Treatments 💉💊
This is my current medication and supplement regimen. It’s a lot — long COVID touches nearly every system, and each item here was added for a specific reason. Many are informed by pharmacogenomic testing (ClarityX), which revealed I’m a CYP2D6 Intermediate Metabolizer and CYP2C19 Ultra-Rapid Metabolizer, among other variants. That matters because it changes how I process a lot of common medications.
This is not medical advice, just what I’m sharing.
Daytime Medications & Supplements
| Medication / Supplement | Dose | Reason | Notes |
|---|
| Sertraline | 50 mg | Anti-anxiety / depression | Switched from duloxetine |
| Nicotine patch | 7.5 mg / 8 hrs | Dopaminergic support | Remove at bedtime |
| L-Tyrosine | 1 g | Dopaminergic support | Empty stomach, 30 min before food |
| Fish oil | 1200 mg | Cholesterol, general health | |
| Pumpkin seed oil | 1000 mg | Cholesterol, hair, general health | |
| Potassium chloride powder | Various | Hypokalemia (lifelong, severe) | CRITICAL — sip throughout day |
| Turmeric | 1000 mg | General health | |
| Famotidine | 20 mg | Indigestion, H2 for suspected MCAS | |
| Quercetin + bromelain | 800 / 165 mg | Antihistamine, suspected MCAS | |
| Vitamin D3 + K2 | 180 / 20 mcg | Heart and bone health | |
| Multivitamin | 1 tablet | General health | |
| Garlic | 400 mg | Heart and general health | |
| Vitamin D3 | 125 mcg | General health | |
| Fexofenadine | 180 mg | Urticaria, suspected MCAS | Stopping if IgE controlled |
| Diclofenac potassium | 50 mg, 2x daily | Pain | Potassium-based formulation |
| NAC | 1 g | Yale Long COVID Study | Paired with guanfacine |
| CoQ-10 | 200 mg | Heart health, statin support | |
Nighttime Medications & Supplements
| Medication / Supplement | Dose | Reason | Notes |
|---|
| Night Rest + melatonin | 2 tablets | Sleep | Contains 5 mg melatonin, 300 mg Mg, 500 mg GABA |
| L-Theanine | 400 mg | Sleep, anxiety, dopamine support | Increases GABA, serotonin, dopamine |
| Ashwagandha root extract | 1 tablet | Sleep, anxiety, HRV | Root extract — HRV studies |
| Ashwagandha KSM-66 | 1 tablet | Sleep, anxiety | Standardized extract |
| Glycine | 1 g | Sleep, neurological support | |
| Tart cherry | 1 g | Sleep | |
| Magnesium glycinate | 200 mg / 2 tablets | Muscle cramps, neuroprotection | |
| Mirtazapine | 15 mg | Sleep, appetite | |
| Guanfacine ER | 2 mg | Sleep, attention | Paired with NAC (Yale LC Study) |
| Atenolol | 50 mg | HTN, anxiety, sleep | First to reduce if BP drops on pramipexole |
| Cetirizine | 10 mg | Allergies, suspected MCAS | Nighttime only |
| LDN | 1.25 mg | Sleep, pain, long COVID | Holding |
| Atorvastatin | 10 mg | Cholesterol | Monitor muscle tightness with exercise |
| Pramipexole | 0.25 mg / am – pm | RLS, treatment-resistant depression | Not working as well anymore |
As-Needed Medications
| Medication / Supplement | Dose | Reason | Notes |
|---|
| Symbicort | 80 / 4.5 mcg | Asthma | Morning/day, as needed |
| Loperamide | Various | IBS-D | Minimal use |
| Fiber | Daily | IBS-D, IBS-C, incontinence | Before/after medications |
| Xolair | 300 mg monthly | IgE, urticaria, suspected MCAS | Monthly injection at home |
| Acetaminophen | 500 mg | Pain — vestibular migraines | |
| Nasal spray | 0.57 fl oz | Nasal congestion | |
| Ondansetron | 8 mg | Nausea | See pharmacogenomics note below |
| Emgality | 120 mg/mL monthly | Vestibular migraines / PPPD | Started May 2026 |
Paused
| Medication | Dose | Reason | Notes |
|---|
| Amphetamine ER | 10 mg | ADHD, dopamine | Paused — potassium / pre-surgery |
Stopped
| Medication | Reason stopped |
|---|
Triamterene-HCTZ | Dehydration risk, PLF confirmed as primary diagnosis |
Meclizine | Blocks vestibular compensation |
Baclofen | Too much CNS depression stacking |
Duloxetine | Switched to sertraline |
Betahistine | On hold pending surgery, likely doing nothing |
Pharmacogenomics Notes
Based on ClarityX pharmacogenomic testing, certain medication classes require special consideration:
- Dopamine-blocking anti-emetics (metoclopramide, prochlorperazine, promethazine): Use alternatives due to DRD2 variant — increased sensitivity to dopamine blockade. Ondansetron is the preferred anti-nausea option.
- Antipsychotics (all classes): Discuss with prescriber — DRD2 variant means increased sensitivity; use lowest effective dose if clinically necessary.
- Diphenhydramine: Use alternatives — CYP2D6 Intermediate Metabolizer increases exposure, plus anticholinergic stacking concern.
- Codeine / Hydrocodone / Tramadol: Use alternatives — CYP2D6 IM decreases activation to active metabolite.
- SSRIs (escitalopram, citalopram): Higher doses needed — CYP2C19 Ultra-Rapid Metabolizer makes standard doses subtherapeutic.
- Atomoxetine: Avoid — CYP2D6 IM increased exposure; documented adverse event (worsened rhythmic tremors).
Vision
- Prism, transitional, blue light filtering, and Rx lens
- Eye patch occasionally (resting the brain by using one eye)
- Brock string exercises (available on Amazon, https://en.wikipedia.org/wiki/Brock_string)
- Vision occupational therapy
Pain (Non-Medication)
- Hot and cold therapy on the neck
- Biofreeze, CBD gels
- Physical therapy for the neck and back (wrapped up May 2025)
Diet and Exercise
- Reduced sugar intake (still a work in progress!)
- Smaller portions, researching and trying Mediterranean and keto options on occasion
- I run 3 - 5 days a week, doing at least a 5k each time
- Although I have fatigue, I do not seem to have ME/CFS