COV-19: What can we do about long Covid?

The individual not the condition

  1. Personalised: there is no ‘one size fits all’ answer - as you have discovered through this series of posts, ‘long Covid’ varies widely between individuals and consequently requires a personalised approach.

  2. Holistic: the approach must also be holistic. Long Covid is a whole body syndrome which usually affects at least 10 body systems. The approach must therefore be systemic and consider the entire body including the mind, and not narrowly focus on one or two body systems, such as respiratory or cardiovascular. Post-mortem studies have shown that the virus finds its way into any and every organ and tissue. 

  3. Demand vs supply: whether you are suffering from acute or chronic (long) COV-19, your body’s response is conditional on the balance of demands vs resources. You need to reduce the demands on it and increase its resources. 

  4. Terrain vs pathogen: the terrain refers to the human body; the pathogen is the virus. The focus of the international mainstream approach has been to reduce our exposure to the virus (with lockdowns, social distancing, masks etc). While this is important, it is only half the story. As individuals within that collective approach, we should simultaneously be strengthening our own terrains by identifying and addressing any imbalances that may reduce our body’s resources. This will not only help to protect from and fight against COV-19 but also all potential pathogenic exposure. We must take care of our own health too.

Identifying imbalances - factors to consider

  • Do you have a balanced, well functioning immune system? 

  • What is your viral load? Do you have any other latent viruses eg cold sores or Epstein Barr? 

  • Do you have any other (non-viral) pathogenic infections eg in the gut?

  • Do you have a rich and diverse healthy gut microbiome?

  • Do you eat a healthy, anti-oxidant rich diet? What is your alcohol and sugar intake? Are you a healthy weight? Do you have good blood sugar regulation?

  • Do you take regular exercise? Get enough sleep? Adequate sunlight/Vitamin D?

  • Do you suffer from chronic stress? Anxiety? Depression? Fear?

  • How toxic is your environment? Do you live with air pollution? EMF exposure? Chemicals and heavy metals?

Common factors

While each individual must identify and address their unique set of imbalances, there are some specific common factors which apply to most.

There is likely to be unresolved inflammation, which may be connected to (or driving) the viral persistence. An anti-inflammatory diet (with supplements) is likely to be highly beneficial. Anti-oxidants and other core nutrients essential for mitochondrial health and energy production should also be considered. 

Anti-virals will help if there is viral persistence and/or Epstein Barr Virus reactivation together with general immune support. More targeted immune interventions should be used if lymphocytopenia or autoimmunity are present.

More immune reactions occur in your gut in one day than take place in the rest of your body over your entire lifetime.

70-75% of our immune system is found in our gut. Ensuring your gut and microbiome are healthy and balanced is really important.

If mast cell activation syndrome is involved, it may help to follow a low histamine diet and eliminate certain foods and drinks which either contain high levels of histamine or are low in histamine themselves but release histamines in other foods (‘histamine liberators’). Diamine oxidase is the enzyme which breaks down histamine in the body. Certain drinks, such as tea and alcohol, block the action of this enzyme and so should also be avoided/reduced. 

I do not recommend following the traditional advice for ME/chronic fatigue syndrome of Cognitive Behavioural Therapy combined with graded exercise.

Can the vaccine help?

Approximately half of long Covid sufferers have reported an improvement in their symptoms after receiving the vaccine, however the other half did not…

Convalescence

It takes time to heal. In our modern lives, facilitated by digital technological advancements, we have come to expect everything to happen faster and faster. But our bodies’ speed of healing has not changed. In the past a period of convalescence usually followed illness – this was a time in which a person gave their body the chance to recover to full health and strength while taking it slowly and looking after themselves. In our haste to move on and get back to normal, we rarely now grant our bodies this recovery time. 

Summary & Conclusion

Long Covid has a very wide array of symptoms – over 200 have so far been identified. The main ones are fatigue, shortness of breath, post-exertional malaise, pain and brain fog. It manifests differently between individuals. There is significant symptom overlap with similar conditions, such as ME/chronic fatigue syndrome, post viral fatigue, mast cell activation syndrome, Epstein-Barr virus reactivation and also postural orthostatic tachycardia syndrome. There is much that nutritional therapy can do to help through recommending diet and lifestyle changes as well as targeted supplements.

I hope you have found this series of COV-19 posts helpful. Please contact me for an online appointment if you would like more personalised and detailed help.

Disclaimer: these COV-19 posts were written based on the evidence available at the time of writing. As new information continues to emerge, they may no longer be up to date or correct.