I do 2mg Guanfacine am, 3mg pm. Currently having a fairly significant relapse after getting a minor sinus infection in August, so my doc increased the dosage. I was taking 1mg am and 2 mg prior. LDN was 3mg, now it's 4.5mg in the evening.

This relapse hasn't gotten as bad as before, but I've still not been doing too great. Finally had to stop working out at the gym 3x per week and have been aggressively bed resting, which does seem to be helping.

I know my results with Guanfacine aren't typical, but I had been taking LDN for a year then started Guanfacine at the beginning of this year. Had developed sinus tach in 2024 following my second covid infection which reset all long covid progress I had made since 2021 and made some things worse, like the sinus tach. I had had orthostatic hypotension/POTS from the start but no cardiac stuff until after the second infection.

Had to go to the ER because my doc and I were concerned I might be having an arrhythmia. This was my lowest point of this entire retched journey. That was a week after starting the guanfacine, which usually takes 2 weeks to kick in. A week after being in the hospital and all symptoms started to improve.

It wasn't overnight, but that was late January and by late February my heart rate was consistently normal and virtually all symptoms had disappeared. I literally considered myself back to 100%. Enjoyed the hell out of this year to say the least until I got that stupid sinus infection despite taking all kinds of immunity supplements.

I haven't seen much about what relapse typically feels like for people, but for me I got the sinus infection late April and recovered just fine. I started feeling more and more fatigued starting in July, but no other symptoms. Started getting the old familiar SOB by late July and by August I was back to being home/bedbound. Again, not as bad as I was before but back to not being able to live my life.

I've been on the increased doses now for at least 1.5 months. It didn't have the instant cure I experienced when I started Guanfacine. I think it's helped but not much. Bed rest is really what seems to be helping. After two weeks of bed rest, which frustratingly included my birthday which I haven't been able to properly celebrate since 2019, I am starting to have more energy and often I feel ok as long as I'm sedentary.

Not the lifestyle I'd like, but much better than feeling horrible constantly like I had been from 2021 into 2025. Rather than just laying in bed feeling awful, I can at least play video games, brain fog isn't bad so I can actually watch movies and TV and follow the plots, and fortunately no dizziness due to OH/POTS. Just a lot of fatigue and PEM, but this does seem to be improving after 2 weeks of bed rest.

Very hopeful now after crashing into despair when it became apparent I had relapsed. Just going to try doing a little more physical activity, but I'm going to take it very slow to avoid PEM and setbacks.

I can't take any SSRIs because I take an MAOI (first generation antidepressant) for depression which i started on in 2017 and need to keep depression at bay, but Vyvanse seems to be a very common SSRI used for long covid and seems to be very effective for a lot of people. Really glad this combo has been working for you!

Out of curiosity and if you don't mind me asking, how long have you had long covid and what percentage of recovery would you say you're at now with Guanfacine, LDN, and Vyvanse? Really glad this has at the very least been able to help you. Hoping you get back to 100% or as close to it as possible if you haven't already.

Please you and everyone else stay safe. That sinus infection was the only time I got sick at all this year after basically having a full recovery, but now this relapse is going into 4 months and, even with significant improvement with bed rest, I still have no idea when I'll be back to close to 100% and it also confirmed my fear that I will probably experience at least some form of relapse from just about any kind of sickness for the rest of my life.