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It can persist for years and does not always respond to the usual treatments for tinnitus (maskers, etc)
Beyond POTS, autonomic dysfunction in long COVID can present as: Dysregulated sweating Impaired gastrointestinal muscle contractions, causing constipation, pain, nausea, or weight loss Temperature dysregulation An exaggerated fight-or-flight response The vagus nerve within this systemthe primary parasympathetic nerve connecting the brain to the gut, heart, and lungsappears to be particularly vulnerable to COVID-19-related damage, with implications for heart rate variability, gut function, and the inflammatory regulatory role the vagus nerve normally performs
The mesolimbic dopamine reward circuit in depression
1 2 "Early versus delayed laparoscopic cholecystectomy for people with acute cholecystitis"
Common side effects (affect 30-70% of users): Testosterone suppression/shutdown: Your natural testosterone production stops Testicles shrink (reduced function) Fertility problems (sometimes permanent) Requires post-cycle therapy (PCT) to recover Some users never fully recover natural production Cardiovascular issues: Increased blood pressure (often significantly) Altered cholesterol (lower HDL, higher LDL) Left ventricular hypertrophy (enlarged heart) Increased heart attack and stroke risk Risk accumulates with each cycle Liver stress (oral steroids): Elevated liver enzymes Potential liver damage with prolonged use Some orals are extremely hepatotoxic Hormonal side effects: Gynecomastia (male breast tissue growth) Acne (often severe on back/chest) Hair loss (if genetically predisposed) Oily skin Mood changes, aggression, anxiety Other common issues: Sleep disruption Increased appetite (some compounds) Bloating and water retention Increased body temperature Night sweats Less common but serious: Psychological effects: Mood swings and irritability ("roid rage" is real for some) Depression during cycle or post-cycle Anxiety and paranoia Body dysmorphia worsening Dependency issues Organ damage: Kidney stress (especially with high doses) Prostate enlargement Potential cardiovascular remodeling (permanent) Metabolic issues: Insulin resistance (some compounds) Diabetes risk increase Thyroid disruption The dose-response problem: Higher doses = better results BUT exponentially worse side effects
