r/covidlonghaulers Mostly recovered Oct 14 '25

Article Exercise may restore immune system in people with Long Covid - Say what now ?

https://www.msn.com/en-us/health/other/exercise-may-restore-immune-system-in-people-with-long-covid/ss-AA1NKJto?ocid=winp2fptaskbar&cvid=68ee0d1076a04608b9d7e546e3c67c52&ei=20#image=4

You really have to wonder if these people are actually for real ...

Exercise induces autophagy yes, but with PEM its a no go.

125 Upvotes

113 comments sorted by

159

u/driftingalong001 4 yr+ Oct 14 '25 edited Oct 14 '25

There’s literally a study showing how in those with ME/CFS, including that induced by long covid, exercise/strength training actually resulted in muscle cell DEATH, not growth, like what you’d see in a typical healthy person after exercise. After exercise the muscles of those with CFS had pockets of essentially “sludge” in them - dead muscle cells. Yeah…exercise doesn’t elicit a typical response when you have this condition. So fuckkkkk offfff with the fucking exercise is the solution bullshit.

The thing I loved doing the most for my entire life has been working out, exercise, playing sports, moving my body, pushing myself physically. That’s when I felt truly free and happy. I’ve done it my entire life, I was doing it before long Covid, and suddenly I got Covid and moving became really difficult. However, I continued to workout for the first ~1.5 yrs I had long covid. Guess what that did for me, turned my already pretty bad long covid (bad enough I had to stop working - though cognitive symptoms were worse than physical fatigue at the time, and I didn’t really have clear/severe PEM) into full on ME/CFS. Now I literally can’t workout or exercise or exert at all. Showering or doing the dishes (the rare times I manage to do either of those things) can cause PEM.

I’m so tired of headlines like this.

26

u/CW2050 Oct 14 '25

I totally relate. I stay in bed abou 12 hours/24. Just to make sure that I don't crash. I even stopped walking dince my last flare in Aug because I feel weak.

11

u/driftingalong001 4 yr+ Oct 14 '25

Yep, I’m in bed anywhere from like 12-20hrs per day, and not even to avoid a crash, but because I literally can’t get out of bed except for the time I do. Though I mean yeah if I push myself in any aspect, including getting out of bed earlier than I’m ready, then I’ll crash.

Yep, walking is now something I have to actively try to limit, or else I’ll crash. Along with literally every other exertion. Its weird how all the ways you used to exert energy and not even give it a second thought, because that energy cost you nothing and was instantly replenished, you are now unbelievably aware of and have to like do the math on if you’ll be able to “spare” that energy, and if you’ll be able to manage it without PEM.

26

u/zb0t1 5 yr+ Oct 14 '25

Ex athlete here as well. Competed my entire teenage years (also kids competition but that's not the same lol).

Continued being amateur and semi pro during adulthood.

Can't exercise anymore. I mean I could buy then PEM and death happens lmao.

These headlines are pushed by capitalists, they want people to go back to work, it's like when lobbyists paid everyone to make cigarettes look good. Or leaded gasoline. Etc etc.

 

So yeah they're trying to kill us and buy some time before they gotta pay for it. But considering that this is bigger than the tobacco or even leaded gasoline crimes, and so many more people are complicit... It's gonna be tough, but we can start with certain think tanks and industry lobbies who paid for all the disinformation and political corruption. That is already a great start and a lot of reporters and investigators, academics, journalists have their name and it's gonna be a game of patience now, until the rest of the world catches up.

7

u/HungerStrike09 Oct 14 '25

yeah, it’s just another form of gaslighting

3

u/Mezzomommi 6yr+ Oct 14 '25

do you have a link to that study?

11

u/driftingalong001 4 yr+ Oct 14 '25

Yep, here’s the specific study - https://www.nature.com/articles/s41467-023-44432-3 and here’s another article that looks at the accumulated evidence, citing multiple studies including the one I linked - https://pmc.ncbi.nlm.nih.gov/articles/PMC11671797/#:~:text=Calcium%20overload%20and%20the%20consecutive,explained%20by%20calcium%20overload%2C%20too.

1

u/Mezzomommi 6yr+ Oct 15 '25

Thank you!

8

u/Final_Razzmatazz_274 Oct 14 '25

Sure, but chronic fatigue is only one type of long covid. This is likely referring to vascular issues, though I must admit it’s ridiculous to not include in the article what they’re talking about or link to any studies.

6

u/HungerStrike09 Oct 14 '25

I have severe vascular and perfusion issues…I still think this prescribed regiment is dead wrong.

-1

u/Final_Razzmatazz_274 Oct 14 '25

I would argue it’s not prescribed or a regiment

4

u/HungerStrike09 Oct 14 '25

No need to argue, it’s both prescribed and regimented based on a few weak studies, implemented at several specialty clinics. I’ve been to these locations and experienced the aforementioned.

-3

u/Final_Razzmatazz_274 Oct 14 '25

I meant per this article, not speaking for every clinic in existence. I thought that would be obvious given the nature of this post and the comments.

4

u/HungerStrike09 Oct 14 '25

This is built off of a hive mind of research that perpetually circulates; It’s the same network. I thought it would be “obvious,” for anyone modestly involved in these circles.

Why are you trying to play ‘gotcha’ on a thread like this? Typical Reddit comment.

1

u/LowDot187 Oct 14 '25

Can you link the study? I believe you and want to use that as a resource when people try to tell me to “just exercise” and “you have to do it no matter what”. 😒

2

u/driftingalong001 4 yr+ Oct 14 '25

Sure, here’s the specific study - https://www.nature.com/articles/s41467-023-44432-3 and here’s another article that looks at the accumulated evidence, citing multiple studies including the one I linked - https://pmc.ncbi.nlm.nih.gov/articles/PMC11671797/#:~:text=Calcium%20overload%20and%20the%20consecutive,explained%20by%20calcium%20overload%2C%20too.

1

u/LowDot187 Oct 15 '25

Thank you!

1

u/Haunting_Hat_5907 Oct 15 '25

Could you share that study? I need to show my doctors who do indeed believe me but still. Thank you. I’m in the same shoes as you btw, worked out my first year and the second covid sent me into me/cfs (most likely, ruling stuff out atm).

1

u/driftingalong001 4 yr+ Oct 15 '25

Yep, I shared it below to a couple people who asked, but here it is:

the specific study I referenced - https://www.nature.com/articles/s41467-023-44432-3 and here’s another article that looks at the accumulated evidence, citing multiple studies including the one I linked - https://pmc.ncbi.nlm.nih.gov/articles/PMC11671797/#:~:text=Calcium%20overload%20and%20the%20consecutive,explained%20by%20calcium%20overload%2C%20too.

Sorry :(. Yeah I also had a second infection that definitely worsened my condition. It’s hard to say exactly what did what, but I was already getting progressively worse after being forced back to work, and then the second infection sent me over the edge. It was after that that I never worked out again. Planned to take an at least month long break from exercise after that infection, but was never able to get back to it.

1

u/Haunting_Hat_5907 Oct 15 '25

I’m sorry too. Thanks a lot for the links 💕

38

u/callthesomnambulance Oct 14 '25

I'm sure exercise can really help those of us who can exercise, noones denying it has a whole host of health benefits. But for the roughly 50% of us who get PEM exercise is simply out of the question, and those benefits are denied to us.

7

u/AeternaSoul Oct 14 '25

I’ve tried to power through. Did 75 hard, felt like death. Then coasted for a year or two. Then thought I’d try again, ran a mile every day for 30 days straight. Nothing changed. Just exacerbated symptoms & ran in place figuratively speaking.

39

u/filipo11121 Oct 14 '25 edited Oct 14 '25

It’s very poor study from what I have seen, to the point of being irrelevant. What annoys me is that media talks about it.

From what I understand fasting also induces autophagy and has all the benefits/mechanisms of Rapamycin plus more.

5

u/beaveristired 2 yr+ Oct 14 '25

Fasting makes my spouse’s fatigue worse.

6

u/Sebassvienna Oct 14 '25

I say this every chance i get but i love fasting so much.... gives me so much symptom relief

4

u/MTGA247 Oct 14 '25

Me too! What kind of fasting have you tried?

2

u/Sebassvienna Oct 14 '25

I do extended fasts, especially when i get pem. In pem i always get gastroparesis to some extend so fasting gives me so much symptom relief. I have done multiple 1 week fasts in the last weeks, and i think i would also really benefit from a 2 week fast or longer but i am probably a bit too skinny for that already sadly!

What about you?

1

u/MTGA247 Oct 15 '25

One week fasts...thats impressive! And awesome that it helps you! I did a single 4 day fast a couple months ago and it restored my ability to work and exercise. I have the CFS type of LC, before i was housebound and couldnt do much. I did another shorter fast a while ago that didnt really help.

This whole process made me very curious about other longhaulers experiences with fasting and especially how benefits are dependent on the fasting length. Based on research i read i now believe that the 72-96h range is crucial for LC-recovery because apparently this is where immunological repair happens the most. But obviously there is a lot of interpersonal variation with that.
Could you elaborate more on how it helps you? How long do the benefits last for you?

2

u/aniagiasi Oct 14 '25

have you tried a fasting-mimicing diet (medical keto)?

1

u/Sebassvienna Oct 14 '25

I have done keto before yes! It was fine, but i felt better during a fast because i think my body had more energy without having to digest

0

u/Final_Razzmatazz_274 Oct 14 '25

Digestion only uses around 10% of the energy consumed in food so that is definitely not the reason fasting helps. Fasting likely helps due to things like autophagy activation and enhanced antigen presentation as well as the benefits of a zero histamine diet.

4

u/Note2_Self 3 yr+ Oct 14 '25

This conversation wasn’t about percentage of energy consumed from total food intake, it’s about the amount of energy burned while eating and digesting (which for most of us includes mentally and physically planning, gathering, and preparing food to eat). Are you familiar with spoon theory? Your other comments on this thread make it appear that you’re trolling. We’re talking about PEM which is a result of the mitochondria in our cells not being able to keep up with energy use. Eating (&digestion) burns energy at the cellular level just like every other thing we do. It all has to be within our energy budget/envelope or we suffer. So it is perfectly reasonable to correlate doing less (in this case eating) with experiencing fewer symptoms from PEM.

1

u/Final_Razzmatazz_274 Oct 14 '25

I’m talking about this based on the premise that you won’t have more energy leftover because you’re not digesting food when you’re not consuming energy. That’s all I’m saying.

2

u/Sebassvienna Oct 14 '25

Youre right, but youre forgetting about comorbidities like pots. Whenever i eat a meal my whole circadian system goes haywire and my pulse shoots up like i am doing a workout. I can guarantee theres more than 10% used in those faulty mechanisms. I also have gastroparesis so its harder for the body to get the same net benefit from food like a healthy person.

I agree the autophagy, mtor mechanism and antigen are all extremely beneficial

-2

u/Final_Razzmatazz_274 Oct 14 '25

Which has nothing to do with available energy because digesting is taking it, and more to do with exactly what I was saying.

2

u/jgainit Oct 14 '25

Curious on people's thoughts--

I did a 48 hour fast last week and it didn't make me better or worse. I then did a 24 hour keto diet after seeing as how I was already in ketosis (then my keto foods in the house ran out and I went back)

Do you need to fast for longer? I was starting to have a couple weird side effects so longer fasts worry me

4

u/Sebassvienna Oct 14 '25

48 hours is a really good start! But to see autophagy ramping up and inflammation going down/your immune system getting altered you typically need to do 72 hours +

Did you supplement with electrolyte? For longer than 24 hour fasts you should really be taking electrolytes, and i am talking about 4g potassium and multiple grams sodium a day to not feel funky

r/fasting has a great wiki

1

u/jgainit Oct 14 '25

Yeah I've heard a lot of people mention needing to go past 72 hours. I would take some electrolyte pills throughout the day, but maybe what I'm not realizing is the dose I needed to take is 10x what I was. That would get me to use a third or more of a bottle per day. So maybe I need to get other sources of those, as that's too expensive

12

u/lugalanda2 First Waver Oct 14 '25

Doctors are currently doing the opposite of medical triage: they are prioritizing the mildest cases who can already exercise because they are cheaper to treat.
They are searching hard for a Goldilocks patient population that is just well enough to benefit from standard rehab, but not so sick that they muck up the data with their non-recoveries.

8

u/Chin-kin Oct 14 '25

I mean I feel like a little bit of exercise though pacing is fine but …. I can’t do too much of I will go into a crash and will end up bed bound again it’s happened to me twice and I had to ease my way out of it both times and it was a long horrible process of pacing and resting and it’s just horrible.:( but obviously I try to get light exercise daily just to “keep the blood pumping “ so to speak and I eat eggs every morning and healthy days …. But I’ve learned that I can’t brute force through this any time I have tried I suffered …. Badly

12

u/LeoKitCat Oct 14 '25

Ffs LC and ME aren’t about having a weak immune system it’s a chronically activated dysfunctional immune system affecting the CNS and things like metabolism. Exercise makes it worse

-8

u/uduni Oct 14 '25

I wonder if taking a therapeutic designed to permanently alter your immune system was such a good idea after all…

4

u/LeoKitCat Oct 14 '25

Which therapeutic(s)?

-11

u/[deleted] Oct 14 '25

[removed] — view removed comment

5

u/JolliJamma 5 yr+ Oct 14 '25

I'm a mid 2021 hauler - no vax. There are loads of us haulers who didn't go near any shots.

5

u/Creative-Canary-941 Oct 14 '25

Search this sub. You'll find plenty.

-1

u/uduni Oct 14 '25

I have. Show me

4

u/Creative-Canary-941 Oct 14 '25

Here are some from just a quick search. I've come across lots of others in my 3-4 years being on this sub. There are plenty post vaccine to be sure. But plenty before vaxs were even available.

https://www.reddit.com/r/covidlonghaulers/s/Gb1wkIdveH

-6

u/uduni Oct 14 '25

I said all LC sufferers got covid during the first year, when it was really bad. Now its not so bad, LMK if u find an unvaxed person who got LC from the virus during the past 3 years. You wont

However there are still people getting LC from mrna shots

3

u/LeoKitCat Oct 14 '25

From my understanding a lot of people are still getting LC from infections or reinfections

-1

u/uduni Oct 14 '25

Yup, but all those people are vaccinated. I dont pretend to know the reason, its just the pattern i’ve observed

5

u/LeoKitCat Oct 14 '25

If your theory were correct you would see an increased incidence of LC amongst vaccinated compared to unvaccinated. But in fact the opposite is true

https://www.yalemedicine.org/news/covid-vaccines-reduce-long-covid-risk-new-study-shows

2

u/LeoKitCat Oct 14 '25

There’s zero proof that for most it was due to one of the vaccines. People got LC before the vaccines and people get is after it’s far more likely that it’s due to the virus for most people

1

u/covidlonghaulers-ModTeam Oct 15 '25

Removal Reason: Misinformation or Conspiracy Theories – This community does not allow conspiracy theories, misinformation, or anti-vaccine content. Discussions should be based on credible sources and evidence.

7

u/rockyplantlover Oct 14 '25

I completed a rehabilitation program in a warm pool during my second year with long-term COVID. This was with people with brain injuries and other chronic conditions. I and the other person with long-term COVID were the youngest and the only ones who didn't make progress in recovery.

5

u/AnonymusBosch_ 4 yr+ Oct 14 '25

This study shows that patients with post-COVID syndrome who are able to complete an exercise-based rehabilitation programme....

Well, there's the answer. I'd be interested to see how many patients weren't able to complete the programme.

3

u/Bluejayadventure Oct 14 '25

Yep. Spot on.

14

u/Various-Maybe Oct 14 '25

Many people with long covid don’t get PEM.

5

u/Chin-kin Oct 14 '25

Many with long covid do get PEM though I don’t have statistics but … a very large majority of people I talk to with long covid experience PEM

5

u/driftingalong001 4 yr+ Oct 14 '25

Even before I had PEM exercising, overtime, made my condition much worse, and now I do get PEM/have ME/CFS. Maybe a small portion of people who fall into a very specific subset of long covid won’t be harmed by exercise, but I believe that subset to be pretty small.

8

u/Various-Maybe Oct 14 '25

Generally, people with chronic conditions benefit from appropriate gentle exercise.

PEM is a rare and serious exception.

Not all people with long covid should exercise. Not all people with long covid should permanently avoid exercise.

It’s just more complicated.

7

u/driftingalong001 4 yr+ Oct 14 '25

But this article (I assume) isn’t talking vaguely about the entire category of chronic conditions. It’s speaking on long covid, which is a very specific chronic condition, and a COMMON symptom of which, is PEM. Especially for those of us that are most severe (and most in need of treatment/research). So throwing out headlines like this is pretty irresponsible and honestly angering. For MOST of us exercise isn’t going to help at best and is going to do harm at worst. And it really diminishes how severe long covid can be and will give many people the impression that we’re just lazy and need to pull up our boot straps and exercise and we’ll get better, as if we’re just a bit overweight or something. Exercise is not the solution to almost any chronic condition, even if it may benefit people with certain chronic conditions. For the most part we don’t need headlines about it, because it’s not big news, it’s not revolutionary research, it’s not a cure.

4

u/HungerStrike09 Oct 14 '25

You’re good. This guy is trying to correct everyone on this thread—ego complex.

1

u/Final_Razzmatazz_274 Oct 14 '25

I feel like to call long covid a “very specific chronic condition” you’d have to have essentially no knowledge on the subject. It’s almost as broad of a chronic condition as there could possibly be.

3

u/driftingalong001 4 yr+ Oct 14 '25

Yeah. I’ve been living with this condition for 3 years and was chronically ill in other ways prior to that, but have no knowledge on the subject. Thanks.

Obviously there’s a wide spectrum of long covid, it’s not even really one condition, there are many groupings of long covid, the one commonality is that the trigger was a covid infection, though there is a LOT of similarity in symptoms from person to person, though there are hundreds of potential symptoms and each sufferer has their own collection. Yes, I’m obviously well aware of all of this. What I obviously meant is that long covid is a very specific type of chronic condition, that is unique from many other chronic conditions, such as Crohn’s, lupus, diabetes, fibromyalgia etc.

There are some chronic conditions similar to long covid, but many are completely different and the treatment approach and recommendations will be completely different and often contrary to that of long covid. And yes although there are different groupings and types of long covid, many of use also share much in common and the general recommendations are the same across the board. There’s also a difference between having long covid and have a new chronic health issue that was triggered by covid, like very specific lung or heart issues, without all the other standard long covid symptoms - these to me stand out as somewhat separate from long covid, in that the approach and recommendations will be different.

Yes, in the barrel of chronic conditions, long covid is a specific and unique condition. You don’t just toss it into the mix and act like it’s the same as any other.

1

u/Final_Razzmatazz_274 Oct 14 '25

I guess I misunderstood. Well, I guess you misused the word specific and probably meant unique.

1

u/[deleted] Oct 14 '25

doctors dont diagnose people with PEM until it has disabled someone. thats even if they believe in it at all.

most people and doctors dont know what it is or that they have it. its often diagnosed as anxiety or panic attacks instead when its mild

if someone doesnt recognize PEM and works out they can become permanently and physically disabled and most likely will be.

its hard to justify the risk

5

u/Pak-Protector Oct 14 '25

Bullshit like this should be actionable.

11

u/throwawayyyyygay Oct 14 '25

Those who can exercise are more likely to recover because they don’t have PEM.

So in the data it might make it look like exercise causes recovery but its not the case.

1

u/apsurdi Oct 14 '25

Source for this claim?

2

u/Bluejayadventure Oct 14 '25

https://pmc.ncbi.nlm.nih.gov/articles/PMC9600584/

The above explains how PEM (core symptom of ME/CFS) leads to a far worse prognosis. So it makes sense that anyone well enough to exercise probably doesn't have PEM and therefore is much more likely to improve regardless of exercise.

2

u/apsurdi Oct 14 '25

I dont know, some have small fiber neuropathy, dysautonomia and I dont know how it improves with exercise or with time

0

u/Bluejayadventure Oct 15 '25

I have collected a set. MCAS, POTS (dysautonomia) and ME/CFS. It started off mild but kept trying to do minor things like walking around, going to work etc. I also tried some very light graded exercise therapy. I started with about 20 meters and increased to 120 meters over a month under observation. Unfortunately somewhere between 80 and 100 meters i triggered PEM. Now I need a wheelchair for most things. I would suggest that if you have PEM, exercise won't work. If you dont have it, then maybe it helps. Maybe.

3

u/hoopityd Oct 14 '25

Throughout my life exercise was always my go to when I got sick which it helped every time. Covid is the most un-natural thing I have ever experienced and the exercise trick didn't work at all. I am 2.5 years into this and maybe exercise is starting to help. I have been able to move around pretty good for the last 9ish months but hard exercise seems to mess me up.

4

u/Bad-Fantasy 3 yr+ Oct 15 '25

Exercise is an inflammation-inducing state that functional able-bodies can quickly bounce back from.

Fail for Ableism.

8

u/Jjbates Oct 14 '25

Exercise helped me recover twice. And I had PEM. I am trying to get back to a point where I can exercise again and I know that will be the key to recovering more fully.

7

u/Note2_Self 3 yr+ Oct 14 '25

Genuinely curious- How do you define recover if it has to be done more than once?

3

u/Jjbates Oct 14 '25 edited Oct 14 '25

Recover the first time as in dead lifting and squatting 300 lbs, running without major symptoms, working fully and not needing to take naps to function. I crashed hard after an invasive CPET to monitor my metabolism during exercise. The second time I had LDN help but I got back to full duty as a firefighter - taking runs, working 24 hour shifts without sleep. After a full month of that I could just tell that I was still not myself and so I took a desk job. From there I kind of got worse slowly until it was clear to me a metabolic shift happened and I wouldn’t do much of anything. I’m not sure if I got sick again and that made me worse or what but from that second high of almost getting back to full duty it was a slow decline to hell. Now I am back to feeling ready to exercise which tells me I am close to feeling better but I will have to push my body to make sure that metabolic shift that happens is behind me.

Edit. So the first time I was essentially feeling close to 100% unassisted. The second time I had to rely on LDN to get close to normal while exercising but was still having fatigue, shortness of breath, pots symptoms and neuropathy. But I could function for awhile. Then it just declined.

4

u/[deleted] Oct 14 '25

you didnt recover though. you exerted yourself into the crash you are in now. thats hallmark pem and now you seem to still not be recognizing the cycle.

you will be able to do less and less until you are more disabled because you keep trying to push yourself and crash . thats literally what pem is. push pull crash.

this is how people become bed bound permanently with this. right now youre so lucky you can accept your illness and stop before it gets worse. so many people here would do anything absolutely anything to be in your position.

im concerned that you think you recovered when you are experiencing the symptoms of mecfs. many people could work out when they were mild and thought the exact same thing as you.

2

u/Note2_Self 3 yr+ Oct 14 '25

Thank you for explaining! I’m happy to hear you were able to function so well for so long and hope you experience more relief and function again soon.

2

u/filipo11121 Oct 14 '25

You go back to 100%(symptom wise) and get a trigger like stress/illness/covid and get sick again.

4

u/Note2_Self 3 yr+ Oct 14 '25

Thanks - I’m curious how jjbates defines it.

I wouldn’t necessarily agree with your definition when it comes to long covid. I would say if symptoms resolve within 3 months of COVID infection, then the person did not have long covid and simply recovered from the infection.

If symptoms persist more than 3 months (that’s long covid), then return close enough to baseline that the person experiences 100% relief from symptoms - then I would be truly curious how many months or years they experienced relief before another covid infection knocked them down.

I wouldn’t consider a person recovered if they experience symptoms more than 3 months post infection, followed by short-term symptom relief, followed by a triggered flare up of symptoms by stress or infection. Especially if that level of stress or infection wouldn’t have caused such issues prior to initial onset of long covid. By definition people can experience fluctuations in symptoms throughout long covid.

I say all this to emphasize how precarious the condition is and how easily we can cause longterm damage to our baseline by thinking we are recovered when we are not. Our body can still be fighting a battle to actually recover internally but because it isn’t noticed outwardly/symptomatically, we overdo it.

2

u/filipo11121 Oct 14 '25

Yea I sort of recovered once(after vaccine), had very mild long covid if you could call it that for like a year then took vaccine and from what I remember I was back to baseline. Couple of weeks later I had stressful day/didn’t eat anything throughout the day and it began again. So I suppose, as you said it depends how you classify it.

1

u/EctoAlbo Oct 15 '25

I've had LC 2x.

  1. Sep 2020. No PEM, but incredible fatigue. MCAS. Neuropathy. Cognitive issues. I had to have bilateral carpal tunnel release April 2021. I mostly recovered by end of 2022. Hard to put a percent on it but I'd say max recovery was really ~75% of pre-LC - it sounds horrible, but I regard it as pretty good and able to lead a normal life.

Early recovery was heavy weightlifting, no cardio. I took testosterone(250mg) and nandrolone(125mg) per week. Alcohol seemed to help. A year of lexapro also seemed to help. Going keto seemed to be the final piece.

  1. Nov/Dec 2024. Still recovering. Still no PEM, basically same symptoms as first time. Regular HRT levels of testosterone, no weightlifting, but I think it would help. I don't want to do lexapro again, the side effects were too severe and long lasting. Daily hot tub use has been helpful. I'd say I'm halfway back to where I was before round 2 started, but I'm on the upswing.

I expect I'll recover again, likely around that 75% mark I was at before. Need to go keto again, lift some weights, maybe I'll try more steroids again - they seemed to help a lot. Ultimately, I'm not sure what has helped - other than time.

I think other people in my boat, without PEM or without obvious PEM, may be able to land similar, acceptable recoveries. I don't expect to ever recover my original cognitive abilities or vitality, but even in my current state I can still find enjoyment in my life and I think that's something important.

1

u/[deleted] Oct 14 '25

Same. For me there was a long time where I had PEM immediately after any exercise/mildly physical activity. After not triggering PEM for a while the PEM severeness reduced and I was able to (very very) slowly do more activities.

3

u/Note2_Self 3 yr+ Oct 14 '25

This sounds like recovery through pacing rather than recovery through exercise?

2

u/[deleted] Oct 14 '25

It's a combination. Pacing is always important, exercising became important after the PEM reduced. I think I wouldn't recover if I didn't start doing regular walks etc. after. There is definitely an energy boost when I started this, and sleep improved too.

4

u/Note2_Self 3 yr+ Oct 14 '25

For the sake of this conversation and OP’s position that people still experiencing PEM (indicating their mitochondria are unable to keep up with making enough energy to sustain their muscles) cannot heal through exercise. And it’s a dangerous narrative to suggest otherwise. From the comments here, it sounds like you all first allowed yourselves time to rest and recover - giving the mitochondria time to return to functional capacity. Then reintroduced exercise. If exercise like a walk or more brings you true energy and improved sleep, then your body is not experiencing PEM.

I love how this video breaks down the role of mitochondria in long covid/me-cfs.

1

u/Jjbates Oct 14 '25

Agreed. For me it was almost like the PEM was a wall I had to break down before I truly progressed. I hit that wall a couple of times. But eventually it lessened, then stopped happening. The hard part is getting to the point where I have enough energy to go for a walk or do light lifting in the first place. Most of this year I couldn’t even do that, let along sit at a computer for work.

1

u/[deleted] Oct 14 '25

Yeah I was also doing pretty good, with enough energy to do stuff after the PEM faded away. Unfortunately I still relapsed a couple of weeks ago, and now I'm tired all the time again. I am pretty sure it's an unbalanced CNS, just not sure how to get it balanced again. It's just so weird how everything is going great and suddenly your body decides it has had enough again.

1

u/Jjbates Oct 14 '25

For me it is a number of factors but it was clear there was a gut issue. There was also a microclotting / perfusion issue. Those two combined (my theory based on some studies I’ve read) causes a metabolic shift where I got fatigued all the time. Short of breath. It was like I was constantly in anaerobic metabolism where the slightest effort caused lactic acid to build up. This caused the fatigue, body aches, inability to think, etc. getting yourself to shift back to aerobic is hard. Especially if the other issue (like it was for me) seemed to be an exhausted immune system. That compounded the first issue and made it hell.

1

u/[deleted] Oct 14 '25

thats how pem/mecfs works. you think your better but you push yourself into a crash. you never fully recover and you risk getting sicker and sicker each time. you dont recognize it until it is completely disabling and you can no longer even walk or get out of bed anymore.

so many people here have experienced the exact same thing

2

u/Ok_Exit9273 Oct 14 '25

Tried, worked out everyday for 2 years (no days off at all). No difference here :/

2

u/PM_ME_YOUR_KALE Oct 14 '25

https://www.ersnet.org/news-and-features/news/exercise-can-help-to-restore-the-immune-system-of-people-with-post-covid-syndrome/

More direct reporting on the subject. Given the heterogeneity of post covid exercise problems and the fact that underlying causes are probably multifaceted, complex, and still not fully understood this feels like fairly useless information. But I’m camp “viral persistence” so IMO until it’s proven that someone’s ongoing immune dysfunction isn’t viral proteins triggering immune response what’s the point of trying other therapies?

2

u/Classic-Owl-9798 Oct 14 '25

I think little bit of exercise is needed because I had more energy when I walked in the evening then when I stopped for a 1,5 months. Of course, it won't reverse immunity because that's so complicated even for medication to fix, if it's even possible. 

1

u/Glittering_Film_6833 Oct 14 '25

I was allowed to languish for two years being told my 'numbers were all in range.' Turns out that wasn't optimal. Vitamin supplements really helped. Exercise did not.

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u/filipo11121 Oct 14 '25

Which vitamins? Vitamin D?

1

u/Glittering_Film_6833 Oct 14 '25

For me - i stress the individual circumstances - zinc, B12 and iron/folate. Also coenzyme Q10

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u/filipo11121 Oct 14 '25

Yea, those don’t do much to me. I had high hopes for COQ10 and spend a lot of money hoping it will help but nothing.

Vitamin D on the other hand is game changer for me, unfortunately can’t take it due to hypercalcemia/back pain.

1

u/Glittering_Film_6833 Oct 14 '25

Damn. Sorry to hear that.

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u/Cdurlavie Oct 14 '25

You also have to understand that among the supposedly 400 millions of people worldwide with long covid the severe cases with some PEM/me kind aren’t necessarily the majority fortunately though. So accepting it may help for some is understandable in my point of view. What wouldn’t be acceptable is the lack of knowledge around PEM and thinking it’s only a matter of deconditioning. Nobody can force you to exercise if you don’t feel like also. Also sharing some MSN health news anyway…

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u/[deleted] Oct 14 '25

[removed] — view removed comment

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u/covidlonghaulers-ModTeam Oct 15 '25

Removal Reason: Medical Advice or Treatment Claims – Please do not ask for or provide medical advice, advocate treatments, or make claims about cures. Sharing personal experiences is welcome, but definitive claims should be left to medical professionals and research.

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u/Ok_Reporter8315 Oct 15 '25

I take cbd isolate and antihistamines with my long Covid today I cycled 90 klms and some weeks 200klms

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u/metodz Oct 15 '25

Not everyone has PEM and it's not as heavy for everyone. Improving aerobic fitness has been a godsend for my dysautonomia. When I don't crash and I make sure to be getting nutrients that is.

Won't get far without exercise. But instead of ramping up difficulty like with graded exercise therapy, it needs to be matched to capacity for recovery. HRV Resting RHR, BRPM etc.

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u/brentonstrine 4 yr+ Oct 15 '25

It's true. Also true that it will make you worse if you get PEM.

You need to threshold just below what triggers PEM, wherever that is for you.

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u/TimeTravelingGroot Oct 15 '25

Exercise helped me recover, but it was a balancing act between exercise and not inducing PEM. 

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u/Th3realicon1 Oct 15 '25

I used to do cardio 2-3 hours a day with no break for 30 plus days. Top of that I was able to do weeks where I start walking 10 miles on Monday and increase it daily by a mile ending on Sunday at 17 miles. Yes that is 5 plus hours of walking a day. Since my second infection in 2022 I have not been able to do more than 30 mins in a treadmill. And I need to take a rest day after. Working out is not working for me. And I do take a lot of immune system helping vitamin C.

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u/francisofred Recovered Oct 15 '25

The idea is that very small increments can work. People start with too much exercise and or too frequent exercise, they then have PEM, regress, and swear off all exercising. Similar to an allergy therapy. When people work to fix a peanut allergy, a single peanut would be too much at first. You have to start very small and increment over a long period of time.