How to manage long COVID - the functional medicine approach

Looking to discover the functional medicine approach to long COVID syndrome, and what long COVID care could look like? This page covers:

At Melbourne Functional Medicine, we’ll give you the help you need to recover from long COVID and live a healthier life again. Learn more about our revolutionary approach to healthcare below.

Learn more

What is long COVID syndrome?

Understanding your condition

Long COVID syndrome (aka PASC - post acute sequelae of COVID-19) is the continuation of symptoms following infection from the SARS-CoV-2 virus, known as COVID-19, for 12 weeks or more. Symptoms can range from mild to debilitating, and can include headache, heart palpitations, fatigue, brain fog, muscle aches and weakness, rash, gastrointestinal disturbances, sweating, sleep abnormalities, persistent cough, and more.

A study out of the UK in June 2022 showed that with the Omicron strain, 4-5% of people infected developed long COVID, versus Delta cases where around 10% developed long COVID. The results may vary from an Australian population, and more research is required in this area.

middle aged man sitting inside tense frown one hand sqeezing bridge of nose between eyes
young woman holding mobile phone in one hand glancing out window smiling

Functional medicine long COVID support

There seem to be few predictors of who is likely to have a prolonged recovery from COVID infection. Risk factors may include having a poor immune response, having had viruses such as Epstein Barr (glandular fever), being female, having depression, anxiety, brain fog, or chronic stress, alterations to the microbiome and poor microvascular circulation. Nevertheless, those who experience it are frustrated by the debilitating nature of long COVID, with many unable to return to work, exercise, or participate in normal life.

The good news is that functional medicine long COVID strategies can help you feel great again. As a chronic multi-systemic condition, functional medicine is well positioned to assess and address all facets of the condition naturally and effectively.

Symptoms of long COVID

More than 200 symptoms have been associated with long COVID, with the most common being fatigue, shortness of breath, chest pain, cough, loss of taste and smell, digestive symptoms, memory loss, brain fog, anxiety, depression, and insomnia.

Symptoms experienced in long COVID often reflect the body organ systems affected during the infectious period. Post COVID symptoms may include:

Systemic symptoms

  • Fatigue
  • Malaise - a general feeling of being unwell, weakness, discomfort, or unease
  • Muscle weakness

Heart and vascular system

  • Chest pain
  • Myocarditis
  • Pericarditis
  • Chest tightness
  • Palpitations
  • Racing heart
  • Altered heart rhythm
  • Fainting
  • POTS (postural orthostatic tachycardia syndrome)
  • Inflammation of veins, and small blood clots - usually to legs

Respiratory system

  • Persistent cough (AKA post COVID cough)
  • Difficulty breathing
  • Worsening of asthma symptoms
  • Pleurisy

Gastrointestinal system

Neurological system

  • Sleep abnormalities
  • Chronic headache
  • Loss of smell / taste
  • Memory loss, poor concentration / brain fog
  • Depression / anxiety (AKA post COVID depression, which is common in patients we see with long COVID)
  • Post traumatic disorder
  • Dizziness / vertigo / poor balance
  • Psychosis and hallucinations
  • Pins and needles, burning, numbness, and tingling or electric shock like pain to fingers, toes, and extremities
  • Postural tremor
  • Pain syndromes
  • Neurodegenerative disorders
  • Neuroinflammation, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)


  • Decreased kidney filtration rate
  • Small amounts of blood in urine

Skin, hair and nails

  • Loss of hair
  • Brittle, weak nails, alterations to nails
  • Skin rash

Inflammation and the immune system

  • Joint pain
  • Small joint arthritis
  • Muscle pain / aches

Endocrine system

  • Persistent blood sugar dysregulation
  • Thyroid dysfunction
  • Lipid abnormalities (fat absorption and storage)
  • Menstrual cycle irregularities


  • Hearing loss / tinnitus
  • Red eyes
  • Sore throat

What causes long COVID?

Much research is being undertaken, however, at this stage it isn’t clear why one person will experience long COVID, and another will recover without issue. Studies have shown correlation between severity of disease and long COVID, and other studies have shown no link with disease severity. Risk factors may include:

  • being female
  • severe disease requiring hospitalisation
  • having more than 5 early symptoms including shortness of breath
  • prior psychiatric disorders
  • some pathology markers - more research is required to substantiate these factors

ACE2 receptors are prevalent throughout the body, including the heart, brain, lungs, nasal and oral mucosa, digestive tract, liver, spleen, blood vessel linings,uterus and kidneys, and it is known the SARS-CoV-2 virus uses its spike protein to bind to these receptors and infect the cell, allowing for replication to occur. It is hypothesised that a combination of mechanisms are involved, such as chronic tissue damage caused by the initial infection, and persistent virus within cells, combined with poor or dysregulated immune response, autoimmunity and chronic inflammation.

One possible mechanism of fatigue is the blockage of the glymphatic system causing a toxic build up in the central nervous system. The glymphatic system, part of the lymphatic system, operates in the brain (mostly at night) clearing the cellular debris, a little like taking out the cellular trash.

EBV (Epstein Barr virus) and long COVID

A strong correlation exists between long COVID and Epstein Barr virus. Similar post viral fatigue symptoms have been previously observed with Ross River fever, Epstein Barr virus (aka EBV, glandular fever, mononucleosis) and herpes viruses. A long retrospective study found that 67.7% of patients with long-COVID were positive for reactivation of the Epstein Barr virus, compared to only 10% of the control subjects, and it is suspected that many of the symptoms of long COVID may in fact be the result of inflammation induced reactivation of EBV.

Researchers are also investigating a condition called mast cell activation syndrome which shares many similarities with long COVID, both causing multiple symptoms and sharing a histamine-mediated mast cell activation. It is theorised that COVID may trigger mast cell activation syndrome, or exaggerate an undetected existing underlying mast cell activation condition.

Whilst encouraging, this early study (not yet peer reviewed) and a peer reviewed study were hopeful that vaccination might significantly reduce the risk of developing long COVID, however, a more recent study in 13 million people showed that there is only a small decrease of around 15% in long COVID symptom development after vaccination. Prevention of COVID infection is recommended by the author as the only reliable means of avoiding long COVID.

Future research hopefully may provide clearer answers to avoid development of long COVID.

It’s time for holistic, long COVID care

Start now

Vitamins for post COVID fatigue and other symptoms

Research shows that patients with long COVID can experience a range of symptoms that stem from inflammation and immune dysregulation, with high levels of pro-inflammatory cytokines, and low T and B immune cells persisting for at least 8 months after the initial COVID infection.

This can cause a range of symptoms, however, rather than treating the symptoms alone (e.g. fatigue),  a comprehensive and holistic approach to treat the root cause is more effective, and will address many symptoms at one time, providing faster recovery overall.

Depending on the post COVID symptoms experienced, this may include dietary or supplemental nutrients, vitamins and minerals, herbal medicine and lifestyle medicines, including the following:

Immune dysregulation:

  • Vitamin A
  • Vitamin D
  • Zinc
  • Vitamin C
  • Medicinal mushrooms e.g Reishi
  • Astragalus, elderberry



  • Curcumin
  • PEA
  • High dose CoQ10
  • B vitamins
  • Quercetin
  • N-acetyl cysteine
  • Liposomal glutathione
  • Zinc
  • Vitamin D
  • Cat’s claw, nigella seed
  • Resveratrol
  • Epigallocatechin gallate (EGCG)

Sleep disturbances:

  • Magnesium
  • L-theanine
  • Glycine
  • B6, Vitamin D, zinc, iron
  • Valerian, ziziphus, passionflower, skullcap, lavender, Californian poppy

Microclotting/vascular dysfunction:

  • Lumbrokinase, nattokinase, serrapeptidase
  • Centella asiatica
  • Ginkgo biloba

Gastrointestinal symptoms:

  • PHGG
  • Prebiotics
  • Dietary polyphenols
  • Probiotics
  • Quercetin

Depression and anxiety:

  • Saffron
  • PEA palmitoylethanolamide
  • Omega 3 fatty acids (high quality fish oil)

Brain fog:

  • Luteolin - the brain fog associated with long COVID is similar to ‘chemo fog’ experienced by patients undergoing chemotherapy, for which the natural flavonoid found in olive pomace oil may reduce the associated brain inflammation underlying this symptom

Long COVID treatment Australia - the conventional approach

The Department of Health recommends avoiding contracting COVID-19 as the most effective way to avoid developing long COVID symptoms in Australia. There is currently no specific treatment for long COVID in Australia, however your GP can suggest ways you can manage symptoms, and they may provide you with the managing post-COVID-19 symptoms brochure.

The RACGP (Royal Australian College of General Practitioners) recommends for patients with long COVID that a holistic, person-centred approach be used, incorporating appropriate examination, and a comprehensive case history assessing all aspects of cognitive, physical, psychiatric, psychological and functional abilities.

For people experiencing severe ongoing symptoms in NSW, SA, VIC and the ACT, new COVID treatment centres applying a multidisciplinary approach are now being offered. These long COVID clinics in Australia offer teams of doctors, GPs, nurses, physiotherapists, dieticians, psychologists, and long COVID specialists to support people with long COVID symptoms.  

Australians also seek out long COVID naturopathic or functional medicine support for a personalised, natural approach to their health.

The functional medicine approach to long COVID

Functional medicine practitioners treat patients with long COVID with a holistic patient centred approach, as part of the fundamental principles of natural medicine practice. As part of the functional medicine long COVID approach, your functional medicine specialist will first take a full, comprehensive case history, including:

  • Full symptom picture and history of COVID-19 infection/s
  • Personal medical history, including childhood illnesses, surgeries and medications, and thorough questioning around immune function and recovery from previous infections
  • Family and genetic predispositions
  • Diet and lifestyle
  • Other pre-existing conditions
  • Environmental toxin exposures, including; mould exposure, heavy metals, pesticides and more

Functional testing may also provide a key to treating any underlying causes of dysfunction to the immune system, inflammation regulation, or other factors that may inhibit recovery, such as:

  • GI Map, or GI 360 for gut microbiome make up and diversity profiles, and to identify parasites
  • Organic acids test to assess cellular metabolic function and nutrient deficiencies
  • Food sensitivity testing
  • Genetic / Nutrigenomic testing
  • Toxins: metals, environmental chemicals, mycotoxins
  • Cardiometabolic assessment
  • Stool & digestive analysis
  • Thyroid health

Your functional medicine practitioner will seek to address:

  • Immunity and possible mast cell activation
  • Inflammation
  • Restoration of microvascular health
  • Restoration of function to each system affected

Your long COVID healthcare plan might incorporate a range of dietary changes, perhaps based on food sensitivities revealed in testing, or may include:

  • An anti-inflammatory diet high in polyphenol rich whole plant foods
  • Low refined carbohydrates such as fast foods, breads, cakes, pastries, biscuits and sugary foods
  • A diet rich in high quality fats and oils such as extra virgin olive oil, cold pressed coconut or avocado oils, nuts and seeds, ghee from grass fed cows, avocados and oily wild caught fish

They may recommend lifestyle measures to improve your resilience to acute and chronic stress, such as:

  • Forest bathing (Shinrin - yoku), meditation and mindfulness practices, Tai chi, yoga, QiGong, or just simply taking a walk every morning in nature
  • Sleep hygiene measures, and techniques for improving sleep onset, time and quality

Depending on your symptoms, other conditions and contributing factors, your treatment strategies will be tailored to your specific circumstances, and may include a range of vitamin and mineral supplementation, herbal medicines, or other nutritional medicine (see ‘Vitamins for post COVID fatigue and other symptoms’ section for more information).

If you have long COVID, our award winning clinic and healthcare team might be just what you need to feel better. In our signature 6-month program, you’ll receive a personalised functional medicine long COVID care plan and ongoing support from your functional medicine practitioner and health coach. We’ll walk with you step by step back to feeling better, so you can get back to living your life.

Case study

See how functional medicine is helping our patients achieve better health and richer lives.

Are you ready for a personalised, natural functional medicine treatment to improve your immune health? Our unique model of care was designed with you in mind. Find out how below, then book a call today!


How long does post COVID insomnia last?

Post covid insomnia can depend on the underlying cause of the insomnia, which in long COVID could include:

  • Stress and anxiety from the illness, or the effects of not working, not seeing family, or not being able to participate in normal activities
  • Inflammation and dysregulation due to the infection, affecting your ability to produce melatonin - the sleep hormone
  • Altered sleep / wake patterns (circadian rhythm) due to fatigue
  • Pain, discomfort

Long COVID symptoms generally resolve within a few months, however individual symptoms like insomnia may persist, and vary from one person to another. Treating long COVID may reduce the amount of time you are affected by insomnia, and also other symptoms of long COVID.

Try practicing sleep hygiene techniques to improve your sleep:

  • Avoid screens (TV, computer, phone, tablet) after dark, or use ‘blue light blocker’ glasses. The blue light that screens emit alters the body’s circadian rhythm that regulates sleep, and suppresses the release of melatonin
  • When you start to yawn early in the evening, take this as the cue to get yourself ready for bed. You have about 90 mins until the next wave of yawning, and can be ready to ‘catch the wave’ if you’re prepared.
  • Avoid reading or watching anything stimulating (whether it’s full of action, comedy, or horror) in the hours before bed.
  • Take a warm bath to prepare the body for sleep
  • Drink some chamomile tea an hour before bed
  • Avoid caffeinated drinks after 2pm (or, at all if you find it over stimulating) as they interfere with the body’s ability to make melatonin (the sleep hormone)
  • Try mindful practices, as they can help in the moment, and when practiced regularly, can train the nervous system to calm down quickly on an ongoing basis

If symptoms persist, and cause much disruption to your life, seeking out long COVID clinics, a long COVID specialist, or the support of a functional medicine naturopath for long COVID might be beneficial.

How long does long COVID last?

It really depends on the person, and the research hasn’t really identified the answers. Usually, though long COVID resolves after a few months, with a handful of people going on to experience symptoms long term. 

Many Australians are now seeking functional medicine long COVID support, or the guidance of a naturopath with an understanding of long COVID, to explore what could be driving the persistence of long COVID, and to address those causes so that symptoms can resolve.

Does vaccination prevent long COVID?

Vaccination is good at preventing the risk of more serious COVID infection, disease and hospitalisation, can limit catching COVID, and can somewhat reduce your likelihood of long COVID.

A study of over 3 million people with COVID showed that vaccination reduced the incidence of long COVID by around 15 % compared to unvaccinated people. Other, older studies from around the world have shown higher percentages, however vaccination alone is not a reliable way of reducing risk of developing long COVID.

Some people have questioned whether they acquired long COVID after vaccination, however long COVID can only be caused by actual COVID infection.

Can you get long COVID from Omicron? Is long COVID contagious?

Yes, any strain of COVID appears to be likely to develop into long COVID symptoms. A study out of the UK in June 2022 shows that in Omicron cases, around 4-5% of people studied developed long COVID, versus Delta cases where around 10.8% developed long COVID. As this was a UK study, the results may vary from an Australian population, so more research is required in this area.

You need to have had COVID recently to develop long COVID syndrome, so it is not contagious in itself. You cannot catch long COVID from others, as it is the continuation of symptoms after a COVID infection resolves.

What are the symptoms of long COVID? How do long COVID symptoms start?

The most common symptoms of long COVID are muscle aches, headaches, fatigue, sweating, insomnia and shortness of breath and a lingering cough.

There are around 200 symptoms that can occur, often linked to the symptoms that were experienced during COVID infection - so, if headaches or migraines were experienced during infection, then they may continue post infection.

It is difficult to determine the start of long COVID symptoms, as it is more of a continuation from the infection. People tend to report that they just don’t completely recover from COVID symptoms, or develop different symptoms as they recover from the initial infection.

What is the best long COVID treatment?

The best way to manage long COVID is a comprehensive, holistic treatment approach, because COVID can affect many systems in the body.

Systemic inflammation appears to be part of the picture, as does dysregulation of the immune system. Many people also experience a reactivation of the Epstein Barr virus (aka; glandular fever, mononucleosis).

Long COVID functional medicine strategies are holistic, comprehensive and person centred. An in depth case history will help to reveal any underlying contributing factors that may be preventing your body from resolving the COVID infection, and a strategy will be tailored to your own case.

Long COVID natural remedies including herbal medicines, nutritional supplementation, dietary recommendations and lifestyle medicine all of which may form part of your treatment strategy. If you’d like to know more about how a long COVID naturopath using functional medicine strategies can help you, call us now.

Can’t find what you’re looking for? Reach out to the team directly – we’ll be happy to assist.