ME/CFS, Long COVID, And Psilocybin

There is significant overlap between both the symptoms and origins of ME/CFS and Long COVID, and psilocybin may be beneficial for both.

Similarities Between ME/CFS And Long Covid

There is significant overlap between ME/CFS and long COVID. The symptoms can be similar, a combination of neurological and autonomic symptoms that leave you wondering if a normal life will ever be within reach again. Many previously healthy young people are finding out about this harsh reality in the aftermath of COVID. The persistent symptoms after a COVID infection closely resemble what Me/CFS patients have been struggling with since long before the pandemic.

These two conditions may in fact be two branches of the same tree. ME/CFS usually occurs in adults after an unknown viral infection. Long COVID occurs after being infected with the specific coronavirus associated with this pandemic. Maybe if we had put more attention and resources all these years into solving the issue of ME/CFS instead of writing it off, we would be better equipped to address it now.

There have been multiple incidents of epidemic myalgic encephalomyelitis recorded up to 200 years in the past. One of the most well-known clusters stemmed from the Lake Tahoe outbreak that occurred in 1984. In a small single small affluent neighborhood, 160 residents developed persistent neurological and fatigue symptoms. Other clusters in various parts of the world occurred after specific events or conferences. We know this is most likely due to an infectious agent because of the distribution of incidents.

While we have known that this is a post viral illness for quite some time, we have not come up with an adequate treatment. This is not a good sign so far for many struggling with long COVID, especially if symptoms have not dissipated within 12 months. With so many more people suffering, it adds additional urgency to the search for a solution.

Inflammation

Elevated inflammatory markers like TNF are present in the blood and cerebrospinal fluid of people suffering with ME/CFS. Inflammation can explain many of the persistent symptoms like pain and fatigue. It can also account for the symptoms that are not so clearly associated with inflammation, like brain fog, depression, anxiety, vestibular issues, and tinnitus.

This is particularly frustrating, because we we don’t usually think of inflammation as a difficult problem. There are dozens of anti-inflammatory medications available over the counter at every pharmacy. It seems like it would be an easy solution; but it is not. The inflammation is locked away in brain tissue and protected from interference with medications by the blood brain barrier. Neuroinflammation is associated with many conditions, including Alzheimer’s and fibromyalgia. No medication currently on the market can safely cross into brain tissue and address it.

Blocking TNF can have a dramatic effect on neuroinflammation. In this study, injecting a TNF blocker called Enbrel directly into the spine of Alzheimer’s patients brought on an immediate dramatic reversal in symptoms. Unfortunately, the results did not last, and frequent invasive spinal injections are not a sustainable plan. The takeaway here is that blocking TNF in the brain can achieve dramatic improvement in symptoms related to neuroinflammation. Therefore, it is not unreasonable to assume that this could be true across multiple conditions.

Psilocybin And Inflammation

While most of the studies presented in the news involving psilocybin have been related to mental health, psilocybin also has strong anti-inflammatory properties. Psilocybin is a powerful TNFa blocker that does, in fact, cross the blood brain barrier. In this study using pig brains, researchers observed immune related genetic changes in brain tissue up to a week after a dose of psilocybin.

Right now, psilocybin is in the limelight for addressing PTSD and treatment resistant depression. However, psilocybin and similar substances could be the future of treating many conditions related to neuroinflammation.

Psilocybin And Pain

The “rewiring” effect that a psychedelic experience has on the brain can change the way we experience pain. Ketamine infusions, another psychedelic-like drug, is the preferred treatment for some of the most painful conditions known to medicine. Psilocybin can have similar results and be a much more convenient and even safer option for pain management. Ketamine infusions are not always easy to access and are quite expensive. The pain relief from any psychedelic is transient, and many people must have infusions 1-2 times a month to stay pain free.

Psychological Benefits

The psychological benefits of psilocybin are well documented. The FDA has granted it “breakthrough therapy” status for severe treatment resistant depression in 2019. The role psilocybin and related substances can play in the mental health field is massive.

Psilocybin Implementation

Psilocybin is a powerful hallucinogenic, and this makes it a particularly challenging therapeutic option. A “trip” can be a scary prospect for the uninitiated. It’s not helpful that most of the information readily available applies to the use of psilocybin for recreational or mental health purposes. The approach for chronic illness or pain is different.

Microdosing can seem like the best choice for those looking to avoid an intense psychedelic experience, but for many in chronic pain it is not the best way to go. Microdosing can have an uncomfortable stimulant effect. This makes it an uncomfortable choice for people experiencing chronic pain. Being restless, agitated, hyper focused, and still in pain is less than ideal. While it is possible that microdosing may have beneficial cumulative effects over time, the road to the finish line can be too long and uncomfortable with this route.

A series of larger loading doses are the most comfortable way to start, but that does not mean it’s necessarily easy. Based on the most effective techniques demonstrated by ketamine clinics, this is probably the fastest and most direct method to benefit from lasting pain relief. It gets tricky because not only would you need to navigate an intense psychedelic experience, but you would also need to be ready to repeat the experience several times in short succession.  Having a guide and learning self-management techniques are essential.