Richard Tellier, DC

07/21/2026

**New long COVID trial — worth a closer look**

A new randomized trial tested an antihistamine combination—famotidine plus loratadine—along with colchicine and an anticoagulant for long COVID fatigue.

The antihistamine combination and colchicine each produced small improvements while participants were receiving treatment. But once the medications were stopped, those additional benefits faded.

At first glance, that might sound disappointing. I would push back on that framing a little.

Temporary improvement is not nothing—it is information.

One possible interpretation is that these medications reduced part of the inflammatory or histamine-related pressure contributing to symptoms without producing a durable change in the system’s underlying capacity to remain stable and recover.

That is a meaningful distinction: temporarily reducing symptoms is not necessarily the same as changing the underlying stability of the system.

This may be especially important in long COVID, MCAS, and other complex multisystem illnesses, where symptom relief and physiological recovery do not always move together.

To be clear, this trial does not prove that mast cells are driving long COVID. What it does reinforce is the importance of identifying which patient subgroups respond—and measuring durability, recovery, and trajectory rather than only whether symptoms improve temporarily.

In participants with long COVID, severe fatigue reduced in all study groups—including the no drug group—over 12 weeks, with small additional reductions in the colchicine and famotidine–loratadine groups compared with the no drug group. Modest effects on FAS were not sustained after drug withdr...

07/13/2026

Two years ago, I had never heard of Mast Cell Activation Syndrome (MCAS).

That changed when a patient with MCAS came into my office seeking care. Like many clinicians, I quickly discovered that this was not something I had been taught in school. Everything I learned afterward came from reading the scientific literature, listening to patients, and trying to understand why this illness could look so different from one person to the next.

This work grew out of frustration—but also hope.

One of the hardest things I encountered was hearing patients being told that this was simply their “new normal” and that recovery was unlikely. I couldn’t help but wonder if we were missing something fundamental.

My hope became simple: if we can better measure and classify the difference between good days, bad days, recovery, and crashes, perhaps we can better understand why patients follow such different paths—and ultimately provide a stronger foundation for future research.

Today, I’m grateful to share that this work has been published in Frontiers in Immunology:

Energetic Stability States in Mast Cell Activation Syndrome: Operationalizing Reserve, Pressure, and Threshold Collapse

This is a Hypothesis & Theory paper. It doesn’t claim to have all the answers, nor was it written for patients. It was written for researchers—to offer a testable framework that can be challenged, refined, and validated in the hope of advancing our understanding of MCAS.

Whether this framework ultimately proves useful will be determined by future research. But every new idea has to begin somewhere, and I’m thankful to have had the opportunity to contribute to that conversation.

Read the full article here:
https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1865449/full

05/31/2026

MCAS remains one of the most misunderstood conditions in medicine. Patients often spend years moving between specialists while experiencing symptoms that affect multiple systems and don't fit neatly into traditional diagnostic categories.

This article highlights the human side of that challenge.

Whether the answer ultimately lies in immunology, bioenergetics, neuroimmune signaling, or some combination of mechanisms, there is a clear need for better models that can explain symptom variability, trigger sensitivity, and recovery dynamics.

Worth the read.
https://nypost.com/2026/05/27/health/the-unpredictable-disease-attacking-women-5-times-more-than-men/?utm_campaign=nypost&sr_share=facebook&utm_source=facebook&utm_medium=social&utm_campaign=nypost&utm_medium=social&sr_share=facebook&utm_source=facebook&fbclid=IwdGRleASJhupleHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEeiB4QBVXRLd2HkqdLwUcrqLiK-QhgNUxYbqHvxt1s80R_uuw0IHGm5tEE7_s_aem_oKIEtEm9lQEJm9sGl834yA

The condition is elusive and shifts without warning. Patients eat normally one day, then go into anaphylaxis the next. Reactions can be triggered by stress, environment or even sunlight.

01/25/2025

Enriched processed foods in the US have folic acid sprayed on them. Not in Europe. When you can’t break down folic acid it results in high homocysteine levels. High homocysteine levels are associated with numerous symptoms including migraines, intestinal cystitis, rashes, hair loss, osteoporosis, and vascular tinnitus.

09/26/2024

Check out this amazing website! Just type in your zip and it will tell you what types of toxins have been found in your water.

Look up your local water system to find out which pollutants might be of concern, and find suggestions on the best kinds of home filters to remove those chemicals.

02/23/2024

This looks delicious! To modify for phase one skip the onion and serve over cauliflower rice.

Easy Italian Chicken Meal Prep Bowls: Brown rice, zucchini, broccoli, tomatoes, onion and seasoned chicken, all cooked on a sheet pan for big flavor, meal prep!

02/17/2024

02/14/2024

Planning on staying in tonight for dinner? Try some lobster tails! To modify for phase 1 use olive oil instead of butter.

This is the best tried and true recipe for tender, juicy broiled lobster tails in just 10 minutes with light seasoning, butter, and lemon!

01/17/2024

Keep it simple with this great phase 1 shrimp dinner. To modify for phase 1 omit the butter.

This easy garlic roasted shrimp with zucchini pasta recipe is a great weeknight gluten-free, paleo dinner — you can have it on the table in 20 minutes.