The Hidden Link Between Long COVID, Lyme Disease & Hypermobility with Dr. Ina Stephens (Ep 205)

Can a single infection permanently change your health, or does it simply reveal something that was already there?
In this episode, host Dr. Linda Bluestein, the Hypermobility MD, welcomes back Dr. Ina Stephens, Associate Director of the UVA Health EDS & Hypermobility Disorders Center, for an in-depth discussion about Long COVID, post-infectious syndromes, and their connection to Ehlers-Danlos syndromes (EDS), hypermobility spectrum disorders (HSD), and immune dysfunction.
Dr. Stephens explains why post-infectious illnesses are real and have been recognized for more than a century, tracing the pattern from the 1917 influenza pandemic and encephalitis lethargica to modern conditions including Long COVID, reactivated Epstein-Barr virus (EBV), Lyme disease, Babesia and other tick-borne infections, and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). She shares the detective work behind her Diagnostic Dilemma Clinic, how a comprehensive history and targeted evaluation uncover hidden diagnoses, and why so many patients with complex chronic illness also have hypermobility.
The conversation explores emerging research showing that people with hypermobility are approximately four times more likely to develop Long COVID, with an even greater risk in those with postural orthostatic tachycardia syndrome (POTS) and mast cell activation syndrome (MCAS). Dr. Stephens and Dr. Bluestein discuss the underlying biology, including immune dysregulation, autonomic nervous system dysfunction, vagus nerve dysfunction, mitochondrial dysfunction, and the ways connective tissue disorders may influence recovery after infection.
They also review evidence-informed treatment strategies, including supporting mitochondrial health with coenzyme Q10 (CoQ10), glutathione, and N-acetylcysteine (NAC); the role of low-dose naltrexone (LDN); optimizing iron and vitamin C status; when antiviral medications may be appropriate; intravenous immunoglobulin (IVIG); and glucagon-like peptide-1 (GLP-1) receptor agonists. Finally, they explain why gradually increasing muscle mass and strength may have a greater long-term impact than any single supplement and share practical strategies for supporting recovery and strengthening your regimen at the first sign of illness.
Whether you're living with EDS, HSD, Long COVID, POTS, MCAS, ME/CFS, Lyme disease, or another post-infectious condition, this episode offers practical, science-based insights into why these conditions overlap and what you can do to support healing.
Takeaways:
• Can a virus, Lyme disease, or another infection permanently change your health? Learn why post-infectious syndromes have been documented for more than a century and how infections can trigger chronic illness through immune dysregulation and autoimmunity.
• Why are people with Ehlers-Danlos syndromes (EDS) and hypermobility spectrum disorders (HSD) so much more likely to develop Long COVID? Discover the research linking hypermobility, POTS, mast cell activation syndrome (MCAS), and prolonged recovery after infection.
• What do Long COVID, Lyme disease, ME/CFS, POTS, and other post-infectious conditions have in common? Explore the shared biology of immune dysfunction, autonomic and vagus nerve dysfunction, and mitochondrial dysfunction that may explain multisystem symptoms.
• Which treatments actually help? Hear the evidence behind coenzyme Q10 (CoQ10), glutathione, N-acetylcysteine (NAC), low-dose naltrexone (LDN), iron and vitamin C, antiviral medications, intravenous immunoglobulin (IVIG), and glucagon-like peptide-1 (GLP-1) receptor agonists.
• Could building muscle be one of the most powerful treatments for chronic illness? Learn why increasing muscle mass and strength may have a greater long-term impact than any single supplement, plus Dr. Stephens' practical strategy for boosting your regimen at the first sign of infection.
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