I’m meeting more and more people who are experiencing symptoms of Long COVID. That isn’t surprising since the Office of National Statistics estimates that 1.5 million people in the UK are experiencing long COVID, and that might well be an under-estimate as many people haven’t been to their GPs to discuss their symptoms. A study in 2021 of 185 randomly selected COVID patients found that 30% were suffering long COVID.
Long COVID is classified by the NHS as:
Ongoing COVIS symptoms for more than 4 weeks, or
Post-COVID syndrome - symptoms that continue for more than 12 weeks and cannot be explained by any other condition.
It is this second group that is more common. Symptoms are wide ranging but can include fatigue, shortness of breath, loss of taste and smell, brain fog or difficulty concentrating, insomnia, nausea or loss of appetite, joint pain, depression and anxiety, heart palpitations, and dizziness. If you are experiencing any of these symptoms for more than four weeks you should contact your GP. The cause of some symptoms can be identified and treated, but for many people with ‘medically unexplained long COVID’ there is little the NHS can do to help.
There are serval theories as to why COVID symptoms persist.
Persistent reservoirs of COVID virus in cells, or small fragments of the virus particles that keep the immune system activated although the disease has passed.
Issues with blood clotting. Increased blood clotting markers have been associated with shortness of breath, fatigue and reduced exercise tolerance.
Re-activation of neurotropic pathogens, for example the herpes virus and Epstein Barr virus (EBV). These viruses ‘hide’ from our immune system in nerve cells and become active when the body is under stress, think of how cold sores appear when you are run down or in a stressful situation. A study in 2021 found that 67% of long COVID sufferers tested positive for Epstein Barr virus.
Several studies have shown that the brain stem can be affected by COVID. This area of the brain controls many of the functions that can be disrupted in long COVID, including nausea and vomiting, pain sensitivity, heart rate, blood pressure and breathing.
Dysbiosis. When our immune systems are under stress this affects our micrombiome, and it has now been seen that COVID not only disrupts the microbiome but also the virome (symbiotic or beneficial viruses living with our bodies) in the gut, urinary tract, pancreas, lings, and oral cavity. There is also evidence that people with pre-existing dysbiosis are more likely to suffer long term effects of COVID.
Increased permeability of epithelial barriers allowing pathogens into the blood stream, leading to inflammation, increased blood clotting and possibly disturbance to the immune system.
Increased histamine production.
Autoimmunity. Many common viruses can trigger autoimmunity, including herpes and EBV. COVID can act in the same way. Autoimmune conditions include rheumatoid arthritis, coeliac disease, multiple sclerosis, Hashimoto’s thyroiditis, lupus and Type 1 diabetes.
Mitochondrial dysfunction. Mitochondria are tiny ‘power packs’ in our cells that produce energy. There are similarities between long COVID and Chronic Fatigue Syndrome, which is considered to be related to mitochondrial dysfunction.
The good news is that nutritional therapy can help. If you are experiencing symptoms of long COVID get in touch with me (anne@acnutrition.co.uk) for an informal chat about your symptoms and what we can do to help you.
There are also plenty of things you do yourself.
Sleep – it is important, especially when your body is under stress. Our bodies heal and repair themselves while asleep. Aim for at least 7-8 hours of good quality sleep per night (see my advice on better sleep).
Avoid or reduce consumption of foods that promote inflammation – such as sugary snacks and drinks, processed foods, red meat, processed meats, white bread, refined carbohydrates such as white rice and pasta, fried foods and alcohol.
Include lots of antioxidants in your diet – from fresh fruit and vegetables. Aim for at least 7 portions of fresh fruit and vegetables per day. Aim for a mixture of different types and colours. This will have the added benefit of improving your microbiome by feeding the good bacteria.
Include omega 3 fatty acids – from oily fish (salmon, sardines, anchovies, herring and mackerel), seed such as chia, hemp and flax, walnuts, green leafy vegetables and algae. Omega 3 reduces inflammation and improves cell membrane function.
If you think histamine may be an issue for you adopt a low histamine diet.
Stay well hydrated – drink at least 1.5l of non-caffeinated drinks per day, for example water and herbal teas. Some teas are particularly good at reducing inflammation such as green tea, ginger tea, rose petal tea, turmeric tea, cinnamon tea and liquorice.
Consider taking a vitamin D supplement – a minimum of 1000iu per day for everyone is recommended unless you spend a lot of time outdoors.
If you are suffering fatigue, especially if you take a statin, then consider taking a good quality CoQ10 supplement to support your mitochondria.
And most of all be kind to yourself, your body is under stress. Exercise, but don’t overdo it and if you feel tired then rest.
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