What I've Learned About Long COVID: A Gut-First Framework — The Frame

What ties all of this together is not the virus alone&#8212;it&#8217;s the collapse of colonocyte bioenergetics . When your gut epithelial cells lose their capacity to access butyrate, when methyl donors are depleted, when epigenetic signals are hijacked, and when tight junctions fail, you lose the organ that was supposed to be your primary barrier and your primary nutrient extractor. Long COVID isn&#8217;t primarily a viral disease anymore (the virus is cleared). It&#8217;s an organ failure disease &#8212;one that starts in the one organ most people don&#8217;t think about. The recovery pathway isn&#8217;t &#8220;wait for the virus to clear.&#8221; It&#8217;s: repair colonocyte bioenergetics, restore butyrate metabolism, rebuild barrier function, and rebalance the microbiota that depends on healthy colonocytes. That&#8217;s what I&#8217;m seeing in the research. And that&#8217;s what&#8217;s driving my clinical framework.