Over the last two years my trajectory of recovery had been relatively upward and even. There were glitches along the way, but for the most part, I’d been happy with my progress.
Well, life doesn’t always go as planned. A series of challenges started to pile up, one on top of another. Then, it was like the story of the child, using her hand to cover a hole in a damn to hold back a flood. I’d somehow managed to keep life events under control, but Long COVID was sitting there, in the wings, just waiting.
I had neglected my diet, I was sleep deprived, and I forgot to take my supplements.
But, the straw that broke the camels’s back was something that could have been avoided. About 20 years ago I had a serious case of shingles that began across the left side of my face, subsequently moving to my left ribcage, arm, leg and foot. It took months for my doctors and some colleagues at the medical school to help figure it out.
In the end, understanding the resistance of the herpetic infection to periodic conventional therapy (Valacyclovir) was relatively simple. My diet was out of balance, too rich in high arginine foods (chocolate and nuts) and too low in lysine (dairy, some meats and supplements). Herpetic viruses thrive on a high arginine versus a low lysine ratio. In a lysine rich environment herpetic viruses are less able to replicate.
Important: lysine is an essential amino acid and arginine is only made in small amounts by the body. In other words, both are needed for good health. It is the imbalance of these two amino acids, in the presence of other factors, that likely led to an opportunistic infection.
My recollection of the events is, that once I’d begun to recognize that my response to stress needed attention and I’d adjusted my diet, the persistent herpetic pain, fatigue and spread of the viral nerve damage began to abate. Occasional short courses of Valacyclovir have been largely effective over the ensuing years.
Lemon Balm (Melissa officinalis), which grows abundantly in my garden, may also play a role. Reportedly, the oils that are contained in its leaves “affect infectivity of enveloped herpesviruses”. The leaves also make a pleasant and relaxing tea. I’ve returned to drinking it daily.
Back to my recent PEM. My symptoms were: extreme debilitating fatigue, brain fog, mild numbness, tingling and burning in places where shingles had previously infected my nerves. I also had some muscle and joint pain. Small efforts (i.e. walking out to our mailbox) made matters worse. A trigger, not mentioned above, was having exposure to significant direct sunlight the day before onset of Post Exertional Malaise.
For a point of possible clinical relevance, please stay with me for a moment. While searching and reading resources relevant to this topic, I ran across a study Effects of Basic Amino Acids and Their Derivatives on SARS-CoV-2 and Influenza-A Virus Infection. Given the broad characteristics of infectivity and proliferation of various viruses, this perspective may be useful in prevention and treatment of viral infections.
This bout of PEM has responded to getting back on my careful diet, getting restful sleep, taking my supplements and pacing myself. I suspect that this series of events reflects a co-infection involving both latent herpetic and the SARS-CoV2 viruses, but of course, this is just an hypothesis.
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Hi Mardi - I’m sorry you’ve been suffering a bit but it is encouraging to know that your box of tools is working to get you back to baseline.
Long COVID has reactivated my EBV and an apparent HH6 infection, along at times with setting off my HSV1 and 2. I have neuropathic sensations frequently as well as prodromal skin sensitivity that I imagine is a milder version of shingles pain. And recently, I developed a herpes whitlow sore on my right index finger, diagnosed correctly by sending photos to a telehealth dermatologist I never actually met or spoke with directly. My sensitivity to stress - including emotional stress but also physical ‘swings’ in my condition or in external factors like temperature swings - has become extremely heightened during LC. I feel very much like a delicate flower. <sigh>
Very interesting note on Lysine and Arginine. Worth remembering. What surprised me is your 20 year old story of your doctors struggling to identify your herpes infection, despite visible symptoms and presentations in you. But then, it can happen. About 16 years ago, my wife about 55 then, started with sudden some severe hip pain. No fall, no accidents and no history of that kind. I went to a UK studied orthopaedic surgeon ( I live in India). He suspected spinal compression, put her on aceclofenac, gabapentin, waist belt and complete bed rest. For several days, there was no relief. In the meantime, she had rashes on her left leg and thigh developing over 2-3 days, with pain and irritation. I went to my old school GP, a 60 plus practitioner. He immediately saw it as herpes infection, put her on acyclovir, methyl cobalamine adjuvants etc. I didn’t tell him about our consultancy with the orthopedist for her back pain. When I was meeting the later, I didn’t tell about her herpes infection. Surprisingly, he didn’t examine her physically either. After about 15 days, the infection showed signs of stopping, with marginal improvement in her back pain. The GP continued his prescription for two more weeks, also adding gabapentin. At this I told him about our consulting the orthopaedic surgeon. He also saw a back X-ray which showed no signs of compression. The GP immediately clarified that her back pain was a reflective response to her herpes in the legs and could have briefly preceded the sighting of the infection itself. From then on, things began improving quickly. When I met the surgeon with the X-ray, he seemed a bit lost as there were no clues to his line of thinking thus far. When I told him now about her herpes treatment, he too immediately concurred, stopped all his treatment, including removal of waist belt etc. Even though he was a specialist, he must have known about the general clinical origins of such sudden, unsuspecting pain episodes. Eventually, it was the old school GP who got us on track right from the start. If it is now, I would have taken a quiet dig at the specialist, I chose to return quietly then. A year later, I developed sudden shoulder pain, followed by tingling irritation. My immediate guess was right, as I waited for two days for the rashes to appear. My GP handled it quickly and competently. The infection was severe, though it visibly subsided in a month, the lingering intermittent pain, irritation and tingling continued for several weeks disappearing slowly. In that recovery phase, I was on a long course of gabapentin and methyl cobalamine adjuvants. If you have confidence in your GP, he must be the first one to consult on unannounced developments. Wishing you your continuing recovery.