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We are three years into COVID-19 and its not over.

At least sixty-five million people around the world have chronic health issues from a COVID infection and /or COVID vaccinations.  Long COVID is a multi-systemic condition with sometimes severe life altering symptoms ranging from disabling fatigue, brain fog, sleep issues, abnormalities in maintaining blood pressure (POTS/Dysautonomia) histamine issues, abnormal clotting, gastrointestinal problems, to name a few.

Not everyone with Long COVID had a serious infection. Many had a mild case of COVID that did not require hospitalization and not everyone is an adult. Children can be affected as well, especially teenagers.

This is a complex disorder resembling myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and other post infectious syndromes.

A lot is not known yet about these chronic conditions. There are likely a number of overlapping causes of Long COVID. There are frequently immune alterations, elevated levels of autoantibodies (immune cells targeting your own body tissues), elevated titers of reactivated viruses (such as EBV, which causes mononucleosis), increased inflammation, changes in the gut microbiome and autonomic dysregulation causing exercise intolerance, heart racing, feelings like you might pass out.

Some of the most challenging symptoms are neurocognitive – meaning there maybe memory loss, weird sensations, loss of balance, ringing in the ears and a loss in the ability to think clearly. These maybe coupled with increased feelings of anxiety and depression. In fact, there is an increase in Alzheimer’s type of symptoms in some people with long COVID.

There are a lot of unknowns about treating long COVID. Some people gradually improve over time. Many people are symptomatic a year later.

The National Institute of Health is doing a study on treatment of long COVID using Paxlovid and other treatments. More information can be found at their website:

Since there is such widespread dysregulation of the bodily systems, treatment, in my opinion, requires a systemic approach including diet, gentle slow exercise, adequate sleep, addressing the inflammation and immune system along with individual supportive care, depending on their symptoms.

Some promising treatments include probiotics to help gut microbiome restoration; pycnogenol, which is a natural antioxidant from pine bark, which reduces inflammation, low dose naltrexone (a compounded medication that is used off label for pain and autoimmune conditions); antiviral herbs and medications. POTS symptoms can sometimes be reduced by adding salt to your water and wearing compression stockings. I’ve used a number of these above protocols and often add in mitochondrial support to help the body make energy more efficiently again.

Like chronic fatigue syndrome (ME/CFS) or post treatment Lyme syndrome, long COVID takes time to heal. So far, there is no magic pill. If you are suffering from it, pace yourself. Treat it like a pilgrimage. Give your body the tools it needs to heal. Get help. And know that you are not alone.


By: Dr. Jennifer Means ND, LAc

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