Introduction: Understanding Autonomic Dysregulation
Yang-Type Sympathetic Dominance and Adrenal Fatigue
Long COVID, officially known as Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), remains a poorly understood condition despite its significant prevalence and impact. Western medicine has identified common symptoms such as fatigue, brain fog, dysautonomia, and exercise intolerance, but the exact mechanisms driving these symptoms remain elusive. Hypotheses center around immune dysregulation, persistent inflammation, mitochondrial dysfunction, microclots impairing oxygen delivery, and potential viral persistence. However, no definitive cause has been established, and treatment options are largely focused on symptom management rather than to address underlying dysfunctions. While progress in research continues, Long COVID highlights critical gaps in understanding chronic, systemic illnesses within the Western medical framework.
The sympathetic dysregulation seen in long COVID is not just about the physical symptoms, which are crushing, but about the broader systemic effects. PT, RT, and rehabilitation cannot succeed under parasympathetic dominance (freeze states) or mixed autonomic patterns because the immune system shuts down. Extreme autonomic dysregulation, compounded by hypoxia, limits the brain’s capacity for neuroplasticity. Cranial nerve involvement often indicates a partial dorsal freeze state and the loss of this capacity. Recovery from long COVID requires rebuilding autonomic pathways in the vestibular system and addressing spasticity in tissues, which are replaced rather than repaired. Ancillary providers play a role by helping to maintain autonomic balance which allow the brain to create new pathways. This process cannot be resolved by medication or steroids; rather, patients must reintegrate portions of their nervous system. Collaboration across modalities is essential, and PT, RT combined with ancillary techniques and minimal supplementation support the internal processes so that PT and RT can be effective.
Parasympathetic Dominance: The Dorsal Vagal Freeze Response
For over 1000 years, Traditional Chinese Medicine (TCM) has demonstrated enduring resilience through its ability evolve with changing times. At the heart of TCM is the fundamental principle of maintaining equilibrium between opposing forces within the body, exemplified by the concept of yin-yang balance. This notion of harmony resonates with current neurological principles, particularly the functioning of the Autonomic Nervous System (ANS). The convergence of Traditional Chinese Medicine (TCM), modern neuroscience, and Polyvagal Theory presents a compelling framework to address complex neurological conditions such as spasticity, stroke, and PTSD. This integration requires a deeper understanding of the fight-or-flight response—a fundamental aspect of human physiology that has significant implications for health and disease management. By exploring the physiological underpinnings of PVT, neuroscience and correlating them with TCM principles, we can develop more effective therapeutic strategies that address both symptoms and underlying cause of these conditions.
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Melatonin is often misunderstood as a simple sleep aid, but its role in human health extends far beyond regulating sleep cycles. It serves as one of the body’s most potent neuroprotective agents and antioxidants, safeguarding against oxidative stress, inflammation, and systemic damage. Melatonin influences cellular repair, immune regulation, and the prevention of chronic diseases, including cancer and neurodegenerative disorders. Its unique ability to cross the blood-brain barrier makes it essential for protecting the brain and spinal cord from the oxidative damage that accelerates aging and cognitive decline. Despite its importance, modern lifestyles actively suppress melatonin production, leaving the body vulnerable to long-term health consequences.
In both adults and children, retained reflexes mobilize the body's resources into the large skeletal motor muscles to prepare for flight, specifically the leg yang channels. Once retained or chronic, strong patterns of spasticity are observed directly in the fascia and often do not resolve with appropriate treatment. Additionally, adult survivors of childhood trauma exhibit long-term issues of malabsorption, middle jiao (gut) deficiencies, and autoimmunity due to long-term inhibition of the enteric nervous system and involution of the thymus.
The recent election cycle in the US came on the heels of a global pandemic that plunged much of the world into prolonged states of confusion, fear, and isolation. As social structures frayed, waves of conflicting information eroded trust in authority and fueled skepticism toward Western medicine across the spectrum. Just as society began to recover from this destabilizing period, an intense, high-stakes political cycle in the US began, marked by aggressive rhetoric and tactics intended to deepen division. This climate, amplified by ongoing global conflicts, has kept the collective nervous system in a reactive state—locked in survival mode and braced for continued turmoil.
