Anticoagulant Expert Views

Dr. Alec Schmaier, a cardiology and vascular specialist, discusses the potential role of anticoagulants in treating Long Covid. He explains that microscopic blood clots, which are too small to detect with standard imaging techniques, might contribute to Long Covid symptoms. These clots could impair gas exchange in the lungs and cause exercise intolerance and fatigue, similar to pulmonary hypertension. While anticoagulants are used in pulmonary hypertension, their effectiveness in Long Covid remains uncertain due to limited research and challenges in detecting endothelial damage. Dr. Schmaier emphasizes the need for further studies and better diagnostic tools to address clotting issues in Long Covid.

Dr. Asad Khan discusses the use of Triple Anticoagulant Therapy (TAT) for Long Covid, emphasizing its role in addressing microclots and overactive platelets. He highlights that combining three drugs—aspirin, clopidogrel, and an anticoagulant like heparin or apixaban—has shown significant benefits. This combination reduces the need for multiple cycles of apheresis, a blood filtration process. Dr. Khan also notes that while the treatment is intense, it has been effective in improving symptoms for many patients, though further research is needed.

Dr. Asad Khan discusses the use of anticoagulants in treating Long Covid, particularly in combination with apheresis, a blood filtration process. He highlights that removing clots and stabilizing the endothelium (the inner lining of blood vessels) with anticoagulants can prevent recurrence of symptoms. He mentions that a combination of three drugs—aspirin, clopidogrel, and either heparin or oral anticoagulants like apixaban—has shown promising results. Dr. Khan also notes that while the treatment is intense, it has led to significant improvements for many patients, reducing the need for multiple cycles of apheresis.

Professor Doug Kell, a systems biologist, has been studying microclots in Long Covid patients. He suggests that Triple Anticoagulant Therapy (TAT) could be effective in addressing microclots, which are believed to contribute to symptoms like fatigue and POTS (Postural Orthostatic Tachycardia Syndrome). He notes that while TAT is well-known in cardiology, it is currently off-label for Long Covid. There is a theoretical risk of bleeding if overused, but this can be managed by measuring coagulation potential. Kell emphasizes the importance of addressing microclots to alleviate symptoms and suggests combining TAT with protease supplements and antioxidants.

Dr. Elaine Maxwell discusses the potential use of anticoagulants for treating Long Covid, particularly in addressing clotting disorders, which appear to be a significant factor in the condition. She mentions ongoing research in the USA examining the combination of anti-inflammatories and oral anticoagulants, with data collection expected to conclude in November. Maxwell emphasizes the importance of managing symptoms and learning from strategies used in other conditions, such as brain fog and chronic pain. She also highlights the need for a recovery-style platform trial to test licensed drugs for Long Covid, similar to the approach used for COVID treatments in intensive care units.

Professor Resia Pretorius discusses the presence of microclots in the blood of Long Covid sufferers and the challenges in diagnosing the condition. She explains that standard pathology tests fail to detect these microclots because inflammatory molecules are trapped in the insoluble parts of plasma. She describes a research method involving fluorescent markers and specialized microscopes to identify microclots, but notes that this technique is not yet available in regular pathology labs. Pretorius also warns against self-prescribing anticoagulants, emphasizing the risks and the need for proper clinical investigation.

Professor Jack Lambert, an expert in infectious diseases, discussed the use of anticoagulants for treating Long Covid. He mentioned that studies in the U.S. have explored heavy-duty anticoagulants like Apixaban and aspirin for patients with severe Long Covid symptoms, such as mini-stroke-like conditions. While these treatments showed some benefits, they also carried significant risks, including serious side effects like brain bleeds and intestinal issues. Lambert emphasized that while anticoagulants might help some patients, they are not without dangers, and a more comprehensive approach involving supplements, pacing, and other therapies might be safer and more effective.

Saskia Mulder, a nurse with Long Covid, shared her experience with Triple Anticoagulant Therapy (TAT) on the Long Covid Podcast. She emphasized that early treatment with TAT increases the chances of recovery, as she observed in others who started therapy sooner. Saskia experienced mixed results: initial improvements in mobility and sensory issues, but also severe side effects like stomach pain and worsened symptoms when on a higher dose of Apixaban. Her menstrual cycle became irregular, leading to low iron levels and hemoglobin, which further impacted her health. Saskia ultimately stopped the therapy after nine weeks due to these challenges and her inability to travel for follow-up care.

Professor Doug Kell, a systems biologist, discusses the potential use of anticoagulants for treating Long Covid, particularly in cases involving microclots. He suggests a combination of triple anticoagulant therapy, protease supplements, and antioxidants as a possible treatment strategy. However, he emphasizes the importance of consulting a physician due to risks like bleeding and drug interactions. Kell also notes that breaking down microclots can release cytokines, which might initially make patients feel unwell. He highlights the variability in individual responses to treatments and the challenges posed by the unregulated supplement market.

Prof. Jack Lambert, an infectious disease expert, discusses the use of Triple Anticoagulant Therapy (TAT) for Long Covid. He acknowledges that while some studies in the U.S. have shown benefits of using strong anticoagulants like Apixaban and aspirin, these treatments come with significant risks, such as brain or intestinal bleeding. Instead, he suggests safer alternatives like baby aspirin or natural supplements like nattokinase, which has anticoagulant properties and may also work on the spike protein. Lambert criticizes the healthcare system for focusing on ineffective treatments like graded exercise therapy and CBT, which he believes mischaracterize Long Covid as a psychiatric issue. He emphasizes the need for safe, evidence-based approaches to improve patients' quality of life.