Category: Medicine

bookmark_borderLong-COVID: reduced exercise capacity and muscle cell death

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A symptom of long COVID may be the reason you feel exhausted after a workout — “long COVID may reduce exercise capacity, measured by how much oxygen your body can use and how your heart and lungs function during exercise.”

In January of 2024, a study found long-COVID patients have muscle abnormalities that resulted in cell death after exercise. “It’s really confirming that there is something inside the body going wrong with the disease,” said Dr Rob Wüst, an author of the study at Vrije Universiteit (Free University) Amsterdam.

In the report Cardiopulmonary Long COVID-19 Symptoms found “exercise capacity was reduced by 4.9 mL/kg/min among individuals with symptoms consistent with LC compared with individuals without symptoms more than 3 months after SARS-CoV-2 infection. Findings among individuals with exertional intolerance suggest that deconditioning, dysfunctional breathing, chronotropic incompetence, and abnormal peripheral oxygen extraction and/or use may contribute to reduced exercise capacity.”

“This decline in oxygen peak rate would roughly translate to a 40-year-old woman with an expected exercise capacity of 9.5 METs, dropping to 8.1 METs, the approximate expected exercise capacity for a 50-year-old woman,” says Dr. Matt Durstenfeld, an author on the study and assistant professor of medicine at the University of California, San Francisco.

The press release “Feeling winded after your workout? Long COVID may claim another symptom” states:
The findings suggest that the long COVID cohort in this subgroup may have reduced oxygen extraction in the muscles, irregular breathing patterns, and a lesser ability to increase heart rate during exercise to match cardiac output. In addition, there was evidence of deconditioning, which occurs to some extent after most physical illnesses that result in inactivity, the researchers noted. Importantly, not all the findings could be attributed to deconditioning.

Exercise tests were conducted at least three months following SARS-CoV-2 infection and involved cardiopulmonary exercise testing (CPET), in which oxygen and carbon dioxide were measured, together with other indices of heart and lung function, while the participant used a treadmill or stationary bike.

Doubles Tennis, Lap Swims May Be Too Strenuous for Those With Long COVID

In comparing exercise tolerance, the researchers found the long COVID group’s peak rate of oxygen was 4.9 ml/kg/min lower than the recovered group. According to first author Matthew S. Durstenfeld, MD, MAS, of the UCSF Department of Medicine and of the Division of Cardiology at Zuckerberg San Francisco General Hospital, this difference is equivalent to 1.4 metabolic equivalent of tasks (METs), a measure of energy consumed during physical activities. “This decline in oxygen peak rate would roughly translate to a 40-year-old woman with an expected exercise capacity of 9.5 METs, dropping to 8.1 METs, the approximate expected exercise capacity for a 50-year-old woman,” he said.

Another way of looking at it, Durstenfeld said, is that a doubles tennis player might need to transition to playing golf with a cart or stretching exercises, and those who swim laps may find that low-impact aerobics is a better match.

The study Muscle abnormalities worsen after post-exertional malaise in long COVID found exercise causes the destruction of muscle cells.

A distinctive symptom of patients with long COVID is post-exertional malaise (malaise is a general feeling of discomfort, illness, or uneasiness whose exact cause is difficult to identify), which is associated with a worsening of fatigue and pain-related symptoms after acute mental or physical exercise, but its underlying pathophysiology is unclear. We show that skeletal muscle structure is associated with a lower exercise capacity in patients, and local and systemic metabolic disturbances, severe exercise-induced myopathy and tissue infiltration of amyloid-containing deposits in skeletal muscles of patients with long COVID worsen after induction of post-exertional malaise.

Patients with long COVID displayed a markedly lower exercise capacity, which related to skeletal muscle metabolic alterations and a shift towards more fast-fatigable fibers. The pathophysiology of post-exertional malaise includes an acute exercise-induced reduction in skeletal muscle mitochondrial enzyme activity, an increased accumulation of amyloid-containing deposits in skeletal muscle, signs of severe muscle tissue damage, together with a blunted exercise-induced T-cell response in skeletal muscle. Collectively, these findings help to decipher the underlying physiology of fatigue and a limited exercise capacity from the development of post-exertional malaise in patients with long COVID.

Viral infections can alter mitochondrial function, and multiple studies have shown that residual SARS-CoV-2 protein presence is associated with long COVID. It is unknown if the full virus is present, or only protein remnants. Because the spike protein is located on the exterior of the virus, this protein may have different proinflammatory/coagulatory effects compared with the nucleocapsid protein. The higher skeletal muscle infiltration of CD68+ macrophages and CD3+ T-cells suggests a locally disturbed immune response in patients with long COVID.

In conclusion, this study reveals that local and systemic metabolic disturbances, severe exercise-induced myopathy, infiltration of amyloid-containing deposits, and immune cells in skeletal muscles of long COVID are key characteristics of post-exertional malaise. While these explain the symptomatology of post-exertional malaise in long COVID, the molecular pathways underlying these alterations in patients suffering from post-exertional malaise remain to be determined.

COVID-19 / SARS-CoV-2 / Novel Coronavirus

bookmark_borderCOVID-19 Significantly Higher Risk of Alzheimer’s

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The risk of older people (over 65) developing Alzheimer’s disease over a one-year period nearly doubled following a COVID-19 diagnosis. The same researchers had previously found that individuals with dementia had a greater risk of contracting COVID-19 and being hospitalized and dying from the disease than those without dementia.

“Many people believe that for Alzheimer’s disease there is a combination of factors that work together to give you the cognitive impairment, and we were concerned that the kinds of things that happened during COVID-19 — the intense inflammation, and perhaps the kinds of direct action on the brain of the of the virus — might be a risk factor,” Dr. Davis, the study’s co-author, said. “So we went looking for that in our study.”

“We can say that they are associated, but we cannot infer causality,” she stressed.

“First, the pandemic presented serious delays for individuals seeking out medical diagnoses like Alzheimer’s disease, meaning these results could be driven by those who already had Alzheimer’s disease when they were infected but had not yet sought out a formal diagnosis,” Dr. Snyder, vice president of medical and scientific relations at the Alzheimer’s Association, explained.

“Alternatively, COVID-19 infection — which is linked to immune changes, including inflammation — may impact the onset of brain changes that are linked to Alzheimer’s disease and other dementia,” said Dr. Snyder. “However, because this study only showed an association through medical records, we cannot know what the underlying mechanisms driving this association are without more research.”

Association of COVID-19 with New-Onset Alzheimer’s Disease

COVID-19 / SARS-CoV-2 / Novel Coronavirus

bookmark_borderThe Cost of Climate Change: USD 178 trillion

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“Time is no longer running out to act on climate change; it’s up,” reports Deloitte. Unchecked climate change could cost the global economy USD 178 trillion over the next 50 years. “The human costs would be far greater: a lack of food and water, a loss of jobs, worsening health and well-being, reduced standard of living.”

Time is no longer running out to act on climate change; it’s up. Download the report.

Time to act—accelerating to zero

With global emissions continuing to rise over the last two decades, we have squandered the chance to decarbonize at our leisure. The global economy needs to execute a rapid, coordinated, sequenced energy and industrial transition that will play out in distinct phases.

* Bold climate plays: Coordination and collaboration set the stage for decarbonization by formulating policies and frameworks for a low-carbon future.
* Accelerating to net zero: Deep investment across systems instigates structural economic adjustments. The decline of emissions-intensive industries would create growing pains for some economies.
* Turning point: Investment in structural economic adjustment is almost complete. Economies would realize the dividend of the transformation and experience net positive growth.
* Low-emission future: Interconnected, low-carbon systems underpin a clean economy that would grow at an increasingly faster rate than its carbon-intensive alternative.

The Human Induced Climate Change Experiment

bookmark_borderClimate Change and Pathogens

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In the report published in Nature entitled Over half of known human pathogenic diseases can be aggravated by climate change, data analyst and associate professor in the Department of Geography and Environment at the University of Hawaii Manoa, Camilo Mora, said climate hazards aggravated 58% of all known human pathogens. That is over half of infectious diseases discovered since the end of the Roman Empire.

A whopping 58% of an authoritative list of infectious diseases documented to have impacted humanity have already been shown to be aggravated by climatic hazards — a finding the researchers found “shocking,” Mora said.

Movement of people and animals caused by climate is one factor. Warming at higher latitudes allowed vectors and pathogens to survive winter is another factor. The report goes on to say, “The human pathogenic diseases and transmission pathways aggravated by climatic hazards are too numerous for comprehensive societal adaptations, highlighting the urgent need to work at the source of the problem: reducing GHG (Greenhouse Gas) emissions.”

This research reveals more evidence that humans will have difficulty adapting to climate change, especially those in developing countries, Mora said.

“The magnitude of the vulnerability when you think about one or two diseases — okay, sure, we can deal with that,” he said. “But when you’re talking about 58% of the diseases, and 58% of those diseases can be affected or triggered in 1,000 different ways. So that, to me, was also revealing of the fact that we’re not going to be able to adapt to climate change.”

Climate Change and Health

The Human Induced Climate Change Experiment

bookmark_borderGood Gut Bacteria (Gut Microbiome)

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by Daniel Brouse
help@membrane.com

Good Gut Bacteria
“Gut bacteria play several important roles in your health, such as communicating with your immune system and producing certain vitamins. Your gut bacteria can also affect how different foods are digested and produce chemicals….” (Why the Gut Microbiome Is Crucial for Your Health)

Most people start fermenting good gut bacteria from their mother’s breast milk. There are around 40 trillion bacterial cells in your body. They come from a wide variety of sources. One type can only be found in the milk or meat of cud chewing bovine. If your gut bacteria are destroyed, it is very difficult to re-establish. Eating and/or drinking probiotics will not in-and-of-itself re-establish good gut bacteria. COVID (and other conditions) destroys good gut bacteria resulting in a compromised immune system. The best way to re-establish your good gut bacteria is to consume breast milk for at least 6 months. Alternatively, you need to get all the right ingredients for fermentation including the proper 300 to 500 bacterial types, chemicals for the reaction, and lots of fiber.

Your gut bacteria changes throughout the day. The makeup of the bacteria cultures varies depending on what your body is doing. Eating, exercising, and sleeping will alter the good gut bacteria needed for the job. Changing your sleep schedule, or other changes to lifestyle, may result in noticeable changes in your digestion (runny stool to constipation.) Other reasons you may notice changes in your good gut bacteria activity include breaking down toxic food compounds or providing protection from pathogenic organisms (that enter the body through drinking or eating contaminated water or food.)

Vitamins
There is a symbiotic relationship between good gut bacteria and vitamins. “It has been known for decades that intestinal bacteria make important contributions to human metabolism and physiology. Perhaps the example best known to clinicians is the microbial synthesis of the essential nutrient vitamin B12 — the enzymes required for B12 synthesis are possessed by bacteria but not by plants or animals.” (Microbial production of vitamin B12)

Several bacterial genera that are common in the distal intestine (e.g., Bacteroides, Bifidobacterium, and Enterococcus) are known to synthesize vitamins. Thiamine, folate, biotin, riboflavin, and panthothenic acid are water-soluble vitamins that are plentiful in the diet, but that are also synthesized by gut bacteria. Likewise, it has been estimated that up to half of the daily Vitamin K requirement is provided by gut bacteria. Interestingly, the molecular structure of bacterially synthesized vitamins is not always identical to the dietary forms of the vitamins. In fact, several specialized epithelial transporters have been recognized to participate specifically in the absorption of vitamins derived from gut bacteria. (Contributions of Intestinal Bacteria to Nutrition and Metabolism in the Critically Ill)

Vitamin D and its nuclear receptor (VDR) regulate intestinal barrier integrity, and control innate and adaptive immunity in the gut. (Vitamin D and the Host-Gut Microbiome)

Sunlight and the photosynthesis of vitamin D also play an important and symbiotic role in maintaining good gut health.

Fiber
Soluble fiber benefits your digestion, gut bacteria, and blood sugar levels.

New knowledge about the gut microbiota and its interaction with the host’s metabolic regulation has emerged during the last few decades. Several factors may affect the composition of the gut microbiota, including dietary fiber. Dietary fiber is not hydrolyzed by human digestive enzymes, but it is acted upon by gut microbes, and metabolites like short-chain fatty acids are produced. The short-chain fatty acids may be absorbed into the circulation and affect metabolic regulation in the host or be a substrate for other microbes. (Dietary Fiber, Gut Microbiota, and Metabolic Regulation)

The best sources of dietary fiber are: beans, whole grains, brown rice, popcorn, nuts, baked potato with skin, berries, and bran cereal. Juicing and/or blending destroys most of the fiber.

A study “Cancer Prevention with Resistant Starch” (conducted over the last 30 years) shows that resistant starch reduces your risk of cancer. Good sources of resistant starch include rice or potatoes that have been cooked and cooled, as well as, whole grains such as barley and oats.

The resistant starches produce good bacteria that reduces a type of acid that promotes changes to your DNA. The changes to your DNA increase the risk of many types of cancer. The discovery may also explain in part why COVID increases your risk of cancer. COVID is known to destroy good gut bacteria.

Back to the NAD+ Immune Boosting Diet

bookmark_borderHow You Photosynthesize (And Why a Vitamin D Supplement Is Not the Same)

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by Daniel Brouse

Did you know you photosynthesize?

Most of the vitamin D in your body is created by exposure to sunlight.

“During exposure to sunlight, the high-energy UV photons (290-315 nm) penetrate the epidermis and photolyze 7-dehydrocholesterol (provitamin D3) to previtamin D3. Once formed, previtamin D3 undergoes a thermally induced isomerization to vitamin D3 that takes 2-3 days to reach completion.” (Photosynthesis of vitamin D in the skin: effect of environmental and life-style variables )

That is to say, the sunlight hits your skin and you photolyze vitamin D3. Actually, it is previtamin D3. This is the important part as to why you can not obtain the same benefits by taking a vitamin D supplement. Previtamin D is not the only part of the chemical equation you produce while photosynthesizing. There are photo proteins, melatonin, other hormones, and important ingredients your body needs to maintain a healthy immune system (among other things.) Some of these ingredients have unique biologic properties. Unique means you can not obtain them any other way than through sunlight.

“Sunshine may play a role in regulating hormones and sleep patterns by affecting the melatonin circadian rhythm. Melatonin is a hormone produced in the pineal gland, from the chemical melanin. Melanin is produced in the skin through sun exposure. Melatonin helps with inducing sleep.” (Sleep, sunshine & vitamin D)

The complex process of photosynthesis and metabolism starts in your skin. Most of the immune system benefits happen from the start of the process (skin) and continue for 2 to 3 days on the way to the blood stream. After a couple days, a small piece of the process makes it into your blood as Vitamin D3. When you take Vitamin D3 supplements, you miss all the benefits of the photosynthesis process, as well as, the “good gut bacteria” process.

IMPORTANT NOTE: There are great risks to exposing your skin to sunlight. Exposure to Ultraviolet (UV) Radiation can cause premature aging of the skin and signs of sun damage such as wrinkles, leathery skin, liver spots, actinic keratosis, and solar elastosis. UV rays can also cause eye problems. Most skin cancers are a result of exposure to the UV rays in sunlight. There are also many people that need to take vitamin D supplements for other reasons. You should talk to your doctor. “Vitamin D supplements have potential harms, such as a risk of hypercalcemia and kidney stones, when given at high doses.” (Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer)

In some cases, vitamin D supplements may be advised by your doctor. Listen to your doctor. For most people, sunlight is the best thing to do. It only takes 30 seconds to a minute-and-a-half of sunlight per day for your body to make enough Vitamin D. The crucial elements of the equation are: how direct the sunlight and how dark the skin. (e.g. If you have dark skin and live in Canada during the winter, you will need a lot more sunlight.) Some studies suggest that once skin is exposed to the sun it becomes increasing less effective at producing D. I try to remember to expose my wrists from time-to-time. The more virgin to sunlight the skin, the better the skin is at creating vitamin D through photosynthesis. It also reduces the amount of time needed exposing the skin to dangerous radiation.

Learn More About Vitamin D and Sunlight
Vitamin D, Health, and Wellness

Back to the NAD+ Immune Boosting Diet

bookmark_borderGood Gut Bacteria and Food Allergies

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The rise in food allergies has nothing to do with GMOs. The increase number of people with fool allergies is mostly to do with good gut bacteria. Many children are not getting introduced to the bacteria needed to establish good gut bacteria. Many adults good gut bacteria is getting destroyed by diseases, such as, COVID. Reestablishing good gut bacteria is difficult. For instance, one of these bacteria can only be found in milk or meat from cud chewing bovine. There are an estimated 100 trillion “good” bacteria.

bookmark_border1 in 6 deaths Worldwide Attributed to Pollution

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* Pollution is the largest environmental cause of disease and premature death in the world today
* 1 in 6 deaths worldwide attributed to pollution
* 9 million people per year die from pollution

The Lancet Commission on pollution and health was updated for 2022:

Pollution and health: a progress update 2022 PDF

Key messages
• Over the past two decades, deaths caused by the modern forms of pollution (eg, ambient air pollution and toxic chemical pollution) have increased by 66%, driven by industrialisation, uncontrolled urbanisation, population growth, fossil fuel combustion, and an absence of adequate national or international chemical policy.
• Despite declines in deaths from household air and water pollution, pollution still causes more than 9 million deaths each year globally. This number has not changed since 2015.
• More than 90% of pollution-related deaths occur in low-income and middle-income countries.
• Key areas in which focus is needed include air pollution, lead poisoning, and chemical pollution. Air pollution causes over 6∙5 million deaths each year globally, and this number is increasing. Lead and other chemicals are responsible for 1∙8 million deaths each year globally, which is probably an undercounted figure.
• Most countries have done little to deal with this enormous public health problem. Although high-income countries have controlled their worst forms of pollution and linked pollution control to climate change mitigation, only a few low-income and middle-income countries have been able to make pollution a priority, devoted resources to pollution control, or made progress. Likewise, pollution control receives little attention in either official development assistance or global philanthropy.
• The triad of pollution, climate change, and biodiversity loss are the key global environmental issues of our time. These issues are intricately linked and solutions to each will benefit the others.
• We cannot continue to ignore pollution. We are going backwards.

Climate Change and Pollution Health Impacts

bookmark_border99% of Population Breathes Air Pollution

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7 Million people die from air pollution related illness every year.

“After surviving a pandemic, it is unacceptable to still have 7 million preventable deaths and countless preventable lost years of good health due to air pollution,” said Dr. Maria Neira, head of WHO’s department of environment, climate change and health. “Yet too many investments are still being sunk into a polluted environment rather than in clean, healthy air.”

WHO reports:
Almost the entire global population (99%) breathes air that exceeds WHO air quality limits, and threatens their health. A record number of over 6000 cities in 117 countries are now monitoring air quality, but the people living in them are still breathing unhealthy levels of fine particulate matter and nitrogen dioxide, with people in low and middle-income countries suffering the highest exposures.

The findings have prompted the World Health Organization to highlight the importance of curbing fossil fuel use and taking other tangible steps to reduce air pollution levels.

WHO Air Quality Database and Report 2022

The Human Induced Climate Change Experiment

bookmark_borderGut Microbiota (Good Gut Bacteria) and COVID-19

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by Daniel Brouse

Good gut bacteria are the microorganisms (bacteria and archaea) that live in the digestive tract. The gut microbiota produces fermentation of non-digestible substrates like dietary fibres and endogenous intestinal mucus.

“Approximately 100 trillion micro-organisms (most of them bacteria, but also viruses, fungi, and protozoa) exist in the human gastrointestinal tract — the microbiome is now best thought of as a virtual organ of the body. he human genome consists of about 23 000 genes, whereas the microbiome encodes over three million genes producing thousands of metabolites, which replace many of the functions of the host, consequently influencing the host’s fitness, phenotype, and health,” according to the Role of the Gut Microbiota in Nutrition and Health. “Gut microbes are key to many aspects of human health including immune, metabolic, and neurobehavioural traits.”

Research published in the Journal Nature states, “The human oral and gut commensal microbes play vital roles in the development and maintenance of immune homeostasis.”

In the study, Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19, it was reported:
Although COVID-19 is primarily a respiratory illness, there is mounting evidence suggesting that the GI tract is involved in this disease. Gut microbiome composition was significantly altered in patients with COVID-19 compared with non-COVID-19 individuals. Moreover, this perturbed composition exhibited stratification with disease severity concordant with elevated concentrations of inflammatory cytokines and blood markers such as C reactive protein, lactate dehydrogenase, aspartate aminotransferase and gamma-glutamyl transferase. SARS-CoV-2 primarily infects the respiratory tract, however, pathophysiology of COVID-19 can be attributed to aberrant immune responses in clearing the virus.

Associations between gut microbiota composition, levels of cytokines and inflammatory markers in patients with COVID-19 suggest that the gut microbiome is involved in the magnitude of COVID-19 severity possibly via modulating host immune responses. Furthermore, the gut microbiota dysbiosis after disease resolution could contribute to persistent (long-COVID) symptoms, highlighting a need to understand how gut microorganisms are involved in inflammation and COVID-19.

2025 Update: COVID-19, the Aging Brain, and Gut Microbiome

With growing evidence that COVID-19 can persist in the body, especially the gut, and cause systemic effects, researchers are calling for greater awareness, ongoing monitoring, and expanded health support — not just for those with long COVID, but for the broader public as well.

About Good Gut Bacteria (Gut Microbiome)
About Persistent SARS-CoV-2 and COVID-19
COVID Chronic Conditions and Long-COVID

Science Based Information on COVID-19 / SARS-CoV-2 / Novel Coronavirus