychol Res Behav Manag. 10, p.231–237. Available from: https://www.researchgate.net/publication/318566692_Cognitive-behavioral_therapy_for_patients_with_irritable_bowel_syndrome_Current_insights
Irritable Bowel Syndrome is not Chronic Fatigue Syndrome, and the positive results obtained for the therapy of one don’t imply similar results will ensue in a similar treatment of the other. On the other hand, both IBS and CFS are believed to have their origin partly, or largely, in the balance of gut biota.
What remains entirely unclear is whether addressing a person’s psychology affects their gut directly or indirectly. That is, while we know they’re connected, does working with the mind address the gut or the brain? Perhaps this is not a valid question; perhaps the two are so deeply intertwined that there is no point in trying to separate them.
On that basis, I offer the piece “The Harmony of the Microbes,” which is a guided visualization toward a balanced gut ecosystem. It approaches the balancing of one’s gut from two directions: imagining an ego-centered sense of relief, and imagining a microbe-centered sense of harmony.
On the one hand, what you as a person know about your gut is largely limited to what you feel. When your gut is well balanced, you feel control, balance, strength, and comfort. Projecting those feelings into or onto your gut is your mind’s way of entraining gut health.
On the other hand, we can imagine what it might feel like to inhabit a strong and balanced gut. That is, we can imagine what strength and balance might mean to a microbe who lives in your intestines. It may well be hopeless to try to “speak microbe,” or to hope this image is accurate; but regardless of whether or not our imagination is accurate, it can still have an effect.
We already know our minds control some elements of our gut environment, so we know we can affect it. Our minds create the chemicals that affect our gut, and the microbes in our gut use these chemicals to communicate. There are many portals of communication; there is communication to the gut, and there is feedback from it.
In any fully interlinked system it does not matter to which “link” you speak, as each link affects the others. It is in this sense that the question of “can psychology affect the gut biota?” is the wrong question. We know it can. The correct question is how much we can accomplish.
medicalxpress.com (2018). “Why Gut Bacteria are Essential for a Healthy Immune System,” retrieved from: https://medicalxpress.com/news/2018-03-gut-bacteria-essential-healthy-immune.html
Roman, P., Carrillo-Trabalón, F., Sánchez-Labraca, et al. (2018). “Are Probiotic Treatments Useful on Fibromyalgia Syndrome or Chronic Fatigue Syndrome Patients? A Systematic Review,” Beneficial Microbes, 9(4):603-611. doi: 10.3920/BM2017.0125
Venturini, L., Bacchi, S., Capelli, E., et al. (2019). “Modification of Immunological Parameters, Oxidative Stress Markers, Mood Symptoms, and Well-Being Status in CFS Patients after Probiotic Intake: Observations from a Pilot Study,” Oxidative Medicine and Cellular Longevity, 2019, Article ID 1684198, https://doi.org/10.1155/2019/1684198
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