A significant percentage (>30%) of people who suffered from Covid-19 infection are struggling to return to normal health (there are also reports of these symptoms after the mRNA injections). Some common symptoms that continue to affect them even months after the initial infection are depicted in the image below.
The most common issues reported are fatigue, low stamina, brain fog, memory issues, anxiety, muscular/body pains and sleep problems.
There is broad agreement that the following pre-existing conditions increase the likelihood of struggle with long haul covid symptoms (referred to as LHC). These are:
- Obesity (including mildly overweight)
- Lung issues – even moderate asthma (including sleep apnea)
- Type 2 diabetes (also pre-diabetes and hyperglycemia)
- Cardiovascular diseases (even hypertension)
- Smokers
- Kidney and liver disease (including low-grade NAFLD)
These points hold true even when these conditions are being managed with medications.
The underlying theme is that if the body is already chronically challenged with increased inflammation, oxidative stress and other metabolic imbalances, it will be more vulnerable to infectious diseases of all types. As also more vulnerable to delayed and slow recovery on the other side of the infection.
Using the functional medicine lens to dig deeper into the underlying imbalances and dysfunctions leads us to the following as the root causes of LHC:
- Unresolved low-grade inflammation
- Mitochondrial dysfunction
- Oxidative damage
- Inflammation specifically of the nervous tissues
- Barrier dysfunction – gut and Blood Brain Barrier
- Histamine overload and intolerance
- Immune hypervigilance/dysregulation
- Nutritional deficiencies(maybe triggered by poor absorption)
- Toxicity
- Disrupted serotonin synthesis
Diet, including supplements, can play a big role in helping to reverse these issues. Let us look at them briefly.
DIET
In the functional medicine approach, food is not considered just as calories. In addition to energy, food also impacts the most fundamental processes of the body. This means that food is a source of energy and information and is a natural medicine for the body. Remember the age-old adage – “Food is medicine”? Here are a few key points that can help us eat our way to recovery from LHC.
- Anti-Inflammatory Diet – The most important thing is to remove foods that create inflammation in the body. Some of the most common examples are dairy products (except good quality ghee), wheat, sugar, refined seed oils and processed foods. These should be eliminated 100% from one’s diet.
- Light Food – It has been understood that a significant part of the LHC symptoms is rooted in impaired digestive tract function. Moving to a diet that is as easy to digest as possible, while still nourishing, is very important. It allows the digestive system space where it can repair itself. Towards this, we want to avoid fried foods, spicy foods, processed foods etc. It is also important that we consume only fresh food. Food that is old and stale (even if kept in the refrigerator) is not supportive of recovery
- Fasting – Fasting is the best way to give a complete break to the digestive system. It may seem counterintuitive to someone struggling with weakness and fatigue, however, the results are immediate and very effective. Fasting not only gives a break to digestion, but it is also one of the most effective ways to rebalance and boost immune function.
If someone is unable to go on a complete (water-only) fast, they can be on fresh juices (avoid fruit juices) or even only on salads or fruits. We have seen very good results with fasts lasting a minimum of 3 days
- Histamine – Histamine is an inflammatory mediator involved in many key functions in the body, including LHC symptoms. Histamine overload goes way beyong respiratory symptoms and includes a variety of dysfunction, including anxiety, insomnia, headache, IBS-like symptoms, brain fog, irritability/restlessness, multiple chemical sensitivity, MCAS and so much more. Hence it is important to remove histamine rich foods like fermented foods, alcohol and other fermented drinks, brinjals, spinach, tomatoes, vinegar, processed meats, pickles, etc.
NUTRITIONAL SUPPLEMENTS
It is increasingly being understood that nutritional deficiencies play a major role in the continuation of covid symptoms.
Earlier in this article, we looked a the main underlying imbalances contributing to LHC symptoms. To make it easier to follow, we will see which nutritional supplements are supportive in resolving each of these imbalances.
1.Unresolved low-grade inflammation: Continued unresolved inflammation is a key component of this issue. It is essential to address this inflammation for substantial progress to happen. The following supplements are useful in bringing inflammation down.
- Omega3 essential fats
- Ginger
- Vitamin D
- Selected probiotics like Lactobacillus spp, some Bifidobacteria species, and Akkermansia muciniphila, Saccharomyces boulardii, etc.
- Curcumin
- Resveratrol
- Green tea extract
2. Mitochondrial dysfunction: Mitochondrial dysfunction is perhaps the most common dynamic in LHC responsible for a very large proportion of the symptoms. The following supplements can help improve mitochondrial function:
- B Complex vitamins (specially B1)
- NAD
- Alpha lipoic acid
- Omega3 essential fats
- Magnesium
- L-carnitine
3. Oxidative damage: Excessive oxidation is the hallmark of LHC related symptoms. These supplements can help bring RedOx back into balance:
- Vitamins E and C
- N-acetyl Cysteine combined with glycine
- Turmeric and ginger
- Quercetin
- Melatonin
- S-acetyl Glutathione
- Milk thistle
4. Inflammation, specifically of the nervous tissues: The following supplements have proven efficacious in reducing inflammation of the nervous tissues:
- All B vitamins (specially B6 and B12)
- Magnesium
- Targeted support to bring about GABA/Glutamate balance
- CoQ10
- Omega3 fats
- SAMe
- erotonin supporting nutrients like tryptophan
5.Barrier dysfunction – gut and blood-brain barrier: Many barrier functions get disrupted and become more permeable leading to dysfunctions. The following supplements can support the repair of the barriers:
- Mucilaginous herbs like aloe, slippery elm, etc.
- Glutamine
- Melatonin
- Zinc
- Collagen fibre
- Quercetin
- Vitamin D
6. Histamine overload and intolerance: As discussed earlier, histamine overload plays an important role in LHC-related symptoms. It is fairly important to address histamine overload via diet as well as the supplements and enzymes mentioned below:
- DAO
- Quercetin (with Bromelain and
- vitamin C)
- Stinging nettle leaf
- B vitamins (especially vitamin B6)
- Histamine degrading probiotics like Lactobacillus rhamnosus, Bifidobacterium longum, etc.
7. Immune hypervigilance/dysregulation:
- Vitamins D, C and A
- Magnesium
- N-acetyl cysteine
- Probiotics
- Zinc
- Green tea extract
- Quercetin
- Melatonin
8. Nutritional deficiencies (maybe triggered by poor absorption): Nutritional deficiencies are the rule rather than the exception in LHC. It is important that they are identified and addressed promptly. Recovery becomes long drawn unless the deficiencies are addressed simultaneously with other treatments.
Most of the common deficiencies have already been discussed above. A good quality multimineral and/or multivitamin can be a good support. One can also consider adding supplements that improve digestion and absorption of nutrients in the gut. Some of these are:
- Magnesium
- Stomach acid support via HCL Betain
- Digestive enzymes
- Vitamin D and A
- Essential fats
9. Toxicity: Toxicity is another dynamic that is often completely missed or ignored. The viral mRNA and spike protein can take weeks to get detoxified and removed from our systems. They are likely to continue having toxic effects till then. It is important to support the body to get rid of these faster.
- Fasting is a great support in mobilising detox processes in the body
- GI binders
- Enzymes – especially proteolytic enzymes
- Good quality detox support formulas can be used
10. Insomnia: Sleep-related disorders are amongst the top complaints in LHC. A lack of good deep sleep also becomes an aggravator as the nervous system gets locked in sympathetic (fight or flight) mode. Hence it is very important to focus on ensuring quality sleep. Here are a few supplements and other tips that can help:
- Calming teas like ashwagandha, peppermint, chamomile, lavender, passion flower
- Supplements like L-theanine and taurine can also be used as teas to relax the nervous system
- Melatonin
- Magnesium (liquid supplements may be more effective here)
In addition to supplements, following good sleep hygiene habits can make a big difference in the quality and quantity of sleep, in turn leading to improvements in LHC symptoms.
11. Liver Health: Liver is the chemical factory of the body and must be working well to ensure quick recovery from covid. Given our modern lifestyles, our livers are often loaded with fat and other unwanted toxins as well as badly inflamed. Estimates suggest over 30% of urban populations have different levels of liver issues, fatty liver being the most common. It is important to work with an experienced practitioner who can help bring your liver function back to normal.
It is very important to remember that supplements, though wonderful as they are, cannot remedy a sympathetic dominant lifestyle. We must remember the fact that for the body to heal itself, first the nervous system has to believe that it is in a safe environment. Else it will not focus the body’s resources on healing and rejuvenating. Remember that deeper healing processes are only activated in the para-sympathetic mode!
Also, always remember the fact that we may be able to fool everyone else, but we can never fool our own bodies. The nervous system is listening to every thought and emotion we generate. If these carry even an undertone of negativity (like anger, frustration, fear, insecurity) then the nervous system will activate the fight and flight mode (sympathetic mode) and you can throw any chances of a quick painless recovery out of the window!
How we eat, what we eat, how we sleep, how we move, think, environmental exposures, history of traumas, our community and sense of purpose and more have a big impact on our body’s ability to heal itself. And all these are completely in our hands. Let us take our health into our hands!
The above is only a small part of what can be done to support the body to recover quickly – much more is actually possible.
Note – It is important the supplements etc suggested above are not taken without the guidance of someone well-versed in their usage.
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References:
- https://pubmed.ncbi.nlm.nih.gov/35334962/ (Luigi Barrea 1 2 , William B Grant 3 , Evelyn Frias-Toral 4 , Claudia Vetrani 5 , Ludovica Verde 5 , Giulia de Alteriis 5 , Annamaria Docimo 5 , Silvia Savastano 2 5 , Annamaria Colao 2 5 6 , Giovanna Muscogiuri 2)
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9212635/ (Matteo Tosato, MD, PhD,a Francesca Ciciarello, MD,a Maria Beatrice Zazzara, MD,a Cristina Pais, MD,a Giulia Savera, MSc,a Anna Picca, PhD,a Vincenzo Galluzzo, MD,a Hélio José Coelho-Júnior, PhD,b Riccardo Calvani, PhD,a,∗ Emanuele Marzetti, MD, PhD,a,b Francesco Landi, MD, PhD,a,b and , on behalf of Gemelli Against COVID-19 Post-Acute Care Team)
- https://pubmed.ncbi.nlm.nih.gov/32664543/ (Elena Campione 1 , Terenzio Cosio 1 , Luigi Rosa 2 , Caterina Lanna 1 , Stefano Di Girolamo 3 , Roberta Gaziano 4 , Piera Valenti 2 , Luca Bianchi)
- https://pubmed.ncbi.nlm.nih.gov/35355308/ (Karina Janice Guadalupe Díaz-Resendiz 1 , Alma Betsaida Benitez-Trinidad 1 , Carlos Eduardo Covantes-Rosales 1 , Gladys Alejandra Toledo-Ibarra 1 , Pablo Cesar Ortiz-Lazareno 2 , Daniel Alberto Girón-Pérez 1 , Adela Yolanda Bueno-Durán 1 , Daniela Alejandra Pérez-Díaz 1 , Rocío Guadalupe Barcelos-García 1 , Manuel Iván Girón-Pérez)
- https://pubmed.ncbi.nlm.nih.gov/35069483/ (Chao Shang 1 , Zirui Liu 2 , Yilong Zhu 3 , Jing Lu 4 , Chenchen Ge 4 , Cuiling Zhang 1 , Nan Li 1 , Ningyi Jin 1 3 5 , Yiquan Li 3 , Mingyao Tian 1 5 , Xiao Li)
- https://www.mdpi.com/2227-9032/10/3/487 (Sonia Sifuentes-Franco 1,2,*, Dellaneira Carolina Sánchez-Macías 3, Sandra Carrillo-Ibarra 3, Juan José Rivera-Valdés 4, Laura Y. Zuñiga 2 and Virginia Aleyda Sánchez-López)
- https://pubmed.ncbi.nlm.nih.gov/32813065/ (Aravind Sundararaman 1 , Mousumi Ray 1 , P V Ravindra 2 , Prakash M Halami)
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