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Dysautonomia, and specifically Postural Orthostatic Tachycardia Syndrome (POTS), frequently co-occurs with Long COVID and ME/CFS

Its uniqueness lies in one detail that changes how it behaves: carnitine is bound to an acetyl group

Thus, the observed bloom of Veillonella may represent a reactive microbiome adaptation to elevated systemic lactate and immune stress, rather than a stable feature associated with enhanced performance in broader athletic populations

As a result, VSMCs shift toward a cell phenotype resembling that of osteoblasts, leading to an increase in the expression of regulatory proteins like Runx2, Osterix, Msx2, and Sox9

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