Long Covid And Adrenal Fatigue: Part I (of IV) Most Relevant Cell Salts

by | Mar 13, 2024 | Cell Salts Paradigm, Nature's Therapies E-Journal

Please note: The information contained herein is intended solely as an educational tool. It is not meant to serve as a prescription guide, nor to replace the services of a health-care professional. Each person is unique and advised to seek the advice of their doctor to determine relevance in a given case. In cases of disease, other health concerns or pregnancy, check with your doctor before applying any information presented here.

In this first of series of 4 articles regarding long COVID and adrenal insufficiency, I will detail the connection between these two conditions, and highlight the value of specific cell salts.

In Part II, the focus will be on essential oils for adrenal support.

In Part III, the focus will be on 3 herbs for adrenal support.

In Part IV, the focus will be on molecular hydrogen therapy as part of a protocol for resolving long COVID.

Table of contents:

  1. Adrenal Glands
  2. Adrenal Glands and the Autonomic Nervous System (ANS)
  3. The Stress Response
  4. The Twelve Cell Salts
  5. ANS Mineral Associations
  6. Cell Salts to Consider for Adrenal Support
  7. Guidance Regarding the Use of Cell Salts

Many people are now suffering from what is being described as “long COVID.” While COVID infection is clearly a factor in these cases, rather than being the primary cause, it is instead a potent exacerbating factor regarding a preexistent state of autotoxemia (high systemic toxic load), enervation (depletion of the body’s vital powers including chi (vital force), nerve force, and metabolism) and neurohormonal dysregulation (imbalance of the regulatory functions of the nervous, and endocrine, systems).

Accordingly, COVID infection is the spark that ignited the powder keg, but not the powder keg itself. The toxicity, inflammation, immunological stress and depletion of vital force that COVID contributes serves as the “straw that breaks the camel’s back.” Nevertheless, it becomes established as an important etiological factor in a complex, obstinate, pathological state.

The phenomenon of long COVID (aka post-COVID 19 syndrome) is defined as a set of symptoms that last three months or longer after a person first presents with COVID symptoms. It is estimated that among people ages 18 to 64, 1 in 5 has at least one lingering symptomatic condition that may be related to COVID-19 infection. Among those 65 and older, the incidence rises to 1 in 4.

The most commonly reported symptoms of long COVID include: deep fatigue, fever, respiratory symptoms such as chronic cough and shortness of breath, neurological symptoms, difficulty thinking or concentrating, depression, anxiety, headache, sleep disturbances, dizziness upon rising, pins-and-needles sensation, loss of smell or taste, heart symptoms such as chest pain and abnormal heartbeat, blood clots and vascular issues, digestive symptoms such as stomach pain and abnormal stool function, changes in the menstrual cycle, joint and muscle pain, rash.

Many of these symptoms are worse for physical or mental effort.

There are a variety of factors that contribute to the phenomenon of long COVID. In this article, I will limit the focus to one of these: adrenal fatigue.

Adrenal Glands

The adrenal glands, one atop each kidney (see above), are two orange-colored endocrine glands; they are essential for life, and secrete a variety of hormones that enable the body to respond to stress.  These hormones include adrenalin (aka epinephrine), noradrenalin (aka norepinephrine), cortisol and cortisone. Adrenalin and cortisol, in particular, activate the body’s fight-or-flight response, which consists of increasing the blood sugar level, blood pressure, and cellular energy production. The adrenal glands are innervated, and stimulated, by the sympathetic nervous system (SNS) branch of the autonomic nervous system (ANS).

The adrenal glands also produce aldosterone, estrogens, testosterone, progesterone, pregnenelone and DHEA, which are centrally involved in the regulation of many physiological functions.

In this modern era when stress is unrelenting and the fight-or-flight response active to one degree or another on a nearly continuous basis, the adrenal glands become fatigued, and a state of chronic adrenal insufficiency is established.

Adrenal insufficiency is commonly associated with the following symptoms, which can vary from mild to extreme: fatigue; decreased tolerance to cold; underactive blood circulation; hypoglycemia with craving for sweets; hypotension (low blood pressure); allergies and food sensitivities; apathy; depression; poor stamina; need for excessive amount of sleep; weakness; lowered resistance to infection; low output of stomach hydrochloric acid (hypochlorhydria); chronic constipation; muscle weakness; joint pain.

Emotional and mental symptoms include:  depression; despair; apathy; feelings of hopelessness; suicidal tendencies; low self-esteem due to chronic fatigue that limits one’s capacity for accomplishment; emotional instability; mood swings; anxiety; irritability. Compulsive behavior and obsessive-compulsive tendencies are sometimes triggered by adrenal burnout, often with addiction to excessive exercise, sex, loud music and other types of stimulating activities with the subconscious goal being stimulation of underactive adrenals.

A healthy body has the ability to efficiently eliminate toxins.  However, adrenal insufficiency reduces the body’s ability to detoxify.  This produces a vicious cycle in which weaker adrenals impair the elimination of toxins, and the resultant autotoxemia further weakens the adrenals and more deeply establishes enervation.

In general, stimulants such as caffeine, refined sugars and alcohol weaken the adrenal glands.  Chronic infections can also play a central role in the etiology of adrenal exhaustion.  Chronic infections (e.g. periodontal disease, chronic genital herpes infection, etc.), contribute significantly to the body’s total toxic load and cause inflammation and emotional stress that must be countered by the secretion of adrenal hormones such as cortisol and cortisone.

A paper published in the medical journal Nature Reviews Endocrinology provides in-depth insight into the role adrenal insufficiency plays in the development and persistence of long COVID.1

The researchers write: “The symptoms of long COVID and chronic adrenal insufficiency have striking similarities. Therefore, we hope to raise awareness of assessing adrenal function in patients with long COVID.”

After the acute phase of COVID infection, approximately 20% of infected individuals report one or more complications (particularly apparent during periods of increased mental or physical stress) that include: extreme chronic fatigue, headache, brain fog, sleep disturbances, shortness of breath,  cough, stomach pain, nausea and/or joint pains.

All of these symptoms are also commonly associated with adrenal insufficiency, suggesting that long COVID may be related, at least in part, to adrenal dysfunction.

Pathogenic bacteria and viruses commonly have an affinity for the adrenal glands, and certain infections can damage them. Adrenal insufficiency is frequently found among those with viral infections.

To be a target of the SARS-CoV-2 virus (the virus that causes COVID infection), cells must express a particular receptor enzyme (angiotensin-converting enzyme 2, or ACE2 receptor), which enables the direct binding of the virus’ spike proteins to the cell’s surface. Also, susceptible cells need to have certain co-receptors (e.g., transmembrane protease serine 2 abbreviated as TMPRSS2), which interact with ACE2 that facilitate the virus’ penetration into the internal environs of the cell. Both ACE2 and TMPRSS2 are colocalized (occur within the same cellular region) in the adrenal cortex.

Furthermore, there is evidence that SARS-CoV-2 not only targets human adrenal gland cells, but also actively replicates itself in them. One study found SARS-CoV-2 RNA and protein were detected in 45% of adrenal glands obtained from patients who died due to a critical course of COVID-19 infection.2

SARS-CoV-2 infection has been associated with increased inflammation and activation of programmed cell death pathways in human adrenal cells.3

COVID-19 is widely recognized for afflicting blood vessels. About 30% of patients with COVID-19 develop blood clots in their veins. Post-mortem analysis of tissues obtained from those who were infected with COVID-19 found fibrin and small blood clot deposition in adrenal capillaries.4

This particular finding suggests the importance of the cell salt Kali. mur. in the treatment of long COVID (see that discussion below).

The adrenal glands are highly vascularized (i.e., contain a great deal of blood vessels) and have a rich blood supply (the adrenal glands have the capacity to receive nearly ten times the amount of blood-flow as would be expected given their size), both of which increase the susceptibility of the adrenal glands to vascular (blood vessel) damage. Accordingly, clotting within the blood vessels of the adrenal glands are frequent findings during examinations of those with COVID-19, and who are suspected to have severe pneumonia.5

There are now quite a few studies in the medical literature describing adrenal insufficiency resulting from COVID-19. Furthermore, pre-existing adrenal weakness or disease is likely to be exacerbated by SARS-CoV-2 infection.6 The authors of the paper observe: “Adrenal vascular damage triggered by COVID-19 might develop as a complication, predisposing the patient to adrenal insufficiency, with potential life-threatening consequences.”

Adrenal insufficiency may develop several weeks after an acute phase of COVID-19. The late-onset of adrenal gland insufficiency in those who have supposedly recovered from SARS-CoV-2 infection could be a direct consequence of persistent dysregulation of the hypothalamus/pituitary gland/adrenal glands axis, reactivation of latent, previously established viral infections, or an autoimmune response against key factors involved in the regulation of cell function within the adrenal cortex.

Adrenal gland insufficiency in those with COVID-19 might be induced through different mechanisms, including vascular damage, the destructive effects of viral replication and spike protein production within the glands, inflammatory factors (related to the immune system’s response to the virus) and long-term use of steroid medications.

The paper’s authors conclude: “SARS-CoV-2 targets the adrenal glands and can cause adrenal insufficiency. Furthermore, numerous patients with COVID-19 have received glucocorticoid [steroid] treatment over an extended period of time. Therefore we believe that adrenal gland insufficiency needs to be considered and carefully ruled out in all patients with COVID-19 and long COVID.”

Adrenal Glands and the Autonomic Nervous System (ANS)

Autonomic Nervous System

The autonomic nervous system (ANS)–activated largely by centers located in the hypothalamus–carries on those life functions over which we have no conscious control. The ANS is mainly concerned with the regulation of visceral functions and interactions within the internal environment. It controls the actions of smooth muscles (which activate the kinetics of the organs of the g.i., respiratory and genito-urinary tracts), heart muscle and most glands.It is concerned with regulating heart rate, blood vessel diameter, respiration, body temperature, hunger, waste elimination and other visceral functions that aid in maintaining homeostasis.

Portions of the ANS are also responsive during times of emotional stress and serve to prepare the body to meet the demands of strenuous physical activity.

There are two divisions of the autonomic nervous system which act in concert:

  1. Sympathetic nervous system (SNS) whose nerve fibers exit from the spinal cord at the thoracic and lumbar regions.  Impulses on one set of fibers tend to activate a specific organ while impulses from the other inhibit it. Some functions of the SNS include: increase in heart and respiratory rates and decrease in activity of the gastrointestinal tract. The prime focus of the SNS is to prepare the body for stressful, energy-expending, or emergency, situations (the so-called “fight or flight” responses).
  2. Parasympathetic nervous system (PNS) whose nerve fibers emanate from the brain and the sacral portion of the spinal cord. Some of the functions of the PNS include: decrease of heart and respiratory rates and increase of gastrointestinal motility as needed for digestion and elimination. The PNS aids in energy conservation and restoration of homeostatic conditions.

During an emergency, the SNS increases heart and respiratory rates and inhibits gastrointestinal activity (which is not essential to immediate survival and would divert blood and energy from those functions warranting greater priority during an emergency).

Following the emergency, the PNS will slow down the heart and breathing rates and restore normal gastrointestinal activity. At this point, elevated g.i. tract function becomes essential to replenish the raw materials consumed by organs during the stressful episode, and to help eliminate the toxic metabolites which accrue during a fight or flight response.

The Adrenal Glands and the ANS

Each adrenal gland consists of an outer cortex of glandular tissue and an inner medulla of nervous tissue.

The adrenal medulla, composed of sympathetic nervous system (SNS) neurons, is actually an extension of the ANS, charged with sustaining homeostasis in the body.

The SNS-adrenal medulla (SAM) pathway features stimulation of the adrenal medulla by impulses from the hypothalamus sent via SNS neurons from the thoracic section of the spinal cord. The medulla is stimulated to secrete the hormones epinephrine and norepinephrine.

The adrenal cortex, as a component of the hypothalamus-pituitary gland-adrenal glands axis, secretes steroid hormones important for the long-term stress response, including inflammatory response, regulation of blood pressure and blood volume, nutrient assimilation and storage, and fluid and electrolyte balance. Primary adrenal insufficiency results from damage of the adrenal cortex.

The adrenal cortex secretes aldosterone, which plays a major role in regulation of blood pressure, volume and potassium balance. Aldosterone can centrally increase sympathetic activity in the brain.

The adrenal cortex and medulla are actually anatomically interlaced, having multiple areas of contact that are not separated by connective tissue. The SAM (SNS/adrenal medulla) pathway and hypothalamic-pituitary-adrenal cortex (HPA) axis are the primary systems for the maintenance, or reinstatement, of homeostasis during stress.

Stressor exposure results in activation of sympathetic neurons in the spinal cord which then project to the adrenal medulla. This sympathetic activation represents the classic ‘fight or flight’ response that increases circulating levels of adrenaline (primarily from the adrenal medulla) and noradrenaline (primarily from sympathetic nerves), heart rate and force of contraction, peripheral vasoconstriction, and energy mobilization.

PNS tone is also modulated during stress. PNS actions are generally opposite of those of the sympathetic system.

The hypothalamus activates the HPA axis, the second component of the stress response system. For the HPA axis, stressor exposure activates the hypothalamus, which then secretes releasing hormones into the blood circulation. These releasing hormones act on the anterior pituitary gland to promote the secretion of adrenocorticotropic hormone, which in turn acts on the inner adrenal cortex (to initiate the synthesis and release of cortisol). Circulating cortisol then promote the mobilization of stored energy and potentiate numerous SNS-mediated effects.

The adrenal cortex is also directly innervated by the SNS, Thus, the HPA axis and SNS exert largely complementary actions throughout the body, including energy mobilization and maintenance of blood pressure during stress.

The anatomical complexity of ANS integration is underscored by the mixing of SNS and PNS projection neurons in the same nuclei (collection of neurons). The ANS and HPA axis are highly coordinated and physically interconnected. The ANS and HPA axis activation in response to stress follows a coordinated, transient sequence. The ANS rapidly promotes physiological changes through the synaptic transmission of its two branches, the SNS and PNS.

The PNS supports the SNS response to stress by down-regulating its own counterbalancing control of SNS activities, thus, enabling SNS-induced physiological changes, including the release of the hormone norepinephrine and stimulation of SNS neurons that increase heart rate.

The parasympathetic branch, centered in the adrenal cortex, uses the neurotransmitters acetylcholine, nitric oxide and cyclic guanosine monophosphate (cGMP) as its chemical mediators.

The central nerve of the PNS that innervates the heart is called the vagus nerve. The parasympathetic nervous system slows heart rate and the SNS increases the heart rate. It is well established that, over time, an imbalance between these two branches contributes to the development of cardiovascular disease.

The PNS is responsible for “rest and recovery” or relaxation responses. It is the “rest-and-digest” arm of the ANS. Activation of the parasympathetic nervous system decreases heartbeat and respiratory rate, stimulates digestion and relaxes blood vessels and muscles, enabling better delivery by the bloodstream of nutrients to the cells and better lymphatic drainage of the intercellular environment. The PNS upregulates all the physiological responses associated with rest and recovery.

The Stress Response

As previously noted, one of the major functions of the adrenal gland is to respond to stress. Stress can be either physical or psychological or both. Physical stresses include exposure of the body to potentially injurious influences (e.g., exposure to cold temperatures and/or rain while not wearing adequate clothing, malnutrition, etc.). Psychological stresses include the perception of a physical threat, relationship, or familial, disharmony, a challenging work environment, etc.

The body responds in different ways to short-term stress and long-term stress following a pattern known as the general adaptation syndrome (GAS).

The first stage of GAS, referred to as the alarm reactionor fight-or-flight response stage, is short-term, acute stress, mediated by the hormones epinephrine and norepinephrine, secreted by the adrenal medulla via the SAM pathway. These adrenal hormones prepare the body for extreme physical exertion. Once this stress abates, the body quickly reverts to a normal, non-alarm state.

However, if the stress does not quickly abate, the body adapts to the ongoing stress state in the second stage of GAS called the resistance stage. For example, if someone is starving, hormones are secreted to stimulate the gastrointestinal tract in order to maximize the absorption of nutrients from food. We can see that during the resistance stage, the SNS and PNS, and adrenal medulla and cortex are engaged.

If the stress state continues for a longer term, beyond the boundaries of the stage of resistance, the third stage of the general adaptation syndrome unfolds: exhaustion stage. During this stage, symptoms metamorphose from fight-or-flight response-type reactions to severe fatigue, depression, immunosuppression, and potentially severe cardiovascular stress. These symptoms are mediated by the hormones of the adrenal cortex, especially cortisol. In this stage, the adrenal cortex is more dominant, and thus, the role of the PNS becomes far more prominent.

While the adrenal glands are more prominently associated with the SNS, there is no question that, in part via the adrenal cortex, the PNS is deeply involved in the stage of resistance and regarding recovery from the stage of exhaustion.

The Twelve Cell Salts

cell salts homeopathic remedies for heat stroke heat exhaustion

In the 19th century, a German medical doctor and homeopath named W.H. Schuessler (1821-1898) made a discovery, the importance of which has never been appreciated nor acknowledged by conventional medicine. Schuessler, by way of analyzing the ash of cremated human remains, discovered the prominent presence of twelve proportionately occurring mineral salts.

In chemistry, a mineral salt is an ionic compound (consisting of ions – electrically charged atoms or molecules) that is produced by a reaction between an acid and a base (an alkaline substance). Salts are composed of positively charged ions (i.e., cations) bonded with negative ions (i.e., anions), the product of which is an electrically neutral (without a net charge) compound. The salt we use to season our food (sodium chloride) is only one type of mineral salt, not the only one.

When living tissues are reduced to ash, all the organic (i.e., living) matter is consumed; all that remains are minerals (inorganic– not consisting of living matter) since they are combustible only at very high temperatures of between 4,000 and 10,000 degrees centigrade (approx. 7200 to 18,000 degrees Fahrenheit). Chemical and spectral analyses can then be used to determine the identity of these minerals.

Schuessler eventually performed similar qualitative and quantitative analyses of various tissues (e.g., bone and muscle) and bodily fluids such as blood, lymph and breast milk. From this, he discovered that certain of these same twelve mineral salts were more prominent than others within specific tissues and fluids. For example, while potassium phosphate and magnesium phosphate are strongly present in muscle and nerve tissue, potassium chloride is more prominent in mucous membranes and calcium phosphate in bone.

Based upon these discoveries, Schuessler theorized that these mineral salts were the essential building blocks of life. He felt that the function of the trillions (the latest estimate are that there are approximately 30 to 70 trillion cells in the human body) of body cells hinged upon the presence of these mineral salts in proper proportions. Therefore, said salts became known as the “cell salts.”

Schuessler’s twelve cell salts are: calcium fluoride, calcium phosphate, calcium sulfate, iron phosphate, magnesium phosphate, potassium chloride, potassium phosphate, potassium sulfate, sodium chloride, sodium phosphate, sodium sulfate and silica.

It is important to note that Dr. Schuessler was involved in research and development of his “biochemic” (i.e., the chemical substances – in this case, the mineral salts – involved in the structure and function of the human organism) theory at a time when the great pathologist Rudolph Virchow (1821-1902) made his observation that all diseases involve changes in normal cells. In other words, all pathology ultimately is cellular pathology.

The twelve cell salts are vital to cellular function, and a deficiency or imbalance in their collective presence will result in dysfunction and disease. On the other hand, supplementation with the proper cell salts, which will correct such deficiency and imbalance, can help to restore body cells to a healthy state.

Schuessler believed that the salts had to engage directly with diseased or devitalized cells. Thus, being a homeopath as well as a medical doctor, he prepared his cell salts using the homeopathic method of sequential dilution and potentization. The resultant high dilution enables the few remaining molecules of the mineral salt to bypass obstructions in the body. They can then be utilized by the cells independent of the processes of digestion and assimilation that are often weakened and inefficient in an ill or devitalized individual.

In this reference, the great 19th century German biochemist Justus von Liebig (one of the founders of organic chemistry; quoted by George W. Carey, M.D. in The Biochemic System of Medicine) stated: “It happens that a tissue in disease reaches a degree of density, becomes so clogged, that the mineral salts of the blood cannot enter the cellular milieu to feed and nourish: but, if for therapeutic purposes a solution of a cell salt be given so diluted, that all of its molecules are set free, it is presumable that no hindrance will be in the way of these molecules to enter the abnormally condensed part of tissue.”

The twelve cell salts have been an important part of my work since I began my work as a practitioner in the late 1970s. I find them to be invaluable. Although they are not as well known nor as widely used as they were back then, they are still widely available online.

ANS Mineral Associations

Persistent SNS activation lowers tissue levels of both calcium and magnesium, enhancing nervous system irritability and shifting the system into a hyper-alert state with a concomitant blood pressure increase initiated by arterial constriction.

The SNS is stimulated by calcium and phosphorus and inhibited by magnesium and potassium. Excessive calcium levels in the body contribute to SNS dominance. Free, excess calcium over-stimulates the SNS, especially when magnesium is deficient.

A stress response, which increases SNS activity, depletes magnesium levels. Magnesium both downregulates an over-reactive SNS and supports the PNS’s rest and recovery actions. Thus, it exerts a general calming, homeostasis-encouraging influence.

The PNS is stimulated by potassium and sodium. The calcium : potassium ratio helps determine the relative systemic SNS/PNS balance.

Cell Salts to Consider for Adrenal Support

In general, the five phosphorus cell salts (Ferrum phos.: iron phosphate is the one phosphate cell salt not discussed in this article as it does not play as prominent a role regarding adrenal glands therapeutics) have specificity for the nerves and nervous system.

As phosphorus (the anion or negatively charged component of the cell salt) supports SNS function, all five phosphate cell salts have, to varying degrees, an affinity for that branch of the SNS. However, the cation (positively charged ion) component of the phosphate cell salt’s mineral compound (i.e., calcium, magnesium, potassium or sodium) determines which branch of the ANS, a particular phosphate cell salt influences more prominently.

In this modern era of unrelenting stress, most people exist in an imbalanced state that influences their general bioelectric polarity, yin/yang dynamics and ANS balance. Commonly, individuals manifest over-sensitization of one or the other of the branches of the ANS resulting in its excessive, easily triggered, or otherwise imbalanced, operations. Thus, the person becomes stuck in either a SNS or PNS hyper-reactional, or complexly dysregulatory, mode.

Calcium and phosphorus are central to SNS regulatory functioning. Potassium and sodium are central to PNS regulatory functioning. Magnesium is more closely associated with the PNS, but actually serves to downregulate both SNS and PNS hyper-reactivity. This is one of the reasons why magnesium is the first place to start when introducing mineral supplementation. It also helps explain why Mag. phos. is one of the leading cell salts in so many cases.

Selecting Cell Salts for Adrenal Support

Note: The symptom pictures for the 4 cell salts discussed below is excerpted from Berkowsky’s Synthesis Materia Medica of the Twelve Cell Salts

Calc. phos. (calcium phosphate)

This cell salt can be used to strengthen a depleted SNS and thus, fatigued adrenal glands. The primary cell salt for adrenal support during the first stage of general adaptation syndrome (GAS), referred to as the alarm reactionor fight-or-flight response stage, (mediated by the hormones epinephrine and norepinephrine secreted by the adrenal medulla via the SAM pathway). Calc. phos. is also a restorative salt that aids revitalization after illness. Thus, it can also play a valuable role during the exhaustion phase of GAS.

Deficiency Keynotes: anemia; kidney disease; respiratory catarrh; chronic indigestion; skin eruptions, including eczema

Modalities: Worse at night in damp, cold weather; worse for change of weather; better for warmth and in a warm room

Relevant symptoms from the Calc. phos. cell salt symptom picture include: forgetfulness; anxiety; grief; vexation; disappointment; drowsiness in old people, associated with depression; sensitive to artificial light; spasms; restorative after disease; chronic wasting diseases with exhaustive discharges; chronic bronchitis; chronic enlargement of the tonsils; sore, dry throat; heart palpitations with anxiety; pain after eating with soreness and pressure; pain in the stomach with debility; frequent urge to urinate; skin dry, cold and wrinkled; sallow complexion; herpes; symptoms worse from cold and better for lying down.

The picture of the constitutional potency of Calc. phos. used in classical homeopathic prescribing provides additional detail. Relevant symptoms and qualities in this regard include: worse for cold air; worse for cold, wet weather; better for rest; better in fresh air and open spaces; worse before and at the beginning of menses; depression; dissatisfaction; desire for change; loss of motivation due to diminished energy; irritability made worse by coffee; fear brings on complaints; seeks solitude to commune with her thoughts and to shun the exertion of society; strong need for security; hypersensitivity; constant stretching and yawning; falls asleep early in the evening with frequent waking during the night; restlessness for 2 or 3 hours after midnight; general bodily weakness; desires fat and smoked meat; desires cheese; desires raw vegetables; aversion to cauliflower; pale skin.

Kali. phos. (potassium phosphate)

Kali. phos. counters SNS hyper-reactivity and plays a supportive role in reversing PNS underactivity as well. While it has some direct value for the SNS-adrenal medulla (SAM) pathway, it primarily counters adrenal fatigue via PNS/adrenal cortex cholinergic nerve pathways.
The SNS pathways are composed of adrenergic nerve fibers which release the neurotransmitter norepinephrine (aka noradrenaline) at the junction between a nerve and its end organ (e.g., a muscle, gland, or another nerve).

The PNS pathways consist of two types of neurons: presynaptic and postsynaptic neurons, which are connected by the axons of the presynaptic neurons. This synapse uses acetylcholine as a neurotransmitter, which is why the parasympathetic pathways are referred to as the cholinergic pathways.

The PNS almost exclusively uses acetylcholine to transmit nerve signals, and so, it is almost entirely cholinergic. Notably, preganglionic neurons of the SNS are also cholinergic. This helps explains the usefulness of Kali. phos. for nervous dyspepsia (indigestion).

Most prominent locations: brain; nerves; muscles; blood cells

Deficiency Keynotes: nerve and nervous symptoms; brain symptoms; insomnia; metabolism and cellular respiration; adrenal fatigue and deficiency; anxiety; depression; chronic fatigue; poor digestion of fats; putrefactive and septic conditions.

Modalities: aggravated by noise, exertion and rising from a sitting position; pains worse for continuous exertion or after rest; worse for cold; symptoms better for rest, warmth, gentle motion, eating and being with pleasant company; worse when alone.

Kali. phos. symptoms are generally worse from mental and/or physical exertion, worse from cold and better for rest, warmth and eating (hypoglycemia is often a factor in constitutional Kali. phos. cases).

Relevant symptoms and qualities of the Kali. phos. cell salt remedy include: nerve nutrient; constituent of brain, nerves, blood and muscles; remedy for ailments of a truly nervous character; deficient vitality (deficient chi); chronic fatigue; languid weariness; atrophic conditions in old people; helps maintain a happy disposition; sharpens the mental faculties; anxiety; nervous dread without any special cause; fretfulness; impatience; ill-humor; gloomy moods; looks on the dark side of everything; dark forebodings; depression (involving weakness of the nerves); nervous exhaustion; irritability; brain fatigue from overwork; timidity; sighing; weeping mood; nervous headaches; restlessness; insomnia after worry or excitement; yawning, stretching and weariness.

Lowered vitality; muscular debility; vertigo when rising from lying to standing up; feeling of faintness or dizziness in nervous people; faintness from fright or fatigue; sensitivity to noise and light; nosebleeds in weak, delicate constitutions; tongue coated brownish like mustard; predisposition to bleeding gums; nervous dyspepsia (indigestion related to nervous tension); indigestion with nervous depression; bladder weakness; frequent urination or passing of much urine, often scalding; neuralgia; irritating skin; skin disorders including eczema and shingles (Herpes zoster) in which nervous stress and imbalance are often key etiological factors; eczema related to hypersensitivity and nervousness; symptoms worse from mental and physical exertion and from cold; symptoms ameliorated by rest, warmth and sometimes by eating.

Relevant symptoms from the Kali. phos. higher potency, homeopathic constitutional remedy include: hypersensitive; delicate; worn-out from long suffering, much sorrow and vexation, and prolonged mental work; great lassitude; apprehension; anxiety; discontented and sad; dullness of the mind in the morning; fear worse in the evening; aversion to answering questions; anxiety about his health, the future, his salvation; discouraged; broods over her condition; aversion to company; exhaustion after exertion of the mind; sleepless with sleepiness; sleepless after midnight; fainting spells; respiration difficult at night; nervous asthma; nervous palpitations; appetite increased or decreased; aversion to food; fullness and distention of the stomach; the stomach is commonly disordered; flatulence, obstructed, noisy; constipation with very difficult, hard, large, knotty stool; craves sweets and sour things; thirst for cold water; anemia; edema; very chilly; cold hands and feet; skin cold, sallow, dry; herpes; itchy, sensitive skin; eczema; psoriasis.

Mag. phos. (magnesium phosphate)

Mag. phos. both downregulates an over-reactive SNS and supports the PNS’s rest and recovery actions. Mag. phos. calms both SNS and PNS nerve hyperexcitability.

Thus, it exerts a general calming, homeostasis-encouraging influence. As a stress response, which increases SNS activity, depletes magnesium levels. Mag. phos. is useful during all 3 phases of the general adaptation syndrome (GAS).

Most prominent locations: muscles (white fibers), nerves (white matter), brain, bones and teeth

Deficiency Keynotes: spasms (cramps) within various tissue sites. Examples include: stomach, menstrual and muscle cramps. Among the cell salts, it is the chief antispasmodic remedy. In some instances of cramps, calcium phosphate (Calc. phos.) will prove more effective. Calc. phos. and Mag. phos. are intimately related. When the administration of Mag. phos. does not relieve a spasmodic symptom, Calc. phos. is the secondary option. Mag. phos. is also the first cell salt to consider for muscle tension and anxiety.

Modalities: Better for heat, pressure and massage. Worse for cold (cold water and cold air). It is often useful to use warm soaks, compresses and other warm applications in concert with the administration of Mag. phos. Taking a few sips of warm water immediately after Mag. phos. pellets dissolve under the tongue enhances the effect of this cell salt.

Relevant qualities and symptoms of the Mag phos. cell salt remedy include: one of the leading nutritional elements for nerve tissue; the antispasmodic cell salt; symptoms better for the application of heat and firm pressure; specific for highly sensitive, nervous individuals who tire easily or tend toward chronic fatigue; illusions of the senses; tearfulness; insomnia from excessive fatigue and/or lack of adequate brain nutrition; nerve pains, including neuralgia and neuritis; darting, shooting pains; nervous headaches sometimes accompanied by sparks before the eyes; TMJ; chronic tension in the neck and shoulders; spasmodic constriction of the throat; asthma; spasmodic cough; angina pectoris; heart palpitations related to nervousness; flatulent distention of the stomach; spasmodic stomach pains; gastro-esophageal reflux; cramping pain in the intestines due to accumulation of flatus; constipation with urging but inability to pass stool; muscle twitching and spasms; cramps in the calves.

Relevant symptoms of the higher potency Mag. phos., homeopathic constitutional remedy include: symptoms better for warmth and gentle pressure; tires easily; complains about chronic pain; anxiety; depression; forgetfulness; sleep disturbed by troublesome dreams; general muscular weakness; nervous headaches accompanied with sparks before the eyes; neck pain extending into occiput often accompanied by low back pain; restlessness caused by neck and occipital pain; TMJ; pain in mid-thoracic region of the back, sensitive to probing touch; asthmatic breathing; dry, spasmodic cough; angina pectoris; nervous heart palpitations; constrictive sensations in the chest; darting pains or oppression in the chest which radiate from the large intestine upward; desires to take a deep breath; distention of the stomach with restlessness; spasmodic stomach pains; cramping pains in the intestines; accumulation of intestinal flatus, sleeplessness from poor digestion or congestive flatulence; low back pain; cramps in the calves; herpes.

Nat. phos. (sodium phosphate)

Nat. phos. is found in greatest concentrations within red blood cells, nerves, brain, muscles and the extracellular fluids. This acid neutralizing cell salt is the principal remedy for any ailment related to excessive acidity of the blood or other tissues.

In the body, Nat. phos. is essential for the conversion of lactic acid into carbonic acid and water. Following that, it absorbs the carbonic acid, transporting it to the lungs to be excreted as carbon dioxide.

Accordingly, Nat. phos. is a specific for symptoms related to lactic acid accumulation in the body, including fatigue, and muscle soreness and weakness. At one time, lactic acid was referred to as “fatigue poison.” A deficiency of Nat. phos. results in systemic acidity and a wide variety of associated symptoms, including nervous, digestive and musculoskeletal disorders.

Nat. phos. stimulates the PNS, and is an important cell salt when depletion of the adrenal cortex is extant.  Fatigued adrenal glands tend to produce inadequate amounts of all of the adrenal hormones, including aldosterone (produced by the adrenal cortex), which controls blood pressure and the levels of sodium and potassium in the body. Thus, insufficient adrenal hormones can affect the balance of water, sodium, and potassium in the body, as well as the body’s ability to control blood pressure and react to stress.

A deficiency of aldosterone, in particular, causes the body to excrete large amounts of sodium and retain potassium, leading to low levels of sodium and high levels of potassium in the blood. The kidneys are not able to retain sodium easily, so there is excessive sodium loss, blood levels of sodium decline, leading to dehydration.

The human body exists in a normal acid-base balance. pH is a measurement of the concentration of hydrogen ions (H+) in the body. H+ ions are produced by the breakdown of dietary acids (derived especially from proteins). These ions are eliminated via the kidneys, with the assistance of the adrenal glands. Thus, high acidity increases the workload of both the kidneys and the adrenals.

The pH scale runs from 0 to 14, with a normal blood pH being 7.35 to 7.36. Lower than this level indicates that the blood is too acidic; higher indicates that the blood is too alkaline.) Accordingly, the greater the number of hydrogen ions in the blood, the more acidic is the blood and the lower is its pH.

A body that is in an acid state (i.e., lower pH than normal) is at increased risk of developing chronic inflammation, pain, malignancies, heart disease, osteoporosis, kidney disease, many other chronic diseases, and most relevant to this discussion, adrenal fatigue. A long-term pattern of acidic body pH dramatically accelerates aging.

Acidity not only derives from dietary sources (commonly in this era, from an acid-forming diet composed primarily of processed foods), but also from poor breathing, infection and emotional and mental stress. The body struggles on a daily basis to maintain or restore a normal acid-base balance using mineral buffers, and through the efforts of various organs, including the liver, kidneys, and adrenal glands.

The kidneys, in concert with the adrenal glands, are responsible for eliminating the excess acids that accumulate in the body every day. The kidneys play a central role in regenerating sodium bicarbonate, generating approximately 20% of the body’s bicarbonate reserve. Blood bicarbonate levels provide a preliminary indication of the state of the body’s acid-base balance.

The adrenal glands help the kidneys reduce an acid load via their secretion of aldosterone. Since the adrenal glands secrete aldosterone in response to acidosis, acidosis increases stress on the adrenal glands. In turn, adrenal fatigue can increase acidity, because, as the adrenal glands become less competent regarding the secretion of aldosterone, the kidneys become less competent regarding the reduction of the acid load.

Chronic acidosis degrades cellular integrity and alters the extracellular environment in a way that leads to the production of the harmful free radicals that fuel inflammation.

Nat. phos:

Most prominent locations: red blood cells, nerves, brain, muscles, kidneys and the intercellular fluids.

Deficiency Keynotes: Hyperacidity; inflammation; chronic digestive symptoms; muscle fatigue; rheumatic symptoms; symptoms related to dysfunction of the biliary tract

Modalities: worse in the afternoon or evening; worse during a thunderstorm; worse during menstruation

Relevant Nat. phos. qualities and symptoms include: nervous weakness; anxious and apprehensive; nervousness accompanied by fatigue, upset stomach, neck tension and heart palpitations; fatigue in hot weather; worse for sexual activity; fearful; fear of bad news; nervous fear upon awakening; easily startled; discontented; irritated by interference; impatient when given advice; restless in spite of weariness; ongoing state of tension which is aggravated by mental effort; nervousness with heart palpitation from stomach hyperacidity; forgetful; indifference to loved ones; restless sleep; starting as if from electric shocks; hyperacidity; diabetes; fever accompanied by nausea; fever with icy cold feet during the day and burning feet at night; congestive headache often at the crown of the head or forehead; headaches with vomiting of sour fluids; stiff neck; face flushes easily; blotchy facial skin; creamy yellow coating at the base of the tongue; sour, acid taste in mouth, sometimes accompanied by canker sores; grinding of teeth (bruxism); respiratory catarrh; cough from tickling in the throat; cough from drinking water; heart palpitations and irregularity of the heart after eating caused by digestive weakness of the stomach; feeling of fullness and contraction in the chest; all conditions of the stomach which feature sour, acidic risings; gastric pain after eating; disordered stomach after eating fatty foods; sour belching; sour craving for fried foods; worse for sour food; flatulence; intestinal parasites; sense of weakness after stool; involuntary stool while passing flatus; habitual constipation; loose stool caused by excess acidity; anal itching and/or soreness; burning urination; frequent urination; stiffness of muscles even after moderate exercise [due to lactic acid build-up]; acidic, watery or creamy, yellowish vaginal discharge; pain in the knees, ankles, shins and/or balls of the feet; sore feeling in the joints; arthritis, especially of the knees, wrists and/or fingers; sour-smelling perspiration; eczema with honey-colored secretion; hives itching all over the body; chafing of the skin.

Guidance Regarding the Use of Cell Salts

After determining the relevant cell salts in a given case of long COVID, each of those salts is administered 3 to 4 times per day. The frequency of dosage is reduced as symptoms begin to abate.

When using two or more cell salts as part of a cell salts protocol, separate administration of one from another by about 5 minutes. This will allow the body time to process a particular cell salt before turning its attention to the next one.

Cell salts are best taken away from meals in order to provide an open road for their sublingual assimilation. Accordingly, administer them at least 15 minutes before a meal or 90 minutes after one.

Cell salts are administered sublingually. Thus, allowing them to dissolve in the mouth.

As cell salts are in homeopathic dilution (most commonly 1 part cell salt : 1 million parts neutral base such as lactose or sucrose), do not touch them with your fingers when administering them. Instead, pour them into the cap of the bottle of onto a spoon. If you touch the tablets, the molecules of the cell salts may disperse into the fluids of the skin, and thus, be gone by the time the tablets are placed in the mouth.

Note: Cell salts are generally very mild and safe. However, any substance may cause an adverse reaction, especially in hypersensitive individuals. If such a reaction occurs, discontinue use of that cell salt until you consult with a doctor experienced in its properties and uses.


1. Waldemar Kanczkowski, Felix Beuschlein & Stefan R. Bornstein. Is there a role for the adrenal glands in long COVID? Nature Reviews Endocrinology volume 18, pages 451–452 (2022). May  2022

2.  Paul, T. et al. Adrenal tropism of SARS-CoV-2 and adrenal findings in a post-mortem case series of patients with severe fatal COVID-19. Nat. Commun. 13, 1589 (2022).

3. Kanczkowski, W. et al. COVID-19 targets human adrenal glands. Lancet Diabetes Endocrinol. 10, 13–16 (2022).

4. Malas, M. B. et al. Thromboembolism risk of COVID-19 is high and associated with a higher risk of mortality: a systematic review and meta-analysis. EClinicalMedicine 29, 100639 (2020).

5. Leyendecker, P. et al. Acute adrenal infarction as an incidental CT finding and a potential prognosis factor in severe SARS-CoV-2 infection: a retrospective cohort analysis on 219 patients. Eur. Radiol. 31, 895–900 (2021).

6. Machado, I. F. R. et al. Primary adrenal insufficiency due to bilateral adrenal infarction in COVID-19: a case report. J. Clin. Endocrinol. Metab. 107, e394–e400 (2021).

Additional References

Berkowsky, B. Berkowsky’s Synthesis Materia Medica of the Twelve Cell Salts. Mount Vernon, WA: Joseph Ben Hil-Meyer Research, Inc., 2023.

Schenker, G.R. An Analytical System of Clinical Nutrition, 2nd Edition. Guy R. Schenker, D.C., 1995.

Jinzhou Xu, et al. Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in patients with psychogenic erectile dysfunction. Front Endocrinol (Lausanne). 2023; 14: 1103621.

Ulrich-Lai, Y.M. and Herman, James P. Neural Regulation of Endocrine and Autonomic Stress Responses. Nat Rev Neurosci. 2009 Jun; 10(6): 397–409.

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Join the membership program to have access to guidance, lectures and workshops and more by Dr. Berkowsky on the theory and practice of the Natural Health Science System (NHSS) and Spiritual PhytoEssencing (SPE).

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Read More Articles by Dr. Berkowsky

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Soothing the Abdominal Brain with Synergy of Blue Chamomile Essential Oil, Labradorite Gemstone Essence and Blue Light Therapy

Disturbances of the abdominal brain require a broad spectrum therapeutic response featuring dietary change, nutrient supplementation, exercises, breathing exercises, hydrotherapy, therapeutic sunbathing, improved rest and sleep habits, etc. The protocol presented in this article is being offered as an example of adjunctive measures that may prove of good service when implemented in concert with the more fundamental elements such as said dietary changes and breathing exercises, etc. .


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