Robert Groysman, MD

09/26/2025

POST-VAX UNDER INVESTIGATION

The FDA is now requiring vaccine manufacturers to study post-vaccination syndrome.

The request stems from three key observations: emerging evidence that spike protein can persist in some individuals after vaccination, the reality that post-acute syndromes affect many Americans, and growing concern about potential connections.

What's particularly noteworthy is that the FDA is asking for randomized, placebo-controlled studies, the gold standard for determining causation.

Recent research has identified distinct immunologic patterns in post-vaccination syndrome patients, with some showing detectable spike protein levels up to 709 days after exposure.

The symptom profile is strikingly similar to long COVID: exercise intolerance, excessive fatigue, numbness, brain fog, and neuropathy affect the majority of those surveyed.

Full story: https://www.medpagetoday.com/neurology/generalneurology/117311

09/25/2025

I keep seeing patients spend hundreds on specialized enzymes, convinced they need something extra to "dissolve" spike protein.

The reality is more straightforward and hopeful.

Your body already produces the enzymes needed to clear spike protein through normal cellular maintenance. These same systems handle all protein debris, including spike.

The issue isn't missing enzymes; it's that chronic inflammation and immune dysfunction have overwhelmed your system.

09/24/2025

When patients tell me they can't think clearly or that simple tasks leave them completely drained, I'm hearing the voice of damaged mitochondria.

Recently, I returned to the Long COVID podcast to break down what's really happening at the cellular level in long COVID.

The problem is, the virus destroys your body's ability to repair and replace mitochondria.

This explains the pattern I see daily.

Push through symptoms, and those compromised mitochondria trigger post-exertional malaise.

Your immune system reads this cellular debris as another attack, keeping you stuck in a cycle of dysfunction.

Most patients aren't dealing with just mitochondrial damage.

We're seeing six mechanisms working together: dysautonomia, mitochondrial dysfunction, gut dysbiosis, endothelial dysfunction, mast cell activation, and hormone disruption. Address one without the others, and recovery stalls.

Listen to the conversation: https://www.buzzsprout.com/1835170/episodes/17677078

Dr. Groysman's Long Covid treatment clinic in Plano, specializes in personalized treatments to address the underlying symptoms. Explore our protocols at Covid Institute.

09/23/2025

I never said ni****ne patches are useless in long covid or are placebo. They help a small set of long covid patients due to ni****ne interaction with the autonomic nervous system. Ni****ne does carry some risk from long term use. What I am contesting is the false claims that grew into accepted myths due to rapid social media spread of false information.
1) ni****ne doesn't interact with spike proteins at all
2) ni****ne can't displace spike protein from receptors because they bind to different areas of the receptor. Both of these facts have been demonstrated in experiments.
3) Ni****ne doesn't have any means to remove spike protein from your body. It is not a protease. At least nattokinase has the capacity to break down spike proteins in vitro, not proven yet in animals or human studies.
4) Spike Detox formulas don't necessarily remove or break down spike protein but may help with inflammation and endothelial dysfunction and microclots the primary role for nattokinase and bromelain.

09/23/2025

The "stuck" sensation so many long COVID patients describe may be more literal than you might think.

When spike protein fragments persist at cellular receptor sites long after initial infection, it's like jamming the locks that control normal cellular function.

The result is ongoing inflammation and dysfunction.

But ni****ne patches don't "remove" spike protein from your system.

For those considering ni****ne patches (which I don't recommend), work with skilled clinicians who understand both the potential benefits and the complexity of your individual case.

09/17/2025

The wellness culture has one fatal flaw: feeling better isn't the same as getting better.

Placebo effects are in fact real.

Your brain will shift chemistry when expectation meets intervention. Pain signals soften, anxiety circuits calm, and sleep patterns regulate.

This isn't imagination; it's measurable brain activity.

But here's the problem:

That same neurological relief can mask underlying disease progression.

Inflammation driving your fatigue doesn't stop because a device made you feel energized. The autoimmune cascade doesn't go on vacation because energy healing provided temporary calmness.

Understanding the power of placebo is critical to your recovery.

Read my full analysis of why the distinction between relief and treatment could be the most important medical concept you understand this year.

Article: https://www.longcovidfamily.com/placebo-relief-is-real-but-its-not-treatment

09/16/2025

Who's really at risk for developing long COVID?

The belief that only severe COVID cases lead to persistent symptoms has proven incomplete.

What determines long-term outcomes is far more nuanced, and understanding these patterns changes everything about prevention.

Your immune system's baseline flexibility matters more than acute illness severity. Some patients breeze through initial infection only to find their bodies trapped in inflammatory loops months later. Others with significant acute symptoms return to full function within weeks.

Age isn't the primary predictor we once believed.

The difference often lies in nervous system resilience, how effectively your body transitions from defense mode back to repair.

Understanding your individual risk profile isn't about fear; it's about informed preparation and early intervention when it matters most.

09/14/2025

There are no human studies showing ni****ne patches reduce spike binding or clear spike protein from receptors. Most data around ni****ne in COVID are about ACE2 upregulation and epidemiologic smoking risks, not receptor displacement. There are 2 possible benefits of ni****ne: 1) activation of the CAIP pathway (however, VNS does this too without all the side effects) and 2) reestablishment of ACE2 receptors on cell surfaces restoring homeostasis with blood pressure control. The second one is completed within a few days and doesn't require taking ni****ne for months and years.

Let me clarify: I am not saying there is NO use for ni****ne. I am contesting the claims made about ni****ne. What I am saying here is that there is no human evidence that ni****ne can reduce spike, displace spike proteins, or clear spike proteins from the body. Ni****ne doesn't bind to ACE2 receptors, but can increase ACE2 production. Ni****ne binds to α7 nAChRs (receptors), this is what activates the cholinergic anti-inflammatory pathway (CAIP), however these receptors quickly habituate to ni****ne and stop responding. Other potential benefits of ni****ne are from its stimulant effects in terms of reducing fatigue and improving mental clarity.

Lets get to the other receptor: Ni****ne definitely binds α7 nAChRs and activates the cholinergic anti-inflammatory pathway. Spike also interacts with α7, but at a different site. Because of this, ni****ne cannot displace spike protein from α7 receptors. This is not my opinion.

Another receptor: Functions of the α4β2 nicotinic acetylcholine receptor (nAChR) mostly in the brain.
Cognition: Supports attention, learning, and memory by modulating excitatory signaling in the cortex and hippocampus.
Reward & Addiction: Drives dopamine release in the mesolimbic system, making it the primary receptor responsible for ni****ne dependence.
Mood & Arousal: Regulates alertness, anxiety, and mood states.
Sensory Processing: Helps with information filtering and neuronal communication efficiency.

The pathophysiological mechanisms underlying the constellation of symptoms that characterize COVID-19 are only incompletely understood. In an effor...

09/08/2025

Yale's PAX LC trial tested whether Paxlovid could help long COVID patients by targeting viral persistence.

The results were clear: the 15-day antiviral course didn't provide significant symptom relief across the study group. But here's what this teaches us about recovery.

The fact that clearing potential viral remnants didn't resolve symptoms tells us something crucial...

Long COVID operates through multiple, interconnected mechanisms.

The initial viral trigger may be gone, but the inflammatory cascade continues, disrupting cellular energy production and nervous system function.

This is why patients often cycle through treatments without lasting improvement. When we focus solely on one pathway—whether antiviral, anti-inflammatory, or symptomatic—we're addressing fragments of a complex biological conversation.

source: https://medicine.yale.edu/news-article/does-paxlovid-reduce-long-covid-symptoms-yale-led-trial-finds-out/

09/05/2025

This is how I diagnose and treat each of the root causes of long covid involved

09/05/2025

The patient sitting across from me describes a familiar pattern: standing brings rapid heartbeat, meals trigger unpredictable symptoms, and temperature regulation feels completely unreliable. What they're experiencing isn't multiple unrelated conditions—it's dysautonomia.

Your autonomic nervous system operates like an intricate conductor, orchestrating involuntary functions from heart rate to digestion without conscious effort. When this system becomes dysregulated, the conductor loses rhythm, and the entire symphony suffers.

Recent research reveals how infections like SARS-CoV-2 can trigger this dysfunction through multiple pathways. Chronic inflammation damages autonomic nerve fibers.

Direct viral impact disrupts neural communication. Vascular changes compromise the delicate blood flow regulation that keeps us upright and functioning.

We're also discovering the critical role of serotonin deficiency and vagus nerve dysfunction, explaining why gastrointestinal symptoms often accompany heart rate abnormalities in conditions like POTS.

The complexity of dysautonomia explains why standard approaches often fall short. These patients need comprehensive evaluation that recognizes the interconnected nature of autonomic dysfunction. Specialized testing reveals patterns that conventional workups miss.

Treatment requires recalibrating these disrupted systems through targeted interventions, from specific medications that stabilize blood pressure and heart rate, to therapies that restore vagus nerve function and parasympathetic balance.

Your autonomic symptoms represent real physiological disruption with identifiable mechanisms and evidence-based solutions. The key is understanding that recovery involves retraining your body's most fundamental control systems.

For those ready to explore comprehensive approaches to autonomic restoration, specialized care can guide this complex healing process.

Go here to learn more: https://covidinstitute.org/what-is-dysautonomia/

Dr. Groysman's Long Covid treatment clinic in Plano, specializes in personalized treatments to address the underlying symptoms. Explore our protocols at Covid Institute.

09/04/2025

Research reveals that 90% of long COVID patients have chronic inflammation in the epipharynx...

The space behind your nose where SARS-CoV-2 first established its foothold.

This isn't just residual tissue damage; it's an active inflammatory cascade that triggers systemic symptoms through two fascinating mechanisms.

The first pathway involves inflammatory cytokines like TNF-α and IL-1, which act like distress signals traveling from the infected throat tissue to the brain. Think of it as a smoke alarm that won't stop beeping, continuously triggering inflammation even when there's no active threat.

The second mechanism centers on vagus nerve endings in this same region. When inflamed tissue irritates these nerve pathways, it disrupts the body's natural anti-inflammatory responses. The vagus nerve normally acts as a master switch, calming systemic inflammation. When it's compromised, the whole system stays stuck in high alert.

Japanese researchers have been studying epipharyngeal abrasive therapy (EAT), a targeted treatment that directly addresses this hidden inflammation.

𝗜𝗻 𝘁𝗵𝗲𝗶𝗿 𝘀𝘁𝘂𝗱𝘆 𝗼𝗳 𝟱𝟴 𝗹𝗼𝗻𝗴 𝗖𝗢𝗩𝗜𝗗 𝗽𝗮𝘁𝗶𝗲𝗻𝘁𝘀, 𝘁𝗵𝗶𝘀 𝗶𝗻𝘁𝗲𝗿𝘃𝗲𝗻𝘁𝗶𝗼𝗻 𝗿𝗲𝗱𝘂𝗰𝗲𝗱 𝗳𝗮𝘁𝗶𝗴𝘂𝗲 𝘀𝗰𝗼𝗿𝗲𝘀 𝗯𝘆 𝟲𝟭%, 𝗵𝗲𝗮𝗱𝗮𝗰𝗵𝗲𝘀 𝗯𝘆 𝟵𝟯%, 𝗮𝗻𝗱 𝗮𝘁𝘁𝗲𝗻𝘁𝗶𝗼𝗻 𝗱𝗶𝗳𝗳𝗶𝗰𝘂𝗹𝘁𝗶𝗲𝘀 𝗯𝘆 𝟰𝟴% 𝘄𝗶𝘁𝗵𝗶𝗻 𝗷𝘂𝘀𝘁 𝗼𝗻𝗲 𝗺𝗼𝗻𝘁𝗵.

The treatment works by removing inflamed tissue and naturally stimulating vagus nerve function, essentially resetting both inflammatory pathways.

What's remarkable is that patients saw improvement even when visible inflammation didn't completely resolve, suggesting the nerve stimulation component offers its own therapeutic benefit.

For those ready to explore comprehensive approaches to long COVID recovery, specialized care is available.

reference: https://www.mdpi.com/1999-4915/14/5/907

Dr. Groysman's Long Covid treatment clinic in Plano, specializes in personalized treatments to address the underlying symptoms. Explore our protocols at Covid Institute.