A genome screening revealed weak points in the energy metabolism.Measurements in her case showed short‑term rises in blood sugar followed by immediate severe hypoglycemia and an elevated lactate level, which points to an energy deficit. Encouraged by this, Susanne Möllmann began reducing long‑chain fats—those normally consumed in the diet—and consuming primarily medium‑chain fats, such as those found in coconut, similar to the therapy for comparable metabolic defects in infancy. These fatty acids are metabolized differently than long‑chain ones. “After three weeks I could sit again, drive a car and take part in social life,” Möllmann says rather matter‑of‑factly about this spectacular improvement in her condition that had been unthinkable for years. She found a laboratory where she paid for a complete genome screening and then went through the results with a bioinformatician.
It turned out that she has small vulnerabilities affecting energy metabolism across different genes. These can be minimal functional impairments of individual enzymes, transporters, or regulators—small vulnerabilities that by themselves do not cause disease. Only when an additional stressor, in this case the coronavirus, is added can this finely balanced system tip over. Then the previously “silent” weak points become apparent. Susanne Möllmann sums it up: “The virus unmasks a previously hidden susceptibility.”
She assumes that patients who, unlike her, suffer more from the classic symptoms of Chronic Fatigue Syndrome (CFS) such as inability to concentrate and other cognitive failures, probably have more of a problem getting glucose into the mitochondria than with fats. The brain, which in her case was comparatively little affected even during the worst phase of the illness, is highly dependent on glucose. It needs a reliable, constantly available energy supply. Therefore, disturbances in the part of metabolism where glucose is further processed can particularly easily lead to “brain fog.”