Recovery from Long Covid and Co-Infections
The Covid pandemic has certainly succeeded in turning the spotlight onto the condition known as ‘post-viral fatigue.' Prior to Covid, post-viral fatigue tended to be dismissed by many health professionals, at best with a recommendation to go to the gym (unfortunately people feel too tired to exercise) or at worst, “you must be depressed, dear, so just take an antidepressant.”
In the last Newsletter, I explained that Long Covid can be a mixture of the recent virus plus reactivation of previously dormant infections like Epstein Barr Virus, shingles and Coxsackievirus. The latter is the Number One virus in the world - and in my opinion - the real pandemic.
Post-viral Fatigue
What are some of the common symptoms of post-viral fatigue?
Tired all the time - energy demands outweigh delivery.
Brain fog with impaired ability to think.
Muscle weakness, aches and pains unrelieved by rest.
Dizziness
Poor exercise tolerance - pushing yourself one day can floor you the next.
Intolerance of temperature changes.
Loss of libido.
The above symptoms are common to many of the infections that keep popping up in the post Covid era - Coxsackievirus, Epstein Barr virus, shingles, other herpes viruses, Cytomeglovirus and even Lyme, which can remain dormant for years following transmission from an insect bite.
Approach to Post-Viral Fatigue
So what can you do if you have Long Covid or post-viral fatigue?
The first thing I do with people in my clinic is take a thorough case history (around two hours to get all the information we need). This is like a detective story filled with clues that tell me what has led up to the unwanted condition (90% of clues come from the history; 10% from observation and lab results). “Just listen to your patient, he is telling you the diagnosis.” (Sir William Osler, Canadian physician 1849-1929). We then get a good idea on what the likely issues are. The stable datum is if you don’t address the root causes of a condition, it will keep coming back, no matter what the treatments.
The second step is carrying out appropriate lab tests which may confirm or refute the hypothesis. I like to include a full blood count plus special analysis of the immune cells that fight viruses and bacteria, iron metabolism (this gets affected by Covid and co-infections), any infections we are suspicious about i.e. Coxsackievirus ( 98% of people tested have been positive for this in the last few years), Epstein Barr Virus, shingles, strep, other herpes infections, Lyme etc. We pick the most obvious from the case history detective work. These are the priorities. There may be other obvious tests to do as well. For example, thyroid, adrenal hormones and digestive function.
Once the lab results and case history are in place, I can piece together the various pieces of the immune map and construct a sensible recovery plan. The ultimate test is does the person get better?
The Recovery Plan
What does it take to get better from Long Covid/post- viral fatigue? What tools should be on a recovery plan? It is not as simple as taking a pill and you’ll be as right as rain. You may have to change a number of things, including lifestyle factors, in order to move away from the ditch and back to optimal health. You may have been close to the ditch for some time and it took Covid or another bug to push you over the edge. To reverse a bad situation, you need to address all the factors making you such a good host for chronic infections. Therefore, the recovery plan is not a ‘one-size-fits-all” protocol, but a series of steps tailored to your unique biochemical needs.
Factors to Address
How long does it take to get improvement? That depends on how successfully you adhere to the plan, how long you have been suffering and how many things you have to do. People don’t all start out on the same level playing field. Instead of the desired “magic pill” it may be far more appropriate to say, “Put on your seat belt and buckle up for a ride that may take some months.” That way people are less likely to turn around and say,” I’ve been doing this a week and I’m not better yet. Maybe I should go and do yoga instead?” In general, however, I look for some initial improvement to occur within three months.
Overview of Recovery Basics
Having said that, here is an overview of some recovery basics that will give you an idea of what it actually takes to tackle post-viral fatigue:
Optimise your diet - Many people think they are eating a wonderful diet. Yet, when we examine it, it is an utter disaster, choc full of sugars, high fructose corn syrup, gluten and cows’ dairy - all the things that make bug and virus heaven. Willingness to ditch inflammatory foods and drinks and to embrace nutrient-dense health-promoting foods is a must for regaining health. People fail to the degree that they cannot stay away from unhealthy, addictive foods and drinks. Tip: fasting or starvation diets are definitely not a part of the plan. Most people I see are undernourished!
Balance your immune system - Your lab results help construct the immune roadmap that helps you navigate your way out of the mess. A typical scenario is a chronic immune suppression picture where the immune army that should be fighting viral and bacterial infections has lost many of its troops and allowing the bugs to have a field day. At the same time, this makes allergic reactions and hollow space infections (those in gut, sinuses, bladder etc.) worse, adding to the immune imbalance. There is big difference between balancing and boosting your immune system. The latter may be entirely the wrong thing to do and send you into a tailspin if you have an autoimmune condition (overactive response of the immune system attacking your own tissues). Using the right tools to address immune imbalance is a vital factor in the recovery equation.
Address infections directly - Antibiotics don’t address viral infections, therefore we need to use smarter, more robust tools to do this. Luckily we have a few of these from plant sources. We also need to address the reactivation of retroviruses that are part of our own DNA or have been acquired through life. The clinical goal is to make infections go to sleep so they are no longer causing the immune system a problem. Targeting retroviruses and making the body generally inhospitable to infections are vital tools for success.
Optimise sleep - Poor sleep can arise from chronic infections or may have been present for a long time, helping to trigger immune suppression and infection. Good quality sleep is as essential to immune function as food and drink. Whatever the sleep problems, these need to be addressed on an individual basis to help the immune system to get on top of infections.
Minimise wifi exposures - This is the elephant in the room! There are many wifi sources in the home (wifi router, cordless phones, smart meter etc.) that seriously undermine your health and make recovery from chronic infections more difficult. Wifi radiation makes infections more active! Scientic studies estimate that a five minute phone call with the mobile pressed to the ear, is capable of keeping Epstein Barr Virus active for five years! Working out ways to reduce wifi exposure is definitely a part of long-term recovery strategy.
Address iron metabolism problems - It is now apparent that Covid and other infections can disrupt iron metabolism. There is such a thing as the anaemia of chronic infection or inflammation. Any anaemia will increase inflammation and drive infection. However, it is not simply a question of popping an iron pill. Repleting iron drives a process known as the Fenton reaction which drives oxidative stress. So, addressing anaemia requires a smarter approach to get the job done and protect tissues at the same time. Additionally, iron overload or iron build-up in the wrong tissues is just as much of an inflammatory issue and needs to be spotted and addressed. A type of iron overload - hereditary haemochromatosis - is quite common (around 10% of the population) and should be looked for with any chronic condition. Neglect of this condition can mean a life threatening situation. It is shocking how often basic iron metabolism labs have been neglected. Since Covid, I have recommended every new person to do these simple inexpensive tests.
Address dental infections/toxins - This is another elephant in the room (if we are allowed to have two!). Quite simply, you cannot make a lasting immune recovery from chronic infections if you have a toxic tap leaking mercury (from fillings) into your body every time you eat, drink and clean your teeth. Similarly, the infections and toxins that live in all root fillings and unhealed dental extraction sites can overwhelm the immune system to the point that it can no longer mount an adequate defence against other invaders. The internal environment can become so polluted that previously dormant infections now bloom. Attending to chronic dental infections with a Biological dentist trained to deal with the above issues can be a critical turning point in recovery as it now gives the immune system a fighting chance to see off the bugs!
Address tonsil infections - The tonsils are known as the “toilet of the body” because waste products from the brain’s nighttime housekeeping functions drain down through this area into the lymphatic system. If the tonsils are chronically infected or inflamed, drainage cannot occur effectively and toxins are backed up into the brain. In some people, surgical tonsil clean-up with an infection-literate Ear Nose and Throat surgeon can help reduce the brain inflammation which is the hallmark of so many viruses and other infections.
Reduce stress - Chronic stress of the unpleasant kind (where we feel less causative) raises the stress hormone cortisol which suppresses the immune cells that fight viruses and bacterial infections. Thus, stress allows infections to bloom! I include physical stressors (infections, toxins, food inflammation, wifi etc.) as well as spiritual stressors (conflicts with others, debts, the stresses inherent in society etc.). This also includes one’s attitude and approach to post-viral fatigue. If you have what is known as a “victim mind-set” i.e. blaming others for your condition, seeing no way out for yourself, it will be hard to be victorious, as the saying goes. Even if you feel like crap, it is important to get outside of yourself, perhaps take a short walk in Nature, do something for somebody else (no matter how small). There are also ways to reduce stress levels with magnesium, adrenal support and adaptogenic herbs.
Liver/gallbladder support - The liver/gallbladder/intestine route is also the way out of the body for Covid, viruses and other infections. Many people’s bile ducts are clogged with sludge which makes this difficult. Supporting your gallbladder and liver starts with your diet and raising your ability to detoxify. It does not start with drastic starvation measures or gallbladder/liver flushes which demand much more energy than you may have at present. As with any strategy, you need to start low and slow, dipping a toe into the waters and seeing the effect. This is very different from provoking detox or Herxheimer reactions which knock back your progress considerably and are a sign you have overdone things.
Support energy delivery mechanisms of the body (adrenals and thyroid) - The thyroid gland is very sensitive to all kinds of things and it certainly doesn’t take much to knock it off balance. A full thyroid panel is essential to see where the energy delivery mechanism may be affected. This is only available privately now. For example, the inflammation caused by chronic infections can slow down the conversion of T4 hormone to the more active T3 hormone, giving the symptoms of an under-active thyroid i.e. chronic fatigue. An under-active thyroid affects every cell in your body, including your immune cells. Adrenal dysfunction should be addressed prior to thyroid function to achieve the best results.
Collateral damage/co-conditions - These could be things like nutrient deficiencies, insulin resistance, diabetes, fatty liver, high blood pressure, low blood pressure, mould exposure, kidney dysfunction, Ehlers-Danlos syndrome (connective tissue disorders), musculoskeletal issues (cranio-cervical syndrome), mast cell activation, excess histamine and many others. You find what you find on a case and if they are affecting the person, they need to be addressed too. Fortunately, many of the tools above go along way to improving a lot of things.
Mystery versus Complexity
So, the take-home message is that there may be a lot to do, however, there is a big difference between mystery and complexity. Mystery means we don’t know what’s going on and we don’t know what to do. That is truly demoralising. On the other hand, if we say - yes, there is some complexity - you have these chronic infections and an imbalanced immune system which are causing a load of other problems that we can see but we have an immune roadmap and can help you navigate your way out, that opens the door to recovery. It may not be the easy route you were hoping for but it is a route out. And it is my job to take care of the complexity while you do the steps.
If you would like help with Long Covid or post-viral fatigue in general, please email the Good Health Clinic on goodhealthclinic@outlook.com or ring on 07836 552936.