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Long COVID, MCAS & Post-Viral

Long COVID, ME/CFS and MCAS overlap heavily with dysautonomia. What connects them, why they travel together, and how to track the parts you can measure.

freestocks / Unsplash
Austin Spaeth October 13, 2026 Long COVID

Antihistamines for MCAS: H1 and H2 Blockers in POTS and Long COVID

Antihistamines block histamine at its receptors, so they calm histamine-driven symptoms (flushing, itch, hives, gut upset and some flares) without stopping the mast cell itself or fixing orthostatic tachycardia. The usual MCAS starting point is a second-generation H1 blocker like cetirizine or fexofenadine paired with an H2 blocker like famotidine, sometimes at higher-than-standard doses under specialist care. Second-generation H1 blockers are preferred for daily use because first-generation ones such as diphenhydramine are sedating and anticholinergic, which can raise resting heart rate and lower HRV. This is educational information, not medical advice.

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Nathan Dumlao / Unsplash POTS

Oct 12, 2026 · Austin Spaeth

Nausea in POTS and Dysautonomia: Why You Feel Sick and What Helps

Nausea is one of the most common and most dismissed symptoms of POTS and dysautonomia. Here is the autonomic physiology behind it, how to tell the different triggers apart, the red flags worth knowing, and the practical steps that settle a queasy stomach.

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Unsplash POTS

Oct 11, 2026 · Austin Spaeth

Cold Hands and Feet in POTS and Long COVID: Why It Happens and What Helps

Cold, pale hands and feet are one of the most common and least talked about parts of dysautonomia. Here is the physiology behind it, how to tell plain cold extremities from Raynaud's and acrocyanosis, and the practical steps that actually warm you up.

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Dan Gold / Unsplash Food

Oct 10, 2026 · Austin Spaeth

CoQ10 for Long COVID and POTS: Does It Help Fatigue and HRV?

CoQ10 is one of the most recommended supplements for post-viral fatigue, usually on the strength of its real role in how your cells make energy. The evidence for long COVID specifically is thin, the heart-failure and migraine data is stronger, and the honest move is to test your own response. Here is the physiology, what the trials actually show, the ubiquinone-versus-ubiquinol question, the POTS and warfarin cautions, and how to track whether it helps you.

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Ronaldo de Oliveira / Unsplash Long COVID

Sep 26, 2026 · Austin Spaeth

Pulse Oximeter Readings in Long COVID and POTS: What SpO2 Can and Cannot Tell You

A fingertip pulse oximeter measures how much oxygen your blood is carrying, and in long COVID and POTS that number is usually normal even on the days you feel most breathless. Here is how to read SpO2 accurately, why a normal reading does not mean nothing is wrong, and what to watch for.

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Unsplash POTS

Sep 25, 2026 · Austin Spaeth

Chest Pain and Tightness in POTS and Dysautonomia: What It Usually Is

Chest pain and tightness are common and frightening in POTS, long COVID and dysautonomia, and in a young person with a structurally normal heart they are usually not cardiac. Here is what actually produces the sensation, how to sort the type you feel, and the red flags that mean call for help now.

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Unsplash Long COVID

Sep 23, 2026 · Austin Spaeth

Internal Tremors and Vibrations in Long COVID and Dysautonomia

Internal tremors are a shaking or buzzing you feel inside your body with little or nothing to see on the outside. They are common in long COVID, POTS, and dysautonomia, and there is a clear autonomic reason. Here is what drives them and how to read the pattern calmly.

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Delaney Van / Unsplash POTS

Sep 22, 2026 · Austin Spaeth

Sweating and Dysautonomia: Too Much, Too Little, and Night Sweats

Sweating is run entirely by your autonomic nervous system, so when that system is dysregulated your sweating often is too, in either direction. Here is why POTS, long COVID, and other forms of dysautonomia can cause drenching sweats, night sweats, or the opposite, and how to read the pattern calmly.

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Unsplash Long COVID

Sep 18, 2026 · Austin Spaeth

Low-Dose Naltrexone (LDN) for Long COVID: How It Works and What to Track

Low-dose naltrexone is the same drug used at 50 mg for addiction, given at a fraction of that dose to calm neuroinflammation. Here is the mechanism, the honest state of the evidence in long COVID and ME/CFS, and what to actually watch if it is in the picture.

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Introducing the Pacing Budget: Know How Much Today Can Take The app

Sep 11, 2026 · Austin Spaeth

Introducing the Pacing Budget: Know How Much Today Can Take

Autonomic now turns your morning readings into a daily pacing budget, measured in minutes of effort. It counts what really costs you, warns you before you cross the line, checks itself two days later, and lives on your Journal, your home screen and your Apple Watch.

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Vitaly Gariev / Unsplash POTS

Aug 31, 2026 · Austin Spaeth

Why Are All My Test Results Normal When I Feel This Sick?

Your ECG, bloodwork and echo came back normal, but you can barely stand up without your heart pounding. Here is why 'normal' and 'this sick' can both be true, what standard tests miss in dysautonomia, and the exact evidence to bring back to your clinician.

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Unsplash Long COVID

Aug 25, 2026 · Austin Spaeth

Air Hunger in Long COVID and POTS: Why You Feel Short of Breath

Air hunger, the feeling that you can't get a full, satisfying breath, is one of the most frightening symptoms in long COVID and POTS. It usually isn't your lungs failing. Here is what actually drives it, why your oxygen reads normal, and how to track it without spiraling.

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Unsplash POTS

Aug 22, 2026 · Austin Spaeth

Small Fiber Neuropathy in POTS and Long COVID: Symptoms, Testing, and What to Track

Small fiber neuropathy damages the tiny nerves that carry pain, temperature and autonomic signals, and it shows up surprisingly often in POTS and long COVID. Here is what it feels like, how it is tested, and the at-home metrics that mirror the autonomic side of it.

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Austin Spaeth Long COVID

Aug 7, 2026 · Austin Spaeth

From Daily Crashes to Living Again: What I Tracked, What I Changed, and What the Data Showed

A patient-founder's honest account of four years with long COVID and dysautonomia: the daily crashes and labile blood pressure, why I started measuring, the routine I built piece by piece, and what my own HRV and blood pressure data actually showed.

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Sage Friedman / Unsplash POTS

Aug 2, 2026 · Austin Spaeth

Is It POTS or Anxiety? How to Tell Them Apart

POTS and anxiety share almost every symptom: racing heart, dizziness, shortness of breath, that wired feeling. The one thing that reliably separates them is what your heart does when you stand up. Here is how to read the difference without spiraling.

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D koi / Unsplash Food

Jul 30, 2026 · Austin Spaeth

Quercetin and Mast Cells: What the Evidence Actually Shows

Quercetin is the most recommended supplement in MCAS and long COVID circles, and the laboratory data on mast cells is genuinely impressive. The human data is much thinner, and there is a large gap between the concentrations that work in a dish and the ones your blood can reach. Here is the honest picture, the safety and interaction issues worth knowing, and how to run a careful trial with your clinician.

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The Ridge Ohio / Unsplash Long COVID

Jul 27, 2026 · Austin Spaeth

Long COVID Brain Fog: The Autonomic Connection (and How to Track the Pattern)

Long COVID brain fog is not just fatigue in disguise. A large part of it tracks with your autonomic nervous system, especially how your body handles being upright. Here is the physiology in plain language, and how to find your own pattern.

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Ousa Chea / Unsplash Research

Jul 7, 2026 · Austin Spaeth

What the Latest Research Says About Long COVID & Dysautonomia (2026)

An honest read on where the science stands in 2026: long COVID and ME/CFS increasingly look like related post-viral illnesses with measurable autonomic dysfunction, and the evidence is converging on why.

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Recovery from Post-Viral Dysautonomia: Turning Data Into Decisions Recovery

Jul 7, 2026 · Austin Spaeth

Recovery from Post-Viral Dysautonomia: Turning Data Into Decisions

Recovery from POTS and post-viral dysautonomia is slow, noisy and non-linear, which is exactly why it's so easy to lose hope in the day-to-day. Here's how to pace, read your trends, and turn months of scattered data into decisions that actually bend the curve.

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POTS, Long COVID & MCAS: Why They Travel Together Long COVID

Jul 5, 2026 · Austin Spaeth

POTS, Long COVID & MCAS: Why They Travel Together

POTS, long COVID, ME/CFS and MCAS overlap so much that many people are told they have several at once. Here's what actually connects them, how they differ, and which parts of each you can track at home.

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Jessica Lewis thepaintedsquare / Unsplash Food

Jul 3, 2026 · Austin Spaeth

The Mediterranean Diet for Long COVID: What Evidence Shows

Long COVID involves persistent, low-grade inflammation, and the Mediterranean pattern is one of the most anti-inflammatory ways to eat. Here is what the 2025 evidence actually shows, and how to start without overwhelming yourself.

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The Autonomic Nervous System & Dysautonomia: A Complete Guide Basics

Jul 2, 2026 · Austin Spaeth

The Autonomic Nervous System & Dysautonomia: A Complete Guide

Your autonomic nervous system runs everything you never think about: heart rate, blood pressure, digestion, temperature. When it stops regulating properly, that's dysautonomia. Here is how it works, what goes wrong, and why it's measurable.

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Ronaldo de Oliveira / Unsplash Recovery

Jul 1, 2026 · Austin Spaeth

What Recovery Actually Looks Like: The Non-Linear Curve

Recovery from post-viral dysautonomia and POTS is real but slow, and it almost never moves in a straight line. Here is what the honest timeline looks like, why plateaus mislead you, and what to watch instead of the daily noise.

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Nik / Unsplash Long COVID

Jun 27, 2026 · Austin Spaeth

Is It Long COVID or POTS? How to Tell Them Apart

Long COVID and POTS are not competing labels: one is a broad umbrella and the other a specific, measurable diagnosis that often sits inside it. Here is how to tell what you are actually dealing with.

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engin akyurt / Unsplash Food

Jun 23, 2026 · Austin Spaeth

SIBO, Histamine & Why Dysautonomia Wrecks Digestion

Dysautonomia doesn't stop at your heart rate, it slows your gut, invites bacterial overgrowth, and can stir up histamine problems. Here is how POTS, SIBO and MCAS feed each other, and the dietary tools that actually help.

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Jay Mullings / Unsplash Research

Jun 22, 2026 · Austin Spaeth

Does HRV Biofeedback Work for Long COVID? The Evidence

Slow resonant breathing is one of the gentlest things you can try for long COVID dysautonomia. Here is what the actual studies found, where they fall short, and how to judge whether it is worth your energy.

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National Cancer Institute / Unsplash Long COVID

Jun 13, 2026 · Austin Spaeth

What Causes Long COVID? Microclots, Neuroinflammation & Autonomic Injury

The leading 2026 theories for what drives long COVID overlap rather than compete: persistent inflammation, microclots, small-fiber nerve damage, autoantibodies and autonomic injury. Here is what each one may explain about how you feel.

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Jordan Bauer / Unsplash Recovery

Jun 6, 2026 · Austin Spaeth

Pacing 101: How to Find and Expand Your Energy Envelope

Pacing is the single most important recovery skill for POTS, long COVID and ME/CFS. Here is how to find the edge of your energy envelope, stop the boom-and-bust cycle, and expand your capacity without triggering a crash.

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Romain Water / Unsplash Recovery

May 21, 2026 · Austin Spaeth

Why You Feel Better at Night With MCAS (and Why Late Nights Still Cost You)

That window between 10pm and 1am where the symptoms lift and you finally feel like yourself is real physiology, not avoidance. Here is what actually produces it, why the relief is borrowed rather than earned, and how to keep the good part without paying for it three days later.

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Kinga Howard / Unsplash Long COVID

May 19, 2026 · Austin Spaeth

Post-Exertional Malaise: What Long COVID Recovery Depends On

Post-exertional malaise is the delayed, disproportionate crash after exertion that defines ME/CFS and shadows long COVID. Here is why the delay makes it dangerous, why pushing through backfires, and how to see it coming.

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Stacey Koenitz / Unsplash Long COVID

May 16, 2026 · Austin Spaeth

Long COVID Symptoms That Point to Dysautonomia

Racing heart on standing, dizziness, brain fog, exertion crashes and temperature swings after COVID often share one root: a dysregulated autonomic nervous system. Here is how to recognize the pattern and what to do next.

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Browse all 31 articles in Long COVID, MCAS & Post-Viral →

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