You Tried the Stellate Ganglion Block. Here's Why It Didn't Fully Work with Evan H. Hirsch, MD

You Tried the Stellate Ganglion Block. Here's Why It Didn't Fully Work with Evan H. Hirsch, MD

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So you got the stellate ganglion block. Maybe you felt better for a few weeks. Maybe you felt good for a few days. And then the symptoms came back. The brain fog returned. The anxiety crept back in. Your heart rate started doing that thing again. And you're wondering, did it fail? Did I waste my money? Is something wrong with me? The answer is no. Something specific is happening and understanding it can help you figure out what to do next.

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So welcome back to the EnergyMD podcast where we help you resolve your Long COVID and chronic fatigue syndrome naturally so that you can get back to living your best life. I'm Evan H. Hirsch, MD. So the stellate ganglion block, or SGB, is one of the most talked about treatments in the Long COVID community right now. And for good reason, it helps a lot of people feel better at least for a while. But I hear from clients every week who had the procedure, felt relief and then crashed again.

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If that's you, I want you to know there is a reason and it is fixable. So let's talk about what the stellate ganglion block actually does, because understanding this is the key to understanding why it does not always last. So the stellate ganglion is a cluster of nerves in your neck. It's part of your sympathetic nervous system, which is your fight, flight, or freeze. In Long COVID and ME/CFS, this system gets stuck in overdrive.

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Your body thinks it's in constant danger. Your heart rate is too high. Your anxiety is too high. Your sleep is disrupted. Your brain fog happens because your nervous system is too activated for your brain to think clearly. The stellate ganglion block is an injection of anesthetic into that nerve cluster. It temporarily shuts down the sympathetic signal. It's like hitting the reset button on your fight, flight, or freeze response. And for many people, it works. The brain fog lifts, the anxiety drops, the heart rate stabilizes.

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Some people get their sense of smell back. It can feel like a big difference. A 2026 systematic review called it a promising treatment that generates substantial benefit for many Long COVID symptoms. So I'm not here to tell you it does not work. It does for a while, but here's the problem. A 2025 study from Brigham and Women's Hospital looked at 52 patients who received SGB. 56% improved, but only about 14% had lasting relief.

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That means the vast majority of people who get relief from SGB lose it. The symptoms come back. Why? Because SGB resets the nervous system. It does not fix what made the nervous system dysregulated in the first place. So think of it like this. Your smoke alarm is going off in your house. SGB turns off the alarm. Good. The noise stops, but the fire is still burning in the kitchen. And eventually the alarm goes off again.

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In my framework, the fire is the Toxic 5: heavy metals, chemicals, molds, infections, including the spike protein, and nervous system dysfunction. In my experience, all of us have all of the Toxic 5 to some degree, and we have to address all of them in order to get all the way better. So SGB addresses that last one. It calms the nervous system, but if you have mold colonizing your sinuses and driving inflammation, that inflammation is going to dysregulate your nervous system again.

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If you have chronic infections like Epstein-Barr or Bartonella or Borrelia reactivating, those infections are going to keep your immune system on high alert, which keeps your sympathetic nervous system on high alert. The SGB resets the nervous system, but the inputs that were driving the system into overdrive are still there. So the system goes back into overdrive. If this is making sense to you and you're interested in learning more about how I address the Toxic 5, head over to fixyourfatigue.com

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and watch my latest masterclass. So let me give you an example. I had a client, let's call her Jennifer, who came to me after two stellate ganglion blocks. The first one gave her about three weeks of feeling almost normal. She was super excited. The brain fog cleared, her anxiety dropped, she could sleep. Then it all came back. She got a second block. Same thing, two weeks of relief and then a crash. When I assessed her, we found mold in her sinuses and chronic Epstein-Barr reactivation.

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The mold and the virus were constantly triggering her immune system, which was constantly activating her sympathetic nervous system. The SGB was turning off the alarm, but the mold and the virus were the fire. So we addressed all of the Toxic 5: the mold, the virus, the heavy metals, the chemicals, other infections, and the nervous system dysfunction with vagus nerve stimulation, nervous system retraining practices to help her nervous system stay calm while her body healed. Once we addressed all of that, her nervous system stabilized on its own.

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No more blocks needed. This is why I always tell people, SGB can be a valuable tool. It can give you a window of relief. It can give you enough energy to do the deeper work. It can give you a break from your symptoms, which can be so important, but it is not a standalone solution for Long COVID or chronic fatigue syndrome because it addresses one of the Toxic 5, not all five. The key is to address all of them. The nervous system dysfunction, the infections, including the spike protein, the mold, the heavy metals, the chemicals,

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and to support your nervous system with practices like vagus nerve stimulation and nervous system retraining while you do the deeper work. So if you had a stellate ganglion block and it did not last, do not lose hope. It means the block worked. It proved that your nervous system can calm down. The problem is that something is still triggering it and that something is one or more of the Toxic 5. So head over to fixyourfatigue.com.

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And watch my free masterclass. It will walk you through how to identify what's still driving your symptoms and how to address all the Toxic 5, so that relief actually lasts. It's free and hopefully it's the thing that makes all of your treatments finally stick. Thanks so much for watching this episode and I'll see you in the next one.

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I hope you learned something on today's podcast. If you did, please share it with your friends and family and leave us a five-star review on iTunes. It's really helpful for getting this information out to more people who desperately need it. Sharing all the experts I know and love and the powerful tips I have is one of my absolute favorite things to do. Thanks for being part of my community. Just a reminder, this podcast is for educational purposes only.

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And is not a substitute for professional care by a doctor or other qualified medical professional. It is provided with the understanding that it does not constitute medical or other professional advice or services. Thanks for listening and have an amazing day.