Robert Groysman, MD

06/01/2025

We are about to go live! Join us on Robert Groysman, MD page, covid_institute on Youtube, Instagram, or Twitter/X.

05/18/2025

I am about to publish 3 new books for Long Covid. The Mitochondrial Dysfunction Volume 3 in the The Complete Long Covid Handbook Series, The Hormone Imbalance in Long Covid, and the Vagus and Trigeminal Stimulation Book. I am already working on Volume 4, Gut Dysbiosis. Volume 5 will be MCAS and Histamine Excess and I am adding Volume 6 Endothelial Dysfunction and Microclots.

05/16/2025

5 years out and still dealing with Long COVID?

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As we both know, even free has a cost.

Isn’t it time you learn about solutions that actually work?

Join the only Dr. led private long covid group on the planet today and jumpstart your recovery.

Right now you can join for only $99/year until May 31st 2025.

Join an empowering community dedicated to helping you recover from lingering symptoms such as brain fog, fatigue, dysautonomia, MCAS, mitochondrial dysfunction, and gut dysbiosis.

04/21/2025

We will be offering 3 new tests in person and new labs to assess for endothelial dysfunction and microclot pathology. We will not be doing the microscope fluorescence staining to look for microclots. Having microclots doesn't equal to microclot pathology. What we will do is see if these are causing your symptoms or not and them offer treatment targeting these. This completes the comprehensive assessment, diagnostics, and treatment for long covid that includes dysautonomia, mitochondrial dysfunction, gut dysbiosis, mcas/histamine, and now endothelial dysfunction.

I will be discussing these in a lot more detail in my new paid ($99/year) group.

Join the waiting list today.

04/18/2025

I'm reconsidering microclots as a secondary mechanism but only in very specific circumstances. I would still first treat the primary mechanisms and reevaluate symptoms before treating micro clots directly. Would you guys like to know under what circumstances I would treat?

04/04/2025

There is a lot of potential for hydrogen water as an antioxidant. Hydrogen is a gas at room temperature. The biggest issue i see is that hydrogen gas poorly dissolves in water unlike carbon dioxide that is used for fizzy drinks. It will prefer to stay in gas form and as soon as you open a bottle guess what happens? It escapes out the bottle and you have, you guessed it ordinary but expensive bottle of water. I guess if you make it and immediately consume it there is a better chance of actually getting H2 molecular hydrogen.

04/04/2025

Regarding microclots, I use the cochrane review because they critically analyze studies for bias. They are very reliable. If I am not sure about something, I check the cochrane review. Microclots do exist and are real, but they are not not true clots. There is insufficient evidence to support microclots as a cause of long covid. I know some docs are very enthusiastic about micorclots. They were enthusiastic about microclots even before long covid. I'm not here to step on someone's work or dreams. This is not personal for me. I follow the evidence. If new evidence shows that they are involved, I will be on board. My problem is with doctors who have jumped the gun and are using a dangerous treatment, and make no mistake that triple therapy is dangerous. Taking a potent and strong anticoagulant together with 2 antiplatelet medications increases your chances of bleeding. I am not talking about a nose bleed here. We get little injuries in our bodies all the time. You form a clot, its repaired, and the clot is dissolved. You never even know about it. Imagine what happens if you get a little vascular injury in your skull in your brain. This is not a theoretical risk. It has occurred and not just once. I have seen it. Other doctors have seen this too. You get surgery if you catch it in time, i think you know what happens if you don't.
If you are treating atrial fibrillation stroke risk, pulmonary embolus, or a high risk from lupus and other blood disorders, sure, but we treat as conservatively as possible. How do we reduce the risk of clots without increasing the risk of bleeding. Its a balancing act. We don't go gung-ho with anticoagulants.

I ask you what is the actual risk from microclots? Not the risk you think is there, not what the microscope showed you, but what is the clinically proven actual risk to you?

Key messages1. The term 'microclots' is not the correct term for the particles being investigated in people with post-COVID-19 syndrome, as they are not clots. The term 'amyloid fibrin(ogen) particles' is more appropriate.2. The evidence shows that amyloid fibrin(ogen) particles are found in healthy...

03/20/2025

Sensitivity to foods and new allergens happens because you are overproducing histamine, eating too much histamine (fermented), or not metabolizing histamine (DAO needs to be methylated! so methylation needs to work and that is from mitochondrial dysfunction. All these occur from excess histamine load regardless of reason. histamine has a profound effect on the gut as well as immune system activating it so therefore the sensitivity to all new allergens and foods you didn't have before. Histamine can activate mast cells too.

03/18/2025

If you are on the fence about stellate ganglion or EAT, consider that even if you don't have POTS or dysautonomia, SGB can help the other mechanisms work. I have patients who are on mito protocol or MCAS but aren't making progress until they do the SGB. Its not that i missed dysautonomia, its that the other mechanisms also are locked down until an SGB is done.

SGB and Mitochondrial Function
SGB can potentially improve mitochondrial health by:
✅ Reducing Sympathetic Overactivity → Excess sympathetic tone contributes to oxidative stress, which impairs mitochondrial function. SGB reduces this stress, allowing mitochondria to function more efficiently.
✅ Lowering Inflammation & Oxidative Stress → SGB has been shown to reduce pro-inflammatory cytokines (IL-6, TNF-α), which are known to damage mitochondria.
✅ Improving Microcirculation → SGB enhances blood flow, improving oxygen and nutrient delivery to mitochondria.
✅ Regulating Autophagy & Mitophagy → By modulating vagal tone and inflammatory pathways, SGB may support mitochondrial repair mechanisms.

MCAS is often worsened by autonomic dysregulation and inflammation. SGB may help by:
✅ Stabilizing Mast Cells → By reducing sympathetic dominance, SGB may prevent excessive histamine release, a hallmark of MCAS.
✅ Reducing Neuroinflammation → Mast cells in the brain are involved in neuroinflammation; SGB’s anti-inflammatory effects may help.
✅ Modulating the HPA Axis → Chronic stress worsens MCAS. SGB can downregulate stress responses, reducing mast cell hyperactivity.
✅ Improving Blood Flow & Oxygenation → Better circulation can reduce local mast cell degranulation and histamine-related symptoms.

👉 Result: SGB may enhance the effects of MCAS treatments like antihistamines, mast cell stabilizers

03/02/2025

red light, near infrared (IR) and infrared light has been shown to help with skin lesion healing. The light effects on mitochondria appear to work great on cultured cells in petri dishes. Issue is how to get this light to pe*****te tissue. Skin, muscle, tendons, and bones are not exactly transparent. How far do you think red light pe*****tes into tissues?

Low-intensity light therapy (LILT) appears to be working through newly recognized photoacceptor systems. The mitochondrial electron transport chain has been shown to be photosensitive to red and near-infrared (NIR) light. Although the underlying ...