 There's a fascinating historical anecdote about Mozart getting sick and never fully recovering that is very relevant to COVID and long COVID. Now, at one point in his life, Mozart was said to have been struck in down with a strong fever where he was constantly dancing between life and death. And his parents weren't sure if he was actually going to recover and get well again. Now, miraculously, he survived and I don't know off the top of my head what that infection was or what that fever was from. But I do know after that period of time, Mozart was said to have had this constant feeling of sickness, like a foreboding that he would not live a long time and that he would die young. Now, for so many of my patients that I've seen get long COVID from COVID, there is a very similar scenario where after this powerful viral infection, they have never felt the same since. Now, this video, let's jump in east and west and look at long COVID, what it looks like and how we treat it with traditional Chinese medicine as well. Hey, guys, I'm Dr. Alex Hain, doctor of acupuncture and traditional Chinese medicine and author of the health book, Master of the Day. So let's jump in, walk over to the whiteboard and look at this a little bit closer. All right, guys, so we're here at this incredibly impressive work of art that I spent weeks of my life creating. When we talk about long COVID specifically, you know, we're going to talk about east and west. And one of the reasons we want to share this east and west is because traditional Chinese medicine for thousands of years has had a very interesting opinion on really viral infections, these febrile events where afterwards people are left in a weakened state, so to speak. When you look at the literature, the acute phase of COVID is generally accepted to be about four weeks. This is weeks here. And then long COVID begins where after 12 weeks, which is a long time, three months, you're still not really doing any better. And those symptoms are lingering. Obviously, if you get a colder flu and three months later, you're still feeling the same symptoms. That's more than a little bit worrying. But when we look not only in my clinical practice and what I see day to day, but also in the literature, there may be about a half dozen buckets of symptoms that you see people having regarding long COVID. And we'll talk about these, you know, east first west as we move towards this little journey here. So the first thing is we tend to see neurological issues. Now, those can range from things like headaches to obviously even strokes. We talk about CFS, Chronic Fatigue Syndrome. Now, it's interesting, chronic fatigue syndrome is now a documented post-viral stage of illness for some viruses, right? Now, initially, when this was being observed, these patients were initially considered to be hypochondriacs or just to have depression or anxiety. They were just given antidepressants and sent on their way and told it was all in their head. Now, this is going back maybe 40 or 50 years or so. But long COVID is another example of a post-viral stage of illness that can lead to something like chronic fatigue syndrome. One of the things I see in my patients with this is that they will say, I used to exercise no problem, but now specifically when I exercise the next day or two, I am like catatonic. I have no energy. I feel depressed. So it is a very distinct feeling that is not just I feel tired because I just did a hard workout yesterday, right? They're really dipping into the negative in terms of their battery reserves, so to speak. The third is obviously respiratory issues, right? One of the main issues people come in with for long COVID to my practice is either they have chronic respiratory issues, chronic neurological or nervous system inflammation issues or nervous system in general, respiratory or GI issues. I would say those make up the four main buckets that make up about 90% of the patients that come in to see me. So in terms of respiratory issues, we see shortness of breath. We see chronic sputum production. People are coughing or they're still wheezing or they're still clearing the throat for months and months and months after. Mostly what I see is that they're coming in because of issues with chronic phlegm production. And again, we're going to talk about damp toxin. You can see over there one of the most common TCM diagnoses for long COVID. The fourth is digestive symptoms. I see people coming in with wandering body pains. Maybe we can put that more in the nervous system bucket. They come in with altered bowels in general, right? They're having upper GI issues. They're having lower GI issues. They're still having diarrhea or severe bloating or wandering abdominal pains I've seen. And the fifth would be issues related to the nervous system. So common ones that I see are wandering aches and pains, chest pain and wandering chest pains. Basically the whole trunk I'm seeing pain. I'm also seeing issues with mental health if you want to call it that, anxiety and depression and sleep issues. I lump these all in the category of nervous system in this regard. And overall, I would say sleep anxiety and depression would be this massive resurgence or after COVID, now my son or my daughter or my wife has insomnia every single night. So I'm seeing that as well. So these five buckets are the most common ones that I'm seeing on a day-to-day basis. And when you look at the literature, certainly outside of, for example, having strokes and heart attacks, cardiovascular events from it. This is a lot of what makes up the chronic long COVID patients that I see. Let's jump over here. There is a concept in TCM. And the reason I wanted to shoot this video is traditional Chinese medicine is about healing. And one thing I'm seeing in conventional medicine is that this has been a real struggle for medicine to try to treat. And even for long COVID, there's really not much that they can offer besides medications. So within TCM, there's a saying, And this expression means tonify or strengthen. Let's just call it your resources and remove what is pathogenic, right? So check this out here. When we're talking about before, this is when you have, let's say, long COVID. Z is going to be, which means let's just say your resources, your immune system strength, right? They're not one-to-one correlates, but we're just going to use that as a metaphor or analogy. So when you have long COVID, what's happening is that your resources, let's just say, are 50% of the pathogenic, right? The viral load, whatever's going on here in the acute infection phase, or in this case, chronic. But here, what happens is your resources have been deregulated or, more commonly, they were this case beforehand, which is why you got so sick in the first place. Not every case, but most of the time I'm seeing this is true, even if you weren't aware of it. Your battery charge is at 50%. Now you get a strong pathogen comes in and it just wipes out anybody that is susceptible. It may wipe them out in terms of they may die. It may wipe them out in terms of they may get very sick for a short period of time, but then they're okay. Or it may wipe them out in the case that they get very sick or maybe kind of sick, but then it lingered because there's still a strong fight basically going on within your body. Now, ancient doctors within traditional Chinese medicine had noted that the strength of the patient's Zheng Qi, right? This upright Qi, let's just call it your reserves, determines how hard you're hit depending on the strength of the infection, how sick you get and how sick you stay and if you are able to recover. So obviously, we're seeing a lot of this with long COVID, right? A lot of people who get very, very sick and the ones who had died, we're looking at this sort of scenario. So if you're older, if you're immunocompromised, if you're not in good health currently, you have weaker Zheng Qi, a weaker battery charge than someone who is the opposite of that. That will determine, number one, how sick you get and how chronic it stays. So now, what we're looking to do after treatment in my clinic is we boost the reserves and we get rid of what's pathogenic. So this expression in China, fuzheng quxia, right, is support the resources and get rid of this pathogenic. And that is what these treatment strategies involve from an acupuncture and an internal medicine and herbal medicine point of view. This is the ultimate philosophy because this is the thing that determines why people get sick in the first place and how they get sick. So I could treat it symptomatically and yet they will end up in this scenario yet again for the next flu, the next pandemic, which will eventually happen again. This is what is most essential. So let's come on over to here and we'll talk about the organ networks that are primarily involved. So number one, we see the tie in lung and spleen organ network. So the tie in organ networks are very, very important here because the lung is obviously your lung and the spleen and TCM governs a lot of digestive functions. It is most likely the spleen pancreas. So it deals a lot with digestive enzymes, bloating, food allergies, low immunity, that kind of thing. We are saying that is the number one organ network commonly affected because do you remember the initial news on long COVID? Do you remember these reports coming out of China of people taking pictures of this thick, glue like flen that they were coughing up? And they were literally basically suffocating to death on this kind of mucus and this chunky flen. Tie in the lung and spleen govern what we call the mucus membranes. And so they're very susceptible to dampness like mucus and conditions that affect those mucus membranes. Obviously, when you catch an up respiratory infection, the lung is one of those things that's affected, right? Because you're coughing and you're sneezing and all of this and, you know, you may feel a little bit of pressure in the chest. The spleen deals with, we say the spleen generates dampness, aka mucus, and the lung is the container of it. So lots of my patients that come in that are more prone to mucus and phlegm, some that's coming up from the digestive system, the stomach, others, it's they have chronic drainage like post nasal drip. The Xiaoyang organ networks are the gallbladder and the triple warmer. Now, a way to conceptualize these is that these organ networks in TCM are in charge of inflammatory conditions. So when someone comes in and we are treating, let's say their acid reflux or we're treating their bronchitis or we're treating their COVID, where, you know what, they're having a dry cough, they're having a sore throat, they're having ear aches, ear, nose and throat issues, and they're having brain fog. We're often treating these organ networks with the Tainan organ networks. And finally, the Xiaoyang organ network, the heart and the kidney. One way you can conceptually think of these is that, yes, that is the axis of the cardiovascular system, because the other one we haven't showed here is Jyan, which is the pericardium and liver. But some of the cardiovascular events here that happened from long COVID, right, like strokes, are in this pattern. And some of the cardiovascular and nervous system symptoms are in this. So the people who are coming out with a crazy anxiety with heart palpitations is one thing we didn't mention. With a very, very elevated resting heart rate, with depression, with sleep issues, that is this organ network that's been deregulated. Maybe people think of it as adrenals, but this is really what it is and it's more nervous system in nature. So let's get into how we actually approach this from a TCM herbal point of view. Let's take a look here at how I treat this verbally, because the TCM herbal point of view, one, there's a lot of evidence about how well these formulas work clinically to treat long COVID. And I'm seeing this often in my practice and it's very effective. So we've talked about some of the neurological aspects, headaches, brain fog, dizziness, right? To me, a lot of these are lymphatic issues and neurological issues. We talked about respiratory issues, shortness of breath, chest symptoms. We talked about nervous system issues, body aches, wandering body pains, that kind of thing, GI issues, etc. Now, when we talk about the herbal treatments for long COVID, first thing we're talking about damp toxin. So when we talk about dampness, we are talking about not only dampness as in mucus, issues involving the mucus membranes, like having to clear your throat or cough up mucus and phlegm, those are the most obvious, but dampness also shows up in the gut. In terms of the gut, it can be candida or yeast issues, bloating, food allergies, that kind of thing, thick white tongue coat. If you look at your tongue while you had COVID, I know a lot of you had a disgusting, thick white tongue coat. That is damp toxin according to TCM. Now to treat dampness, signs and symptoms of dampness are, for example, it can be bloating and GI issues, loose stools and diarrhea was also and crapping was another COVID symptom. Headaches, brain fog and dizziness can often be signs of dampness. Now, we treat this not only from a nervous system and a dampness point of view. And we typically use herbs like Guajir, which is cinnamon twig or roguay, cinnamon bark, an herb called Baiju, fuling, and another one called Bancha, which is Penelia. Penelia is one of the strongest for these lymphatic issues. People who have chronic lymphatic issues who are chronically exposed and prone to brain fog and that kind of thing. So we ended up using herbs that we say dry dampness and help with mucus and phlegm. But one of the most common ones I'm using for this, fuling is also poria, Bancha is Penelia. Penelia one of the strongest that people have brain fog in particular or pressure sensations in the head. It's also one of the best for mucus and phlegm in the chest. So lots of acid reflux. People are getting mucus and they're coughing a lot. Penelia Bancha is one of the most important. The second pattern is what we call, let's say residual damp heat. So sometimes what shows up for this is sometimes people are having skin rashes from COVID. Sometimes people are having even hot flashes. They're having what look like fungal or bacterial conditions. Sometimes people have issues like jock itch where it's red and it's raised. These kind of issues that are inflammatory or fungal in nature are called damp heat. So the herbs we use for a damp heat very frequently include herbs like chaihu, buplorum, as well as huangchin, which is scudalaria. The other one being coptidus rhizoma, which is huanglian, very, very effective antibacterial agents and antifungals as well. They're also really well studied for treating candida and yeast issues, that kind of thing. When we talk about chi and blood stasis, a lot of the time this involves symptoms like fixed pain. So obviously one of the scarier symptoms we saw of COVID was these cardiovascular events like strokes and even for some people heart attacks, right? So these clotting events are often viewed as blood stagnation. Now in an ordinary person that develops, let's say a clot or a stroke, there's some kind of chronic cardiovascular impairment, right? There's an issue in the flow of that river that is not working and now you're leading to clotting elsewhere in the body. Due to the unique aspects of COVID, we're seeing this also. So the herbs that we use are herbs like tauren and honkwa and these herbs help what we call, say, move blood stagnation. A lot of these same herbs are herbs that we use for blood stasis elsewhere in the body. You can use them to assist, let's say, for example, leomaeomas, ovarian cysts. It can be used for as well or fixed abdominal pain due to other gynecological conditions like endometriosis, for example. Let's talk about lung and spleen cheat efficiency. What we're seeing here is most often respiratory and digestive symptoms that linger. Respiratory being like chronic shortness of breath, chronic wheezing, chronic sputum production, mucus. And on the GI side, we're typically seeing very low appetite. We're seeing bloating. We're seeing loose stools, food allergies, and sometimes for women, discharge, that kind of thing. So remember, lung and spleen often govern issues with the mucus membranes and with dampness, basically the mucosa, right? Not only lung, but it can be the nose, the sinuses, it can be the stomach, it can be the intestines. So for this, we often use a combination of herbs. Some are, again, roguay, cinnamon bark. Some are renchen, ginseng. Baiju, attractor loads, dries a lot of the dampness. And fuling poria is like a mild diuretic, basically, that flushes some of this residual congestion people have. So we use these for lots of other general internal medicine conditions, but that one in particular, we end up using for these residual, that kind of pattern. And then when we say yin deficiency, generally we're talking about for some people they have sensations of hot flashes after. Sometimes we treat that as yin deficiency is almost like your engine oil has run out on your car. Now the car is running hot and that heat is just smoking and rising out of the car. In this case, it's usually the head that people say they feel hot. So those are some of the main herbal patterns that I'm seeing clinically, day to day. And let's talk about a case so I can describe exactly what she was experiencing and what that looked like and how we treated it. So this particular woman came in who was 34 years old and she came in with a few symptoms of different organ networks here in TCM. First was the Xiaoyang organ network because her primary symptom she was complaining of was, you know, when she was young, she had a history of headaches and migraines, but now that she's had COVID, they've just gone to crisis mode every single day, right? She'll have a migraine for three days straight. And that was not something she normally had before. So headaches and migraines are often these signs of what we call either constraint or floating young, right? It's almost like there's this heat in the system and the heat, heat, heat is just packed and then it just starts rising and it causes havoc. So for this pattern, headaches and migraines, it was almost like COVID had brought up a constitutional or genetic susceptibility that she had prior. For her migraines, we use the formula that is called Xiaochaiutang. Now Xiaochaiutang, that modification is basically something we use to unblock the gallbladder and the triple warmer and the lymphatic system in particular. So Chihu is often used for issues involving, you know, the submandibular lymph nodes, for example, where people will say all my glands are swollen, right? Because I have a sore throat and I'm getting sick. The second was she came in with dizziness, brain fog and shortness of breath. Now these conditions are typically involving dampness or lung and spleen chi deficiency. So the dizziness, the brain fog and the shortness of breath were associated with these POTS symptoms, right? She was having pretty significant dizziness and vertigo. Dizziness and vertigo, we often utilize formulas that one treat the nervous system. We call this weak yang or heart yang deficiency because they often have issues with heart rate variability, palpitations, that kind of thing. And we combine them with herbs that we say move the lymphatic system and drain dampness. So herbs like Penelia, Bansha, Attractalodes, Baiju, Fuling, Poria, Rogue Way, Cinnamon Bark, all of these really, really effectively move the lymphatic system and improve the circulation to these zones. And then when we talk about the Shaian organ network, the heart and the kidney, we're really treating her nervous system at that point, the adrenals, if you want to call it that. A lot of these symptoms present with what the lay person calls adrenal issues, heart rate variability, elevated heart rate, anxiety, chronic fatigue, exhaustion, that sort of thing. She was having POTS, so a lot of dizziness, a chronic fatigue like pattern, where, for example, she couldn't exercise anymore. Actually, she couldn't even work when she came to me. So she's quite fatigued. General body aches and also insomnia. So for this, we use the combination of a high dose of the cinnamon twig, Guajur, and Cinnamon Bark Rogue Way. And what those herbs are very effective for is for taking the nervous system down a couple of notches. And with conditions that also involve palpitations, elevated heart rate, anxiety, Guajur is the king of anything on the planet for treating that kind of thing. So that is a sample case. And for her, within about three weeks, the migraines had decreased by 50%. And within about three months, she was 95% back to normal after two years of not being able to work. So this was a very interesting sort of overview of long COVID, what it is East, West, and how we treat it. Now, also, if you guys are interested in healing with traditional Chinese medicine in particular, I have a free guide on my website. It's the first link right below this video for daily rituals that could potentially help you add years to your life with traditional Chinese medicine. Also, I do see patients like this in my private practice in Los Angeles, or virtually via telemedicine. So you can reach out, the link to reach out to my clinic and private practice is below this video, if you ever want to discuss more. And before we go, I also have a related video for you right there.