Thursday, September 21, 2023
Mitochondrial Health

How Viral Reactivation Might Trigger Autoimmunity in Long Covid | With Dr Bhupesh Prusty

This is the second in a series of three films with Dr Bhupesh Prusty. Here Dr Asad Khan and I ask about how autoimmunity fits in with reactivated latent viruses, what role SARS-Cov-2 persistence might play, and how you’d go about trying to treat this complex picture.

Supporting resources:

Film 1 with Dr Bhupesh Prusty:

Latest pre-print:

Herpesviruses, Messed Up Mitochondria and a Biomarker for ME/CFS and Long COVID:

Tissue specific signature of HHV-6 in ME/CFS

Chronic viral infections in ME/CFS:

Interested in my second channel?

Here are some links!

5 Reasons Why Top Gun Maverick Crushes the Original | Film Director Breaks it Down:

Why Succession Shouldn’t Work at All, But is Somehow the Best Show on TV:


The Long Covid Handbook (Feb 2023) by Gez Medinger & Professor Danny Altmann (and published by Penguin Books) is now available in paperback, ebook and audiobook. A singular resource that brings together everything patients, clinicians and academics have learnt about the condition to date, as well as lessons from sufferers and researchers of ME/CFS and other chronic conditions. It offers world leading expert advice on understanding, managing and treating Long Covid. It is available from the following links.




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32 thoughts on “How Viral Reactivation Might Trigger Autoimmunity in Long Covid | With Dr Bhupesh Prusty
  1. we do IgM IVIG? My nIgM is definitely depleted at 26 with 50 being the low range. However IgM is not part of IVIG in the US so would just boosting IgG help?

  2. I have long Covid. Got Covid March 2020. Not recovered. I've had a reactivation of hsv1, hhv6 & hhv7. That's 3 herpes viruses reactivating. Maybe others. Those are the confirmed ones. I'm unable to take antivirals due to adverse reactions, so there's no treatment and my reactivations are back-to-back. As I start to recover my energy slowly improves, then the next reactivation starts. I'm in a living hell. I'm now under Southampton Immunology and my immune system is being mapped to see if they can find a reason. I hope that more help comes our way as I'm sure that there are many people not recovering because of this. Thank you for all you are doing to help people like me.

  3. There’s one thing I still don’t understand. If a viral reactivation causes long covid, what causes relapses? Is the virus never neutralized again? Why do we get better and then worse again?

  4. I have the kind of ME where I don't seem to catch any virus or bacterial infection at all. How does that fit in with the autoimmunity picture? 🤔

  5. Sorry, foggy… What was the proposed mechanism behind IgM depletion, again? Could it be (in large part) the continual moping up of dead cells killed in smouldering (Herpes) virus reactivation? (That Prusty talks about here.)

  6. Oh this also explains why some people being treated with paxlovid fully recover! Although it is curious that after taking the drug symptoms come back. This is all very mysterious 🤷🏻‍♀️

  7. Thank you for the another well-explained long haul COVID video interview. Having long haul COVID has forced me into a proactive mode of learning as much as is possible for the layman. I anxiously await the releases.

  8. So is the thesis that once autoimmunity begins, it will continue and worsen unabated? If that is the case, then surely we need urgent advice on how to quell the autoimmunity fire, regardless of what caused it.

  9. I have had low natural IgG, IgA, and IgM since the first time I was infected with covid….Are there any drugs/supplements to boost them? I have tried several things but with no success

  10. Gez have you done brain retraining for your LC? Been watching lots of interviews by Raelan Agle and many people, who suffered with CFS/ME for years and decades seem to make a recovery that way.

  11. Gosh ! It doesn't get any simpler does it ?! Who could have imagined the underlying pathology of LC could be this indicate and complex , and some. Still confident we will find a drug or somevothet therapy to turn the lives around of all of those who suffer from the on going pathological legacy of post – viral infection…the amazing researchers slogging away to unravel and find answers , and then Gez , distilling and elucidating it then presenting it for us in an accessible form. Great job ! ❤😊

  12. I know only one thing. Between second amd third Covid I test viruses and bacterial infection. After second I had 5×higher EBV antibodies, but after third 35×higher EBV antibodies, positive chlamydia IGG amtibodies ( I am not sure numbera after second) but my weight go down and I was tested on yerseniye – after second Covid negative, third Covid positive IGG = i know about latent infections 2 years, but I dont know what to do. Only what helped me ( and I was trying very much pills withouth doctors) because they said "we dont know, or its psychosomatic" 😑😑😑 only what helped me was Doxycykline. Corticosteroids no, fluoxamine no, ivermectin no, fluoxetine no etc only Doxycykline. And on my symptoms only works dont heal Clonazepam nothing more. I think I have low oxygen in my body amd microclots, muscles stiffness, joints pain, vertigo, head pressure after Clonazepam its 40% better. ( I know about this DRUG everything, but I havent choice) …

  13. I haven’t understood all of the ramifications of this, but I do want to ask whether the ideas that I have would make sense in terms of the processes described here. In the course of ME/CFS, even over the long term, it continues to get worse after exertion and to improve the more one rests. Some severely ill people who have sought treatment, and tried treatments over the years have only begun to recover after they had ‘given up’ – given up the search. I think that when we get sick with a viral illness, we should take the old-fashioned advice – go to bed and stay in bed until after you have recovered – in my childhood, defined as having a normal temperature for 24 hours.
    People with mononucleosis (glandular fever) were specifically warned that they risked long-term illness if they did not seriously rest for an extended period.
    Ramsay made his ME patients go to bed for six months.
    All this is anathema to our exercise-focused modern culture, where recovery seems completely conflated with regaining exercise fitness, and there seems to be a medical phobia of deconditioning as a result of inactivity – Clare Gerada actually said that there is nothing that is not improved by exercise.
    But going to bed and staying there had the purpose of enabling the patients to have full use of all our body’s resources for dealing with pathogens.
    Here we are talking about an extremely complex set of interactions and reactions, in which certain functions start working against us (autoimmunity), and set off processes which continue to cause us harm.
    Does it not make sense that patients should be strongly advised to adopt some version of ‘going to bed and staying there’? Should we not be encouraged to understand resting, conserving our energy resources by minimising the demands of physical activity is actually the most comprehensive, safe and effective treatment which we yet have?

  14. I’ve got 0 help from my GPS
    I take medicinal mushrooms as they are immune modulating / antioxidant / anti inflammatory and antiviral – krill oil and very high vit D3 + K2, antihistamine + montelukast quercetin zinc and magnesium- NAC ashwaganda and I’m nearly a normal person the rest I have to do by OMAD

  15. Really helpful as ever Gez; digestible content delivered well 🙌 I've read and listened to several Prusty interviews/articles and i think im just starting to understand it 😆

  16. Hey there I have question I just had ct scan done saying I have multivessel coronary artery calcification sounds like covid did this. It got worse from April anything that you have studied on this and what to do Please let me know. I even got high cholesterol levels from covid

  17. This is so interesting and this presentation triggers more questions that I cannot articulate properly. What I take from this is everyone who has been infected by the virus takes about a year to return to normal even if they do not present with symptoms of Long Covid. Would a second or third infection within that period put a person at a greater risk of developing Long Covid? If the majority of the infected population does seem to recover, does that mean that Sars-Cov-2 did not reactivate the herpes virus that most everyone harbours, or have their bodies successfully modulated the reactivation (for the time being)? As time goes on and immune systems weaken due to aging, is it likely there will be problems down the road and that autoimmunity may be inevitable for everyone? Will repeated infections also increase that likelihood? If an antiviral such as Paxlovid were taken immediately upon awareness of infection, can we assume the reduced viral load on the body is likely to reduce the time the body needs to recover? Anyway, thank you Gez for your curiosity and your willingness to share with everyone. Erika

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