When the symptoms don’t tell the whole story…
Do you remember how it was “difficult” for doctors to be able to diagnose COVID and Long COVID because it manifests as a wide variety of symptoms?
I remember talking it through with a doctor (frined) who is an A&E specialist. He also sufferred COVID and Long COVID and had some bizarre symptoms himself. He said it was impossible. There was no consistency and some people had extreme symptoms.
Well, doctors still don’t know how to diagnose properly. The guidelines in the UK (I am in touch with one of the tech companies that provides the latest guidelines to doctors based on NHS England agreed parameters) are still a group of fairly generic symptoms.
For me this tells me that there isn’t an accurate diagnostic available. I mean, there is but its only just edging its way into the market and our nearest is in Germany - so, not that near then. Hopefully, there will be one in the UK soon.
What is this diagnostic? Well, it’s based on a well established technoloy which has been modified to be able to identify the micro clots that are the foundation of all the issues.
If you want to read about the micro clots this research paper is a good starting point but I’ll be writing about them in more detail because of how significant their discovery is.
Back to the diagnostic, its a blood test. The sample of blood is passed through an imaging flow cytometer - this is a piece of equipment that can identify small molecules in the blood and it has been modified to be able to identify the clots that are originated by COVID.
These small clots aren’t like normal thrombotic clots. They do something very tricky to deal with. They clog, probably temporarily, any and every organ in the body that has capillarys (the smallest of the blood system’s vessels). When they cause a blockage they starve any cells downstream of the blockage from receiving oxygen and nutrients. BUT critically because the blood isn’t flowing the cell waste isn’t being removed.
This leads to the cells behaving as if they are in fight or flight mode and operating anaerobically but that can only happen for a short time (about 10 seconds - which is why 100m is about a 10 second race! - sprinters rely on this anaerobic activity to run fast for a short time).
What happens next is disasterous…
The cells operating anaerobically fill with the waste product - lactic acid, which would normally be taken away by the blood but you’ll remember that the blood isn’t flowing past those cells. They are poisoned.
The team at Renegade Research did a citizen science experiement, the acid test, to see if people suffering with Long COVID had higher than normal levels of lactic acid. They do. Significantly. And, unusually at time of day when they shouldn’t, liek first thing in a morning when waking up. A time when lactic acid levels would be at their lowest.
Of course, thinking about the random temprorary partial blockages in every organ would mean that as the micro clots move, block, move, block around the blood stream cells that were down stream would be implicated and swap into anaerobic mode, then back again allowing the lactic acid to be removed and filtered out as normal. But then the liver and kidneys are also organs with many small capillarys, and they are probably partially blocked too so the filtering probably isn’t that effective.
Lactic acid is a toxin and high levels can lead to all sorts of inflammation and worse… that’s for another post.
A little recap of whats going on:
Cells that are starved of oxygen and nutrients; Causing cell hypoxia
Cells that are poisoned;
Areas of all organs that are partially blocked;
The upshot of all this is that nothing is working fully, areas of the body are hypoxic and under severe stress. Inflammation is rife and most of the signalling pathways are disrupted.
Is there any wonder that the symptoms are varied? They will depend on what organs are blocked & by how much. It is, by degrees, utter chaos.
And yet, our bodies continue to function.
Although, we feel, unsurprisingly exhausted.
That makes it highly unpredictable from a diagnosis point of view and gives doctors little chance to pin down what is going on.
When you start to look at the symptoms associated with hypoxia, at least for cognitive function, there are some very clear parallels.
And yet, all this is treatable.