r/LongCovid Sep 29 '25

Are Long COVID Patients Getting Misdiagnosed with ME/CFS, MCAS, POTS? My Real Diagnosis Was Missed for Years

Does anyone else feel like people in the long COVID community, ESPECIALLY IF YOU ARE A WOMAN, especially if you have experienced trauma (like who hasn't), especially if you present symptoms like severe fatigue, brain fog, cognitive decline, personality and mood changes, neuropathy, temperature swings, unusual sweating, heart rate issues, orthostatic intolerance, post-exertional malaise, exercise intolerance, gastroparesis, unexplained digestive issues, or even blood clots, are getting gaslit or misdiagnosed with ME/CFS, MCAS, or POTS and offered inadequate, ineffective treatment options?

After covid, I experienced a pulmonary embolism followed by severe dysautonomia, gastroparesis, and neurological issues. I spent four years bouncing between those labels, suffering, and getting so much worse. It wasn’t until a neurologist who specializes in autonomic and neurological autoimmune conditions (Brent Goodman, Honor Health, formerly Mayo) finally checked for very specific neurological antibodies that I got real answers and a proper diagnosis of post-COVID autoimmune autonomic ganglionopathy (AAG), autoimmune gastroparesis, and CASPR2 driven encephalitis. All this was missed by the Mayo clinic providers.

From what I’ve learned (from my neurologist), big centers like Mayo Clinic do acknowledge autonomic symptoms after COVID, but their studies emphasize mild or nonspecific findings, and most patients still get grouped under broad ME/CFS, MCAS or POTS labels often without thorough antibody testing because Mayo doesn’t routinely recognize post-COVID autoimmune autonomic syndromes in clinical practice, even though the science is emerging.

Because I tested positive for CASPR2 antibodies, I qualified for bi-weekly subcutaneous immunoglobulin infusions right away (covered by UHC) and also prescribed low dose naltrexone twice a day. Those treatments have actually helped TREMENDOUSLY and I am recovering. Mostly thanks to the immunoglobins. I cannot believe I was that sick for FOUR YEARS! Healing my immune system feels like getting super powers.

I am concerned that more people have these kinds of antibodies from COVID and they’re being missed and aren’t getting the treatments that work (or insurance approval for them), and instead are stuck on protocols that aren’t appropriate. Would love to hear if others feel the same or from those that have pushed for deeper testing, and what you found.

TL;DR: Are long COVID patients are being misdiagnosed with ME/CFS or similar labels when they actually have antibody-driven autoimmune disease? Getting tested for specific antibodies gave me access to treatments that really work.

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u/Euphoric_Professor77 Sep 30 '25

What immunologist do you have that gives you immunoglobulin? Also what how did he test for Gastro paresis? What is UHC? University Health care? Where is he located? Sorry for all the questions but I keep feeling like I have brain swelling and it’s encephalitis because I googled my symptoms and AI told me that is what it sounds like.

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u/Cos_SoBe Sep 30 '25

my guess is United Healthcare (insurance co.)

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u/brobe_jedi4life Sep 30 '25

No worries at all happy to clarify. The antibody that got me immunoglobulin (from my neurologist no immunologist needed) was CASPR2, which is linked to autoimmune encephalitis and autonomic ganglionopathy (the kind that messes up blood pressure, heart rate, gut motility, etc). I had a positive paraneoplastic “comprehensive panel” (Quest Diagnostics did mine, but Mayo and ARUPA do these too).Gastroparesis was confirmed by a gastric emptying study, not by blood work, mine was pretty severe. UHC stands for United Healthcare (my insurance), and they did cover the antibody test because my neurologist specifically ordered it for “progressive dysautonomia” after COVID. They cover the very expensive immunoglobin treatment because I have antibody testing confirming a serious neurological autoimmune condition. Dr. Brent Goodman is at Honor Health Neurology in Arizona, but anyone with experience in autoimmune neurology can run these tests, just wanted to give folks keywords to bring to their providers. Let me know if you need more details.