Long Covid is a neurological issue
I see a steady stream of people in my clinic whose health has worsened since the start of the Covid pandemic in 2020. In a lecture given to the Academy of Nutritional Medicine last month, Professor John Lambert, Consultant in Infectious Diseases and Genitourinary Medicine at the Mater University Hospital, Dublin, outlined the main findings he has observed for the post-Covid health decline in the last three years. This Newsletter comments on these findings.
What is Long Covid?
A working definition of Post Covid or Long Covid is ‘still being sick three months after having the virus.’ The syndrome can be difficult to diagnose due to the variety of symptoms it produces. This is because the virus attacks multiple organ systems. There is no one magic biomarker. Therefore, a multi-systems approach is needed.
The most common symptoms include: fatigue, brain fog, cognitive deficits such as difficulty finding the right word, migrating aches and pains, central nervous system symptoms, gastrointestinal symptoms, loss of smell/taste, increased anxiety and depression, poor exercise tolerance, shortness of breath, palpitations, night sweats, hair loss and more. Dysfunction varies from struggling to do a day’s work and collapsing with fatigue at the end of the day to being bedridden.
Who gets Long Covid?
Not only those who have been hospitalised but also people with pre-existing inflammatory conditions like diabetes, chronic infections, being overweight etc. Also those who live in poverty with poor access to nutritious foods.
Long Covid - a physical illness
Professor Lambert outlined the similarities of Long Covid with chronic fatigue syndrome, M.E. and post-Lyme syndrome. And just like chronic fatigue, M.E. and Lyme, patients are being misunderstood by their doctors and wrongly steered towards the psychiatric waste basket. Many people feel devastated from having gone from healthy productive lives to now living a half life. Therefore, to be told that they are making up their illness just adds insult to injury.
Professor Lambert was quite clear; Long Covid is a physical, neuro-inflammatory condition, not a psychiatric one. Psychiatric drugs worsen brain inflammation. Scientific studies over the last three years adequately demonstrates that (e.g. see Yong et al., 2021) Persistent brain stem dysfunction in Long Covid and (Sutherland, 14th Feb., 2023) Long Covid Now Looks Like a Neurological Disease: Helping Doctors to Focus Treatments. It is a real pity that this information is not yet filtering down to grass roots level. Therefore, the more knowledge patients have about the root causes of their conditions, the more they will be able to help themselves and access the right help and support.
What is happening in the body to produce the symptoms of Long Covid?
These are some of the key scientific findings:
Just because a CT scan is normal, it doesn’t mean that something isn’t going on in the brain. Pet scans of the brains of Long Covid patients show underperformance of the posterior parts of the brain. These are the areas that regulate balance control, pain, breathing, the sympathetic/parasympathetic (fight/flight) responses and the vagus nerve. An analogy of the collateral damage caused would be concussion from a rugby accident.
Covid attacks endothelial cells which line blood vessels. Reduced blood supply to the brain stem, cranial nerves and vagus nerve is what produces POTs (postural tachycardia syndrome). Symptoms include dizziness/fainting/lightheadedness and blood pressure dysregulation. Beta blockers can be a disaster if they lower blood pressure further. Blood clotting abnormalities are present with some patients.
Cranial nerve inflammation triggers vertigo, dizziness, balance, smell, taste, and tinnitus problems.
Inflammation of the respiratory centres at the back of the brain trigger breathing problems - not of the asthmatic variety, but air hunger. Therefore, breathing exercises may be more effective than inhalers.
Low exercise tolerance means a flat battery as seen in poor adrenal function. People get easily overwhelmed. Instead of ‘pushing’, the answer is to rest and pace to avoid crash and worsening symptoms.
Migrating joint and muscle pains are also triggered by an inflamed posterior part of the brain. The message is don’t go out and run marathon if you are on crutches.
Inflamed meninges can produce poor sleep patterns, vivid dreams and nightmares. Professor Lambert mentioned that melatonin used in head trauma produces no further collateral damage and may be effective.
Covid triggers viral reactivation i.e. the waking up of previously dormant infections. We all carry a viral load depending on what we have been exposed to in our lifetime. An example of a virus waking up from a dormant state is the shingles reactivation of the chicken pox virus. Some of the most common post-Covid viral reactivations include the herpes viruses (Epstein Barr Virus (glandular fever), Varicella Zoster Virus (shingles), Cytomegalovirus (CMV)) and Coxsackievirus.
The lymphocyte count, which is part of the immune army that fights infections, is usually down and can be seen on blood tests.
Autoimmunity can be triggered or worsened by Long Covid. This is down to a mechanism known as molecular mimicry - when the immune system mistakes your tissues for something else like a virus or a toxin or food. Gastrointestinal symptoms are also common.
The solutions to Long Covid include:
Repair the immune system
Fight the infections
Reduce the inflammation
The first step is to do a thorough case history to look at the likely triggers for symptoms, to carry out the appropriate lab tests (not all of which are available on the NHS) and then to construct an immune roadmap to map the way out of the condition and away from the precipice.
If you would like help with any of the above issues, please contact the Good Health Clinic on goodhealthclinic@outlook.com to request a free 30 minute Enquiry Call or book an initial appointment.