Looking to discover the functional medicine approach to long COVID syndrome, and what long COVID care could look like? This page covers:
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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.
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:
Heart and vascular system
Skin, hair and nails
Inflammation and the immune system
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:
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.
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:
Depression and anxiety:
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.
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:
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:
Your functional medicine practitioner will seek to address:
Your long COVID healthcare plan might incorporate a range of dietary changes, perhaps based on food sensitivities revealed in testing, or may include:
They may recommend lifestyle measures to improve your resilience to acute and chronic stress, such as:
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.
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!
Post covid insomnia can depend on the underlying cause of the insomnia, which in long COVID could include:
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:
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.
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.
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.
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.
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.
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.
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