As we wind our way through the uncertainties and stressful times of recurring COVID-19 variant spikes, one thing is consistently being reported: some folks are just not getting better after their bodies dealt with an acute COVID infection. These people are tired, complain of brain fog and depression, and often have lingering issues with joint aches and muscle and nerve pain.

So, what’s going on? Why do most folks recover completely after a COVID infection while some continue to struggle?

The Centers for Disease Control defines such post-COVID-19 conditions as ongoing or new symptoms occurring a month or more after a COVID-19 infection. It is estimated that between 10% and 30% of people who had COVID-19 may experience Long COVID. If you do some internet research, you will quickly find there are no confirmed causes or reasons for Long COVID but many theories. Here are two of the most common ones:

 

  1. Most experts agree that the cause of Long COVID is related to persistent, widespread inflammation and likely a limited auto-immune reaction. 
  2. Many chronic inflammatory processes that are viral will frequently be exacerbated and prolonged by coexisting viruses that may have been kept in check by the immune system before the COVID infection. A recent study published in the journal Cell reported reactivation of an Epstein-Barr virus, or EBV, that causes infectious mononucleosis. Other chronic viral infections that can be reactivated by COVID include cytomegalovirus (CMV) and herpes simplex viruses (HSV). 

 

Unfortunately, the current mainstream treatment options have significant limitations. According to a February 2022 article in Becker’s Hospital Review, 66 hospitals nationwide have launched Long COVID support programs. When you look at these programs, they all leave much to be desired. 

Many will only see patients remotely, most likely just adding to the patients’ anxiety. All have a team of conventional medical specialists that may include a pulmonologist, rheumatologist, infectious disease specialist, neurologist, and kidney specialist. These doctors are trained to simply look at potential organ injury and then attempt to treat it. None look at the root cause of why those organs may have been adversely affected in the first place. The treatments therefore will at best relieve specific symptoms temporarily but will in many cases exacerbate the underlying issues. In many ways, this approach by conventional medical specialists resembles the classic parable of blind men surrounding an elephant and attempting to identify it by feeling it. Each one reaches out to feel a part of the elephant and interprets it as something else, and none of them has the total picture of the elephant. 

 

The Integrative Approach

Rather than focusing on Long COVID individual manifestations in various organs and tissues, integrative medicine looks for a root cause or causes of this syndrome and then tries to fix and eliminate them. On the most basic level, most of the syndrome’s issues come from injured mitochondria. Furthermore, it is highly likely that these people’s mitochondria were already in a weakened state and that COVID significantly amplified the problem, throwing the infected person into a downward spiral. As these organelles are responsible for making energy, when they become ineffective, the ramifications are far-ranging. The body becomes unable to clear inflammation, the immune system becomes dysregulated, and there is not enough energy for normal brain function, leading to both brain fog and depression. 

For us to be able to offer productive and effective treatments for this condition, however, we need to go deeper and understand what is driving this mitochondrial disfunction. 

 

Root Causes of Mitochondrial Disfunction: 

  1. Chronic viral and bacterial infections often leave mitochondrial damage in their wake. The previously mentioned viruses such as EBV, CMV, and HSV all leave their marks on the cells. They can also hide in the body, coming out of dormancy or being reactivated when the immune system is down and cells are under a high level of stress. Chronic bacterial infections will do the same, with Lyme Disease infections being the best example. Because these infections typically remain with us for a lifetime, they cause our immune system to be always on high alert. This state will often trigger an overreaction and an attack on the person’s own body by its own immune system when it is exposed to additional infections. This is a state we call autoimmunity.
  2. Toxins are notorious for disrupting mitochondrial function. These range from industrial pollutants, such as heavy metals in our environment, to mold in our home if it was been water damaged, to pesticides and herbicides in our foods. In these cases, genetic predisposition to various toxins is key to determining whether exposure will actually make a person ill. As with chronic infections, the person is frequently exposed to these toxins long before having been infected with COVID, thus making the person susceptible to poor recovery and developing Long COVID syndrome. All toxins also disrupt gut function, creating a “leakiness” that allows for other toxins carried in our foods to cross into the bloodstream, exacerbating the autoimmune and inflammatory response seen in this syndrome.
  3. Chronic illness and inflammation. Chronic inflammatory illness is by definition a mitochondrial disfunction. Conditions such as diabetes and rheumatoid arthritis cause mitochondrial damage that manifests in a multitude of symptoms, ranging from fatigue to joint pain to neuropathy. An acute COVID infection simply further damages the already weakened mitochondria, making it more difficult for the body to recover.
     
  4. CIRS, or chronic inflammatory response syndrome, is now becoming recognized as a common and yet undiagnosed cause of chronic fatigue, inflammation, and autoimmunity. This condition is most commonly created by the first two root causes mentioned above, infections and toxins. When genetic signatures of Long COVID patients were compared to those of CIRS patients, they were found to be identical. This revelation is in large part responsible for the understanding that not only is Long COVID a mitochondrial condition but that, most likely, patients with this syndrome had underlying CIRS before their COVID infections. 

 

An Integrative Approach to Long COVID Treatment: 

  1. First and foremost, remove the triggers! If there is ongoing exposure to infections or toxins, the cycle of inflammation and mitochondrial disfunction will be endless. For example, if mold spores are triggering mitochondrial disfunction, then the house must be remediated. If it’s exposure to heavy metals, then they need to be chelated out of the body. If there is a concomitant acute infection, it must be treated. 
  2. Reduce inflammation by repleting antioxidant vitamins and minerals. Good mitochondrial function is essential to fighting off inflammatory particles called reactive oxidative species, or ROS. Multiple vitamins and minerals such as vitamins C and B, zinc, and selenium are depleted during prolonged exposure to stress. Once depleted, their absence further reduces mitochondrial function and allows for an increase in inflammation. Repletion frequently is necessary by intravenous methods, as gut absorption of essential antioxidants in most Long COVID patients is poor.
  3. Directly support mitochondrial function. Integrative medical techniques include repletion of the energy cycle’s co-factors, such as NAD (nicotinamide adenine dinucleotide), and increased ketone production with a ketogenic diet, ketone ester supplementation, and elimination of carbohydrates.
  4. Eliminate gluten. Gluten has been shown to be a major gut-lining disruptor, creating a leaky gut condition. It is, therefore, an independent cause of inflammation and has far-ranging manifestations, such as mood disorders, autoimmune inflammatory joint disease, and neuropathy.
  5. Offer treatments that directly reduce inflammation by activating innate anti-inflammatory and energy-producing pathways. The most prominent treatment here is intravenous ozone, also known as major autohemotherapy, thus named for its potent effects on autoimmunity and inflammation. A new treatment, ozone dialysis, or EBOO (extracorporeal blood oxygenation and ozonation), takes this concept even further. During EBOO treatment, the blood is ozonated as it is run through a filter before being returned to the patient. This process not only improves the cell’s oxygen and energy production status but simultaneously traps and eliminates a significant amount of inflammatory particles circulating through the body.
  6. Increase the body’s protective immune side. By doing so, many reactivated co-infections can be brought back in check. Integrative medicine uses special peptides such as thymosin alpha and thymosin beta to accomplish this in addition to the previously mentioned EBOO. 

I hope you will agree that simply “supporting” a person through a Long COVID illness with group therapy, antidepressants, and traditional prescription medicines that are designed to treat organ injury is just not enough and will rarely lead to any significant impact on this debilitating condition. 

It is only by identifying the underlying root causes of Long COVID and treating and eliminating them that we will be able to help sufferers. At OWM Integrative Wellness, we prescribe and utilize this approach.

 

For more information, please visit: Long Haul Covid Management by OWM