Two people can have the same Long COVID symptom for different reasons. At Dr. Groysman’s clinic, evaluation focuses on how your symptoms behave: what brings them on, when they worsen, which symptoms occur together, and what helps them settle.
The Groysman Method uses these clues, your medical history, and targeted testing to assess likely contributing mechanisms and guide an individualized treatment plan. These four steps explain the approach; they are not a fixed testing package or a promise of recovery.
Four Steps to an Individualized Treatment Plan
1. Focus on what matters for your diagnosis and treatment
Dr. Groysman recognized early in his work with Long COVID that retelling the entire illness history from the first infection does not change the diagnostic assessment or treatment plan. He therefore focuses on the last 30 days: your current symptoms, what triggers them, their timing, what helps, and how they affect your daily life.
Your experience matters, and you do not need to recount every stage of your illness to be understood. Keeping the discussion focused on your recent symptom patterns leaves more time to identify likely mechanisms and discuss treatment. Relevant earlier history, test results, medications, supplements, and previous treatment responses are reviewed when they help answer a clinical question or affect treatment choices.
Standing, heat, meals, physical or mental effort, sleep disruption, and stress can reveal different patterns. Symptoms that worsen immediately on standing and improve when lying down raise different questions from a crash that develops a day or two after activity. These are clues to investigate, not diagnoses by themselves. You do not need to deliberately provoke a flare.
2. Assess the mechanisms that may be contributing
The evaluation considers six interacting domains:
- Autonomic dysfunction: regulation of heart rate, blood pressure, temperature, and other automatic functions.
- Mitochondrial and bioenergetic impairment: cellular energy production and recovery after exertion.
- Endothelial and microvascular dysfunction: small-vessel function and circulation.
- Gut dysbiosis and barrier disruption: gut function, microbial balance, and intestinal barrier health.
- Mast cell and histamine-mediated signaling: patterns involving histamine and other mast cell mediators.
- Neuroendocrine dysregulation: hormone and metabolic regulation.
More than one domain may contribute. The aim is to identify the likely dominant driver and other contributing systems, while considering alternative diagnoses and factors such as sleep disruption or ongoing immune activation that may amplify symptoms.
3. Use targeted testing and prioritize treatment
Testing follows the clinical question. Depending on your history and findings, it may help evaluate a suspected mechanism, identify another treatable condition, assess severity, or monitor treatment safety. There is no standard advanced-testing panel that every patient needs, and normal routine results do not make symptoms less real.
Dr. Groysman uses the combined clinical picture to discuss treatment options, expected benefits, risks, and the strength of the available evidence. Treatment is selected and sequenced for your pattern, medical circumstances, and tolerance. Having Long COVID does not automatically mean you need a particular procedure, medication, or supplement.
4. Reassess your response and adjust the plan
Follow-up considers symptom changes, daily function, activity tolerance, side effects, and relevant objective measurements. Your response helps refine the working assessment and treatment priorities, but improvement with a treatment does not by itself prove a specific mechanism.
The plan can change as your condition changes. Some treatments may be continued, adjusted, stopped, or considered later. Recovery varies, and no single treatment or sequence works for everyone.
The Framework Behind Your Evaluation
Dr. Groysman’s published work describes Long COVID as a network of interacting physiological systems. His Trigger-Timing Framework organizes four clinical clues: the trigger, the timing of worsening, the symptom pattern, and the relief or recovery pattern.
These are proposed, hypothesis-generating frameworks. They help organize clinical questions and treatment priorities, but they are not validated diagnostic tests and do not establish that every patient has the same mechanisms.
- Long COVID as a network disorder: a mechanism-anchored framework for biological stratification and therapeutic targeting — Frontiers in Medicine, 2026.
- The trigger-timing framework for long COVID: using symptom triggers and temporal patterns to guide mechanistic stratification and treatment planning — Frontiers in Medicine, 2026.
Learn more about the Groysman Method.
What Patients Are Saying
“Dr. Groysman & his team are so wonderful. I came in for 2 SGB’s and an EAT procedure. I flew in and felt so comfortable with the staff. I got some relief from my long covid and dysautonomia as well! I came back the next day for an ANS test and you couldn’t ask for a more knowledgeable doctor and staff who have experience!” — Amy M.
“When I first engaged with Dr. Groysman I was at the point of desperation due to intense long Covid symptoms. Before seeing him I had seen numerous doctors who were unable to provide much help. Some of their recommendations actually made me more sick. Dr. Groysman developed a treatment protocol specific to my situation and my needs. I’m not being dramatic when I say with these treatments I have been resurrected. I’m no longer struggling with debilitating cognitive, emotional and physical fatigue. My crushing headaches, head pressure and tinnitus are gone. The horrible cough that kept me from sleeping for more than a year and a half is gone. My body feels like I’m alive again. I still have to pace myself as my body continues to heal. But it’s simply life changing to be able to hold a conversation without feeling as if I’m going to collapse, to enjoy cooking again, walk my puppy, grocery shop, or go to the nursery. Thank you Dr. G and your amazing staff. You saved my life!” — Lisa W.
Take the First Step Toward Recovery
Schedule a consultation to review your symptom patterns, discuss likely contributing mechanisms, and consider appropriate next steps. For help preparing your history and records, see our Patient FAQ.