Dr Michael Scoma

"Tirzepatide in ME/CFS, Long COVID, and MCAS

In a spectrum where many interventions prove inconsistent, microdosed tirzepatide has demonstrated a reproducible clinical signal in my practice. The relative consistency observed justifies examining plausible biologic mechanisms."



"GLP-1 activity may also enhance insulin sensitivity, improve mitochondrial efficiency, and reduce systemic inflammatory burden. In illnesses characterized by post-exertional malaise and impaired energy production, this may be clinically meaningful."

"In microdosing, tolerability in my cohort has been favorable. The majority of patients have remained free of significant nausea, abdominal pain, or constipation. Dose reduction appears to preserve therapeutic effect while limiting adverse gastrointestinal side effects."
 
"Post COVID autonomic dysfunction with neuroimmune and MCAS phenotypes with durable response to autonomic and neuromodulators as well as antivirals with MAB represents with recrudescent clinical picture and smear as below (shared with patient permission)"



"Presently with clinical improvement on courses of doxycycline + rifampin + azithromycin + atovaquone. True clinical - not theoretical - reminder of commonality of underlying tickborne disease."
 
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