A path I never planned,
but was meant to walk.

For many years, much of Dr. Groysman's work centered on treating trauma, chronic pain, and PTSD using a procedure known as the stellate ganglion block (SGB). It was during those treatments that something unexpected happened.

A number of patients came in after COVID infections, unable to smell or taste. These were symptoms many initially thought were irreversible. But almost immediately after receiving an SGB, their smell and taste returned. That was the first spark, a sign that there was more going on beneath the surface.

As Long COVID emerged as a recognized condition, patients arrived with fatigue, brain fog, dizziness, pain, insomnia, and dozens of other complaints. What struck Dr. Groysman most was that these symptoms did not fit neatly into one category. Two people could have the same symptom for completely different reasons.

That realization (that the same presentation could have multiple distinct root causes) became the foundation for everything that followed.

Through clinical observation, research, and treating hundreds of patients, Dr. Groysman identified six major root causes driving the majority of Long COVID symptoms.

1. DysautonomiaDysfunction of the autonomic nervous system
2. Mitochondrial DysfunctionImpaired energy production at the cellular level
3. Gut DysbiosisImbalance of the gut microbiome and intestinal barrier issues
4. Mast Cell Activation (MCAS)Immune dysregulation and histamine intolerance
5. Endothelial DysfunctionVascular injury and microclots
6. Hormone ImbalanceDisruptions in testosterone, estrogen, thyroid, and cortisol

At first, Dr. Groysman approached patients by focusing on their symptoms. But he quickly realized that was not enough. The same symptom could come from any of the six mechanisms. Fatigue, for instance, might stem from dysautonomia, mitochondrial issues, hormones, or microclots. Unless the actual root cause was identified, treatment would be incomplete.

What helped was learning to use triggers as diagnostic clues. Patients often noticed their symptoms worsened with heat, stress, certain foods, or exertion. By mapping which triggers worsened which symptoms, the underlying mechanism could be inferred. That shift from chasing symptoms to tracing mechanisms changed everything about how he practiced medicine.