A Naturopathic Perspective on Long-COVID

By Dr. Birgit Lenger, ND, Anchorage Naturopath

Long-COVID, also known as post-acute sequelae of SARS-CoV-2 (PASC), is a condition that may impact up to half of people who have had a COVID-19 infection. There is a good chance that you may know someone who is struggling to get back to their usual self after having had COVID. They may suffer from a variety of new, returning or ongoing health problems that showed up four or more weeks after first being infected with SARS-CoV-2. Long-COVID encompasses a myriad of symptoms that negatively impact day-to-day functioning and overall quality of life – and may linger even beyond one year.

Symptoms of Long-COVID

Symptoms of long-COVID may include:

·      Fatigue and low stamina

·      Cognitive dysfunction/brain fog with memory impairment or difficulty with attention and focus

·      Headaches

·      Sleep disturbance

·      Dizziness; there may also be postural orthostatic tachycardia syndrome (POTS) with dizziness, lightheadedness and heart racing upon standing

·      Loss of taste and smell

·      Muscle and joint aches

·      Digestive issues

·      Anxiety and depression

Whether or not someone develops long-COVID does not seem to depend upon the severity of the initial illness. Asymptomatic, mild and severe COVID infections may all result in long-COVID.

Researchers at Johns Hopkins University School of Medicine are noting similarities between long-COVID and chronic fatigue syndrome, also known as myalgic encephalomyelitis. In both conditions, it is thought that free radicals are causing oxidative stress and ensuing inflammation in various organs. 

What’s going on?

Causes of long-COVID may include:

·      Chronic systemic inflammation

·      Oxidative stress on the body created by free radicals

·      Reduction in glutathione, one of our body’s most powerful antioxidants and the most abundant antioxidant in the lung lining

·      Lung inflammation due to loss of antioxidants

·      Micro clotting; microscopic clotting can occur in various organ systems, including the brain, heart, liver and lungs

What Can I Do About Long-COVID?

The good news is there are actions you can take to restore your health. Individuals experiencing the effects of long-COVID should focus on:

·      Rest. Get adequate rest. Sleep at least 8 hours nightly.

·      Whole foods. Focus on good nutrition and eat a healthy anti-inflammatory diet, such as the Mediterranean diet. Avoid added sugars and limit processed foods, saturated fat and refined grains. Eat plenty of vegetables and fruit. They are loaded with anti-inflammatory and antioxidant phytochemicals. Eating fruits and vegetables is associated with improved respiratory function, with reduced airway inflammation and oxidative stress. Incorporate legumes, fish, lean protein, whole grains, spices, nuts and seeds into your diet. The omega 3 fats in salmon are great for your brain. Don’t be shy with garlic; it helps to reduce inflammatory cytokines.

·      Digestive health. Repair the gut as it plays a very important role in our immune system, and impacts brain and lung function (see Laura Evans, FNP’s post on the importance of the gut microbiome). It has been noted that lower levels of Faecalibacterium prausnitzii, a beneficial bacteria in our gut, have been correlated with more severe COVID disease. This keystone bacteria can be boosted with increased fiber, particularly fibers with inulin and FOS found in bananas, leeks, Jerusalem artichoke and asparagus. Include fermented foods in your diet, such as sauerkraut or miso soup.

·      Antioxidants. Boosting anti-oxidants will squelch free radicals and ensuing tissue damage. This is where all those vegetables and fruits shine in addition to many nutrients and herbs. Two useful anti-oxidant supplements include liposomal glutathione and n-acetyl-cysteine (NAC).

On a side note, diabetes, obesity, coronary artery disease, cognitive decline, COPD and aging are all associated with low glutathione levels. These are also the co-morbidities associated with increased risk for severe COVID-19 infections. 

·      Anti-inflammatory herbs. Curcumin (an extract from turmeric) and Boswellia (frankincense) are excellent herbs to reduce inflammation.

·      Adaptogens to support energy. Herbs such as cordyceps, rhodiola, Siberian ginseng and licorice root are wonderful at supporting a return to normal energy and stamina.

·      Other items to consider: Balance an overactive clotting system with nattokinase. Ensure vitamin D3 levels are adequate. Ensure heart-supportive nutrients including taurine, CoQ10 and magnesium taurate.

·      Melatonin. Melatonin is a potent endogenous antioxidant, anti-inflammatory and immunomodulatory molecule.

·      Cordyceps. Cordyceps is a medicinal mushroom with a long tradition of use due to its antioxidant and anti-inflammatory action. It can increase exercise performance after 12 weeks of supplementation and reduce airway inflammation markers. Cordyceps is also supportive to the kidneys, which are often hit hard by COVID.

·      Breathing exercises. A variety of breathing techniques have been shown to be helpful for recovery, including diaphragmatic breathing, purse lipped breathing, yoga breathing relaxation techniques and pranayama, tai chi breath work, or singing. This can be a nice place to start before moving on to more rigorous exercise. You might start with 10 minutes daily. 

·      Exercise. Ease back into exercise. It is an important piece of the recovery process but should occur gradually. Avoid high-intensity exercise until fully recovered. Consider starting with one week of stretching and light exercise. The next week may include 10-15 minutes of moderate exercise 1-2 times per day on alternating days. You might walk or bike to the level that still allows you to breathe without difficulty or only minimal difficulty. Then, increase incrementally every few days to a maximum of 45 minutes per session.

·      Hydrotherapy. Try ending your hot shower with a splash of cold, or follow your sauna with a cool rinse. These are excellent ways to enhance immune health and boost mood.

·      Stress management. Support your body’s recovery by minimizing stress as best as possible. This may include connecting with nature, listening to nature sounds or calming music, having supportive and positive social interactions, finding a creative outlet such as painting or writing, or using aromatherapy with essential oils such as lavender.

·      Humidity. Interestingly, humidity levels can also impact our stress response and sleep quality, especially when levels are lower than 30% or higher than 60%. During the Alaska winter, most of us are dealing with low humidity and a humidifier may be needed to attain the optimal 40% humidity level in the home.

The Road to Recovery After Long-COVID

The journey back to optimal health may not be a straight path, but if we provide our bodies with the necessary support to heal, then wellness should be restored over time. Let us remind ourselves that our bodies have an innate wisdom and ability to heal.

Also remember that COVID-19 affects people and organ systems in different ways. Recovery is a unique process for everyone and an individualized approach is best. Your naturopathic doctor can guide you on your journey to discover what combination is right for you to restore your health. We have an experienced and compassionate team of naturopathic providers at Natural Health Center who would love to support you on your road to recovery; contact us to learn more or to schedule an appointment.

About Dr. Birgit Lenger, ND, Anchorage Naturopath

Dr. Birgit Lenger is a naturopathic physician in general family practice and welcomes patients of all backgrounds. As a naturopath, she enjoys caring for people in all stages of life, from infancy and adolescence through advanced age. She helps patients and families overcome obstacles to health, thrive and achieve lasting wellness. Learn more about Dr. Lenger or schedule your appointment.