Once a person has healed from Long COVID, the focus shifts to optimizing health and preventing recurrence.
Risk Factors
While Long COVID appears to be more prevalent in people with severe COVID-19 illness, anyone who had mild or no symptoms can experience persistent symptoms as well. Clinical evidence points to a person’s prior immune system function, inflammation levels, toxin load and infection load as potential risk factors; however, any otherwise “healthy” person, regardless of vaccine status, can develop Long COVID. This likely occurs because the infection can tip the scale, bringing occult disease into the light and/or lowers a person’s susceptibility to another disease process.
Common Symptoms
Long COVID symptoms often occur in clusters, overlap with each other and can involve multiple organ systems. Symptoms also may fluctuate or relapse over time. The main symptoms include fatigue, muscle weakness, brain fog, insomnia, headaches, migraines, difficulty breathing, cough, chest pain, heart palpitations, tachycardia, bloating, nausea, diarrhea, stomach pain, anxiety, depression, neuropathy, loss of smell/taste, tinnitus, lightheadedness, joint pain, rashes, changes in menstrual cycles and thyroid disorders.
Potential Causes
The pathophysiology is similar to other chronic, complex illnesses such as Chronic Fatigue Syndrome, Mast Cell Activation Syndrome, Mold Illness and Lyme Disease. The cause is often multifactorial and each of these causes should be considered:
- Persistence of inflammation and immune system dysregulation.
- Impaired mitochondrial and metabolic activity.
- Autonomic nervous system and endocrine system dysfunction.
- Viral-induced autoimmunity.
- Secondary and/or reactivated infections such as EBV, Mycoplasma and Lyme Disease.
- Alterations of gut microbiome leading to dysbiosis, IBS and leaky gut.
- Microcirculatory and endothelial cell damage causing fibrosis, hypercoagulation, low oxygen levels and scarring.
- Tissue damage to the heart, lungs, brain, kidneys and/or muscle tissue.
- Hidden reservoirs of the virus in the sinuses, brain stem and gut.
Initial Work-Up
Initial work-up involves gathering a thorough patient history, physical exam and testing to rule out other conditions and identify impaired organ systems. Bloodwork often includes CBC, CMP, vitamin D25OH, fibrinogen, d-dimer, hsCRP, AM cortisol, thyroid panel, sex hormones, HbA1c, ferritin, iron studies, auto-immune testing, and co-infection testing. Specialized testing may include stool analysis, tick-borne diseases panel, mycotoxin testing, heavy metal testing, food sensitivity testing, genetic testing, and so forth. Work-up often includes referrals to specialists for evaluation and imaging (chest X-ray, EKG, pulmonary testing, etc.).
Treatment Overview
It’s important every person receives an individualized treatment plan focused on addressing their specific root cause(s). Integrative medicine shines in its ability to combine the best of naturopathic, conventional, cutting-edge and traditional therapies to help a person feel better faster. It’s also vital to optimize nutrition, detoxification, sleep, exercise and mental/emotional health, so a person experiences a deeper healing response.
Most Promising Treatment Ideas
- IV therapy – Enhanced Myers Cocktail, NAD, ozone, EGCG, and resveratrol.
- Hyperbaric oxygen therapy (HBOT) to promote oxygen diffusion and tissue regeneration.
- Immune function supports – vitamins D3/A/C/E, zinc, selenium, Astragalus, Japanese knotweed, Chinese skullcap and medicinal mushrooms.
- Nasal and sinus therapies such as nebulizing NAC, colloidal silver/EDTA nasal sprays and essential oil steam inhalations.
- Compounded medications – hormone replacement therapy, LDN, Methylene Blue and Alinia.
- Cardiovascular supports – hawthorne, bilberry, horse chestnut, ginkgo and garlic.
- Gut healing – probiotics, Saccharomyces b., L-glutamine, slippery elm and marshmallow root.
- Anti-inflammatories – fish oil, curcumin, Boswellia and Pycnogenol.
- Peptide therapies to re-regulate biochemical pathways – BPC-157, LL-37 and TA-1.
Health Optimization is the Best Prevention
Once a person has healed from Long COVID, the focus shifts to optimizing health and preventing recurrence. The goal is to not only return to normal work and social activities, but to thrive in a healthier and more resilient body. Start by writing a list of short- and long-term health goals. Then, work with your health care provider to make a plan going forward. COVID-19 is likely here to stay, so let’s all be even stronger the next time we face it! FBN
By Paul M. Despres, NMD
Dr. Paul M. Despres is a licensed naturopathic physician and newest member of the Aspen Integrative Medical (AIM) Center medical team. Dr. Despres specializes in acute care and complex chronic disease such as Long COVID, Lyme disease, Mold Illness, gastrointestinal disorders and environmental toxicity. For additional information or to schedule an appointment, please visit aspenmedcenter.com or call 928-213-5828.
