Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺

@cetkat.bsky.social

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@GageBruch @BenjaminPDixon @Pontifex So is the Pope.

You realize it only means being anti-fascist, right? There's no group.. there was a group of idiots smashing things.. but the term already existed before that. It never belonged to them. I happen to like personal freedoms and rights.

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@lavawitch @drseanmullen Doctors can be complete idiots. Hospitals like MayoClinic and MassGeneral regularly advise their providers to mask during patient encounters during higher risk times, with or without known spread of resp illness. They're masking at work atm. Why wouldn't you follow their example?

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@Norm235 @xyphophorus Killing white brain matter is brain damage. Most would also consider grey matter loss to count too. Personally, I don't. Every inflammatory/immune related thing does,including mental health conditions. I don't care about the way it's said - it's alarmist,but not technically wrong

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@xyphophorus @sarahnadav The honest good news is that the protection saved my life. I did everything right, and was Covid free until last year. It swept through a hospital, and I had an appt. I immediately got a secondary bacterial infection. Almost ended up in the hospital. I wouldn't be here w/o vaxing

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@kittykate852065 @sarahnadav The rapid tests do still catch it. There are methods for better sampling, but the viral load makes it hard to miss. It won't stop because it's like the flu. Eventually we might find true immunity, but it's harder than other things. Not spreading the flu for a year didn't end it.

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@ZainulA40877140 @sarahnadav I wish it would change how people see hidden disabilities, but I doubt it. I do think a lot of the medical profession has woken up to being more accepting of those seeking mental health care. The studies have also proven T4 conversion issues are real. That was resisted for 30+yrs

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@ZainulA40877140 @sarahnadav The good thing about it actually is the research. LC is a part of a cluster of conditions with overlapping systemic problems. Particularly Disautonomia/CFS/MS/Fibromyalgia. The main difference is that it doesn't just shrink gray matter, it destroys white.

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@Hamasnik2 @jcarole @sarahnadav They cited a case study -- theirs. Would you like them to write it up and put it online for you?
The word is also used in describing events witnessed, and is the basis of the word, citation. Police are citing an incident they observed.

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@drseanmullen @proveitworks I'll have to dig deeper into the research, but just in case you might know.. Is there anything about tinnitus, hearing loss, and nerve damage actually increasing your ability to hear high pitched noise?
I'm probably the only person very glad that you lose the ability as you age.

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

https://t.co/804dPJYIY3

[LegalAF by MeidasTouch @MTLegalAF]

Full video: https://t.co/Dovkh8TQtM

[LegalAF by MeidasTouch @MTLegalAF]

Former Federal Judge Luttig:

So, we’re only six, seven weeks before the election, Michael, and as all of your intelligent viewers and listeners know, Donald Trump has been trying to control—again, that’s his word, Michael—control the midterm elections.

[VoteVets @votevets]

The Pentagon has been caught in two separate scandals this week: undercounting casualties and hiding the extent of our destroyed infrastructure in the Middle East. Both are what Maj. Gen. Paul Eaton (Ret.) would describe as "military malpractice." Watch his full analysis now:

[SARS‑CoV‑2 (COVID-19) @COVID19_disease]

🚨 BREAKTHROUGH: Scientists from McMaster University have developed AeroVax a breathable vaccine mist that delivers immunity directly to the lungs in just 2 minutes.🧵

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@LarisBNossaDiva @diddydoop1 @michaelmoran @Dremerso No doctor should be giving individual prescription advice to non-patients. Assembling study results is not the same thing, and is basically just an open source meta study. NEVER trust anything like this - I guarantee money is going to be asked for. It's a scam. 🚩🚩🚩

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@HeidiAronsonMFT @michaelmoran Usually insurance will fill one instance of a prescription not covered on your formulary. For more, you'd need a formulary exception, which would be hard to get for COVID usage. Rxassist is a great site for finding discounted and free medication programs. Use the prescriber side.

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@michaelmoran Found it:

[Cetkat 🏴󠁧󠁢󠁳󠁣󠁴󠁿🍻💙🇨🇦🇲🇽🇺🇦🇬🇱🇪🇺 @cetkat]

@michaelmoran What was determined to be the sufficient dose of metformin in this trial?

[Michael | APC Injury @michaelmoran]

References by Topic(DOIs for Concision):

RECOVER-NEURO: cognitive interventions in Long COVID
Randomized trial; the tested interventions did not outperform control.
10.1001/jamaneurol.2025.4415

Guanfacine + N-acetylcysteine for cognitive symptoms
Clinical case series/experience—not a randomized trial.
10.1016/j.nerep.2022.100154

Vortioxetine randomized controlled trial
10.1093/brain/awad377

Low-dose naltrexone for Long Covid
10.1101/2025.09.09.25335451
10.1016/j.bbih.2024.100733

Hyperbaric hyperoxia randomized controlled trial
Negative trial.
10.28920/dhm55.2.104-113

Palmitoylethanolamide + luteolin (PEA-LUT)
Longitudinal study of olfaction and memory.
10.3390/cells11162552

Metformin during acute COVID-19 and subsequent Long COVID risk
COVID-OUT prevention trial; not treatment of established Long COVID.
10.1016/S1473-3099(23)00299-2

Spike protein persistence at the skull–meninges–brain axis
10.1016/j.chom.2024.11.007

Amyloid fibrin microclots and fibrinolytic resistance
Mechanistic review/hypothesis paper - not a clinical treatment trial.
10.1042/BCJ20220016

SARS-CoV-2 monoclonal antibody trial (AER002 / outSMART-LC)
Negative phase 2a preprint.
10.64898/2026.03.07.26347857

Triple anticoagulant therapy
Uncontrolled preprint; not evidence of efficacy or safety.
10.21203/rs.3.rs-2697680/v1

This thread was informed, in part, by https://t.co/C8mWm8lD3O

[Michael | APC Injury @michaelmoran]

Low-dose naltrexone - very promising, and mechanistically it's a near-perfect fit.

A 2025 systematic review found zero randomized controlled trials of LDN for Long Covid - only four observational pre-post studies (n=155). The pooled effects were moderate: reduced fatigue (g = −0.74), brain fog (g = −0.53), improved sleep (g = −0.60), and large effects on pain and daily functioning (g = −0.93). A separate pilot of LDN (4.5 mg/day) plus NAD+ patches in 36 patients found significant improvements in fatigue and quality of life, with 52% classified as responders. The signal is consistent, but the certainty is low, and a double-blind RCT in British Columbia is now underway to settle it.

But here's why LDN is so mechanistically compelling: it's one of the few interventions that hits two of the core drivers of Long Covid brain pathology at once:

It calms the inflamed microglia. At standard doses (50–100 mg), naltrexone is a pure opioid antagonist. But at low doses (0.5–4.5 mg), it undergoes a paradoxical shift in receptor affinity, binding preferentially to Toll-like receptor 4 (TLR4) on microglia and macrophages rather than opioid receptors. TLR4 is the alarm receptor that microglia use to detect damage-associated molecular patterns and LPS - and its activation drives the release of TNF-α, IL-1β, and IL-6, the exact cytokines behind neuroinflammation and central sensitization. By antagonizing TLR4, LDN directly suppresses the microglial activation that the brain damage thread identified as a core Long Covid lesion. Preclinical work with the non-opioid enantiomer (+)-naltrexone confirmed this is a separate mechanism from opioid blockade - it reverses neuropathic pain and reduces microglial activation markers on its own.

It restores the brain's own opioid brake. The second mechanism is a rebound effect. LDN's short half-life means it only blocks µ-opioid receptors for 4–6 hours; the body responds by upregulating endogenous opioid production and receptor sensitivity, so the net effect over 18–24 hours is increased opioidergic tone - the opposite of what a steady-state full dose would do. This matters because endogenous opioids (β-endorphin) normally act as a brake on sympathetic outflow and help preserve vagal/baroreflex gain. When that brake weakens - from receptor downregulation, ligand depletion, or microglial-driven desensitization - the system tilts toward sympathetic overdrive, reduced heart rate variability, and blunted baroreflex sensitivity: the physiologic signatures of ysautonomia. LDN restores the brake.

This dual action explains why LDN responders so often carry the combined phenotype - fibromyalgia + POTS + MCAS + dysautonomia + Long Covid with orthostatic intolerance - and why a single drug produces broad benefit across pain, fatigue, sleep, and cognition. A 2024 meta-analysis of randomized trials in fibromyalgia found significant pain reduction (pooled SMD −0.85) and improved function, and Long Covid shares the same therapeutic responsiveness in early reports.

The honest caveat, unchanged: the randomized trial base in Long Covid specifically is still zero, and a 2025 review of 105 LDN studies (15 RCTs) concluded that positive findings from early uncontrolled studies are rarely confirmed in placebo-controlled trials - the evidence is dominated by small, low-quality studies vulnerable to publication bias. LDN is safe, cheap, and well-tolerated, but its experimental status should be made clear. The mechanism is a near-perfect fit for Long COVID's neuroimmune pathology; the proof is still catching up.