As a functional medicine physician who has dedicated my career to uncovering the root causes of complex chronic illness, I've been closely following the emerging research on Long COVID. The persistent, debilitating symptoms that follow COVID-19 infection have puzzled many conventional medical practitioners, but new research is shedding light on a promising pathway to understanding and treating this condition.

The Microclot Connection: A Breakthrough Discovery

A groundbreaking study recently published on medRxiv investigated the relationship between microclots (also known as fibrinaloids) and Long COVID. The researchers developed a method to quantify these microclots and found that patients with Long COVID had significantly higher microclot counts in their blood compared to control groups. Interestingly, people who had recently recovered from COVID-19 also showed elevated microclot levels, with counts gradually decreasing over time after infection.

This research confirms what many functional medicine practitioners have suspected: the lingering effects of COVID-19 may be due in part to circulatory and vascular issues that persist long after the virus has cleared the body.

What Are Microclots and Why Do They Matter?

Microclots are tiny blood clots that can block capillaries and restrict blood flow throughout the body. These aren't the large clots that cause strokes or pulmonary embolisms, but rather microscopic formations that can impair circulation at the cellular level.

Researchers have discovered that the SARS-CoV-2 spike protein itself can induce these unusual fibrin formations resistant to normal breakdown (fibrinolysis), potentially causing blood hypercoagulation that persists long after the acute infection.

The implications are profound. When microclots restrict blood flow:

• Oxygen delivery to tissues is compromised
• Nutrient exchange at the cellular level is impaired
• Waste removal from cells is hindered
• Inflammatory molecules can become trapped in these clots
• Energy production in the mitochondria becomes inefficient

This helps explain the constellation of symptoms reported by Long COVID patients, including profound fatigue, brain fog, shortness of breath, and exercise intolerance.

The Fibrinolysis Factor: Why Some People Can't Break Down Clots

One of the most intriguing aspects of the research relates to fibrinolysis—the body's natural process for breaking down blood clots. In healthy individuals, the formation and dissolution of blood clots remain in perfect balance, but COVID-19 appears to disrupt this delicate system.

Recent research published in the Journal of Thrombosis and Thrombolysis found that severe COVID-19 cases exhibit persistent hypofibrinolysis (reduced ability to break down clots) associated with elevated activity of fibrinolysis inhibitors including PAI-1 and alpha 2-antiplasmin, which may contribute to long COVID manifestations.

Studies have shown that the timeline for onset and resolution of COVID-related coagulation abnormalities varies between mild and severe cases, with some patients experiencing a hypercoagulable state beginning in the second week after symptom onset and potentially persisting for weeks or months.

This explains why some people recover from COVID-19 without long-term effects, while others struggle with persistent symptoms—their bodies may have difficulty dismantling these resistant microclots.

Sex Differences in Long COVID and Microclot Formation

The study revealed an interesting pattern: female participants with Long COVID had significantly higher microclot counts than female controls, while no significant difference was observed between male groups. This aligns with clinical observations that women are more likely to develop Long COVID symptoms.

While the exact mechanisms behind this sex difference aren't fully understood, it may relate to hormonal influences on coagulation and immune function. As a functional medicine practitioner, I always consider how hormonal balance affects all body systems, and this finding underscores the importance of personalized approaches to treatment.

Supporting Healthy Blood Flow and Fibrinolysis: A Functional Medicine Approach

From a functional medicine perspective, addressing microclots and supporting healthy blood flow requires a comprehensive approach. Here are key strategies I recommend for my patients dealing with post-viral circulatory issues:

1. Natural Fibrinolytic Enzymes

Certain enzymes have the natural ability to break down fibrin and support healthy blood flow. Two of the most powerful are:

Lumbrokinase: This potent enzyme derived from earthworms has been used in traditional medicine for centuries and has gained scientific recognition for its exceptional fibrinolytic properties.

Nattokinase: Produced during the fermentation of soybeans to make natto (a traditional Japanese food), this enzyme has demonstrated impressive abilities to dissolve fibrin and improve circulation.

2. Anti-inflammatory Support

Chronic inflammation contributes to hypercoagulation and endothelial dysfunction. Key supplements to address inflammation include:

• Curcumin (from turmeric)
• Boswellia serrata
• Specialized pro-resolving mediators (SPMs)
• Omega-3 fatty acids
• Quercetin and other flavonoids

3. Endothelial Support

The endothelial cells lining your blood vessels need specific nutrients to repair and regenerate, especially after viral damage:

• Vitamin C
• Resveratrol
• Pine bark extract
• L-arginine and L-citrulline (to support nitric oxide production)
• B vitamins

4. Lifestyle Modifications

Never underestimate the power of foundational lifestyle changes:

• Hydration: Adequate water intake helps maintain healthy blood viscosity
• Movement: Gentle, appropriate exercise improves circulation without triggering post-exertional symptom exacerbation
• Intermittent fasting: May help reduce inflammation and support cellular cleanup mechanisms
• Stress management: Chronic stress promotes hypercoagulation
• Sleep optimization: Critical for repair and regeneration of all tissues

Introducing NEW Products for Vascular Support

After years of research and clinical experience, I've developed several premium supplements specifically designed to address the circulatory and vascular issues associated with chronic inflammatory conditions, including those seen in Long COVID.

LumbroPro: The Fibrinolysis Specialist

LumbroPro is a specialized formulation centered around lumbrokinase, one of nature's most potent fibrinolytic enzymes. This remarkable compound helps break down excess fibrin—the primary component of microclots—and supports optimal blood viscosity and circulation.

The key benefits of LumbroPro include:

• Superior Fibrinolytic Activity: Lumbrokinase specifically targets excess fibrin, helping to dissolve abnormal clots that can impair circulation.
• Cardiovascular Wellness: By supporting healthy blood flow, LumbroPro helps maintain cardiovascular health and reduces the risk of abnormal clot formation.
• Enhanced Vascular Integrity: Beyond just addressing clots, LumbroPro supports the overall health of your blood vessels.
• Potent Enzymatic Activity: Each capsule delivers clinical-strength enzymatic potency for maximum effectiveness.

What sets LumbroPro apart is its highly specialized action. While most circulation supplements offer general support, lumbrokinase specifically targets fibrin—making it uniquely suited for addressing the microclot issues now being identified in Long COVID research.

BloodFlowPro: The Comprehensive Circulation Formula

For those needing broader vascular support, BloodFlowPro offers a synergistic blend of six clinically-studied ingredients designed to optimize blood viscosity, enhance circulation, and support overall cardiovascular health.

This comprehensive formula includes:

• Bromelain: This pineapple enzyme supports healthy fibrin breakdown and modulates inflammatory pathways.
• Boswellia Serrata Extract: Contains powerful anti-inflammatory compounds that inhibit 5-lipoxygenase (5-LOX), a key enzyme in inflammatory processes.
• Turmeric Extract (Curcumin): A potent anti-inflammatory that modulates NF-κB and supports endothelial health.
• Nattokinase: Helps break down fibrin clots and reduces blood viscosity.
• Pine Bark Extract: Rich in proanthocyanidins that improve endothelial function and enhance microcirculation.
• Lumbrokinase: Provides additional fibrinolytic support to maintain healthy blood viscosity.

BloodFlowPro works through multiple mechanisms:

1. Promoting Fibrinolysis: The three enzymes—bromelain, nattokinase, and lumbrokinase—work synergistically to support the natural breakdown of fibrin.
2. Reducing Inflammation: Boswellia, turmeric, and pine bark extract address the inflammatory component of vascular dysfunction.
3. Supporting Circulatory Health: Each ingredient contributes to improved oxygen and nutrient delivery throughout the body.

Nattokinase 100: Targeted Fibrin Support

For those seeking a focused approach to fibrin regulation, Nattokinase 100 provides a potent dose of this specialized enzyme derived from traditional Japanese natto. Each capsule contains 100mg of nattokinase, which helps support normal blood flow, healthy circulation, and balanced fibrin levels.

Nattokinase works by resembling plasmin, the body's own fibrin-dissolving enzyme, and may help increase the body's natural production of this important compound. This makes it an excellent option for those specifically looking to address fibrin accumulation.

Quercetin Complex: Vascular and Immune Support

Quercetin Complex combines quercetin phytosome with bromelain for enhanced bioavailability and effectiveness. Quercetin is a powerful flavonoid with antioxidant and anti-inflammatory properties that help stabilize mast cells and support vascular health. The addition of bromelain not only enhances absorption but also provides complementary anti-inflammatory and fibrinolytic effects.

This combination is particularly valuable for individuals experiencing both immune dysregulation and circulatory issues, as is often seen in Long COVID. The quercetin phytosome technology ensures optimal absorption and utilization.

Omega Essentials DHA: Essential Fatty Acid Support

Omega Essentials DHA provides high-potency omega-3 fatty acids, with 580mg of DHA per softgel. These essential fatty acids are crucial for modulating inflammation, supporting healthy blood vessel function, and promoting overall cardiovascular health.

DHA has been shown to support healthy blood pressure, improve endothelial function, and reduce inflammatory markers—all important factors for individuals dealing with vascular issues. This high-quality, pure, and sustainable fish oil formula ensures optimal absorption in the natural triglyceride form.

MitoVite: Cellular Energy Support

For those experiencing profound fatigue and reduced energy production due to compromised circulation, MitoVite offers comprehensive mitochondrial support. This formula combines alpha-lipoic acid, N-acetyl cysteine, acetyl L-carnitine, and key micronutrients to boost cellular energy production, combat oxidative stress, and replenish essential energy reserves.

MitoVite also includes resveratrol, a powerful antioxidant that supports vascular health, protects endothelial cells, and promotes healthy circulation. This makes it an excellent complementary supplement for those addressing both energy depletion and circulatory issues.

Personalized Protocol Recommendations

If you're dealing with post-viral symptoms or other conditions where microclots may be a factor, you might be wondering which supplement combination would be most beneficial. Here are my suggested protocols based on different needs:

Basic Circulatory Support:

• BloodFlowPro: 1 capsule twice daily on an empty stomach
• Omega Essentials DHA: 1 softgel twice daily with meals

Advanced Fibrin Support:

• LumbroPro: 1 capsule twice daily on an empty stomach
• Nattokinase 100: 1 capsule daily on an empty stomach
• Quercetin Complex: 1 capsule twice daily with meals

Comprehensive Protocol for Post-Viral Recovery:

• LumbroPro: 1 capsule twice daily on an empty stomach
• BloodFlowPro: 1 capsule twice daily with meals
• MitoVite: 2 capsules twice daily with meals
• Omega Essentials DHA: 1 softgel twice daily with meals

Note: These are general recommendations. It's always best to consult with a healthcare provider for personalized advice, especially if you're taking blood-thinning medications or have bleeding disorders.

The Future of Long COVID Treatment

The emerging research on microclots offers hope for millions suffering from Long COVID and similar post-viral syndromes. By addressing the vascular component of these conditions, we may finally have a path forward for many who have struggled without answers.

The study authors conclude that while not all Long COVID patients have elevated microclot counts, those who do might benefit from treatments targeting these microclots. This suggests the importance of proper phenotyping of this heterogeneous condition to identify which patients might respond to specific interventions.

As a functional medicine practitioner, I'm excited by these developments but also cautious. We must remember that each person's journey with Long COVID is unique, and treatment approaches should be personalized. The microclot pathway represents one important piece of the puzzle, but not the entire picture.

Taking Action: Next Steps for Those with Long COVID Symptoms

If you're struggling with persistent symptoms after COVID-19 infection, here are my recommendations:

1. Work with a knowledgeable practitioner: Find a functional medicine doctor familiar with post-viral syndromes and the latest research on Long COVID.
2. Consider appropriate testing: While microclot testing isn't widely available clinically yet, other markers of inflammation, coagulation, and endothelial function can provide valuable insights.
3. Address foundational health factors: Focus on anti-inflammatory nutrition, stress reduction, gentle movement as tolerated, and quality sleep.
4. Consider targeted supplementation: Products like LumbroPro, BloodFlowPro, and Nattokinase 100 can be valuable additions to your protocol, but should be used under professional guidance, especially if you're taking prescription blood thinners.
5. Practice patience and self-compassion: Recovery from Long COVID often isn't linear, and healing takes time. Small improvements are worth celebrating.

The road to recovery from Long COVID may be challenging, but with emerging research and integrative approaches, there is genuine reason for hope. By addressing the root causes—including vascular dysfunction and microclots—we can help restore optimal health and vitality.

For more information about LumbroPro, BloodFlowPro, and other science-backed supplements to support your health journey, visit drjillhealth.com.

References

1. Dalton CF, de Oliveira MIR, Stafford P, et al. Increased fibrinoid microclot counts in platelet-poor plasma are associated with Long COVID. medRxiv. 2024. https://doi.org/10.1101/2024.04.04.24305318
2. Okazaki E, Barion BG, da Rocha TRF, et al. Persistent hypofibrinolysis in severe COVID-19 associated with elevated fibrinolysis inhibitors activity. J Thromb Thrombolysis. 2024;57:721-729. https://doi.org/10.1007/s11239-024-02961-8
3. Grobbelaar LM, Venter C, Vlok M, et al. SARS-CoV-2 spike protein S1 induces fibrin(ogen) resistant to fibrinolysis: Implications for microclot formation in COVID-19. medRxiv. 2021. https://doi.org/10.1101/2021.03.05.21252960
4. Turner S, Naidoo CA, Usher TJ, et al. Increased levels of inflammatory molecules in blood of Long COVID patients point to thrombotic endotheliitis. medRxiv. 2022. https://doi.org/10.1101/2022.10.13.22281055
5. Hranjec T, Estreicher M, Rogers B, et al. Integral Use of Thromboelastography With Platelet Mapping to Guide Appropriate Treatment, Avoid Complications, and Improve Survival of Patients With Coronavirus Disease 2019-Related Coagulopathy. Crit Care Explor. 2020;2(12):e0287.
6. Pretorius E, Venter C, Laubscher GJ, et al. Prevalence of readily detected amyloid blood clots in ‘unclotted' Type 2 Diabetes Mellitus and COVID-19 plasma: a preliminary report. Cardiovasc Diabetol. 2020;19(1):193.
7. Meizoso JP, Moore HB, Moore EE. Fibrinolysis Shutdown in COVID-19: Clinical Manifestations, Molecular Mechanisms, and Therapeutic Implications. J Am Coll Surg. 2021;232(6):995-1003.