Your fatigue is physiology, not weakness.
Post-acute sequelae of COVID-19 (PASC) has measurable mechanisms — immune dysregulation, mitochondrial dysfunction, autonomic imbalance, endothelial injury, neuroinflammation. Mechanisms can be worked on. That is what this clinic does.
Five reasons you still feel like this.
Research has converged on interacting mechanisms behind persistent symptoms. Your care plan starts by identifying which ones apply to you.
Immune dysregulation
Persistent inflammation, autoimmune reactivation, and reactivated latent viruses (including Epstein-Barr) that keep the body in a defensive state.
Mitochondrial dysfunction
Reduced cellular energy production — the biology behind post-exertional malaise and exercise intolerance.
Autonomic imbalance
Vagus nerve and autonomic dysregulation: racing heart, POTS, temperature swings, poor stress recovery — measurable with heart rate variability.
Endothelial injury
Blood-vessel lining dysfunction affecting circulation, blood pressure, and oxygen delivery to muscles and brain.
Neuroinflammation
Brain fog, anxiety, depression, and attention problems driven by inflammatory signaling in the nervous system — not by lack of willpower.
Gut & hormones
Microbiome disruption, digestive symptoms, menstrual changes, and metabolic shifts frequently travel with PASC and are part of the evaluation.
Four pillars, paced deliberately.
- 1 · Full evaluation. Detailed history and targeted labs: inflammatory markers, EBV panel, nutrient status, thyroid and cortisol, cardiovascular and metabolic screening — plus orthostatic vitals when POTS is suspected.
- 2 · Nervous system retraining. HRV biofeedback with a BCIA board-certified practitioner to rebuild autonomic regulation — one of the most practical, measurable tools in PASC care.
- 3 · Cellular and nutritional repair. Whole-foods nutrition planning, targeted supplementation for mitochondrial and antioxidant support graded by evidence, and IV nutrient therapy where appropriate.
- 4 · Paced return to capacity. Exercise-science-informed pacing that respects post-exertional malaise — expanding your envelope without crashing it. Plus FMLA paperwork, return-to-work support, and specialist referrals when needed.
"Feeling brain fog, anxiety, and just generally weak — I never could have thought that even my mild COVID infection could have such lasting effects. I was thankful to find the team at Rebel Med to find the path I needed to start feeling better again."
— Long COVID patient, Rebel Med NW
Integrative medicine's role in Long COVID care.
Watch — Dr. Simon presents to the ACP Washington Chapter Long COVID Interest Group
Dr. Simon was invited by the American College of Physicians' Washington Chapter Long COVID Interest Group to present on where integrative and naturopathic care fits in PASC management — the same mechanisms-first, paced approach described on this page.
It's a physician-audience talk, but patients often find it useful: it explains why the evaluation is broad, why pacing comes before pushing, and how nervous-system retraining earns its place in the plan.
Long COVID questions.
How common is Long COVID?
Large surveys estimate roughly 6% of US adults have experienced Long COVID symptoms lasting three months or more (CDC Household Pulse Survey). It can follow mild infections, and it is a recognized medical condition — not deconditioning or anxiety alone.
What symptoms does the clinic address?
Fatigue and post-exertional malaise, brain fog and attention problems, POTS and heart palpitations, shortness of breath, sleep disruption, anxiety and mood changes, digestive symptoms, and hormonal or menstrual changes following COVID-19 infection.
Should I exercise my way out of Long COVID?
Not with post-exertional malaise. Graded exercise done wrong causes crashes. Dr. Simon uses pacing strategies from exercise physiology — expanding activity within your energy envelope while the underlying mechanisms are treated.
Is telemedicine available?
Yes — many Long COVID visits work well by telemedicine for Washington State residents, with in-person visits for physical evaluation and biofeedback training.