New Ideas on Long Covid Recovery

This month on our podcast I chat to Rachel Jessey, MSc DipNT, of BeNourished. We have a fascinating conversation all about the role of the microbiomes in relation to long covid recovery. Rachel is a Long Covid and MCAS/HIT nutritionist and quantum biologist. In her Hampshire based clinic she offers a fresh perspective to her clients on health optimisation using the power of nutrition, gut restoration and circadian retraining and connecting your biology back to how nature intended it.  
As with all of my guests I never have enough time to discuss all aspects of the subject that could be helpful for the audience, maybe longer versions should be done?
I really hope you enjoy this episode. 

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Transcript

Peter Williams  00:02
And welcome to this new podcast, functional medicine, bitesized, subjects long covid. I think one of the most important things probably in medical history happened several years ago. And you know the concern was not so much the infection. I remember writing something in LinkedIn about it wasn't so much about people being infected, it was the After Effects and how that was going to shape people's health and society, and sort of seems to have played out in real time. And so today I'm going to be introducing Rachel Jessey. Now I again, usually don't bring people onto my podcast that I haven't known for a long time. I've sort of been in the same LinkedIn group as Rachel for about three years now, and Rachel, as I'll explain to you in a minute, and is doing some really great stuff in long covid and super smart as well, big thinker, systems thinking, and we'll get into that as well. But I think the key thing for us is what we're trying to do today is that, because maybe this is you, you're still suffering with the after effects of long covid And you're still no clearer. Or, you know, people who are still suffering from long covid and are no clearer and to be fair, numbers are pretty substantial. And you know, when something new comes up, like a disease, order, disorder, however you want to group it, and I still don't think we know you medicine in the way it's structured. At the moment, struggles to know what to do, and so you have to have systems thinkers who can look at this and look at it from the bigger picture about what to do and how to do. And I think Rachel's doing a pretty great job of doing that. So we always like to introduce people Rachel, from a point of view of give us a little bit of your background and but also the turning points for you to moving from you know your normal work as a nutritional therapist into the sort of much more specific work with regards to long covid. So if you could just introduce that, because everyone loves the story ever we want to hear about how you've got into how you've got into it. Yeah,

Rachel Jessey  02:15
thank you, and thank you so much for having me here today. Pleasure, absolute pleasure your platform and inviting me here to speak. So, yeah, from my perspective, I've been a nutritional therapist for 14 years. So from my perspective, it's always, you know, I've always looked at things from nutrition as one part, but also had a very keen interest in the gut microbiome, and you know, how the body works. And what was really interesting when I was starting my studies and when I went on to do my my subsequent learning and my degrees in university, is that I had a real I was just able to get biochemical pathways. I was just able to understand them. You know, I kind of noticed that people were struggling in the class, and I was like, No, this makes complete sense to me. So I've always taken every case that I have and looked at it from a biochemical perspective, and tried to unpick some of the kind of root issues that are going on with that particular client, and the microbiome ties very much into that. And I think really the whole thing for me really started to kind of go a lot deeper when my son contracted sepsis, and he ended up in hospital for around five weeks, and after he came out of hospital, it was really evident that he was still quite poorly. So I then discovered that there was this thing called post sepsis syndrome, which the doctors really didn't know anything about, and they didn't know how to help me with his recovery. That's when I had to kind of do this in depth research, and I stumbled across the microbiome after sepsis. So I did a lot of deep dive research into that, and subsequently managed to get him to have now today, he's had a full recovery and and, and everything's fine. So when covid hit, I immediately thought this is going to end up in a post Sepsis or a post sepsis like syndrome, because I could see that there was this big inflammatory cascade happening in some people after they'd contracted the initial virus. So I then thought, right, well, I need to pull on this research that I've been doing in the gut microbiome. Started posting about it on LinkedIn, and I guess the rest is history, and I've just been going going from there, really Pete,

Peter Williams  04:37
yeah, so, and it's pretty much all you do now, isn't it pretty much, pretty

Rachel Jessey  04:43
much long covid. It's kind of moved into Mast cell activation syndrome as well. So those that really the key areas that I've kind of ended up specializing in over the last four years.

Peter Williams  04:55
So I mean, there's a very significant proportion of the population now who has long. Covid. Can we Can we sort of break it down into maybe the sort of two aspects of it, and then sort of expand out and also, so, I suppose that from a point of view of the the sort of clotting aspect, the inflammatory aspect, and then, you know, whether we've got viral persistence and whether that's the problem, and and then if we could just build out and build out, because we, we, we chatted, didn't we? Several months ago, we spent literally all afternoon trying to just, what did you think? What? What do you think on this? What do you think on that? Because we both, well, you know, I've had a lot of patients on long covid, and some you resolve really easily. It's sort of almost like it's quite easy. And then some of them with almost like your very best attempts, are still probably doing better than they were, but they're certainly not out of the woods by any means, of course,

Rachel Jessey  05:52
of course. So I think from my perspective, and I think based on the things that I'm seeing in the research now, I do believe that the root cause of what's going on within the digestive tract and the microbiomes. And I say microbiomes because I feel that if something's happening in one microbiome, it's likely happening in another. I believe that spike protein viral persistence is that driving factor in amongst all of it, and we have a two we have two aspects to this, because we have what's going on systemically from a cellular perspective, and then we have what's going on within the microbiomes, so where people are kind of taking this systemic arm and they're going off and doing the research and doing all of the triple therapy, anti clotting factors. I feel that if you, if you don't address what's going on in the microbiomes as well, it's likely not going to have a beneficial outcome long term. So the two kind of need to go hand in hand,

Peter Williams  07:07
so which beautifully ties into I remember very, very early when when covid came out, and there was an article in Nature by a couple of scientists, and they basically said, we're going to need systems thinkers to allow us to work out how we sort long covid out. And you know, if you're not a systems thinker, you're only going to see part of the puzzle, which is, I think what you're alluding to, aren't you? Because you know, if humans are more bacteria in human cells. If we're forgetting that side, we might be missing the biggest piece of the cheese 100%

Rachel Jessey  07:46
and remember our mitochondria are derived from bacteria as well. So likely what's going on within our microbiome bacteria could potentially be emulated within the mitochondria as well. So it becomes a much bigger picture than just treating micro clotting and looking at the gut microbiome and all of those other aspects. I think it needs to take a really wide angle lens at it and have people looking at all of those interactions and how they all impact on each other.

Peter Williams  08:21
So could you explain, I mean, I mean, I know how it feels, but can you explain, as a clinician, how difficult that is when a patient comes in, and we know that long covid could be identified with up to 200 symptoms, yeah, so, you know, it's a pretty big, pretty big symptom presentation. How does, how does that work? How do you take a patient and work through everything? What's your sort of process, given that there are multiple things that you're working on? Yeah,

Rachel Jessey  08:53
so from my perspective, I try and get down to the foundations. So I view things as kind of, I guess, a little bit of a pyramid. And I've not actually given this much thought, but I think I do think of things as a pyramid structure, and I feel what, at the moment, we're tackling long covid at the top of the pyramid. So we're going in with medications, supplements, we're trying to stop various different components and various different pathways using those intervention strategies. But when we kind of get down further at the bottom of the pyramid, the foundations we need to think about, okay, I look at things like connection to nature, circadian rhythms, whether they're sleeping effectively, how effective that sleep is? Are they bringing in melatonin effectively? What's the what? What's the actual nutrition? Like, what are what blood work? Have we got that is out of balance? And then I kind of start with those foundations, because from my perspective, and what I've been seeing all the. That you're trying to suppress things, and you do that with both supplements and medications. You're not actually dealing with what it is that's actually going on underneath. So in the context of the gut microbiome, for instance, if there is viral persistence going in on there, and we can kind of, from the research gather that it's taking down Keystone bacterial species. If someone goes in with a probiotic on top of that, are you inadvertently generating a replication site, or that bacteriophage activity in the gut? So these are all the things that I think about, and so my from my perspective, we need to work on trying to get it out of the gut, and we need research on what are the best interventions to get that spike protein, get that bacteriophage out of the gut without taking out the rest of the gut microbiome.

Peter Williams  10:54
So I think you're bringing and I think about Hannah Davis's paper in Nature immunology. I think it was last year. And what she was clear about, obviously her and her science, science group, I suppose it brings us back to what is long covid And why people still sick and you know, she's very clear in her in that paper, that viral persistence may be a player for maybe up to 60% of the people with long covid, which is pretty substantial. Can we just explore. And what she's stating on that is that you're pretty much finding in every single organ system, the gut, being one of them. Can you? Can you just expand on what viral persistence actually means and why it's so important to try and get rid of it. So

Rachel Jessey  11:46
viral persistence is where the virus will hijack certain elements, whether that is a cell or whether it is the bacteria, in the context, again, of the gut microbiome, Carlo Bronner's actually done some really interesting research. In his papers, and his research team have been showing that what's going what's happening is that the SARS cov two is infecting bacteria within the gut microbiome, and that is then generating that bacteriophage replication. So that could be happening, then again, from a mitochondrial perspective as well, if we think about how certain viruses can kind of hijack cellular, cellular processes, so it could be happening in any of any of our cells. And also, when we think about, okay, how does that virus actually get in, into the body. We know that the ACE two receptors are a big component, but there's research that's just been released this year to show that the SARS cov two virus can actually dock with the h1 receptor. And then when you start thinking of h1 receptors being G coupled protein receptors, you think, Well, is it just h1 or is it all of the gdprs as well?

Peter Williams  13:04
And when you're talking about h1 gdprs, what do you mean for the layman's so

Rachel Jessey  13:08
h1 is a histamine receptor. So h1 is one of the four known histamine receptors that SARS, cov two would be potentially using.

Peter Williams  13:22
And is that why the histamine MCAS aspect of long covid? I think there was Tina Pearce was the first one I remember.

Rachel Jessey  13:30
Yeah, Tina Pearce was the first, first one to kind of bring that to public domain. So yeah, she's been working in the field of MCAS for for a good number of years. So yes, she she was the one that started to identify in her clinical practice that there were her patients were coming in with this kind of big mast cell activation presentation. So yes, she started to use h1, h2, and other mast cell stabilizers and nutraceuticals to kind of dampen down that kind of mast cell response.

Peter Williams  14:03
Can we jump into that? Because obviously, I know you're you stated that you definitely have moved down the MCAS side of this is that because you you see it consistently in long covid patients, it's

Rachel Jessey  14:14
because I see it consistently . And again, it was one of these areas that I had to do a real deep dive into. Because, again, when you think of mast cell activation syndrome, we have kind of what I call the centralized approach to that, which is to use medication, supplements and dietary interventions, which they can do really great things. They can help to calm and they can help to stabilize things, but they don't actually address why that is, why those mast cells are activating in the first place. So while you've got again, thinking of that pyramid I was talking about, that's the top of the pyramid, we need to come in under and work out what it is that's activating those mast cells. Yes, it could be viral  persistance systemically. But equally, again, the microbiomes play quite heavily into this, because the the mast cells become that almost first line of defense from anything that's coming from the gastrointestinal tract, also the oral cavity, the nasal cavity, so anything that's crossing the mucous membranes from those areas is going to be activating mast cells. So again, shutting down what's going on within those particular microbiomes. I believe it would be a very sound and solid intervention to prevent both mast cell activation syndrome, but then that cascade of clotting that's coming that could be potentially being caused by that that that interaction as well.

Peter Williams  15:41
So, so, I think what you're saying, so there's just almost like two arms, isn't there? Traditional long covid, you've got the, the the increase of of of clotting, which is one, then you've got the the inflammatory cascade with the cytokine storm, which is, you know, increased inflammation. What you're saying is that they are a response to something, and you want to you not you want to not just help to control both of those, but you also want to understand, well, classic upstream medicine about but why is it happening in the first place? So if we do that to your microbiome, what do you see? So and do you test? And

Rachel Jessey  16:28
I have been, I have been, I have been testing. So over the last four years, I've been testing. But do you know what Pete, I don't test anymore, because it all comes out with the same it's all coming out with the same type of phenotype, which is what I've I've started to kind of coin in my clinical practice, which is the long covid microbiome phenotype, which, of course, is likely going to evolve over time. But what I am seeing is a takedown of important Keystone bacterial species, whether that be the lactobacillus or the bifidobacteria, nine times out of 10 it's bifidobacteria. And then there's very strange things going on with akamansia. It's either really increased or it's completely depleted. And then we're seeing a disruption to short chain fatty acids with the takedown of the butyrate producers. In some cases, there may be other bacterial species that have had an opportunity to grow and develop. So you see an increase in Secretory IgA. There's an immunogenic response going on in the gut microbiome, and that is generally what I see quite a lot, an increase in blastocyst hominis. So it's almost like these Keystone bacterial species are being taken down, and it's giving the opportunity for other microbial species to kind of grow and proliferate. Now, whether that so taking it again, one step further in the way that my brain thinks is this evolutionary pressure to SARS, cov two? Do we need to leave it alone to sort itself out, or do we go in with interventions? And that's what we don't really understand at this moment in time. Now, when I do go in with very careful, specific interventions, I do see benefit.

Peter Williams  18:20
Okay, okay, so let's just break that down. Can you just explain what if? Because the whole point about this isn't it, is that with any disorder, and we use long covid As this were, or see the new word in a literature, long Vax, because obviously there's a vaccine induced injury as well, which maybe you could chat about. Yeah, you're going to have an individual presentation. Everyone's long covid is different. So that's what you're talking about. The phenotype, isn't it? There is, and what you're seeing is specific phenotypes, whether it's purely inflammatory, purely micro clots, or what you're alluding to, which is microbiome phenotype. Is that because so when you're talking about the microbiome phenotype, are those patients who are specifically noted when they had covid, that they had gi their digestion was a key player in some of their symptoms,

Rachel Jessey  19:23
not all the time. Okay, no, it isn't all the time. I would say that the majority of people, when you track through their history, they've likely had some degree of like IBS type symptoms, you know, non specific issues. Some people have come to me and they've had complete you know, they got covid, they had diarrhea, they had chronic diarrhea, you know, they had very marked increases in gastrointestinal upset, gastroparesis, and so, yes, they were very notable changes. But in some people, they're quite shocked about their micro. Buy in results because they feel that that area is actually okay. But equally, it's about defining what's okay and what's normal for people, because sometimes people can just put up with symptoms and not actually realize that that's not necessarily a normal a non normal functioning GI system, you know?

Peter Williams  20:21
So the other thing about this, isn't it, is that, I suppose it so? Are you suggesting that you believe partly that long covid is when the virus is is taking over? Is the wrong word? What's the word I'm using. It's almost like kidnapping, hijacking, hijacking, these, these. Does that mean it's, it's hijacking and killing those species or or, what is it doing when you when you mean hijacking? I'm trying to sort of get my head,

Rachel Jessey  20:56
from what I see, it is taking down Keystone bacterial species. So if the microbiome is trying to keep up and trying to help produce and proliferate a healthy microbiome, it's either being taken down by viral replication or the whole thing is just being wiped, completely wiped out. I don't know the full answer to that question, because I don't have a laboratory. I can't see and it's very hard to replicate a health, you know, a human microbiome in a clinical setting. But yes, that is, that is generally what I see. Now, I know that Sabine Hazen, has been doing a lot of research on this herself, using her own kind of laboratory, her own laboratory and her own her own kind of clinical trial set up, and she has seen that both vaccination and the natural infection is taking down Bifido bacteria specifically, and she's also seeing that in her subset of patients as well. So

Peter Williams  22:07
it's not just that, is it? I think if you can expand on, I suppose we're talking about layers of defense, that's what I think about when you're talking because obviously, and also your your notes on akamansia, and if you like the sort of the compromise of the border, can you try and expand on that? Because I look at this and we're trying to, you know, if, if we're always going to have a compromise border, yeah, then we're always going to have some degree of immune system activation, you know. And I think a lot of a lot of long covid patterns that we're going to see is part of our immune system gets exhausted because it's continually having to fight. And I always go back and I get well, if the borders are open, there's always going to be invaders. You're always going to have an immune system that just becomes completely, completely, just, you know, beaten down from the from the consistent battle. So can you explain those steps? Because I think a lot of people might not understand when the barriers are compromised and what happens and Akermansia's relationship within that whether it's good or bad, whether it's high or whether it's low, which is really interesting, what you're saying,

Rachel Jessey  23:19
yeah. And actually, just to touch on that, with akermansia being low, that has been correlated with autoimmune conditions such as multiple sclerosis. So again, it's not cause and effect necessarily, but it's just that that overall correlation. So yeah, so basically, kind of looking at my, my overall hypothesis on this is that I I do feel that it depends on what state the gut microbiome is in and what state the oral and nasal microbiome are in before someone has that subsequent infection. So if there's any potential dysbiosis or imbalance going on, I think that compromises that person totally agree with you, potentially having that viral persistence going on. So this isn't necessarily something that happens to everyone, right?

Peter Williams  24:07
I think what you're saying with that is that you're going to have patients where the straw that broke the camel's back across several aspects of that and, you know, and the covid infection has broke the camel's back. That puts them into that picture. Yeah, absolutely.

Rachel Jessey  24:25
So then, if we hypothesize that, then there's this viral persistence or this bacteriophage activity going down, what you will start to see, this is what I start to see, is that the microbiome is going to try and fight back in some way, right? So you might start to see an increase in methanogens. You might start to see an increase in hydrogen sulfide producers, because they're trying to create and emulate a situation where they're trying to kill off whatever's going on in us. We know hydrogen sulfide, it's, it's a potent killing machine, and. Allergens can capture hydrogen as well. So there's all of that potential pathway going on within the gut. So I think the gut microbiome starts to adjust in a semi beneficial way to try and get rid of it. But as a consequence of that, you've got these two mechanisms that are starting to then disrupt the actual microbiome and starting to take down some of these Keystone bacterial species, akermansia, bifidobacteria, lactobacillus, some of the butyrate producers as a result of that. Now when we start to see a disruption in those Keystone bacterial species, because they're so pivotal to producing things like B vitamins and supporting the mucosal layer, the mucosal barrier. They're important for that gut brain axis. They're important for the gut liver axis. You start to see, then systemic disruption as a result of that. Now what the beneficial bacterial species do, particularly the short chain fatty acid producers and akermansia is that they have a role to play in keeping the mucosal layer, or that Muco Muco mucus barrier healthy. So akamansia in particular, are mucus degraders. So there can they? They are degrading the mucus, because we need a healthy turnover, right? So we need it to kind of be broken down, so that the new mucus can be can come through and be nice and fresh. So that's what acamensia ultimately does, where the butyrate produces, they help to nourish the colonocytes, and they help to nourish and produce a really healthy mucosal mucosal layer in a mucous membrane. So when that all starts to break down, what you will start to see is a translocation of the tight junction proteins. And Zonulin is one of those tight junction proteins, so they keep the cells of the gastrointestinal tract nice and close together. But when you start to see a translocation of Zonulin, those cells start to become what I call hyper permeable. Don't like to use the word leaky, so they become more hyper permeable. So then that's when more immune system activation can come through, because there will be certain things that will communicate from the gut to systemic circulation or the lymphatic system, to turn on that immune system. And I think that is where, where that whole process comes in. Now there's so many other elements that are coming into this, because we've got disruption to tryptophan, amino acid metabolism, serotonin, we've got all of those kind of neurotransmitters being being kind of misfired within the gut as well, plus that leaky gut. So then you've got this situation where there is immune system activation. You've got mast cells coming in, you've got neutrophils coming in, you've got Synthesia being formulated, and yes, and neutrophil elastase will come in. So that's when the kind of mechanisms come into that kind of micro clotting, because anything that comes into the bloodstream needs to be encapsulated so that it doesn't create a problem like sepsis.

Peter Williams  28:19
So I think what we start to see is the complications on complications and complications that you know. And I think you mentioned autoimmunity well again. And if your gut is more permeable than you like, then there's, you know, you're going to get an increased risk of autoimmunity from that. So is one of your strategies then to shore up the borders. Yeah,

Rachel Jessey  28:45
Yeah 100% I I've been adapting, Obviously, I've been adapting this through clinical practice, but I have been and again going on researchers who are kind of looking at the viral persistence and the bacteriophage in particular.

Peter Williams  28:59
Can you just explain what a bacteriophage is, yeah. So

Rachel Jessey  29:02
it is basically where a virus infects a bacteria that is basically it, and it creates a bacteriophage that can go off and and continue replication within. They're funny

Peter Williams  29:14
lookers, aren't? They look a little bit like a spider with long legs.

Rachel Jessey  29:17
They look so alien, yeah, they do look very alien. Um, so from that end, Carla bronia has been using antibiotic therapy, so Rifaximin or amoxicillin. Of course, I can't prescribe that, so I've been using that makes

Peter Williams  29:36
sense to you, though? What? Why

Rachel Jessey  29:38
he's using it? Yeah, does

Peter Williams  29:40
that make sense when? Because I'm assuming, I'm assuming you get patients were, you know, the you know that obviously could go back to their GP, is that, some time, have you done that with with some patients, with

Rachel Jessey  29:53
With some patients, they've already come to me having taken Rifaximin. So we then go in and do the the kind of next stage. for people who, who are too compromised to use antibiotic therapy, I might use something like Berberine or oregano oil, and that seems to be just as effective. So I have a very specific protocol that I use for that. And then I will go in and I will use, and it depends on where, where, where that particular client is at. But then I will go through and I will do things with maybe toxoprevent or pectins or humic acids to try and get some binding effect going on there. Because the other element of this is that there could be toxic peptides being produced within the gut microbiome. I'll go in and do a bit of a clean up operation, and then go in with and I've been using a lot of humic acids, and I've been using not humic acids, human milk oligosaccharides. I've been using what's the other one, the immunoglobulins, globulin therapy as well. I've found that to be quite effective, and you don't have to put people on this massive, long list of supplementations. And of course, if their tolerance to food starts to increase after that point, then we start to use, you know, polyphenols, and try not to go in probiotics. Sometimes I might use a probiotic, but I try, I try not to go in with with probiotics.

Peter Williams  31:27
Why is that? Because? Why would that? Why would that be? Because

Rachel Jessey  31:31
I'm just worried about the viral

Peter Williams  31:36
so you think, if you consistently are bringing probiotics into the system, it keeps the replication going. Potentially,

Rachel Jessey  31:47
Potentially, it's one thing that I just have a really big question mark at the moment. You could argue, do the probiotics actually get to that part of the colon, right? I don't, I don't know, but, yeah, I'm just cautious. It's not to say that I don't use them in clinical practice, but I'm just generally quite wary and cautious of using them.

Peter Williams  32:10
So what your practice is built on? The fact that we're trying to keep we're trying to keep invaders out? Well, let me just, let me backtrack that. Let me try and explain this. There's been a massive battle, and we lost it because the viruses are in whether or not they're persisting there, we're not sure. But we're looking at, how do we treat the battlefield after we sort of lost the battle, and many of our soldiers, many of our best soldiers, have been lost within that as well. So it there's a risk that we might bring new soldiers in, but there's a risk that that actually might reactivate the battle, and we're going to lose on that side. But also, we've got this situation where you're trying to shore up the borders, because if any of these soldiers get across the border, it's going to hyper stimulate the immune system that's probably already hyper stimulated. It's going to increase the the pro the thrombolytic aspect, ie clotting. Because, you know, if you're in a war and you get cut, you want to clot, you want to clot quickly. So does that sort of somebody's almost like consistently in the battle and preparing itself, or in the battle. Now, within that, I, what I'm trying to think about on this one, which you could, you can go on to, is that there comes a point where I think, for many people, um, your immune system is so tired and exhausted that other viral aspect, other viruses that we've been able to control for decades suddenly reappear. And there's, there's quite a lot of research out there, isn't there? They're saying is long covid Simply, you know, the glandular fever virus reactivated. What are your thoughts on that? I mean, there's clearly quite a lot of literature

Rachel Jessey  33:57
on this. There is a lot of literature, and we're seeing it as well in clinical practice, so that, I think the main things that we're seeing reactivated are Epstein Barr Virus and Lyme and Bartonella. I've never seen Bartonella positive tests until covid. Okay, interesting, as it's intracellular. It's so difficult to get Bartonella on a positive test result because it hides in in the cells, but it's coming up everywhere it's so it's been so unusual for me to see that in clinical practice, and so that's been a really interesting observation. But that

Peter Williams  34:34
would make sense, wouldn't it? If the, I mean, it's almost like this is down to, you know, immune system exhaustion that we can't keep all these other prisoners under control.

Rachel Jessey  34:44
Yeah, yeah. So of course, you've got all of these things being activated. And if imagine if all of these viruses and all of these bacteria use the same mechanisms as SARS, cov two, you can imagine. The amount of microbiome takedown that's going on, immune system activation that's occurring, and also mitochondria dysfunction that's happening as a result of all of this, this immunogenic activity that's going on in the body,

Peter Williams  35:16
and I suppose border border controls that get even more compromised as we go along. So what do we do? I think this is the key thing, isn't it? Is that, you know, I can think about, I can think about one of my patients, Dan. He actually came up with the name long callers. He was one of the very first ones who really, yeah, yeah. So good on him. But you're talking a guy, and he won't mind me talking about him. But, you know, super fit. He was a he was a model, super fit. And covid really took him. I mean, unbelievable. And still, now, five or six years later, he's not 100% you know, we're very happy with where we're at, but it's not the old Dan, not yet, anyway. And so I suppose the question is, I mean, you must have that as well. And we had a long chat, didn't we about Yeah, you know, everyone that comes in is, is a different presentation, so it's very difficult to to know how to work them. But can you give us some of your treatment strategies and why you would do that, and how long you need to do that, and and I think also what patients are going to need to do from a point of view of an you know, someone who's taken many patients down this pathway, how easy, or how difficult is that going to be? So

Rachel Jessey  36:42
So how easy and how difficult it's going to be depends on the patient and where the patient is at, how sensitive they are and and the level of function that they have. So I think it's it's difficult for me to say exactly what I would do in every single situation, because I meet patients where they're actually yeah, and how they're functioning. However, in the context of someone who has been say, for instance, to see a lot of medical practitioners, they've seen a lot of practitioners, and they're kind of at the end of the road. They're the they're the people that I tend to get so I take them right back to basics. So if that person has tried everything, but they spend all of their time indoors. They're not connecting in with nature. Their circadian rhythms are completely disrupted. Then I want an I want to deal with that first interesting that part and parcel of a lot of presentations is their world becomes so tiny. It becomes so tiny you are so right? They

Peter Williams  37:48
They lose the capacity to just live 100%

Rachel Jessey  37:52
100% and the more chronically ill someone becomes, the more disconnected they healing powers of nature. So that's where I start to take people. Now, the people who have had, very interestingly, the most beneficial, clinically relevant recoveries have been those who can get on a plane to a lower latitude and sit in the sun. 

Peter Williams  38:17
Do you want to give us any theories about why? Why you think that's the case? So

Rachel Jessey  38:21
I feel that the sun is probably one of the biggest healing modalities that we have available to us on this planet. If you think about every single living organism on this earth, it has become that way because of the sun, and us as humans have we have evolved with the sun. We have developed our our whole being is because of the sun. Our circadian rhythms are directed by the daylight and the night. And so from my perspective, connecting people back into that has probably been one of the most powerful things that I have given to my clients. Now, from a biochemical perspective, we need the sun to interact with our eyes, and we need the sun to interact with our skin, and I found a very interesting kind of correlation, because so many people with long covid have high cholesterol, so many people with chronic illness have high cholesterol, and there is a reason for that, because the body's inflammatory. Our cells are our cell membranes are made of cholesterol. So we need to produce more cholesterol, because it's likely that some turnover is higher. However, when we are sunlight deficient, we are not producing vitamin D. Cholesterol makes vitamin D. When we are sunlight deficient, we cannot convert cholesterol into progesterone, testosterone, cortisol, estrogen, so. So we have all of these biochemical processes that are reliant on our connection to the sun in order to divert cholesterol to where it needs to go to make vitamin D. When we think about vitamin D in the microbiome and the skin, gut connection, when we are vitamin D deficient, our intestine will become more hyper permeable, because the vitamin D receptors help to keep those tight junctions kind of nice and closed or nice, and you know, the right level that they need to be. So this is where the sun can help with leaky gut. And then when we take that further into infrared spectrums. Infrared can actually it can go right through our human body, and we know that the mitochondria can respond to infrared light and produce energy without even touching food. So we also can see in the research on phyto, phyto photo bio modulation that red light can help to produce beneficial bacteria within the gut, and blue light can destroy it.

Peter Williams  41:11
Sorry, I'm going to chip in on quite a few things on here. We're using blue light therapy in oral disease.

Rachel Jessey  41:25
So interesting. 

Peter Williams  41:27
So there's a couple of companies out there now who've built some really nice systems, and they're actually quite cheap to do one what Finnish company in particular, that we seem to be doing well, because as I said to you, you want to kill the bad guys and grow the good guys. I also want to take you look again. We've been very and I think, you know, if you've been in the game for a long time, you know that medicine isn't perfect, and but if I bring you back to the vitamin D, this is, I suppose I look back now, and I think there were two papers that came out early on, Spanish papers early on in I think it was delta and they were exceptional, papers showing that high dose vitamin D, given in the ER department, reduced Oh, god, what's it called? Intensive Care stays with covid by 75% and they were completely ignored. And you know, that's when I started thinking this this sort of stinks a bit. How can that be ignored? Because if that was a drug that would have been, that would have been the Nobel Peace Prize for sure, for medicine, for sure. And so because, but I look back now and I just think, but maybe that's because medicine doesn't think in a system's way. You know, the people who are making decisions could not see how important that may be. And, you know, I think that was a couple of years ago, may or two, three or four years ago, the paper came out to show that the minimum requirement of vitamin D was 125, nanomols to sort of almost get rid of you, not, not not contracting covid. So still, now, every year since then, I say to people, as we go into the winter, we need to make sure your vitamin D is minimally managed at 125 nanimols, that's the minimum requirement. I mean, what was your I mean, so, so what we're saying is vitamin D receptor every single cell in the body, which means that the sun's pretty, pretty important for us, or external vitamin D is important. There's no doubt that Vitamin D plays a massive role on mucosal immunity. Why are we still giving such low dosage, low, low dosages?

Rachel Jessey  43:55
I have absolutely no idea, but I will caveat this in that I prefer people to get vitamin D from the sun as opposed to supplementation, because it's still a synthetic way for us to be getting vitamin D into the body. So

Peter Williams  44:13
Well, I think the other thing isn't it, is that the sun also creates a lot of opioids as soon as it hits the skin. So actually, it feels so much better

Rachel Jessey  44:23
things it does, you know, it helps with dopamine, it helps with serotonin, it helps, it helps with the, you know, I've dug into, and maybe this is another one for another podcast, but I've dug into the whole histamine pathway and the histidine pathway, with regards to how that interacts with UV, light. So UV for us as humans, is 100% needed. We have UV receptors within our skin, within our eye, and we are made to be addicted to the sun. So for healthcare professionals to tell us to avoid the sun, and what did they do in covid? Locked us all down in our houses, just weren't out, able to go out now with if people were going out and getting a suntan and getting that proper light and doing exercise outside, it could well have been a completely different picture. And then, you know, the whole vaccination program may not have been needed. Hey, you know, I'm putting it out there. It's controversial, but our connection to these natural modalities is so important, and I will say that I did talk about vitamin D a lot during the first wave of of the pandemic, and I got de platformed for it. Okay? I was de platformed from meta, and I had my Instagram and my Facebook taken away for promoting actual clinical studies on on the benefits of vitamin D for immune health, which

Peter Williams  45:47
Which is a bit crazy, really. I got, I got warned, um, did you go so far? Yeah, I

Rachel Jessey  45:54
I top trumped you there. 

Peter Williams  45:58
But, you know, the sad thing about that is that, you know, this the same thing again? It's that, you know, and I suppose I look back and I think maybe I get it. Why, Why that that was going to be the case? Because when you set yourself up to do such a big thing that governments did, you've gotta, I suppose you've gotta, keep it going, regardless of what, what's been said (100%) in the literature, and actually, you know, voices who are genuinely concerned and want to help people and you know, and as I said to you, that's when it started for me. I'm like, this doesn't smell right? You can't have studies so good like this that no one's interested in even (in a hospital setting as well). But remember, even the vaccines were were brought out for immune emergency use, again, in a whole point about why we locked down. We locked down to save the NHS, and yet, these studies come out showing that you can reduce hospital stay in, you know, by 75% it's like, it doesn't make any sense?

Rachel Jessey  47:05
And I think this is the thing that, you know. I think a lot of people in hindsight are understanding that there was no sense to any of the, any of the kind of interventions that were placed upon us in those initial stages. But, yeah, that that's, that's a long subject.

Peter Williams  47:24
It is, yeah. So I think we're all probably just sort of, yeah, not bored of that. But I think kind

Rachel Jessey  47:31
We need to, you know, go to the future now and deal with it

Peter Williams  47:35
So let's talk about some of the things then have you dealt with? Because clearly, it's, it's noted substantially in the literature, and more so now with regards to and they call it long Vax, (yes) these are the vaccine induced in Yes, have you seen any of that? I've seen a couple, but haven't. Didn't feel like I was comfortably enough in, in, in the way that I felt I could do a good job on treating them. So what about you? Have you seen any on that side? Yeah. So,

Rachel Jessey  48:08
yeah, quite a few people come to me with with clear vaccine injury. As soon as they had that vaccine, that's when, when things started, very quickly. I think that the problem has come now Pete, because so many people have been vaccinated and then had a covid infection. So when you kind of track through the health history, it's difficult to determine what, what's which one has caused, what.  And again, kind of pulling back on Doctor Sabine Hazan's work is that she's seeing similar takedown of Keystone bacterial species with vaccinated interesting population groups. So I do it all the same. It's the same strategy  same strategy, same strategy. Yeah,

Peter Williams  48:58
interesting. Can we talk? I mean, I know, okay, so I know you don't want to get into some degree of, but what would be your and again, it's an individual base, but, but let's try and give some sort of, here's maybe what's a good idea. I mean, what on the basics of a dietary intervention would you ask your patients to do. And I know it's an individual case base, but is there something similar that you may ask? Yeah, so

Rachel Jessey  49:27
I try and get people onto a paleo style of eating. I try to get them to increase their intake of fish and shellfish, if possible, because I feel that that's one of the most nutrient dense foods that we have. You know, the majority of the population depleted in iodine, and also the Omega three oils, which are so important, not just for gut health, but also that gut brain connection as well, and also for our cell cell membranes. Uh, eating in a Paleo way, alongside kind of I get them to increase their salt intake. So Celtic sea salt has been a staple in my clinical practice, and I follow the kind of general rule of having breakfast like a king, lunch like a prince, and then evening meal like a pauper, and that falls in line with those circadian rhythms. So a lot of what I do is based on circadian entrainment, so making sure that people are eating within an hour of waking up, to support cortisol levels, but also to help with the digestive processes as well, and ensure that there's energy being taken on in that first half of the day for the requirements needed throughout the rest of the day, and then that we can use that evening meal as kind of a gentle meal to have so that then blood sugar levels are stabilized, and we've got the opportunity to bring melatonin in in an optimal way, just

Peter Williams  51:00
as you're on that and because, obviously melatonin is big in the long covid literature. Do you think that's because it induces you might have a disrupted circadian rhythm, you may have reduced melatonin per se within long covid patients? Or is it also because it does an amazing job as an antioxidant? Or all three?

Rachel Jessey  51:21
Yeah, I think all three. And it also helps to stabilize mast cells. So when you have melatonin dominant during the night, that helps with the immune system, and helps to keep the immune system nice and organized and just at a level where it's not hyper activated. I don't like to use melatonin in clinical practice, because I feel if the body makes it, you shouldn't have to take it. That's not to say that there is not a place for it to be used in clinical practice for a short period of time. However, what melatonin supplementation can do over time is make your receptors in your eye less responsive to those light signals that we need. So I get people to optimize their melatonin. I get them to look at the sunset or be outside when the sun is setting, and I get them to completely wipe out artificial light in the evening. First up, it's interesting,

Peter Williams  52:14
isn't it, because I look at even the stuff that the IFM put out, who did an amazing job of putting stuff together and but their melatonin dosages were Whoppers, you know, 30 grams. Yeah,

Rachel Jessey  52:27
crazy. And I think you have to be so careful with these hormones, because the body, the body can become very responsive and very adaptive if you're putting kind of synthetic things into the body,

Peter Williams  52:44
yeah, interesting on that one. What I would say on that is that all the people that I've seen use melatonin. It's a question whether, if you're drowsy in the morning, that's unnatural, then you're taking way too much. Absolutely. Yeah. And so what about, what about sort of we've hardly spent any time on MCAS, but I would like, I'd like to just what to avoid if you and what would be the symptoms that you would still see if someone you felt like there was a histamine problem or MCAS, what would you expect to see? How would you treat and are there any drugs or supplementation that you may want to put in as well?

Rachel Jessey  53:24
Yeah. So with regards to kind of symptomology, because the mast cells release so many different mediators, it has a multi systemic effect on the body. So what I kind of say is that people are generally hyper activated, so they may have increased anxiety, they may have disruption to sleep. They may get these dumps and these waves of kind of adrenaline rushes the digestive system will either slow down or it will speed up. So there may be constipation or diarrhea as a result of that, some people will get very immediate reactions to, for instance, food, or may have chemical sensitivity, or may have developed an allergy to things like molds and mycotoxins. There may be a skin involvement in place, so people might come out in hives. POTS can kind of tie into this, these kind of symptom and also exacerbation of hypermobility syndromes as well. So a brain fog, yeah, just really and really sensitive to the overall environment as well. So when people come to me with so they generally come to me having had a diagnosis of Mast Cell activation syndrome. So they already kind of know, I don't really get involved in that kind of diagnostic criteria or that, that kind of yes, you have MCAS. So we have what I call the centralized and decentralized approach to dealing with mast cell activation syndrome. So the centralized approach would be to use H1 and H2 blockers. So that may be Famotidine as an h1 fexofenadine is an h2 and then something like ketotafen, which is a medication which stabilizes the mast cells, but it's also an h1 blocker. But the interesting thing about ketotafen is that it actually helps to stimulate nitric oxide, which can have an antimicrobial effect. Which is why some people who have that kind of underlying Lyme, Epstein Barr Virus, Bartonella presentation, do really well on ketotafen. So that's kind of and then there's other medications, like montelukas that may be implemented. Then you've got supplementation. So quercetin is a big one, bacon diamine oxidase. Those could be implemented as a kind of antihistamine protocol. There's a ton of other polyphenols that can be used. And then you've got a low histamine diet. So with a low histamine diet, really, you really want to be putting someone on a low histamine diet for two to four weeks to monitor symptoms. If symptoms improve, then you then what I do is I go deeper and I work out why, why that whole immune system activation is occurring. So that might be microbiome might be dealing with mycotoxins, viral persistence. So there's a number of things equally, circadian rythym  in training, and, you know, mitigating artificial light and EMFs come into this as well. Okay? And what's really interesting is the World Health Organization acknowledge that electromagnetic frequencies can cause problems in people. So some people can have hypersensitivity to electromagnetic frequencies. Interestingly, very similar to MASTl activation syndrome type presentation. So I kind of look at that whole picture with people. So we do circadian entrainment. We get people, you know, building what we call their solar Calix, because sometimes the sun can trigger MAST cells. But so we start off very slow and low with the sunset and the sun rises, deal with any environmental issues that are going on, and I may use supplements. So I love pectosol, which is a modified citrus pectin. I really like that because that can help to detoxify histamine in the gut. But it also is a galectin three inhibitor, which can be quite helpful, and I might use some other MAST stabilizers. It just depends how sensitive the person in you know, I've had some good results with things like Toxa prevent as well. So yeah, those can all be helpful. But again, it's just meeting the patient where they're actually at and seeing what they can tolerate.

Peter Williams  57:46
So I probably got, I mean, we're already an hour in. I've got a couple of questions more. I really appreciate it. What conversation do you have with your patients at the beginning, with regards, because we talked about this a lot, it's a question of trying to give them an honest understanding about what the journey looks like and what they may have to do. How does that go down?

Rachel Jessey  58:10
So I kind of caveat that by pointing into my website. So on my website, on my E consult page, I have very clear I've put in place my expectations before people even come and book in with me. Because I think, from my perspective, I don't want to work with people who just want to take a supplement and make everything go away, because I know four years later, it;s  not going to work. It doesn't work. People do have to put the work in. And I feel that even if someone is bed bound, there is a degree of things that can be done. You can meet any patient where they're at but they need to be able to understand that they have to make incremental changes in order to facilitate that route to recovery. I'm not guaranteeing a recovery,

Peter Williams  59:00
I think you're I think this is probably almost like the crux of any discussion with chronic disease, whether it's long covid, is that they have to be the captain of their own ship 100%

Rachel Jessey  59:11
100% I I provide the tools to put the work in, so clear on that In my onboarding process. Well,

Peter Williams  59:21
I think probably so clear, probably because you like me, you've had your hands burnt on that many times then,

Rachel Jessey  59:27
yeah. I mean, even quite recently, I've had that. I've had again, you know, they just wanted to take supplements. They weren't willing to kind of look at all of the other proposals that I'd put in place, and I get it, I nderstand Pete, because people want to, they do want to just have their symptoms go away. So I completely empathize with it. But you know, aren't you? Well,

Peter Williams  59:53
it's really difficult because, again, I was, I'm helping out one of their functional medicine organizations. At the moment, and I was chatting to one of the guys this morning about it, and, you know, it's the same conversation. I almost said, in many ways, conventional medicine is easier. It is everyone, because it gives you, I think it's x, here's y, yeah, and it sort of doesn't work. It may help to some degree, 100%

Rachel Jessey  1:00:21
100% you might put a medication in, and it's like, wow, that's amazing.

Peter Williams  1:00:25
And I think, but that's the difficulty for us, is that it's not a question. There could be 20 plates spinning at any one time, and you as a clinician have to be able to know which plates you've got to keep spinning, or will you intervene at any one time. And it's incredibly complex, which makes it so difficult. So I'm glad you said that, because, you know, unfortunately, we have to say the same thing that just I wish I could give you the magic bullet, but there isn't one. Yeah. So one more question I would like to ask is that, are there any specific biomarkers that you would look for, anyone, that allows you to know, hey, we're doing okay. Or before you come on board, I probably need to check X, Y and Z,

Rachel Jessey  1:01:09
cholesterol and vitamin D. They give me so many clues, so many clues. So if someone, you know, and almost, and hormone balance and things like that. But yeah, cholesterol and vitamin D are that the ones that I really go and thyroid function, you know, general kind of full blood count. But if those markers are off, I'm like, You need to like we need to do your circadian rythym training. You need to get out in the sun. I know, I know when I look at people's blood, whether they're sunlight deficient or not, and and what's really interesting is that the majority of people may be taking a vitamin D supplement, but still deficient in vitamin D. Because maybe they're not optimizing that supplementation. But two, they've just been so sunlight deficient for a long period of time.

Peter Williams  1:02:09
And what would you so just on the cholesterol? What would you expect to see elevated above normal?

Rachel Jessey  1:02:16
Majority of the clients that I have come through with long covid or any chronic illness, they have elevations in total cholesterol, elevations in LDL and imbalances with HDL. So that kind of HDL LDL ratio is completely out of whack, and triglycerides are generally quite normal. So that's not indicating to me that that's a metabolic dysregulation that is an issue with cholesterol. So

Peter Williams  1:02:44
do you think that's an issue because it's, it's, it's doing an immune role somewhere.

Rachel Jessey  1:02:50
Yeah, I think there's two, two arms to this. I think it's, I think it's indicative of cellular breakdown, so high cell turnover, because LDL will naturally make sense. LDL is a delivery, delivery molecule of cholesterol. Where does it go? To the cells? So what are the cells likely doing? They're likely being broken down quickly, which is why LDL is being being pushed up and elevated to kind of facilitate that repair. The other thing is, is that cholesterol needs to get sulfated by the sun in order to get down into the vitamin D synthesis pathway, and also to help with hormone in hormone balance as well. And if someone is, if someone's got an A maladaption of the HPA axis and a pushing in the cortisol pushing down that cortisol pathway at the expense of kind of progesterone, and then making DHEA and all of those other elements. Is cholesterol increasing to try and get that hormone balance going. But obviously it's not getting sulfated because there's deficiency in sun. So if you get someone out in the sun, you generally tend to see their cholesterol levels come back to normal.

Peter Williams  1:04:06
Interesting, all right, I'm going to summarize

Rachel Jessey  1:04:13
summary, because I love your summaries, and I think I might actually copy them if you don't mind

Peter Williams  1:04:17
No, I think I'm going to summarize from a point of view of if someone's listening to this with long covid, or you know someone with who has long covid or long VAX, what are going to be your three most important things, or three or four that you would you would tell them to do, what would be the most important pieces advice that you'd give them,

Rachel Jessey  1:04:44
circadian in training, circadian rhythm in training and getting out in the sun and connecting with nature. Number one. Number two, see a specialist, speak to someone about how to optimize your gut function and. And to help with, help with kind of getting that gastrointestinal tract, the oral, nasal microbiome, kind of supported. And three, get with someone who is medically trained, who is able to kind of support you with the systemic side of long covid or long Vax as well. So that's looking at specific experts within this particular area. So I would obviously recommend Dr Ben Sinclair. I would recommend Dr Bonita Kane and also Dr Tina Pierce as kind of what I would feel are the most knowledgeable practitioners medical practitioners within this space right now. Okay,

Peter Williams  1:05:47
brilliant. All right. Rachel, just super interesting kid. I really appreciate it, because there's always stuff that I learned that, particularly when I'm speaking to you, that I just haven't thought about, or you've added quite a bit more on there again, certainly for me that I didn't think about. I'm sure everyone who's listened to today will, you know, take a load of new information from this. Or maybe again, it's, it's been explained in a in a different way that, you know, if they've just, I think, well, just into the GP that the GP has gone, okay. Well, you've got long covid, off you go 100%

Rachel Jessey  1:06:26
100% and I think if anything, if this sparks off more conversations and some areas of research. And yeah, we've just got to keep having these discussions to kind of get new ideas out there. And yeah, and hopefully just just see things a different way. I think that's really important.

Peter Williams  1:06:43
All right. Well, let's hope we, let's hope this doesn't get taken down off off Instagram or podcast,

Rachel Jessey  1:06:52
you'll have to go on rumble. No,

Peter Williams  1:06:53
I'm pretty I'm pretty sure it won't, because I'm pretty sure, as you say, I don't think, I don't think you can avoid what the literature is coming out to say these days. So okay, I really appreciate your time. It's been great. So thanks. You're welcome.


Transcribed by https://otter.ai