Mermaid Central Medical Clinic Research

Sharing research in Long COVID, POTS, fibromyalgia and other areas

Amino Acid, Essential Vitamin and Mineral Burn off in Post Exertional Malaise

A Preliminary Study -September 2024, currently being peer-reviewed Dr Graham Exelby Brainstem hypoperfusion, coat hanger pain and PEM...

Graham Exelby

62 min read

Breaking Through in POTS and Long Covid

Revised April 2025. Dr Graham Exelby We have moved away from the traditional model of treating POTS, CFS, Long COVID, and Fibromyalgia...

Graham Exelby

3 min read

The Glymphatic System

Glymphatic System (or glymphatic clearance pathway or paravascular system) Dr Graham Exelby. January 2024- Currently under revision...

Graham Exelby

33 min read

Low Glutamate Diet

December 2023 Dr Graham Exelby, Dr Valerio Vittone, Ms Kelley Bright Diet change can be extremely important managing the inflammatory...

Graham Exelby

6 min read

DNA Mutations in POTS and Long Covid-Practitioner version MCAS Conference- April 2 2023-

By Dr Valerio Vittone Screendumps from Dr Vittone's presentation at the MCAS Conference April 2023

Graham Exelby

1 min read

DNA Mutations in POTS and Long Covid- Patient version-MCAS Conference- April 2 2023

by Dr Valerio Vittone These are "screendumps" of the patient presentation by Dr Vittone at the MCAS Conference April 2023. I apologize...

Graham Exelby

1 min read

Nigella Sativa in COVID

Black seed or N. sativa that belongs to the Ranunculacea family has a rich historical and religious background. It is native to southwest...

Graham Exelby

13 min read

Nicotinamide Mononucleotide (NMN)

Dr Graham Exelby May 2024 Currently being revised to incorporate the use of nicotinamide in amino acid dysfunction Nicotinamide...

Graham Exelby

8 min read

Low Dose Naltrexone, Ketotifen and other Mast Cell Treatments

Dr Graham Exelby May 2024 This is part of a personal management protocol in POTS, Long Covid and other MCAS-associated conditions. There...

Graham Exelby

12 min read

Articles Categories

Articles List

POTS 2026: Preload Failure, Pericyte Loss, and a New Path to Recovery

Long COVID in 2025: Why You Keep Crashing – and Why There’s Hope

Neuro-Immune–Hydraulic Integrative Phenotype Axis (NIHPA): The Conceptual Framework where One Core Engine drives Multiple Phenotypic Variants

Upright Head Pressure in Long COVID- from Acute Neurovascular Injury to Chronic Hypoxic Support Failure- a Mechanistic Hypothesis

Long COVID Beyond the Acute Phase: Inflammation, Hypoxia, and Redundant Pathways Driving Chronic Disease

Targeted Management of Preload Failure in POTS and Long COVID: A Phenotype-Driven Therapeutic Framework

Reframing Postural Orthostatic Tachycardia Syndrome (POTS) as a Disorder of Preload Failure: Integrating Neurovascular and Immune Pathways

Genomic Redundancy as a Driver of Chronicity in POTS and Long COVID: a Preliminary Study of Convergent Pathway Disruption

Supine–Standing Echocardiography Reveals Preload Failure as the Primary Driver of POTS and Long COVID Orthostatic Intolerance

Gastroparesis in POTS and Long COVID: A Simplified Version

Gastroparesis in POTS and Long COVID: A Unified Hydraulic–Neuroimmune Model

Decoding POTS: A Patient Guide to Preload Failure and Recovery

Reframing POTS as a Disorder of Preload Failure: Physician Version

Chronic Phase Pathways in Long COVID and POTS - for GPs and Patients

Epstein–Barr Virus Reactivation in Long COVID: A Clinical Overview for Physicians

What DNA Can Teach Us in Understanding POTS, ME/CFS, and Long COVID

Tilt Testing in POTS : Safe and Effective Options

Sensitization in POTS, Long COVID, and ME/CFS: A Guide for Patients

Upright Head Pressure in POTS and Long COVID: Understanding a Common but Overlooked Symptom

Malignancy Risk in Long COVID: a Guide for Patients and GPs

Ascending Aortic Dilatation in Athletes with Thoracic Outlet Syndrome and the Therapeutic Role of Telmisartan

Therapeutic Interventions in Long COVID: Phase-Specific Strategies for Family Physicians

Pericyte and Astrocyte Dysfunction in Long COVID: Key Insights for Family Physicians

Long COVID Beyond the Acute Phase: Key Insights for General Practitioners

Therapeutic Interventions in Long COVID: A Guide for Patients to current research

Long COVID: Inflammation, Hypoxia, Pericytes, Astrocytes, and Chronic Disease – A Patient Guide

Azygous Vein Dysfunction in POTS

The Systemic Consequences of STAT3 Dysregulation in Long COVID:

Long COVID and Autism Spectrum Disorder- a Shared Pathophysiology-

Extracellular Matrix Toxicity and Post-Exertional Malaise

Fascial-Lymphatic Obstruction and Brainstem Hypoxia in Long COVID and POTS

Origin of Brainstem Hypoperfusion in POTS and Long COVID: A Dual-Gate Hypothesis Linking Mechanical and Molecular Initiation

POTS Comorbidities- by Functional Domain

RAGE: A Central Amplifier in POTS

POTS Activators – Clinical Overview with Mechanistic Insights

POTS Symptoms Overview

Lymphatic Obstruction in POTS, CFS, and Long COVID: A Call for Integrated Therapeutic Approaches

Mast Cell Activation as a Driver of Central Sensitization in POTS, Long COVID, and Fibromyalgia

Neurovascular-Endocrine Dysfunction as a Core Axis in POTS, Long COVID, and Fibromyalgia

Neurometabolic Modelling of PEM and Central Sensitisation

Mould, Sustained Stress, and PTSD Converge on the RAGE–TLR4 Axis: A Unifying Model of Neuroimmune Dysregulation

Locus Coeruleus Hypoperfusion and Noradrenergic Vasospasm: A Central Mechanism in Dysautonomia and Cerebral Hypoperfusion

Intracranial Hypertension, Venous and Lymphatic Flow Dysfunction- the Core Hydraulic Dysfunctions

Hydraulic and Vascular Autonomic Dysregulation in POTS- The Modified Geddes Baroreceptor Hypothesis

Dysautonomia as a Neuroimmune–Metabolic Disorder: A Unified Model Linking TLR4 Activation, Brainstem Hypoxia, and Autonomic Plexus Dysfunction

Coeliac Plexus in POTS : Insights into MALS, SMA and Nutcracker Syndrome in POTS

Cardiac Plexus in POTS- a Central Node in POTS Pathophysiology

Preload Dysfunction in POTS and ME/CFS: The Azygous System, Autonomic Plexii, and Inflammatory Pathways

Autonomic Dysregulation: A Systems-Level Integration of Brainstem Hypoperfusion, Plexus Dysfunction, and Immune-Metabolic Crosstalk in Dysautonomia

Amino Acid Neurotransmitter Dysfunction as a Central Driver of Mitochondrial Failure and Autonomic Instability in POTS, CFS/ME, Long COVID and Gulf War Syndrome

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Mermaid Central Medical Clinic Research Sharing research in Long COVID, POTS, fibromyalgia and other areas

Amino Acid, Essential Vitamin and Mineral Burn off in Post Exertional Malaise

Breaking Through in POTS and Long Covid

The Glymphatic System

Low Glutamate Diet

DNA Mutations in POTS and Long Covid-Practitioner version MCAS Conference- April 2 2023-

DNA Mutations in POTS and Long Covid- Patient version-MCAS Conference- April 2 2023

Nigella Sativa in COVID

Nicotinamide Mononucleotide (NMN)

Low Dose Naltrexone, Ketotifen and other Mast Cell Treatments

Articles Categories

Articles List

POTS 2026: Preload Failure, Pericyte Loss, and a New Path to Recovery

Long COVID in 2025: Why You Keep Crashing – and Why There’s Hope

Neuro-Immune–Hydraulic Integrative Phenotype Axis (NIHPA): The Conceptual Framework where One Core Engine drives Multiple Phenotypic Variants

Upright Head Pressure in Long COVID- from Acute Neurovascular Injury to Chronic Hypoxic Support Failure- a Mechanistic Hypothesis

Long COVID Beyond the Acute Phase: Inflammation, Hypoxia, and Redundant Pathways Driving Chronic Disease

Targeted Management of Preload Failure in POTS and Long COVID: A Phenotype-Driven Therapeutic Framework

Reframing Postural Orthostatic Tachycardia Syndrome (POTS) as a Disorder of Preload Failure: Integrating Neurovascular and Immune Pathways

Genomic Redundancy as a Driver of Chronicity in POTS and Long COVID: a Preliminary Study of Convergent Pathway Disruption

Supine–Standing Echocardiography Reveals Preload Failure as the Primary Driver of POTS and Long COVID Orthostatic Intolerance

Gastroparesis in POTS and Long COVID: A Simplified Version

Gastroparesis in POTS and Long COVID: A Unified Hydraulic–Neuroimmune Model

Decoding POTS: A Patient Guide to Preload Failure and Recovery

Reframing POTS as a Disorder of Preload Failure: Physician Version

Chronic Phase Pathways in Long COVID and POTS - for GPs and Patients

Epstein–Barr Virus Reactivation in Long COVID: A Clinical Overview for Physicians

What DNA Can Teach Us in Understanding POTS, ME/CFS, and Long COVID

Tilt Testing in POTS : Safe and Effective Options

Sensitization in POTS, Long COVID, and ME/CFS: A Guide for Patients

Upright Head Pressure in POTS and Long COVID: Understanding a Common but Overlooked Symptom

Malignancy Risk in Long COVID: a Guide for Patients and GPs

Ascending Aortic Dilatation in Athletes with Thoracic Outlet Syndrome and the Therapeutic Role of Telmisartan

Therapeutic Interventions in Long COVID: Phase-Specific Strategies for Family Physicians

Pericyte and Astrocyte Dysfunction in Long COVID: Key Insights for Family Physicians

Long COVID Beyond the Acute Phase: Key Insights for General Practitioners

Therapeutic Interventions in Long COVID: A Guide for Patients to current research

Long COVID: Inflammation, Hypoxia, Pericytes, Astrocytes, and Chronic Disease – A Patient Guide

Azygous Vein Dysfunction in POTS

The Systemic Consequences of STAT3 Dysregulation in Long COVID:

Long COVID and Autism Spectrum Disorder- a Shared Pathophysiology-

Extracellular Matrix Toxicity and Post-Exertional Malaise

Fascial-Lymphatic Obstruction and Brainstem Hypoxia in Long COVID and POTS

Origin of Brainstem Hypoperfusion in POTS and Long COVID: A Dual-Gate Hypothesis Linking Mechanical and Molecular Initiation

POTS Comorbidities- by Functional Domain

RAGE: A Central Amplifier in POTS

POTS Activators – Clinical Overview with Mechanistic Insights

POTS Symptoms Overview

Lymphatic Obstruction in POTS, CFS, and Long COVID: A Call for Integrated Therapeutic Approaches

Mast Cell Activation as a Driver of Central Sensitization in POTS, Long COVID, and Fibromyalgia

Neurovascular-Endocrine Dysfunction as a Core Axis in POTS, Long COVID, and Fibromyalgia

Neurometabolic Modelling of PEM and Central Sensitisation

Mould, Sustained Stress, and PTSD Converge on the RAGE–TLR4 Axis: A Unifying Model of Neuroimmune Dysregulation

Locus Coeruleus Hypoperfusion and Noradrenergic Vasospasm: A Central Mechanism in Dysautonomia and Cerebral Hypoperfusion

Intracranial Hypertension, Venous and Lymphatic Flow Dysfunction- the Core Hydraulic Dysfunctions

Hydraulic and Vascular Autonomic Dysregulation in POTS- The Modified Geddes Baroreceptor Hypothesis

Dysautonomia as a Neuroimmune–Metabolic Disorder: A Unified Model Linking TLR4 Activation, Brainstem Hypoxia, and Autonomic Plexus Dysfunction

Coeliac Plexus in POTS : Insights into MALS, SMA and Nutcracker Syndrome in POTS

Cardiac Plexus in POTS- a Central Node in POTS Pathophysiology

Preload Dysfunction in POTS and ME/CFS: The Azygous System, Autonomic Plexii, and Inflammatory Pathways

Autonomic Dysregulation: A Systems-Level Integration of Brainstem Hypoperfusion, Plexus Dysfunction, and Immune-Metabolic Crosstalk in Dysautonomia

Amino Acid Neurotransmitter Dysfunction as a Central Driver of Mitochondrial Failure and Autonomic Instability in POTS, CFS/ME, Long COVID and Gulf War Syndrome

Mermaid Central Medical Clinic Research

Sharing research in Long COVID, POTS, fibromyalgia and other areas