I'm happy to report that this treatment is working amazingly well for me!
I'm currently on day 21. Yesterday I was able to do 10 minutes of computer work in one go with no problems at all (edit: actually I did get a small flare-up from this), while before I started even about two minutes of computer would give me a big headache lasting an hour or two. I haven't had a serious headache in nearly two weeks, all the while actually raising my activity level slightly. Any headaches I've had have been much milder like a dull ache that's not too hard to ignore, previously there would be an intense feeling like someone was driving a nail into the top of my skull.
I started noticing a difference around day 4, and by day 7 the improvement was obvious and undeniable. I've been having small flare-ups from not being disciplined with pacing, but they aren't as bad as before and they passed quickly. Recovery isn't always linear but the trend is obviously upwards for me since starting L-Arginine. I still need to rest and pace but my symptoms are much reduced and my energy limit is much higher. The hope that this treatment will be an effective, low-cost way for Long Covid people to get their life back is very likely to be true in my experience. I had experienced a small amount of improvement before this with 5 weeks of total rest (ie lying down staring at the ceiling or the clouds all day), but the improvement from the L-Arginine is noticeably faster and more dramatic.
For a little background on me: I got covid in March 2022, felt ok initially but in the next few weeks and months crashed a few times until in July I had to stop socializing and stop working as a computer programmer. My major symptom is headaches, I also get chest pain, sleep disturbances and intolerance to many foods. I experience post-exertion symptom exaserbation (PESE). Previous to covid I suffered from some chronic pain and GI issues (the L-Arginine capsules actually caused me stomach trouble, but probiotics and antacids seemed to solve that).
The L-Arginine capsules came in 500mg amounts so I actually had 1.5g twice a day rather than the 1.66g as in the paper. It seems to work anyway. Also your blog post missed "headaches" as a symptom being studied although they are listed in the paper, I only notice because headaches are my worse symptom. Any idea how long this dose can be used safely? Your blog post mentions at least 90 day but for 30g/day which is 10x more than I'm on. I'll ask a pharmacist or doctor but in case you already knew. Also any idea if full/empty stomach makes a difference? I saw on some bodybuilding forums some of them take it on an empty stomach which I've been doing just to be on the safe side.
Thanks so much for writing about this Jonathan! I never would have found it myself with my poor health. From what I see nobody is talking about L-Arginine on the various long covid groups, I have no doubt that will quickly change.
Edit: there is actually a thread on Reddit about this paper from a few weeks ago. There's not that many comments and only one person tried it, they said it reduced their blood pressure which made their brain fog worse. I think that didn't happen for me because for a few months already I've been on a high-salt (5-10g/day), high-fluid diet. That's a basic first thing to try when the problem is low blood pressure as it commonly is with long covid dysautonomia/POTS. As always ask a doctor before doing this because some people shouldn't eat more salt.
Update at day 30: the improvements continue. I haven't had a headache at all lately and when I get one it doesn't last long and is very mild. The chest pain is still there though, but a bit better. I continue to rest and pace. Still not working though.
Update at 7 weeks: the improvements continue I think. I still get headaches here and there but they're much better than I remember. I feel like the rate is improvement has slowed. I'm still not working, and I still need to pace, so although this is good it's not a complete cure.
I think you are right, there was no specific mention of a double-blinded design in the paper. And any study does need replication before we can say with relative certainty that a treatment is effective.
Having two arms that both got treatments (multivitamin or arginine+C) does provide some statistical control, it does zero out many of the potential placebo effects and statistical noise. Presumably, neither group understood whether their daily dose was the potential therapy or the control, people in both groups thought maybe they were getting something that would help them.
And you mention a point that motivates much of my writing: scientific certainty may take years or decades, but people are suffering right now. So the question is how to proceed with limited information and uncertainty. If there is some research, if there is a strong rationale, if we can say that something is relatively safe, and if it is inexpensive, then it might make sense to try something - people have to make their own decisions. If something has no research and no good rationale (like putting magic crystals on the chakras), if something carries high risks, or if something is expensive, then it seems illogical to pursue that. Science likes black/white certainty, but at this point, we have only greys.
I'm happy to report that this treatment is working amazingly well for me!
I'm currently on day 21. Yesterday I was able to do 10 minutes of computer work in one go with no problems at all (edit: actually I did get a small flare-up from this), while before I started even about two minutes of computer would give me a big headache lasting an hour or two. I haven't had a serious headache in nearly two weeks, all the while actually raising my activity level slightly. Any headaches I've had have been much milder like a dull ache that's not too hard to ignore, previously there would be an intense feeling like someone was driving a nail into the top of my skull.
I started noticing a difference around day 4, and by day 7 the improvement was obvious and undeniable. I've been having small flare-ups from not being disciplined with pacing, but they aren't as bad as before and they passed quickly. Recovery isn't always linear but the trend is obviously upwards for me since starting L-Arginine. I still need to rest and pace but my symptoms are much reduced and my energy limit is much higher. The hope that this treatment will be an effective, low-cost way for Long Covid people to get their life back is very likely to be true in my experience. I had experienced a small amount of improvement before this with 5 weeks of total rest (ie lying down staring at the ceiling or the clouds all day), but the improvement from the L-Arginine is noticeably faster and more dramatic.
For a little background on me: I got covid in March 2022, felt ok initially but in the next few weeks and months crashed a few times until in July I had to stop socializing and stop working as a computer programmer. My major symptom is headaches, I also get chest pain, sleep disturbances and intolerance to many foods. I experience post-exertion symptom exaserbation (PESE). Previous to covid I suffered from some chronic pain and GI issues (the L-Arginine capsules actually caused me stomach trouble, but probiotics and antacids seemed to solve that).
The L-Arginine capsules came in 500mg amounts so I actually had 1.5g twice a day rather than the 1.66g as in the paper. It seems to work anyway. Also your blog post missed "headaches" as a symptom being studied although they are listed in the paper, I only notice because headaches are my worse symptom. Any idea how long this dose can be used safely? Your blog post mentions at least 90 day but for 30g/day which is 10x more than I'm on. I'll ask a pharmacist or doctor but in case you already knew. Also any idea if full/empty stomach makes a difference? I saw on some bodybuilding forums some of them take it on an empty stomach which I've been doing just to be on the safe side.
Thanks so much for writing about this Jonathan! I never would have found it myself with my poor health. From what I see nobody is talking about L-Arginine on the various long covid groups, I have no doubt that will quickly change.
Edit: there is actually a thread on Reddit about this paper from a few weeks ago. There's not that many comments and only one person tried it, they said it reduced their blood pressure which made their brain fog worse. I think that didn't happen for me because for a few months already I've been on a high-salt (5-10g/day), high-fluid diet. That's a basic first thing to try when the problem is low blood pressure as it commonly is with long covid dysautonomia/POTS. As always ask a doctor before doing this because some people shouldn't eat more salt.
Update at day 30: the improvements continue. I haven't had a headache at all lately and when I get one it doesn't last long and is very mild. The chest pain is still there though, but a bit better. I continue to rest and pace. Still not working though.
Update at 7 weeks: the improvements continue I think. I still get headaches here and there but they're much better than I remember. I feel like the rate is improvement has slowed. I'm still not working, and I still need to pace, so although this is good it's not a complete cure.
It looks like this trail is not double-blind.
I'm still trying it for a month though. Desperate times when you're a long hauler.
I think you are right, there was no specific mention of a double-blinded design in the paper. And any study does need replication before we can say with relative certainty that a treatment is effective.
Having two arms that both got treatments (multivitamin or arginine+C) does provide some statistical control, it does zero out many of the potential placebo effects and statistical noise. Presumably, neither group understood whether their daily dose was the potential therapy or the control, people in both groups thought maybe they were getting something that would help them.
And you mention a point that motivates much of my writing: scientific certainty may take years or decades, but people are suffering right now. So the question is how to proceed with limited information and uncertainty. If there is some research, if there is a strong rationale, if we can say that something is relatively safe, and if it is inexpensive, then it might make sense to try something - people have to make their own decisions. If something has no research and no good rationale (like putting magic crystals on the chakras), if something carries high risks, or if something is expensive, then it seems illogical to pursue that. Science likes black/white certainty, but at this point, we have only greys.