After my recent posts about recovering from PEM, fixing my shortness of breath (mostly), and the dozens of different treatments I've tried rated by effectiveness... I've received a lot of questions about my exact "supplement protocol".

For context, I've been dealing with long covid for 18+ months. After 6 months of hoping & praying for a recovery, but getting nowhere - I began rigorously researching & testing treatments to get my health back. Lots of discoveries were made between month 8-14, and the last months have been spent removing unnecessary things & refining my stack. I've been working out in the gym 5+ days a week for about 4-6 months now. Seeing consistent improvements, and even hitting new personal records this past week, out-lifting pre-covid 2023 me. Hope this helps.

Disclaimer: This is purely my personal experience, for entertainment purposes & should not be construed as medical advice.

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1) My Supplement Philosophy:

Before I jump into my protocol, let me start off by saying that my approach to supplements seems to be very different from most other people on this subreddit.

Personally, I do not take supplements in search of instant "magical effects".

Supplements are simply one of the useful tools I use to slightly optimize my recovery. Not magic pills or cures.

I view it the same as supplementing protein-powder after going to the gym...

Are you going to feel your muscles grow after drinking a single protein shake? Definitely not.

How about after a month of protein shakes? Nope, still definitely not.

Yet, we clearly know adequate protein intake is required for muscles-protein-synthesis (muscle growth), and over a long enough time frame.... the person who is consuming proper amounts of protein alongside proper progressive overload in their weight training sessions... will see faster/greater performance improvements than the person who isn't.

I believe the body can eventually heal itself (it does so for 90% of people who didn't develop long covid). So by providing proper nutrients & supplements that target the proper pathways - we can hopefully accelerate & kickstart our body's healing process.

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2) Why I consider these supplements "essential":

Over the past 18ish months I've tested 100's of different supplements, many of which have come & gone....

There are only 2 qualifiers I follow to curate my protocol & decide which supplements I take.

1. The science is extremely compelling (regardless of whether I feel it or not).

2. OR, I actually feel the difference.

Those are the 2 qualifiers for the following supplements in my protocol below.

... and yes, I've tried many more supplements... but if the evidence isn't strong enough, AND I also don't feel a difference. Those get phased out.

So, the following list is ONLY comprised of supplements I believe have strong evidence targeting the underlying mechanics or Long Covid, OR have provided me a noticeable boost.

Therefore, I consider all of these "non negotiable" and "must have" for optimizing my Long Covid recovery as quickly as possible.

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3) My Long Covid Supplement Protocol:

PS. The only supplements on this list that DO have noticeable immediate benefits are the Nootropics (moderate-high effects) & Mitochondrial Supplements (mild-moderate effects)

a) Brain Function & Cognitive Enhancement (Nootropics):

• Nicotine (optional, but potent cognitive boost)

• CDP Choline (500mg)

• Noopept (10-20mg orally, or 1mg via Nasal Spray)

• Fish Oil (High Dose, 4 Capsules Daily. 3-4grams EPA/DHA)

Explainer: Nicotine functions as a nootropic by acting on the cholinergic system which enhances cognition. Choline is a primary source of fuel for the brain which helps form short & long term memory. Noopept is a nootropic that increases acetylcholine signaling, increases the expression of BDNF and NGF, and protects from glutamate toxicity. Fish oil is one of the most well established & beneficial supplements, helping support healthy fats for the brain & support cell-membrane health.
Studies:
- Is the post-COVID-19 syndrome a severe impairment of acetylcholine-orchestrated neuromodulation that responds to nicotine administration?- Nicotine and the nicotinic cholinergic system in COVID‐19
- Neuroprotective effect of noopept- Noopept modulates persistent inflammation by effecting spinal microglia dependent BDNF throughout apoptotic process- Citicoline and COVID-19-Related Cognitive and Other Neurologic Complications
- Long COVID – a critical disruption of cholinergic neurotransmission?
- Imbalanced Brain Neurochemicals in Long COVID and ME/CFS: A Preliminary Study Using MRI

b) Mitochondrial Support (helpful against PEM & fatigue)

• CoQ10 (250-500mg)

• Methylene Blue (10mg)

• PQQ (20-40mg)

• NAD+ injected subcutaneously (50mg)

• Benfotiamine or TTFD 100-200mg (B1)

• Alpha Lipoic Acid (250-500mg)

Explainer: CoQ10 is a vital part of the mitochondrial electron transport chain, playing a crucial role in ATP production (energy). Methylene Blue acts as an backup electron carrier in the mitochondrial transport chain, bypassing complex I & III dysfunction to improve ATP production (if you have dysfunctional mitochondria). PQQ stimulates mitochondrial biogenesis by activating PGC-1α, leading to creation of new, healthy mitochondria. NAD+ is another essential coenzyme in cellular metabolism, ATP production, & DNA repair. Vitamin B1 (Benfotiamine or TTFD) support the Krebs cycle by converting pyruvate into acetyl-CoA. Without B1, pyruvate accumulates and is shunted to lactate, impairing energy production and leading to fatigue and lactic acid buildup.
Studies:
- Methylene blue as a mitochondrial enhancer and neuroprotector- Potential use of methylene blue in viral infections, including COVID-19- Mitochondrial dysfunction and oxidative stress in post-viral fatigue syndromes
- NAD+ replenishment and chronic fatigue syndrome- Low-dose naltrexone and NAD+ for the treatment of patients with persistent fatigue symptoms after COVID-19
- Mitochondrial dysfunction and oxidative stress in Long Covid
- PQQ enhances mitochondrial function and biogenesis

c) ATP Support (helpful against PEM & fatigue)

• BCAA’s 3-5grams

• L-Glutamine 5grams

• L-Citrulline Malate 5grams

• L-Arginine 3grams

• Exogenous Ketones / BHB Salts 3-5grams

Explainer: This powdered recovery drink cocktail is based of the promising research done for AXA1125 on Long Covid, showing improved recovery & fatigue scores. The ingredients listed above are ingredients needed to make AXA1125 at home. My personal twist is adding L-Citrulline & Ketones which I do find add extra benefits, especially the Ketones.
Studies:
- Efficacy AXA1125 in fatigue-predominant long COVID: a single-centre, double-blind, randomised controlled study

d) Sleep Optimization

• Melatonin (3mg)

• Magnesium L-Threonate (200-300mg)

Explainer: Melatonin is a potent detoxifier for the brain. Personally I noticed improved sleep & mental clarity in the mornings with low-dose Melatonin (even though I thought I didn't have sleep issues prior). Mag L Threonate is a form of magnesium that passes the blood-brain-barrier, and can help increase synaptic plasticity in the brain, calm NMDA receptors, and reduce oxidative stress in the brain.
Studies:
- Magnesium L-Threonate Improves Brain Cognitive Functions in Healthy Adults
- Magnesium-L-threonate improves sleep quality and daytime functioning in adults: A randomized controlled trial
- Melatonin in Mitochondria: Mitigating Clear and Present Dangers
- The Case for Sunlight & Melatonin in COVID 19 Patients: Oxidative Stress

e) Basics

• Vitamin D3 & K2 (10,000mg D3 + K2)

• Liposomal Vitamin C (1,000mg)

• Zinc (50mg)

• Vitamin E (400iu)

Explainer: Vitamin D3 supports healthy immune system (taking it with K2 is essential). K2 helps the increased calcium from D3 supplementation get channeled to the right places (into your bones, instead of your arteries). Zinc & Vit C help immune function through T Cells & NK cells. Vitamin E helps promote cell-membrane health & works synergistically with the others listed here.

f) Methylation Support

• TMG (2-3grams)

• Methylfolate (B9) 1,000mcg

• Methylcobalmin (B12) 5,000mcg

• Pantethine (best) or Pantothenic Acid (cheaper) (B5)

• Riboflavin (B2)

• P-5-P (B6)

Explainer: Methylation is one of the most important biochemical processes in your body - it controls everything from detox, DNA repair, and neurotransmitter balance to energy production and inflammation. 50% of people have impaired methylation genetics (I reccomend doing a DNA test to confirm this, mine showed slightly impaired methylation genetics - therefore the above are crucial part of my stack IMO).
Studies:
- Blood DNA methylation in post-acute sequelae of COVID-19 (PASC): a prospective cohort study
- MTHFR and LC, CFS, POTS, MCAS, SIBO, EDS: Methylating the Alphabet

g) Digestive Health (helpful if you have bloating or cramping)

• Digestive Enzymes

Explainer: Digestive enzymes help break down fats, carbs, protein, and lactose for improved digestion. Definitely beneficial during periods that digestion needs optimization.

That's it for my "non-negotiable" supplements. I will continue to take these for the next 1-2 years of my recovery journey.

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4) OPTIONAL ADD-ON'S:

Here are additional supplements I also occasionally take, but consider "less essential" than the ones I listed above for my protocol.

• Curcumin (anti-inflammatory)

• Quercetin (natural mast cell stabilizer, anti-histamine)

• Boswellia (5-LOX inhibitor, reduces leukotrienes, anti-allergy)

• Sulforaphane (Nrf2 activator, enhanced detox & epigenetics)

• Black Seed Oil (anti-inflammatory)

• Palmitoylethanolamide / PEA (anti-neuroinflammation)

• EGCG (detox and antioxidant)

• Luteolin (anti-inflammatory & theorized spike protein detox)

• Lactoferrin (iron pathway support)

• Liposomal Glutathione (detox support)

• Liposomal PhosphatidylCholine (cell membrane support)

• Calcium AKG (Krebs cycle support, boost ATP, and mitochondrial energy)

• NAC (Glutathione precursor, enhances detoxification)

• Milk Thistle (liver detox support)

• Sodium Butyrate (HDAC inhibitor / DNA support)

• Vitamin A (Immune regulation)

• Larazotide (Anti-zonulin peptide, repairs leaky gut)

• Probiotics (Enhance microbiome & digestion)

5) Discontinued Supplements:

These some supplements I found "promising" but didn't notice any benefit from and/or the science wasn't convincing enough to keep investing IMO. However, there are some anecdotal success stories from others in this forum, so it may still be worth trying these:

• Nattokinase / Lumbrokinase (very promising, but lacked results for me).

• DAO Enzyme (helpful for MCAS & histamine issues, which it turns out I don't have).

• NAG

• Diosmin & Hesparidin

• Apigenin

• Resveratrol

• Pterostilbene

• Andrographis

• Chinese Skullcap

• Astaxanthin

• DMG

• Inosine

• Shilajit

• Forskolin

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6) Medications & Treatments (previous posts):

• View all of the treatments I've tried (what worked).

• View all of my current medications, testing, and long-covid hypothesis.

• View the top treatments that have helped my shortness of breath.

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Final Thoughts;

Look, I get it - the time & money spent on protocols like this may sound excessive to some of you (these supplements + antihistamines + NAD+ injection + TRT + Prescriptions isn't standard by any means).

But for me, 12+ months of barely breathing, zero energy, and watching life pass by from my bed? That cost me everything.

30 minutes a day sticking to this protocol & a few hundred bucks a month invested towards my health is a no-brainer for me (especially considering the alternative).

My protocol isn't perfect. But it took me from completely house-bound to hitting new PR’s in the gym again. From canceling plans with friends to actually showing up & enjoying the night. From wondering if my life was over, to having full confidence a complete recovery is on the horizon.

I still can't do heavy sprints or intense cardio without consequences, but I'll take the weightlifting sessions, social life, and quality of life improvements as a solid win for now.

For me, health isn't an expense. It's simply the #1 most important thing in my life, and I'm literally willing to do anything to get it back.

Anyways, this stack works for me... maybe it can help you too (just do your own research & consult with your doctor).

Wishing you health, wealth, and happiness - Julian

If you want my one-on-one help creating a tailored recovery plan, schedule a call with me here.

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Disclaimer: I'm not a medical provider or practitioner. Nothing here should be construed as medical advice. These are purely my personal experiences shared for entertainment purposes.