Rouleaux Formation Post-COVID Vaccination
The dark field blood examinations seen below come from a 62-year-old female who had received the COVID vaccination roughly 60 days earlier. The first picture reveals mild rouleaux formation of the blood. After a sequence of six autohemotherapy ozone passes, the second picture shows a completely normal appearance of the RBCs.
mild rouleaux formation
normal appearance of RBCs
A second patient, a young adult male who received his vaccination 15 days earlier without any side effects noted and feeling completely well at the time, had the dark field examination of his blood performed. This first examination seen below revealed severe rouleaux formations of the RBCs with extensive branching, appearing to literally involve all of the RBCs visualized in an extensive review of multiple different microscopic fields. He then received one 400 ml ozonated saline infusion followed by a 15,000 mg infusion of vitamin C. The second picture reveals a complete and immediate resolution of the rouleaux formation seen on the first examination. Furthermore, the normal appearance of the RBCs was still seen 15 days later, giving some reassurance that the therapeutic infusions had some durability, and possibly permanency, in their positive impact.
severe rouleaux formation
resolution of the rouleaux formation
A third adult who received the vaccination 30 days earlier also had severe rouleaux formation on her dark field examination, and this was also completely resolved after the ozonated saline infusion followed by the vitamin C infusion. Of note, similar abnormal dark field microscopy findings were found in other individuals following Pfizer, Moderna, or Johnson & Johnson COVID vaccinations.
Preventing and Treating Chronic COVID and COVID Vaccine Complications
In addition to the mechanisms already discussed by which the spike protein can inflict damage, it appears the spike protein itself is significantly toxic. Such intrinsic toxicity (ability to cause the oxidation of biomolecules) combined with the apparent ability of the spike protein to replicate itself like a complete virus greatly increases the amount of toxic damage that can potentially be inflicted. A potent toxin is bad enough, but one that can replicate and increase its quantity inside the body after the initial encounter represents a unique challenge among toxins. And if the mechanism of replication can be sustained indefinitely, the long-term challenge to staying healthy can eventually become insurmountable. Nevertheless, this toxicity also allows it to be effectively targeted by high enough doses of the ultimate antitoxin, vitamin C, as discussed above. And even the continued production of spike protein can be neutralized by a daily multi-gram dosing of vitamin C, which is an excellent way to support optimal long-term health, anyway.
As was noted in an earlier article (Levy, 2021), there appear to be multiple ways to deal with spike protein effectively. The approaches to preventing and treating chronic COVID and COVID vaccine complications are similar, except that it would appear that a completely normal D-dimer blood test combined with a completely normal dark field examination of the blood could give the reassurance that the therapeutic goal has been achieved.
Until more data is accumulated on these approaches, it is probably advisable, if possible, to periodically reconfirm the normalcy of both the D-dimer blood test and the dark field blood examination to help assure that no new spike protein synthesis has resumed. This is particularly important since some patients who are clinically normal and symptom-free following COVID infection have been found to have the COVID virus persist in the fecal matter for an extended period of time (Chen et al., 2020; Patel et al., 2020; Zuo et al., 2020). Any significant immune challenge or new pathogen exposure facilitating a renewed surge of COVID virus replication could result in a return of COVID symptoms in such persons if the virus cannot be completely eliminated from the body.
Suggested Protocol (to be coordinated with the guidance of your chosen health care provider):
- For individuals who are post-vaccination or symptomatic with chronic COVID, vitamin C should be optimally dosed, and it should be kept at a high but lesser dose daily indefinitely.
- Ideally, an initial intravenous administration of 25 to 75 grams of vitamin C should be given depending on body size. Although one infusion would likely resolve the symptoms and abnormal blood examination, several more infusions can be given if feasible over the next few days.
- An option that would likely prove to be sufficient and would be much more readily available to larger numbers of patients would be one or more rounds of vitamin C given as a 7.5 gram IV push over roughly 10 minutes, avoiding the need for a complete intravenous infusion setup, a prolonged time in a clinic, and substantially greater expense (Riordan-Clinic-IVC-Push-Protocol, 10.16.14.pdf).
- Additionally, or alternatively if IV is not available, 5 grams of liposome-encapsulated vitamin C (LivOn Labs) can be given daily for at least a week.
- When none of the above three options are readily available, a comparable positive clinical impact will be seen with the proper supplementation of regular forms of oral vitamin C as sodium ascorbate or ascorbic acid. Either of these can be taken daily in three divided doses approaching bowel tolerance after the individual determines their own unique needs (additional information, see Levy, vitamin C Guide in References; Cathcart, 1981).
- An excellent way to support any or all of the above measures for improving vitamin C levels in the body is now available and very beneficial clinically. A supplemental polyphenol that appears to help many to overcome the epigenetic defect preventing the internal synthesis of vitamin C in the liver can be taken once daily. This supplement also appears to provide the individual with the ability to produce and release even greater amounts of vitamin C directly into the blood in the face of infection and other sources of oxidative stress (www.formula216.com).
- Hydrogen peroxide (HP) nebulization (Levy, 2021, free eBook) is an antiviral and synergistic partner with vitamin C, and it is especially important in dealing with acute or chronic COVID, or with post-COVID vaccination issues. As noted above, the COVID virus can persist in the stool. In such cases, a chronic pathogen colonization (CPC) of COVID in the throat continually supplying virus that is swallowed into the gut is likely present as well, even when the patient seems to be clinically normal. This will commonly be the case when specific viral eradication measures were not taken during the clinical course of the COVID infection. HP nebulization will clear out this CPC, which will stop the continued seeding of the COVID virus in the gut and stool as well. Different nebulization approaches are discussed in the eBook.
- When available, ozonated saline and/or ozone autohemotherapy infusions are excellent. Conceivably, this approach alone might suffice to knock out the spike protein presence, but the vitamin C and HP nebulization approaches will also improve and maintain health in general. Ultraviolet blood irradiation and hyperbaric oxygen therapy will likely achieve the same therapeutic effect if available.
- Ivermectin, hydroxychloroquine, and chloroquine are especially important in preventing new binding of the spike protein to the ACE2 receptors that need to be bound in order for either the spike protein alone or for the entire virus to gain entry into the target cells (Lehrer and Rheinstein, 2020; Wang et al., 2020; Eweas et al., 2021). These agents also appear to have the ability to directly bind up any circulating spike protein before it binds any ACE2 receptors (Fantini et al., 2020; Sehailia and Chemat, 2020; Saha and Raihan, 2021). When the ACE2 receptors are already bound, the COVID virus cannot enter the cell (Pillay, 2020). These three agents also serve as ionophores that promote intracellular accumulation of zinc that is needed to kill/inactivate any intact virus particles that might still be present.
- Many other positive nutrients, vitamins, and minerals are supportive of defeating the spike protein, but they should not be used to the exclusion of the above, especially the combination of highly-dosed vitamin C and HP nebulization.
Recap
As the pandemic continues, there is an increasing number of chronic COVID patients and patients post-COVID vaccination with a number of different symptoms. Furthermore, there is an increasing number of vaccinated individuals who still end up contracting a COVID infection. This is resulting in a substantial amount of morbidity and mortality around the world. The presence and persistence of the COVID spike protein, along with the chronic colonization of the COVID virus itself in the aerodigestive tract as well as in the lower gut, appear to be major reasons for illness in this group of patients.
Persistent elevation of D-dimer protein in the blood and the presence of rouleaux formation of the RBCs, especially when advanced in degree, appear to be reliable markers of persistent spike protein-related illness. The measures noted above, particular the vitamin C and HP nebulization, should result in the disappearance of the D-dimer in the blood while normalizing the appearance of the RBCs examined with dark field microscopy. Even though new research is taking place daily that may modify therapeutic recommendations, it appears that taking the measures to eliminate D-dimer from the blood and to maintain a consistently normal morphological appearance of the blood is a very practical and efficient way to curtail the ongoing morbidity and mortality secondary to the persistent spike protein presence seen in chronic COVID and in post-COVID vaccination patients.
There are many vaccinated individuals who feel well yet remain cautious about potential future side effects, and who really have no easy access to D-dimer testing or dark field examination of their blood. Such persons can follow a broad-spectrum supplementation regimen featuring vitamin C, magnesium chloride, vitamin D, zinc, and a good multivitamin/multimineral supplement free of iron, copper, and calcium. Periodic but regular HP nebulization should be included as well. This regimen will offer good spike protein protection while optimizing long-term health. Furthermore, such a long-term supplementation regimen is advisable regardless of how much of the protocol discussed above is followed.
(OMNS Contributing Editor Dr. Thomas E. Levy is board certified in internal medicine and cardiology. He is also an attorney, admitted to the bar in Colorado and in the District of Columbia. The views presented in this article are the author’s and not necessarily those of all members of the Orthomolecular Medicine News Service Editorial Review Board.)
References
Alifano M, Alifano P, Forgez P, Iannelli A (2020) Renin-angiotensin system at the heart of the COVID-19 pandemic. Biochemie 174:30-33. PMID: 32305506
Aucott J, Rebman A (2021) Long-haul COVID: heed the lessons from other infection-triggered illnesses. Lancet 397:967-968. PMID: 33684352
Barshtein G, Waynblum D, Yedgar S (2020) Kinetics of linear rouleaux formation studied by visual monitoring of red cell dynamic organization. Biophysical Journal 78:2470-2474. PMID: 10777743
Batah S, Fabro A (2021) Pulmonary pathology of ARDS in COVID-19: a pathological review for clinicians. Respiratory Medicine 176:106239. PMID: 33246294
Belouzard S, Millet J, Licitra B, Whittaker G (2012) Mechanisms of coronavirus cell entry mediated by the viral spike protein. Viruses 4:1011-1033. PMID: 22816037
Biswas S, Thakur V, Kaur P et al. (2021) Blood clots in COVID-19 patients: simplifying the curious mystery. Medical Hypotheses 146:110371. PMID: 33223324
Carli G, Nichele I, Ruggeri M, Barra S, Tosetto A (2021) Deep vein thrombosis (DVT) occurring shortly after the second dose of mRNA SARS-CoV-2 vaccine. Internal and Emergency Medicine 16:803-804. PMID: 336876791
Cathcart R (1981) Vitamin C, titrating to bowel tolerance, anascorbemia, and acute induced scurvy. Medical Hypotheses 7:1359-1376. PMID: 7321921
Chen Y, Chen L, Deng Q et al. (2020) The presence of SARS-CoV-2 RNA I the feces of COVID-19 patients. Journal of Medical Virology 92:833-840. PMID: 32243607
Cho S (2011) Plasma cell leukemia with rouleaux formation involving neoplastic cells and RBC. The Korean Journal of Hematology 46:152. PMID: 22065968
Cicci G, Pirrelli A (1999) Red blood cell (RBC) deformability, RBC aggregability and tissue oxygenation in hypertension. Clinical Hemorheology and Microcirculation 21:169-177. PMID: 10711739
Eweas A, Alhossary A, Abdel-Moneim A (2021) Molecular docking reveals ivermectin and remdesivir as potential repurposed drugs against SARS-CoV-2. Frontiers in Microbiology 11:592908. PMID: 33746908
Fantini J, Di Scala C, Chahinian H, Yahi N (2020) Structural and molecular modelling studies reveal a new mechanism of action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection. International Journal of Antimicrobial Agents 55:105960. PMID: 32251731
Favaloro E (2021) Laboratory testing for suspected COVID-19 vaccine-induced (immune) thrombotic thrombocytopenia. International Journal of Laboratory Hematology 43:559-570. PMID: 34138513
Hoffman M, Kleine-Weber H, Schroeder S et al. (2020) SARS-CoV-2 entry depends on ACE 2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 181:271-280. PMID: 32142651
Hu B, Huang S, Yin L (2021) The cytokine storm and COVID-19. Journal of Medical Virology 93:250-256. PMID: 32592501
Iba T, Levy J, Levi M et al. (2020) Coagulopathy of coronavirus disease 2019. Critical Care Medicine 48:1358-1364. PMID: 32467443
Iba T, Levy J, Warkentin T (2021) Recognizing vaccine-induced immune thrombotic thrombocytopenia. Critical Care Medicine [Online ahead of print]. PMID: 34259661
Kesmarky G, Kenyeres P, Rabai M, Toth K (2008) Plasma viscosity: a forgotten variable. Clinical Hemorheology and Microcirculation 39:243-246. PMID: 18503132
Lehrer S, Rheinstein P (2020) Ivermectin docks to the SARS-CoV-2 spike receptor-binding domain attached to ACE 2. In Vivo 34:3023-3026. PMID: 32871846
Levy T Guide-to-Optimal-Admin-of-IVC-10-18-2021.pdf
Levy T (2002) Curing the Incurable. Vitamin C, Infectious Diseases, and Toxins Henderson, NV: MedFox Publishing
Levy T (2019) Magnesium, Reversing Disease Chapter 12, Henderson, NV: MedFox Publishing
Levy T (2021) Resolving “Long-Haul COVID” and vaccine toxicity: neutralizing the spike protein. Orthomolecular Medicine News Service, June 21, 2021. http://orthomolecular.org/resources/omns/v17n15.shtml
Levy T (2021) Rapid Virus Recovery: No need to live in fear! Henderson, NV: MedFox Publishing. Free eBook download (English or Spanish) available at https://rvr.medfoxpub.com/
Lewi S, Clarke K (1954) Rouleaux formation intensity and E.S.R. British Medical Journal 2:336-338. PMID: 13182211
Lundstrom K, Barh D, Uhal B et al. (2021) COVID-19 vaccines and thrombosis-roadblock or dead-end street? Biomolecules 11:1020. PMID: 34356644
Mendelson M, Nel J, Blumberg L et al. (2020) Long-COVID: an evolving problem with an extensive impact. South African Medical Journal 111:10-12. PMID: 33403997
Naymagon L, Zubizarreta N, Feld J et al. (2020) Admission D-dimer levels, D-dimer trends, and outcomes in COVID-19. Thrombosis Research 196:99-105. PMID: 32853982
Paliogiannis P, Mangoni A, Dettori P et al. (2020) D-dimer concentrations and COVID-19 severity: a systematic review and meta-analysis. Frontiers in Public Health 8:432. PMID: 32903841
Patel K, Patel P, Vunnam R et al. (2020) Gastrointestinal, hepatobiliary, and pancreatic manifestations of COVID-19. Journal of Clinical Virology 128:104386. PMID: 32388469
Perricone C, Ceccarelli F, Nesher G et al. (2014) Immune thrombocytopenic purpura (ITP) associated with vaccinations: a review of reported cases. Immunologic Research 60:226-235. PMID: 25427992
Perrotta F, Matera M, Cazzola M, Bianco A (2020) Severe respiratory SARS-CoV2 infection: does ACE2 receptor matter? Respiratory Medicine 168:105996. PMID: 32364961
Perry R, Tamborska A, Singh B et al. (2021) Cerebral venous thrombosis after vaccination against COVID-19 in the UK: a multicentre cohort study. Lancet Aug 6. Online ahead of print. PMID: 34370972
Pillay T (2020) Gene of the month: the 2019-nCoV/SARS-CoV-2 novel coronavirus spike protein. Journal of Clinical Pathology 73:366-369. PMID: 32376714
Ramsay E, Lerman M (2015) How to use the erythrocyte sedimentation rate in paediatrics. Archives of Disease in Childhood. Education and Practice Edition 100:30-36. PMID: 25205237
Raveendran A (2021) Long COVID-19: Challenges in the diagnosis and proposed diagnostic criteria. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 15:145-146. PMID: 33341598
Rostami M, Mansouritorghabeh H (2020) D-dimer level in COVID-19 infection: a systematic review. Expert Review of Hematology 13:1265-1275. PMID: 32997543
Saha J, Raihan M (2021) The binding mechanism of ivermectin and levosalbutamol with spike protein of SARS-CoV-2. Structural Chemistry Apr 12. Online ahead of print. PMID: 33867777
Samsel R, Perelson A (1984) Kinetics of rouleau formation. II. Reversible reactions. Biophysical Journal 45:805-824. PMID: 6426540
Saponaro F, Rutigliano G, Sestito S et al. (2020) ACE 2 in the era of SARS-CoV-2: controversies and novel perspectives. Frontiers in Molecular Biosciences 7:588618. PMID: 33195436
Scully M, Singh D, Lown R et al. (2021) Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination. The New England Journal of Medicine 384:2202-2211. PMID: 33861525
Sehailia M, Chemat S (2021) Antimalarial-agent artemisinin and derivatives portray more potent binding of Lys353 and Lys31-binding hotspots of SARS-CoV-2 spike protein than hydroxychloroquine: potential repurposing of artenimol for COVID-19. Journal of Biomolecular Structure & Dynamics 39:6184-6194. PMID: 32696720
Sevick E, Jain R (1989) Viscous resistance to blood flow in solid tumors: effect of hemocrit on intratumor blood viscosity. Cancer Research 49:3513-3519. PMID: 2731173
Shang J, Wan Y, Luo C et al. (2020) Cell entry mechanisms of SARS-CoV-2. Proceedings of the National Academy of Sciences of the United States of America 117:11727-11734. PMID: 32376634
Sloop G, De Mast Q, Pop G et al. (2020) The role of blood viscosity in infectious diseases. Cureus 12:e7090. PMID: 32226691
Subramaniam S, Scharrer I (2018) Procoagulant activity during viral infections. Frontiers in Bioscience 23:1060-1081. PMID: 28930589
Thaler J, Ay C, Gleixner K et al. (2021) Successful treatment of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT). Journal of Thrombosis and Haemostasis 19:1819-1822. PMID: 33877735
Townsend L, Fogarty H, Dyer A et al. (2021) Prolonged elevation of D-dimer levels in convalescent COVID-19 patients is independent of the acute phase response. Journal of Thrombosis and Haemostasis 19:1064-1070. PMID: 33587810
Wang N, Han S, Liu R et al. (2020) Chloroquine and hydroxychloroquine as ACE2 blockers to inhibit viropexis of 2019-nCoV spike pseudotyped virus. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology 79:153333. PMID: 32920291
Zhang S, Liu Y, Want X et al. (2021) SARS-Cov-2 binds platelet ACE2 to enhance thrombosis in COVID-19. Journal of Hematology & Oncology 13:120. PMID: 32887634
Zuo T, Zhang F, Lui G et al. (2020) Alterations in gut microbiota of patients with COVID-19 during time of hospitalization. Gastroenterology 159:944-955. PMID: 32442562
Nutritional Medicine is Orthomolecular Medicine
Orthomolecular medicine uses safe, effective nutritional therapy to fight illness. For more information: http://www.orthomolecular.org
Find a Doctor
To locate an orthomolecular physician near you: http://orthomolecular.org/resources/omns/v06n09.shtml
The peer-reviewed Orthomolecular Medicine News Service is a non-profit and non-commercial informational resource.
Editorial Review Board:
Albert G. B. Amoa, MB.Ch.B, Ph.D. (Ghana)
Seth Ayettey, M.B., Ch.B., Ph.D. (Ghana)
Ilyès Baghli, M.D. (Algeria)
Ian Brighthope, MBBS, FACNEM (Australia)
Gilbert Henri Crussol, D.M.D. (Spain)
Carolyn Dean, M.D., N.D. (USA)
Ian Dettman, Ph.D. (Australia)
Damien Downing, M.B.B.S., M.R.S.B. (United Kingdom)
Susan R. Downs, M.D., M.P.H. (USA)
Ron Ehrlich, B.D.S. (Australia)
Hugo Galindo, M.D. (Colombia)
Martin P. Gallagher, M.D., D.C. (USA)
Michael J. Gonzalez, N.M.D., D.Sc., Ph.D. (Puerto Rico)
William B. Grant, Ph.D. (USA)
Claus Hancke, MD, FACAM (Denmark)
Tonya S. Heyman, M.D. (USA)
Suzanne Humphries, M.D. (USA)
Ron Hunninghake, M.D. (USA)
Bo H. Jonsson, M.D., Ph.D. (Sweden)
Dwight Kalita, Ph.D. (USA)
Felix I. D. Konotey-Ahulu, MD, FRCP, DTMH (Ghana)
Jeffrey J. Kotulski, D.O. (USA)
Peter H. Lauda, M.D. (Austria)
Alan Lien, Ph.D. (Taiwan)
Homer Lim, M.D. (Philippines)
Stuart Lindsey, Pharm.D. (USA)
Victor A. Marcial-Vega, M.D. (Puerto Rico)
Charles C. Mary, Jr., M.D. (USA)
Mignonne Mary, M.D. (USA)
Jun Matsuyama, M.D., Ph.D. (Japan)
Joseph Mercola, D.O. (USA)
Jorge R. Miranda-Massari, Pharm.D. (Puerto Rico)
Karin Munsterhjelm-Ahumada, M.D. (Finland)
Tahar Naili, M.D. (Algeria)
W. Todd Penberthy, Ph.D. (USA)
Zhiyong Peng, M.D. (China)
Isabella Akyinbah Quakyi, Ph.D. (Ghana)
Selvam Rengasamy, MBBS, FRCOG (Malaysia)
Jeffrey A. Ruterbusch, D.O. (USA)
Gert E. Schuitemaker, Ph.D. (Netherlands)
T.E. Gabriel Stewart, M.B.B.CH. (Ireland)
Thomas L. Taxman, M.D. (USA)
Jagan Nathan Vamanan, M.D. (India)
Garry Vickar, M.D. (USA)
Ken Walker, M.D. (Canada)
Raymond Yuen, MBBS, MMed (Singapore)
Anne Zauderer, D.C. (USA)
Andrew W. Saul, Ph.D. (USA), Editor-In-Chief
Associate Editor: Robert G. Smith, Ph.D. (USA)
Editor, Japanese Edition: Atsuo Yanagisawa, M.D., Ph.D. (Japan)
Editor, Chinese Edition: Richard Cheng, M.D., Ph.D. (USA)
Editor, French Edition: Vladimir Arianoff, M.D. (Belgium)
Editor, Norwegian Edition: Dag Viljen Poleszynski, Ph.D. (Norway)
Editor, Arabic Edition: Moustafa Kamel, R.Ph, P.G.C.M (Egypt)
Editor, Korean Edition: Hyoungjoo Shin, M.D. (South Korea)
Editor, Spanish Edition: Sonia Rita Rial, PhD (Argentina)
Contributing Editor: Thomas E. Levy, M.D., J.D. (USA)
Assistant Editor: Helen Saul Case, M.S. (USA)
Technology Editor: Michael S. Stewart, B.Sc.C.S. (USA)
Associate Technology Editor: Robert C. Kennedy, M.S. (USA)
Legal Consultant: Jason M. Saul, JD (USA)