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09/04/2026

Mitochondrial dysfunction is one area of growing interest in research on Long COVID and ME/CFS.

In this clip, Dr. David Putrino shares emerging work on mitochondrial transplantation, an experimental approach that involves extracting, expanding, and infusing mitochondria in an effort to support mitochondrial function and cellular energy production.

He discusses the early progress of this work, including its initial use in a patient outside of Long COVID and ME/CFS, and efforts underway to move toward a clinical trial in these patient populations.

Join Dr. David Putrino, Dr. Lucinda Bateman, Dr. Jennifer Curtin, and moderator Charlie McCone for the full How to Manage and Treat Post-Exertional Malaise (PEM) webinar.

Comment PEM and we’ll send you the link to the full webinar recording on YouTube.

Have you tried Low Dose Naltrexone (LDN) for Long COVID, ME/CFS, or other chronic illness symptoms? Please share in the ...
09/02/2026

Have you tried Low Dose Naltrexone (LDN) for Long COVID, ME/CFS, or other chronic illness symptoms? Please share in the comments.

According to real-world data, 61% of RTHM Platform users who had taken LDN reported improvements, and 39% of those described the benefits as significant.

The most commonly reported improvements were reduced fatigue, decreased aches and pains, improved mental clarity, lower inflammation, and reduced post-exertional malaise. Many users saw more noticeable benefits at the 90-day mark than after just 30 days, showing that LDN can take time to reach full effect.

LDN is often started at very low doses (0.5–1.5 mg) and gradually titrated up to a tolerated dose of 3–4.5 mg. It works by modulating immune and inflammatory responses, offering support for some of the most challenging symptoms of complex chronic illness.

Swipe through to see more and learn whether LDN could be a helpful part of your treatment plan.

You can explore potential treatments like LDN through RTHM or join our email list for updates on research and treatment access. Link in bio to get started or sign up.

09/01/2026

Could dextromethorphan help reduce the severity of PEM?

In this clip, Dr. Lucinda Bateman discusses how she has been experimenting with dextromethorphan as a tool for PEM, particularly before and immediately after activities that are likely to trigger a crash.

She also shares why she uses it conservatively, what she has observed in patients with Long COVID and ME/CFS, and the important limitations in what we currently know about longer-term use.

Join Dr. David Putrino, Dr. Lucinda Bateman, Dr. Jennifer Curtin, and moderator Charlie McCone for the full How to Manage and Treat Post-Exertional Malaise (PEM) webinar.

Comment PEM and we’ll send you the link to the full webinar recording on YouTube.

Always consult with your healthcare provider before starting any new supplement, over-the-counter medication, or treatment. Individual risks, potential interactions, and appropriate dosing should be discussed with and monitored by your clinician.

09/01/2026

Could dextromethorphan help reduce the severity of PEM?

In this clip, Dr. Lucinda Bateman discusses how she has been experimenting with dextromethorphan as a tool for PEM, particularly before and immediately after activities that are likely to trigger a crash.

She also shares why she uses it conservatively, what she has observed in patients with Long COVID and ME/CFS, and the important limitations in what we currently know about longer-term use.

Join Dr. David Putrino, Dr. Lucinda Bateman, Dr. Jennifer Curtin, and moderator Charlie McCone for the full How to Manage and Treat Post-Exertional Malaise (PEM) webinar.

Comment PEM and we’ll send you the link to the full webinar recording on YouTube.

“Always consult with your healthcare provider before starting any new supplement, over-the-counter medication, or treatment. Individual risks, potential interactions, and appropriate dosing should be discussed with and monitored by your clinician.”

Patient-Led Research Collaborative (Patient-Led Research Collaborative) and RTHM Clinic recently released the Long COVID...
08/27/2026

Patient-Led Research Collaborative (Patient-Led Research Collaborative) and RTHM Clinic recently released the Long COVID Treatment Guide to support more informed conversations between patients and their clinicians.

The guide covers over 30 different treatments. Today, we’re highlighting low-dose transdermal ni****ne patches, which may be especially relevant for people with Long COVID experiencing cognitive impairment or fatigue.

Ni****ne acts on nicotinic acetylcholine receptors, which play a role in neuronal communication. One proposed hypothesis suggests that SARS-CoV-2 may disrupt cholinergic signaling through its interaction with these receptors, potentially contributing to some Long COVID symptoms. Transdermal ni****ne has also been studied for its effects on cognitive function, attention, memory, and inflammatory pathways.

Current evidence is still limited, but a survey of 231 people with Long COVID using low-dose transdermal ni****ne found that 73.5% reported improvement, with remission reported in approximately one-third of cases. In the Harvard/Stanford/OMF TREATME study, 43% of people with Long COVID who tried ni****ne patches reported moderate to much better symptom improvement, though the Long COVID sample was small at seven participants.

Low-dose ni****ne patches should be discussed with a qualified clinician to determine whether they are appropriate for an individual case. This includes reviewing risks, contraindications, drug interactions, allergies, and potential side effects. The treatment guide is an evidence-grounded resource designed to support patients and clinicians in making informed decisions together.

If you want a direct link to download the guide, comment below, and we’ll send you a DM.

08/26/2026

What is happening in the body during PEM?

While the underlying pathomechanism of PEM is still unknown, Dr. David Putrino shares emerging research into the pathophysiology of PEM and what it may tell us about why exertion can lead to such significant symptom worsening.

He discusses how problems with waste product clearance, oxygen extraction, energy production, and more may be connected, offering a clearer picture of what could be happening physiologically during PEM.

Join Dr. David Putrino, Dr. Lucinda Bateman, Dr. Jennifer Curtin, and moderator Charlie McCone for the full How to Manage and Treat Post-Exertional Malaise (PEM) webinar.

Comment PEM and we’ll send you the link to the full webinar recording on YouTube.

A new study published in Frontiers in Neuroscience found MRI-based evidence of reduced glymphatic function in people wit...
08/25/2026

A new study published in Frontiers in Neuroscience found MRI-based evidence of reduced glymphatic function in people with ME/CFS.

The glymphatic system helps clear metabolic waste from the brain and is particularly active during sleep. Researchers used a specialized MRI technique called DTI-ALPS to compare glymphatic function in 31 people with ME/CFS and 27 healthy controls.

People with ME/CFS had significantly lower DTI-ALPS scores overall, suggesting reduced glymphatic function. The difference was most pronounced in the right side of the brain. Lower estimated glymphatic function was also associated with worse sleep disturbance and greater difficulty concentrating, but not with fatigue severity.

The findings raise the possibility that impaired brain waste clearance may contribute to cognitive symptoms, sleep disruption, and neuroinflammation in ME/CFS. Importantly, this was a preliminary, cross-sectional study, so it cannot establish whether glymphatic dysfunction causes these symptoms or results from other disease processes.

Read the full study: https://ow.ly/Tmrw50ZFjPr

This week, we’re highlighting five recent publications that may help explain the biological mechanisms underlying Long C...
08/21/2026

This week, we’re highlighting five recent publications that may help explain the biological mechanisms underlying Long COVID, showcase potential prevention strategies, and inform practical trial infrastructure. They range from sex-specific neurologic and cognitive impacts in adults, prolonged SARS-CoV-2 persistence and immune–metabolic changes in hamsters, acute-phase nirmatrelvir–ritonavir reducing Long COVID risk, and spike-driven reactivation of latent herpesviruses as a post-viral mechanism, through to innovative remote recruitment approaches that can accelerate testing of therapies.

RTHM’s Research Corner helps patients stay up to date on emerging Long COVID research, with studies curated to your health conditions, symptoms, and topics of interest.

Not living with Long COVID? You can still personalize your weekly research email by selecting the conditions, symptoms, and topics most relevant to you.

Sign up for weekly curated research emails here: https://www.rthm.com/research-corner/tags

For Paige, Long COVID changed nearly every part of daily life. Once vibrant and active, she became fully disabled, unabl...
08/18/2026

For Paige, Long COVID changed nearly every part of daily life. Once vibrant and active, she became fully disabled, unable to work, and left searching for answers.

After uploading her medical records to RTHM’s AI-powered platform, Paige received a personalized roadmap she could bring to her primary care provider. It helped her explore potential options with her doctor and build a clearer plan forward.

Paige’s story reflects why RTHM exists. We help people living with complex chronic illness better understand their health information, identify possible next steps, and feel more supported in conversations with their care teams.

Thank you, Paige and Bob, for sharing your experience and helping others navigating Long COVID feel less alone.

Learn more and create your free account at rthm.com.

08/17/2026

Why can one type of activity trigger PEM while another doesn’t?

Dr. David Putrino and Dr. Jennifer Curtin explore why PEM triggers may vary so much from person to person, including possible roles for mitochondrial dysfunction, persistent infections, and ongoing inflammation.

They discuss how different tissues or systems may have different thresholds for exertion, which could help explain why PEM can look and be triggered so differently across people.

Join Dr. David Putrino, Dr. Lucinda Bateman, Dr. Jennifer Curtin, and moderator Charlie McCone for the full How to Manage and Treat Post-Exertional Malaise (PEM) webinar.

Watch the full webinar recording here: https://youtu.be/Na5znc92ylY

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