New Kids On The Block

Guanfacine, Truvada & What To Try First

I am frequently contacted by patients who have read a few articles on a particular promising drug for Long COVID or Vax injury and are convinced that it’s just what they need to get better.

There are actually 100s of drug candidates for Long COVID & Vaccine injuries.

I have yet to find any that work more than 80% of the time and the newest ones are no different.

The guiding principle must always be to try safer therapies first and if they have high batting averages, all the better.

There is a shortlist of simple, safe and reliable therapies (beginning with lifestyle measures, supplements, over the counter meds, ivermectin etc) that should always be tried first, because they may provide rapid and sustained relief of symptoms and the alternatives being offered up nowadays have been used far less and like maraviroc often have significant side effect profiles.

A couple of examples of meds that have started to stir excitement are guanfacine (brand name Intuniv) and emtricitabine/tenofovir (brand name Truvada).

Guanfacine

Guanfacine is an alpha 2 adrenergic agonist used on label for ADHD, as an alternative agent for hypertension, and also used off label for autism, tic disorders, Tourettes syndrome, anxiety and PTSD. There are significant

Guanfacine is thought to work by decreasing sympathetic nervous system activity.

This would seem to be ideal for Long COVID & Vaccine injuries, since a primary pathology seems to be sympathetic overactivity, which may u nderly much of the anxiety, brain fog, fatigue, altered taste and smell and other symptoms.

Completely interrupting sympathetic activity to the head and neck for a few hours with a stellate ganglion block is highly effective at reversing symptoms of Long Covid & Vax injury.

Guanfacine is supposedly generally well tolerated, but up to 57% or patients may develop drowsiness, half of patients may develop dry mouth, up to 28% may have headaches, up to 22% fatigue, up to 19% stomach pain, up to 15% dizziness and/or constipation, up to 8% irritability, 7% impotence, and nightmares in up to 4%.

There are also some more serious side effects that can develop more rarely: heart block in 2%, low blood pressure in up to 9%, paradoxically increased blood pressure in 2%, syncope (passing out) in 1%, weight gain in 3%, and depression in 2%.

Post marketing reports include rare occurrences of even more concerning “side effects” including heart attacks, heart failure, stroke, kidney failure and cardiac arrhythmias.

Truvada

Truvada is a combination of two medications: tenofovir and emtricitabine. They are antiretroviral reverse transcriptase inhibitors usually prescribed for HIV or Hepatitis B.

Up to 7% of patients may develop headaches, 5% decreased neutrophil counts (immune system cells), and 4% stomach pain.

Significant risks of Truvada include the relatively common occurrence of mild decreases in kidney function with rare cases of severe kidney injury, up to 8% of the time there is evidence of liver dysfunction and there are rare instances of severe liver failure, up to 13% incidence of bone loss and 2% incidence of fractures.

What To Try First

I’m open to trying both guanfacine and Truvada, but only after someone has tried some of the safer approaches that have more clinical data behind them.

I have personally had patients find rapid and complete relief from their symptoms after using things as simple as: ibuprofen, Claritin/Pepcid, nicotine gum, ivermectin, hydroxychloroquine, fluvoxamine, and low dose steroids.

These are not the only safe and easily available medications that might work.

Others have reported rapid improvement with aspirin, nattokinase/lumbrokinase, methylene blue, over the counter high dose Omega 3s (or prescription vascepa), antibiotics (eg augmentin and rifampin/rifaximin) and Ubrelvy.

For those willing to try some lifestyle changes the ones with the highest batting averages are fasting and cold therapy.

Things that may work, but can take longer are LDN (low dose naltrexone), breathwork/meditation/vagal nerve stimulation, and simply optimizing micronutrients (lab testing can help guide this).

What have you tried for Long COVID and/or a Vax injury?

What have you heard might work and what do you want to try?