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Comment by garganzol | Hacker News Reader

One should pay attention to the following symptoms: tingling/burning sensations especially in limbs, complexities with swallowing (dysphagia), chronic fatigue, shortness of breath with >= 96% SpO2, uncontrolled muscle cramps, panic attacks, agoraphobia, persistent tinnitus, appearance of dark dots in the field of vision, problems with regulation of body temperature (persistent hypo- or hyperthermia), persistent distortion/loss of smell/taste.

Post-covid is mostly physiological. Sure, it may cause some cognitive and psychological manifestations as well (asthenia, depression, derealization), but without treating the underlying physiology there is no way out.

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>One should pay attention to the following symptoms: tingling/burning sensations especially in limbs, complexities with swallowing (dysphagia), chronic fatigue, shortness of breath with >= 96% SpO2, uncontrolled muscle cramps, panic attacks, agoraphobia, persistent tinnitus, appearance of dark spots in the field of vision, problems with regulation of body temperature (persistent hypo- or hyperthermia), persistent distortion/loss of smell/taste.

With the exception of loss of smell and taste, these are all also associated with stress physiology. The exact mechanisms are unclear, but lifelong anxiety sufferers will be familiar with many of these. I've personally experienced all of these since I was a young teenager/child. Well before COVID was around.

I don't want to minimize long COVID, because it is very real. But we should be careful about encouraging people with generalized anxiety symptoms to over-identify as long COVID.

Yes, exactly. All of these are physiological symptoms of anxiety.

When the body is in a fight or flight mode and there is no apparent danger, we tend to notice these much more. But overall, they are absolutely and without doubt harmless.

It is almost never a good idea for the general population to read a list of symptoms to watch out for.

Many of those are so subjective that just posting it here is almost guaranteed to lead to people freaking out and seeking unnecessary treatment.

If you have underlying conditions which could be worsened by the physical damage from COVID, you should absolutely talk to your doctor.

Just like "freaking out" can cause unnecessary doctor trips, telling people they're seeking unnecessary treatment can cause negative health outcomes. There are many minority communities (most of which have almost no representation on HN, but anyway) have a myriad of different factors preventing them from going to or listening to doctors.

Ultimately you can't control if someone "freaks out" or not. But you can share information that someone might use to protect their health.

> most of which have almost no representation on HN

How did you learn this?

They didn't, they made it up.

Sharing a list of subjective symptoms to “watch out for” so people can “protect their health” isn’t helping anyone.

There’s a difference between telling people to talk to their doctor if they have concerns and posting a list of symptoms which is likely to create concern where none of existed. Most of the mentioned symptoms are highly correlated with stress and anxiety. Listing them and encouraging people to pay attention to them is almost certainly doing more harm than good.

There is also no widely recognized evidence based treatment for any of this. Advising people to seek treatment is likely going to be completely unhelpful, or worse encourage people to go down some quack rabbit hole and start mega dosing vitamins.

Also I’d appreciate if you didn’t imply that cautioning people against posting this kind of medical advice was somehow anti-minority. I can guarantee you that no serious medical professional or minority health advocates are happy to see people posting these symptom lists on forums.

I completely agree, but the current public health system haven't caught up yet. A minimal amount of awareness may save someone's life and wellbeing.

One should pay attention to how big one's tongue feels in one's mouth and to also not think about pink elephants.

> but without treating the underlying physiology, there is no way out.

Are there any actual treatments though, besides "rest"?

This video [0] may be a good intro to the topic. There are other resources like [1] who gather and publish related information, including the first-hand experiences of post-Covid sufferers.

[0] https://www.youtube.com/watch?v=7UOyE-3PbJY

[1] https://www.hormonesmatter.com/

Would be nice if YouTube URLs gave some context (e.g. author, title)

This one is:

@EONutrition

Mega Dose Vitamin Therapy: Viral Infection & Post-viral Illness

Thanks, but I was looking for some actual scientifically recommended treatment programs, with backing research consisting of large enough sample sizes, not yet another YouTube video that cherry picks whatever the author is convinced is the root issue.

You’ve inadvertently listed many symptoms associated with anxiety and panic disorder.

Slow metabolic rate triggers a flight or fight response, just like a panic disorder, so no wonder there is an intersection of symptoms.

But there is a big difference: slow metabolic rate leads to eventual cell death (metabolic encephalopathy), while panic disorder is physiologically harmless in comparison. It's hard to distinguish between the two, and not every doctor is able to do that.

As an interesting observation, a metabolic disorder is not responsive to antidepressants alone.

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