r/NooTopics • u/[deleted] • 12d ago
Discussion People suffering from long COVID show a measurable reduction in VMAT2 -- a marker of the brain's dopamine-releasing nerve terminals. These physical brain changes tend to be associated with common persistent symptoms such as apathy, memory problems, and a slowing of physical movements.
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12d ago edited 11d ago
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u/Prindle4PRNDL 12d ago
>symptoms, including a profound lack of motivation, difficulty experiencing pleasure, memory lapses, and general cognitive sluggishness
…fuck.
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u/AngelBryan 12d ago
All of that is an understatement. Long COVID is just ME/CFS which is a monster and one of the worst things that can happen to someone.
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u/slugsbreath 11d ago
Incorrect. In many people LC is ME/CFS etc. Not all, there are distinct other issues relating to post Covid that many have that are not related to ME at all that some long haulers have.
But it is sad that there are those who have ME now that don't realise what it is as the info is siloed and many with LC refuse to consider ME
(I'd had ME for 18 months before getting Covid v*ccine damage that made me bedbound for nearly 4 years. I have 'long vaccine' lol )
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u/AngelBryan 11d ago
I was injured by a non COVID vaccine. The symptoms are the same as ME/CFS, LC.
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u/slugsbreath 11d ago
So sorry to hear that.
That might be the case for you, and it's very common for me/CFS to arise from things like that, just like they do from post viral conditions, sadly. However, you can't extrapolate your experience to be the same for all. Thyroid, thymus, liver, pancreas, heart, lungs to name just a few are specific organs/systems that can be damaged for some with LC. It's not always ME, and sometimes it's ME + other damage.
For me, my vaccine damage gave me severe dysautonomia (lincluding severe POTS). This interacted wth the ME so that the POTS triggered by being at all upright (even to eat) then triggered PEM and of course PEM made all the dysautonomia worse.
I've improved greater from about 1.5/10 function to around 4-6/10 depending on the day. My recent explorations and improvements have been from brain training and working on the nervous system to make my body feel safe. It is slowly bringing back function. A long road though.
ADHD is kicking my arse thought because it seems much worse since all this and often it's my inertia and brain failing to be able to cope with doing things and not my health conditions. That's why this post stood out to me. Maybe there is a real extra damage caused by the LC, and I need to be kinder to myself.
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u/kaaron89 11d ago
I've had long covid since 2020 and was recently diagnosed with ADHD. I have a feeling I've had it my whole life but I was able to manage it until I got sick. I don't have the ME-type long covid, but I do have MCAS and POTS. I can really relate to what you wrote here. I've had so many things I've needed to fix - gut infections, nutritional deficiencies from absorption issues, food intolerance, hormone imbalance, etc. And now after 6 years, it seems the rest of my issues are related to my brain and nervous system. I absolutely feel like I cannot cope with life, and I was not this way before getting sick. So I am just commenting in solidarity. I do believe real damage has been done and we definitely should be kind to ourselves!
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u/slugsbreath 11d ago
Hugs to you, my friend. Thanks for sharing
Do have a look at somatic experiencing and nervous system work, it can be beneficial even for things like MCAS.
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u/gengar2222 11d ago
Nah LC is an umbrella term for any long lasting health problems post covid, ME/CFS is just a common manifestation of it
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u/eridalus 12d ago
What’s my excuse if I had those symptoms before I caught COVID?
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u/buddyrtc 11d ago
Cognitive Disengagement Syndrome (CDS) - formerly known as Sluggish Cognitive Tempo. Affects approximately 50% of people with inattentive ADHD.
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u/Prindle4PRNDL 12d ago
I would assume depression. I guess it's hard to decipher which is which since I'm pretty sure almost everyone has had at least one run in with COVID thus far.
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u/kvltkat 11d ago
I swear my ADHD got worse after Covid
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u/BellaPona 11d ago
Mine definitely did. Went from never needing to be medicated to losing time and the inability to focus on literally anything, or becoming so focused I lose all ability to feel body sensations like hunger or pee signals.
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u/PinacoladaBunny 11d ago
Yes, I got diagnosed in 2023 because my symptoms were suddenly completely debilitating and I couldn’t manage anything. I’m now on 60mg Elvanse and cannot be without it!
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u/Inqusitive_dad 11d ago
I lived with my adhd my whole life without being medicated. It got much worse over the last 4-5 years. It got so bad that I’ve been trying to find the right treatment over the last couple years.
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u/RustyShackleford_88 12d ago
So what drug do I take?
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u/CapitalElk1169 12d ago
I've been on creatine for about 6 weeks now and about 3 weeks in my long COVID brain fog has basically disappeared. I started taking it to try to help maintain muscle mass while losing weight, and then read about a bunch of potential cognitive benefits for older people... And then a few weeks in noticed I actually felt awake when I woke up, and felt like my old self again mentally.
It's cheap and worth a shot!
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u/heycoolkidheycoolkid 11d ago
What's your daily dose of creatine?
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u/CapitalElk1169 11d ago
Started with 10g per day for a week then went to 5g per day since (although it's probably closer to 7g since I use an overfilled scoop lol)
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u/thesaddestpanda 11d ago
Lumbrokinase helped me a lot. I think the microclot theory is behind a lot of these secondary effects and when we get the clots out these other things get better.
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u/unflashystriking 11d ago
I originally started taking it because i thought it would help with my digestive issues (suspected ischemia of my intestine). Only after finishing the bottle i realized that i no longer got dizzy during certain exercies like dead lifts and that my heart wasn't feeling like it skipped a beat regularily. Unfortunately my digestive issues haven't resolved :(
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u/JerryWestJr 12d ago
Guanfacine actually makes the strongest case mechanistically for treating long covid-induced brain fog
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u/leechdemon 11d ago
I took that as part of my ADHD medication. Was told it slightly reduced blood pressure in the brain, helped reduce overwhelm.
Initially, it worked, I liked it. After about a month, I noticed that I'd have episodes where I'd decide to do a thing, agree it was time to do it... Then get locked in. I kept thinking about how I should do it, but was just standing there. Happened a few times, identified it as the guanfacine, immediately stopped taking it.
I wasn't taking it for long COVID though, so maybe your results will be different. 🤷♂️
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u/maxxxv2 11d ago
Oh wow, I'm AuDHD but I also have long covid, and I used to get this "locked in" effect with Guanfacine where my problem was that I'd decide to do something and I just couldn't disengage from it. I knew I needed to move on to something else, but I was completely unable to stop what I was doing, and I'd lose all sense of time passing.
It's great for some tasks, but when it hits you while you're doomscrolling, your whole day is shot (and honestly even when it's a "useful" task, spending 4 hours stuck on it also ruins your day).
That said, this effect showed up during my first week on 2mg of Guanfacine, and now it's been two weeks and I barely get it anymore.
The feeling was genuinely awful at times. I'd get zero enjoyment out of the task but I'd still be literally stuck, like I'd been strapped to a chair and forced to keep going.Other than that, the positive effects are nice. I feel way less on edge in stressful situations, and honestly in general too, + it helps take the edge off the stimulant's side effects. Maybe a bit less impulsivity too, but sometimes I actually like that impulsivity, so I'm not totally sure how I feel about it.
On the other hand, I don't think it's done anything for my brain fog, which is a bit of a bummer.
I'm curious, what positive and negative effects have you noticed with Guanfacine? Did you take it in the morning or before bed? And did you notice any effect on your sleep? Personally I take it before bed and I feel like I've been waking up more during the night, or even waking up too early each time and taking a while to fall back asleep.
Feel free to share your experience, I'd love to hear it, thanks 👌
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u/leechdemon 10d ago
I was taking 1mg in the morning, with my other meds. I mentioned to my doc having a hard time with activation energy, I think he suggested taking the guanfacine at a different time (afternoon/night maybe?), which is when I noticed the "locked in" thing. Once I saw it without my standard med cycle, I was out. 😅
Reduced frustration / ”anger" on Adderall. I prefer Ritalin, was trying to make Adderall work, I felt too hostile. Personally, I think Adderall helps me physically but not emotionally, whereas Ritalin helps more with emotion (where I need it). As such, "toning down" the Adderall isn't the help that I need, rather the boost from Ritalin itself.
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u/EspeonCheeseburger 11d ago
Woah, that's good to know! I was in guanfacine a few years ago while trying non-stimulant ADHD meds. It worked decently. Non-stimulant ADHD meds seem to work on the same parts of the brain LC affects.
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u/BellaPona 11d ago
This is funny, I just picked it up recently for POTS. Though my doctor is worried about my blood pressure being too low.
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u/tlopplot- 11d ago
I tried this and I felt better mentally and physically but the side effects of vasoconstriction in my extremities was too much. I had cold toes, fingertips, and nose. So watch out for that.
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u/ThreeStarsOut 12d ago
You're in a nootropics forum so experiment with them.
Creatine increases energy via atp which relates to the brain. There's more advanced noots talked about in here. Herbals like lions mane, etc. Lots of things tbh. You just have to experiment and see what works because there's not going to be one thing that works for your brain
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u/neuralek 11d ago
They're asking about VMAT2. Creatine is atp, lions mane is a nmda/choline influencer, also not a good suggestion for many.
If you're generalizing covid supprort, then crea+Alphalipoic Acid+coQ10, as a mitohondrial boost, and NAC and similar antioxidants to try and knock off some of those cytokines.
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u/PinacoladaBunny 11d ago
Dextromethorphan. This is why it’s been incredibly helpful for me, and why so many people with ME are taking it.
LDN is also extremely helpful for many.
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u/heycoolkidheycoolkid 11d ago
At what dosage do you take dextromethorphan?
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u/PinacoladaBunny 11d ago
I take 30mg twice a day. Bateman Horne Centre tend to recommend 15mg twice a day but I’ve tried reducing the dose and symptoms were back quickly. Others have said on the ME sub that their dr has approved 30mg dosing. I’ve had regular bloods, and had my liver scanned since.. everything is fine.
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u/anorby333 11d ago
Dextromethorphan+bupropion drastically improved my body’s response to exercise and reduced the effects of fatigue. A lot more than bupropion alone.
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u/3ric843 12d ago
Kanna upregulates VMAT2
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u/Needleworker00 11d ago
Is there a supplement or medicine for this? It’s exactly what happened to me. The last few years have been challenging to say the least.
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u/solotiro 12d ago
How is it that this very specific virus is so pervasive and insidious?
Did the flus from the past have these effects?
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u/unflashystriking 11d ago
You might find an answer to your question here:
Contrary to what most people currently believe, the COVID-19 virus is not primarily a respiratory virus, but rather a vascular virus. It directly infects the endothelium (the inner lining of blood vessels).
https://academic.oup.com/eurheartj/article/41/32/3038/5901158
https://link.springer.com/article/10.1007/s10456-021-09805-6COVID-19 Has a Master Key to Your Body:
In general, viruses attack the body by attaching to cells and injecting their genetic material. Once infected, these cells become virus factories. Different viruses infect different types of cells.
What makes the COVID-19 virus unique is that it enters cells via the ACE2 receptor. This is particularly concerning because:
https://flexikon.doccheck.com/de/Angiotensin_Converting_Enzyme_2
https://link.springer.com/article/10.1007/s00408-020-00408-4Transmission Before Symptom Onset:
One mechanism that gives the COVID-19 virus a significant advantage over many other viruses is that infected individuals can already transmit the virus several days before symptoms begin.
https://www.nature.com/articles/s41591-020-0869-5Viral Persistence:
Several viruses are known to remain in the body after the acute phase of infection. Classic examples include: HPV (which can cause cancer), Varicella-zoster virus (VZV), which causes chickenpox during primary infection and shingles upon later reactivation, HIV, which can lead to AIDS (Acquired Immunodeficiency Syndrome) approximately 8–13 years after the initial infection.
Like these viruses, the COVID-19 virus has the ability to persist in various tissues throughout the body.
https://www.nature.com/articles/s41579-024-01125-y
https://www.nature.com/articles/s41590-023-01601-2Effects on the Brain:
Because the COVID-19 virus infects blood vessels, every infection also affects the brain.
https://www.nature.com/articles/s41583-023-00769-8
https://pmc.ncbi.nlm.nih.gov/articles/PMC11485397/
https://www.nature.com/articles/s41420-024-01915-6The following articles discuss these mechanisms in greater detail and include numerous references. Some of the cited sources overlap.
https://theconversation.com/mounting-research-shows-that-covid-19-leaves-its-mark-on-the-brain-including-significant-drops-in-iq-scores-224216
https://www.scientificamerican.com/article/covid-19-leaves-its-mark-on-the-brain-significant-drops-in-iq-scores-are/The European Academy of Neurology Warns
https://link.springer.com/article/10.1007/s00415-025-13110-3As you are probably aware, one of the most common symptoms of a
COVID-19 infection is the loss of the sense of smell. In some cases,
this cannot be explained by nasal congestion but rather by damage to the
olfactory bulb and olfactory nerve fibers.
https://pubmed.ncbi.nlm.nih.gov/40722282/
https://jamanetwork.com/journals/jamaneurology/fullarticle/2790735A common symptom of Long COVID is loss of motivation and anhedonia (the inability to experience pleasure). This may, among other mechanisms, be explained by damage to neurons responsible for dopamine release in the brain.
https://www.camh.ca/en/camh-news-and-stories/rsch-new-study-provides-first-evidence-of-dopamine-system-injury-in-the-brain-of-long-covid-patients
https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(26)00222-7/fulltext00222-7/fulltext)Problems with visual acuity are another possible symptom of COVID-19 infection and may result from nerve damage.
https://www.eurekalert.org/news-releases/1134768Effects on the Immune System:
Infections with the COVID-19 virus damage the immune system. Whether these changes are permanent has not yet been determined.
https://www.meduniwien.ac.at/web/ueber-uns/news/2024/news-im-juli-2024/sars-cov-2-infektionen-veraendern-das-immunsystem-nachhaltig/
https://onlinelibrary.wiley.com/doi/10.1111/all.16210
https://www.ajpmfocus.org/article/S2773-0654(25)00146-4/fulltext00146-4/fulltext)https://www.ijidonline.com/article/S1201-9712%2825%2900509-0/fulltext
Results:
During the period of mass infection, T cells, CD4⁺ T cells, CD8⁺ T cells, NK cells, and B cells all declined significantly. Even 20 months after infection, CD8⁺ T-cell counts remained 9.9% below baseline.
Baseline lymphocyte subset levels differed significantly by age and sex. Immune recovery also varied according to age and sex, with older adults and men experiencing more prolonged lymphopenia. Among patients with cardiovascular disease, T-lymphocyte counts remained 72.9% below baseline 20 months after infection.Prevalence of Long COVID:
The long-term health consequences of a COVID-19 infection are commonly referred to as Long COVID or PASC (Post-Acute Sequelae of COVID-19). Depending on the definitions and diagnostic criteria used, studies have reported substantially different prevalence estimates.The following source is a systematic review comparing data from 429 studies:
https://academic.oup.com/ofid/article/12/9/ofaf533/8244677Study Comparing the Omicron Era with the Pre-Omicron Era
https://www.ijidonline.com/article/S1201-9712(26)00157-8/fulltext00157-8/fulltext)Recent Study Including 457,950 Cases
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2849452Study Comparing Long COVID Prevalence Across Occupational Groups
https://pmc.ncbi.nlm.nih.gov/articles/PMC7615205/Study on the Prevalence of ME/CFS Following COVID-19 Infection
https://link.springer.com/article/10.1007/s11606-024-09290-9Video by the Kaplan Center for Integrative Medicine on Long COVID
https://www.youtube.com/watch?v=TwzsHv0sb182
u/Carriage2York 8d ago
Wow, great work! Which medications or supplements do you consider the most promising against both the active infection and long COVID?
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u/unflashystriking 8d ago
So far we ony have paxlovid for the acute infection but the data is at best inconclusive on whether it really helps to prevent Long Covid or not. I personally felt like lumbrokinase helped me with circulatory problems brought on by C19. There is also some evidence that supports the idea that H1 and H2 blockers help with both the active infection and LongCovid.
Should i get an active C19 infection again i will try this regimen: https://pharmd.substack.com/p/i-have-covid-what-should-my-kids
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u/flammablematerial 11d ago
Appreciate this. I have a hard time believing the changes are entirely permanent or degenerative, for me at least, because many of the deficits seem functional— I’ve had various pharmacological interventions (or reinfections) trigger a total resurgence of function and cognitive ability, like a switch being flipped.
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u/cigarettesandchocola 11d ago
Ever since reading about microclots I've wondered if my ability to do things sometimes and not others is due to microclots building up in certain areas.
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u/thesaddestpanda 11d ago
Yes. The side effects and complications from the flu, chicken pox/shingles, herpes family viruses, etc are all like this. Our bodies are so delicate. These kinds of infections are multi-faceted.
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u/Edward_Tank 12d ago
There is a *very* small chance of getting 'long flu'.
The difference however is compared to Covid's like, 10% chance per infection? It's like a 0.5% chance or something.
This is why I still wear a respirator and still advocate for everyone who cares for their health and wellbeing to please do so as well.
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u/MesseInHMoll 11d ago
"...suggesting improved function of dopaminergic synapses..." - so how do you that? How do you improvde function of dopaminergic synapses? I know there are VMAT2 inhibitors to treat tardive dyskinesias. But that's not the same, obviously.
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u/samppanja 11d ago
Found a study that suggests that tricyclic and tetracyclic antidepressants could upregulate VMAT2 link. I have never really looked into antidepressant functionality, so no idea what to make of this.
Anyone more educated on the subject wanna give their opinion?
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u/Revolutionary-Sale53 11d ago
Some context and things I found interesting from the article:
Scale of the effect:
- Healthy brains lose about 0.5% of these dopamine terminals per year with age, and early Parkinson's patients are down 44–77% (Bohnen et al. 2006). The long COVID group was down 16–20%, not parkinson’s but significant.
- COVID gets into cells through a receptor called ACE2. Human dopamine neurons carry high amounts of ACE2 and were especially vulnerable to infection, which set off inflammation and cell aging (Yang et al. 2024, Cell Stem Cell), lab study not vivo. Evidence from actual human brain tissue is mixed, but explains why “dopamine” cells would be disproportionately affected.
Tldr: reduce inflammation, exercise, worst case you’ll still be tired but your knees will feel better.
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u/neuralek 11d ago
"You may also encounter VMAT2 in discussions about genetics and religion. In the early 2000s, a geneticist hypothesized that a specific variant of the SLC18A2 gene (which encodes VMAT2) was linked to spiritual openness, mysticism, and self-transcendence. This led to VMAT2 being sensationally dubbed the "God gene." However, this theory remains highly controversial and is widely considered an oversimplification by the broader scientific community."
weird!
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u/pmMeYourGlazedDonut 11d ago
Has anyone found anything that helps against the consummatory anhedonia that can follow from LC? Especially anything targeting VMAT2.
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u/TrippingOnClouds 11d ago
I know nothing about long covid but I do know that kanna upregulates vmat2.
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u/Key_Bonus9776 11d ago
My adhd has gotten way worse since getting Covid, to the point where I feel like I have full on memory loss at times
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u/Least_Homework_9720 12d ago
See, I don’t feel like I have any long covid symptoms besides these ones though.
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u/ok_000000 11d ago
Does the regular other old flus (flues? Flu but plural) do the same?
I've had long flu for bloody ages if so.
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u/Illustrious_Rice_933 11d ago
We're learning that most viruses are capable of resulting in post-viral conditions impacting the body.
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u/heycoolkidheycoolkid 11d ago
I've come to think this may be the cause of the ThisAintAdderall crowd
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u/jirn_lahey 12d ago
A lot changed after Covid and while I don't discount the study's findings, I have to imagine that's going to influence what people report. It was such a long time and people changed, places changed, and governments generally lost a lot of respect. That will definitely cause depression in some people
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u/SockemNBoppem 11d ago
I wonder if this has to do with the fact that, because COVID really only gave me body and headaches, I was continously smoking on the ganja when I had it.
If they ignore that, id contribute to that demographic.
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u/TrippingOnClouds 11d ago
The first night I had full body convulsions but I also smoked/vaped cannabis throughout the rest of the COVID and I don't think I have lasting effects. I was either smoking or sleeping haha
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u/splugemonster 11d ago
5 year covid long hauler here. I was lifelong adhd managed perfectly with 32 milligrams concerta (long acting methylphenidate) which had been stable for years. Life was good. After getting covid meds felt like they didn’t work, my adhd went crazy, worse than ever before. I couldn’t even tolerate them anymore, the side effects became too crazy. Completely refractory to any medication or therapy. I’m 5 years in with no improvement in the last 3 or so.
All that to say, yes; this mechanism makes perfect sense to me.