We’re all familiar with the unpleasant side effects that come with getting sick. Whether it’s a cough, body aches, or unrelenting fatigue – we can all attest to the fact that being sick is no fun.
But what happens when those unpleasant symptoms linger for not only weeks but months? And what happens when those persisting symptoms send your body into a tailspin – causing serious and even life-threatening side effects?
This is the scary and unfortunate reality for a growing number of people who have contracted COVID-19, who have been dubbed COVID-19 “long-haulers.” Today we’re going to dive into exactly what it means to be a COVID long-hauler, the root cause of these lingering symptoms, and most importantly – how we can begin addressing the long-term effects of this virus.
Who Exactly Are COVID-19 Long-Haulers?
Covid-19 long-haulers is a term used to refer to individuals for whom COVID-19 is far more than a passing infection. You see, a growing number of people who have contracted the coronavirus continue to be slammed with a barrage of symptoms, long after the virus has supposedly been cleared. It’s estimated that anywhere from 50% to a whopping 80% of COVID patients are still struggling with lingering symptoms 3 or more months after their initial onset of COVID symptoms.1
So what exactly are these persisting symptoms that COVID-19 long-haulers are experiencing? Let’s take a look.
COVID-19 Long-Haulers Symptoms List
Some COVID-19 long-haulers may experience ongoing symptoms that are quite similar to many of the cardinal symptoms associated with this virus, such as:2
- Shortness of breath
- Tightness in the chest
- Ongoing fatigue
- Body aches
- Joint pain
- Loss of the sense of taste and smell
- Difficulty sleeping
- Brain fog
These nagging symptoms in and of themselves can be debilitating and significantly detract from your quality of life. But sometimes the lingering effects seen in long-haulers can be life-threatening.
Some long-hauler syndrome sufferers may end up with conditions like:3
- Heart damage – resulting in heart failure and other cardiac complications
- Lung damage – scarring to lung tissue and long-term respiratory problems
- Injury to the brain – such as Guillain-Barre syndrome, seizures, and strokes
- Advancements of neurological conditions – like Parkinson’s disease and Alzheimer’s disease
- Increased blood clotting – these tiny clots can block circulation to vital organs like your kidneys and liver and cause tissue damage
- Weakened blood vessels – resulting in leakage of blood and subsequent damage to tissues and organs
But how exactly can a viral infection lead to such a vast array of seemingly unrelated and potentially life-threatening long-term symptoms? Let’s investigate.
COVID-19 Long-Haulers: What’s the Underlying Cause?
While more research is needed to fully understand the exact underlying mechanism of how COVID-19 provokes these long-term effects, we do have an idea of how and why some individuals end up with these residual effects.
You see, a viral infection like COVID-19 can cause a massive shift in the homeostasis of your immune system – and subsequently your entire body. It goes something like this:4,5,6
- Viral latency: Once contracted, the virus can remain dormant in your body – eluding detection by your immune system and triggering low-level inflammation.
- Persistent production of immune mediators: When your immune system senses a threat that it can’t seem to identify, it stimulates the ongoing production of mediators that promote inflammation – further depleting your immune system and diminishing its ability to regulate itself.
- Decreased function of natural killer cells: Natural killer cells engulf and remove infected cells. As your immune system’s balance is pushed further and further out of whack, your natural killer cells’ function is depressed. This creates a vicious cycle of immune suppression and burn-out.
- T-cell interference: T-cells help to mediate the ramping up and down of inflammation. As your immune system’s homeostasis becomes imbalanced, your T-cells can become confused and continue pushing your immune system further off-kilter.
- Mitochondrial burn-out: As the virus hides out in your cells, it strategically manipulates the functions of your cells to better suit its own viral replication. In particular, the virus alters your multi-tasking mitochondria – your cellular machinery that influences cellular survival, energy production, metabolism, and immune signaling. So with the virus draining the mitochondria’s power, there’s little left for the cell itself to use – this leads to mitochondrial burn-out.
This combination leads to immunological dysfunction and mitochondrial deficits. This shift in balance can upend various processes within your body and subsequently lead to the array of symptoms seen in long-haulers.
COVID-19 Long-Haulers Treatment
So if the root cause of COVID-19 long-haulers’ symptoms is immune dysfunction and mitochondrial burn-out, how do we address it? Treating this requires a specific multipronged approach that includes all of the following:
Your gut and your immune system are intricately linked – and an imbalance in one undeniably leads to a dysfunction in the other. So restoring the health of your gut is crucial to bringing your immune system back into balance. To do this, I recommend following the 5-R program, which encompasses:
- Removal: It’s critical to remove anything that may negatively impact the environment of your gut such as common allergen foods, parasites, harmful bacteria, and/or yeast.
- Replacement: Your gut relies on digestive secretions for proper digestion, so it’s important to ensure you’re giving your body a boost of things like digestive enzymes, hydrochloric acid, and/or bile acids.
- Reinoculation: Beneficial bacteria play a monumental role in your gut health and your immune system. Reinoculating your gut with plenty of “good” bacteria will help rebalance your gut flora and strengthen the communication between your gut and immune system.
- Repair: If the integrity of the lining of your intestines is compromised, it can create a vicious cycle of further immune activation. So it’s important to give your gut the key nutrients it needs to repair itself like zinc, antioxidants, fatty acids, and glutamine.
- Rebalancing: Factors like quality and quantity of sleep, your stress levels, and the intensity of your exercise can all affect your digestive tract. So making intentional choices that support a happy healthy gut and immune system is key.
If you want to learn more about the 5-R program and how to implement it, click here to read my article on Restoring Digestive Health With the 5-R Program.
Detoxification is a key component of keeping your immune system running smoothly. And your liver is your detoxification powerhouse. Enhancing your liver’s ability to effectively process and eliminate toxins is a critical component of addressing the symptoms that COVID long-haulers are experiencing.
To bolster your liver detoxing capabilities, here’s what I recommend:
- Focus on an anti-inflammatory diet
- Limit alcohol intake
- Drink plenty of water
- Minimize exposure to toxins
- Take liver-supporting supplements like Liver Essentials and detox binders
To learn more about how you can best support healthy liver function, head over and read my article The Truth About Liver Detoxes: Do You Really Need One?
Bringing your mitochondria back to baseline functioning is critical in addressing the symptoms of COVID-19 long-haulers. To protect and bolster your mitochondrial biological energy production, I recommend implementing some specific lifestyle tweaks such as:
- Eating a well-balanced anti-inflammatory diet
- Prioritizing sleep, rest, and relaxation
- Minimizing your toxic burden
- Getting plenty of mitochondrial-boosting nutrients like B vitamins, coenzyme Q10, and Vitamin C
Making these simple nutritional and lifestyle tweaks can go a long way in supporting and resuscitating your mitochondrial function.
Your immune system has been injured post-viral infection, so it requires restoration and healing. You see, as your cells replicate themselves, they are essentially encoded with memories of the viral infection and “pass on” the message of inflammation. So it’s crucial to get rid of these old damaged cells and replace them with new cells that don’t hold onto these “bad memories.”
To do that, we need to enhance a process known as autophagy, which boosts cellular recycling and promotes the proliferation of new healthy cells. Some ways to enhance autophagy include:
- Getting plenty of specific immune-enhancing nutrients like Vitamin D and zinc
- Taking plant-derived phytonutrients and flavonoids that enhance autophagic mechanisms like quercetin, luteolin, and Himalayan buckwheat
- Incorporating intermittent fasting
- Ensuring you’re getting plenty of quality sleep
Enhancing autophagy is a key component of healing immune function. But truly rejuvenating your immune system requires a big-picture approach that focuses on the multitude of factors that contribute to your overall health.
Are You a COVID-19 Long-Hauler?
If you’ve had COVID and are concerned that you’re struggling with the residual effects of this viral infection, I cannot overemphasize the importance of partnering with an Integrative and Functional Medicine Doctor. While conventional medicine is incredible and has an undeniably important place in healthcare, the conventional medical model simply doesn’t hold the answer to addressing COVID-19 long haulers.
The functional medicine approach will address the “upstream” issue that is causing your “downstream” symptoms. Without addressing this underlying root cause, the lingering effects of a coronavirus infection can spiral into life-altering and even life-threatening symptoms. So seeking out the guidance of a practitioner that will treat the problem – not just the symptoms – is critical to begin the process of healing.
If you’re concerned about finding a qualified functional medicine practitioner you can trust, I suggest reading my article on How to Choose a Good Integrative and Functional Medicine Doctor. And if you’re looking for ways to implement healthy lifestyle changes, or simply want more information before seeking the guidance of a functional medicine doctor, I encourage you to head over and check out my blog. It’s full of information to help you prioritize your wellbeing, and will give you a better insight into the functional medicine approach.
Now it’s time to hear from you. Were you surprised to learn that COVID-19 can have such serious and long-lasting effects? If you’re struggling with lingering COVID-19 symptoms, what steps are you taking to fight back against this virus? Leave your question and thoughts in the comments below!
* These statements have not been evaluated by the Food and Drug Administration. The product mentioned in this article are not intended to diagnose, treat, cure, or prevent any disease. The information in this article is not intended to replace any recommendations or relationship with your physician. Please review references sited at end of article for scientific support of any claims made.
I am 8 months post covid. I was very ill for roughly 5 weeks. Symptoms waned for a few weeks then came back hard and have been getting worse since. I have a Dr who is chasing my symptoms frantically but it just seems like things are getting worse. I saw her today and she said my lungs are not moving any air and I sound like an end stage COPD patient. My headaches are daily, I cannot tolerate heat AT ALL ( especially hot showers). My joint pain in my knees is continuous and my shortness of breath and SVT are growing worse. I feel like my quality of life is completely gone. My newest issues that started about 2 months ago… insomnia. It is so bad there are nights I do not finally go to sleep until 4 or 5 am. As a nurse, this is not congruent for working safely. I know that there are very little answers but IF anything comes to light in the coming months, I would love to be included in it. This long haul is by far, worse than the initial disease. With COVID, you knew that eventually you would be negative. With this, I feel like it is a terminal sentance.
In a paper published May 7, 2020, in The Lancet, researchers Dennis McGonagle and others determined that covid-19 is not a respiratory disease, but rather “diffuse pulmonary intravascular coagulopathy,” a kind of blood clotting disorder that presents in lung tissue. This explains why patients with covid-19 are dying from hypoxia (lack of oxygen) and are frequently killed by the use of ventilators. Approaching it from a diffuse pulmonary angle may help, as well as some of these treatments below.
I received a newsletter from Dr. Lindsey Berkson on long hauler’s. She states, “Covid causes lung damage, or fibrosis, which can lead to scarring. High-dose taurine and niacinamide are helpful to reduce transforming growth factor beta1, that is the molecule that “drives” all this. Knowing what is going on at the molecular level is where I think health understanding and care is at.” She also mentions the Frontline Doctors using Ivermectin and melatonin.
Dr. David Brownstein, who has a clinic just outside of Detroit in case you’re near there, has successfully treated over a hundred patients with nebulized hydrogen peroxide and iodine. I also listened to an interview where he stated he was also using ozone therapy on some patients (maybe that would be you). He has published the results of his nebulizing work in a study that you can download here https://bit.ly/2YHLH8v
• Hydrogen peroxide sits inside and outside cells of your cells in low levels, ready and waiting to be generated in greater amounts as soon as a pathogen is detected by your immune system
• Nebulizing hydrogen peroxide into your sinuses, throat and lungs is a simple, straightforward way to augment your body’s natural expression of hydrogen peroxide to combat infections
• In addition to having direct viricidal effects, iodine improves white blood cell function and thyroid hormone production. This provides a metabolic boost to white blood cells to increase hydrogen peroxide antimicrobial properties which is one way your immune system works to kill pathogens
• Vitamin C also increases hydrogen peroxide production when used at high doses, while vitamin A helps modulate your immune system
• Buy a desktop nebulizer and stock food-grade hydrogen peroxide, Lugol’s iodine and some saline. That way, you have everything you need and can begin treatment at home at the first signs of a respiratory infection.
In other countries (Europe and Asia) I have read doctors using IV vitamin C (in clinic or hospital) and high dose vit C (at home) with great success. We’re talking 1,000-5,000 mg an hour, or up to bowel tolerance. Vit C is antiviral and anti-inflammatory. The Lancet study also found that inflammation triggers a worsening of the condition, which implies that anti-inflammatory interventions might be the key to saving lives and ending the pandemic. From the study, “The immune mechanism underlying diffuse alveolar and pulmonary interstitial inflammation in COVID-19 involves a MAS-like state that triggers extensive immunothrombosis…” MAS stands for Macrophage Activation Syndrome, and it is an inflammatory response stemming from an over-reactive immune response, similar to the “cytokine storm” that’s being widely discussed (which vitamin C helps prevent, according to published research).
Lastly, when Ecuador was severely plagued, integrative medicine researchers (Andreas Kalcker) claim a 100 percent recovery of all patients from covid-19 using chlorine dioxide (ClO2) intravenously. Chlorine dioxide reportedly floods the blood with oxygen, allowing patients to breathe again while disinfecting the blood and eliminating pathogens, according to researchers. Another clinical trial involving chlorine dioxide is currently under way, documented by the US National Library of Medicine at ClinicalTrials.gov. The study uses oral chlorine dioxide (rather than intravenous) and is titled, “Determination of the Effectiveness of Oral Chlorine Dioxide in the Treatment of COVID 19.” The trial is being conducted by the Genesis Foundation and involves 20 patients. The ClinicalTrials.gov identifier for that trial is NCT04343742.
I hope some of this will be helpful
Hi Stacie, I’m sorry to hear about your long-term symptoms post-covid. I have had a milder but similar experience (3 months now) and I wanted to share that high dosing of melatonin helped me. There are several articles and studies related to this available online. My doctor said that melatonin was safe so he wasn’t concerned, even if he didn’t believe that it was helping. It helped my shortness of breath, although it didn’t make it go entirely away, I can now go for long walks and go to work. I am slowly improving. I agree with Dr. Jill that functional medicine is a better approach to deal with long covid. I am a healthcare practitioner with training in functional nutrition, and having this as a tool literally saved my life.
My journey started in 1989, when a post-viral syndrome took me into ME/CFS. I’ve brought myself back to reasonable functionality over and over thanks to dietary and other lifestyle changes, but I have also relapsed when newly triggered (mold in my house in 2009, COVID-19 last year). I progressed past overt COVID symptoms (no more coughing, chest pain, shortness of breath) and am now experiencing POTS, symptoms suggestive of MCAS, and neck/neurological issues (sudden migratory stabbing pains in nail beds, weird smells, coat hanger pain, mood swings). I’ve overhauled my diet even further (I was already eating on dairy, gluten, or sugar) and now follow a low-histamine protocol. I’m meditating, deep breathing, taking long baths, sleeping 8-9 hours a night if I can get it. I’m taking a boatload of supplements, many of which you’ve recommended here, but I’m not on everything recommended here yet. My biggest problem is the POTS – I can’t sit or stand for more than 15 minutes at a time without severe flare and payback for days. I do okay lying down – I’ve got my laptop on my thighs as I type this, and I’m lucky I’m a writer/book editor and can work with my clients this way. But it would sure be nice to have more time on my feet or even sitting up. Living life in 15-minute snatches is hard and depressing.
Could you please address the differences in needs of those with either depleted or over-active Phase One liver detoxification, and those who have depleted or over-active Phase Two liver detoxification? Balancing the two pathways is vital, and for some it is a crucial need.
This article at EI Resource gives some good beginning information:
Here is a post discussing a detoxification profile:
And a post on food and supplements for helping the different phases:
Could you please elaborate on this? Many, many people have severe, chronic symptoms due to environmental contaminants, and their symptoms are not resolved by “one size fits all” solutions.
Thank you very much.
Yes, couldn’t agree more! These cases need personalized treatment plans – there is no one-size-fits all
I think it would be helpful to know what treatment the patient was given and the number of days it was given after the infection. It would seem that earlier treatment would lessen the viral load. Blessings for an early treatment for anyone who gets this.
Great article Dr. Jill. I had it back in July and can definitely attest to what others are saying in regards to fatigue, dizziness, POTS, and mast cell issues.
After working on mold, lyme, and co-infections I was significantly better, and then CV hit and I took a leap backwards.
Stephen Buhner has a great protocol that I’ve implemented personally and clinically and the nebulizer with thernaturals glutathione has been a game changer. I’ve had several clients avoid going into the ICU just using that. One client of mine reported 98% improvement in her shortness of breath after just two sessions of the glutathione and nebulizer protocol. It’s important that anyone reading this uses the version with the sodium bicarbonate added and it’s mixed with 2ml of saline.
Jill, we should do podcasts together? We met at mindshare years ago. Hang in there everyone!
Thanks so much for your comments!
So appreciate your wisdom,
I am four months post Covid and a long hauler. Thankfully I was never hospitalized but now I am a teacher who can’t teach and a singer who can’t sing. The after effects of this disease are devastating. Four rounds of antibiotics for post viral infections and now I am on my third round of prednisone to battle the ongoing inflammation and breathing issues. Headaches and fatigue dictate my everyday activities. I can’t work or even clean my own house. My family has had to pick up a lot of the slack for me. That being said, I believe that my functional medicine doctor saved me from so much worse. A year and a half ago I had my first evaluation with him and he discovered Vitamin D deficiencies. With his help and regular bloodwork done, I ramped up to 10,000 Vitamin D a day to keep me on the high end of normal. If I had not had that in my system when I got Covid, I have no doubt that my story would be far different. I am very blessed to have a General Practitioner who is integrative and a Functional Medicine Doctor who are helping me with diet and supplements to manage my symptoms. For those who think this virus is not a big deal, it is. There are those who have died but there are even more that are living months and now even a year with the debilitating post viral affects. I am hopeful with a supportive family, functional medicine, and integrative medicine doctor…and lots of prayer, that my story will turn around. Thanks for writing this blog and drawing attention to this growing problem.
I had Covid a little over a month ago and I’ve been dealing with the after affects ever since. I’ve been noticing lately that I’m beginning to feel like I’m getting sick again, and it’s happening right after I finally got rid of the cough. I’m exhausted all of the time and am noticing that as tired as I am, my sleep is awful!! I barely sleep at all. I just feel awful- worse than when I had Covid, and I had it the worst in my family. What are my options to start feeling better?
That’s why I wrote the article, Kelly! Please see tips above
I agree with Dr. Jill and her recommendations. Also, consider getting the book, A Holistic Approach to Viruses by Dr. David Brownstein, MD. Consider evaluation of your toxic metal body burden.
A functional approach is one of the greatest weapons in addressing long haulers.
There is a suspected relationship between long Covid and MCAS. https://www.drtaniadempsey.com/post/mast-cell-activation-syndrome-mcas-covid-19-coronavirus