Recommendations for Long-Hauler Syndrome

If you are experiencing symptoms of long hauler syndrome, I recommend a number of dietary and lifestyle strategies and supplementation to improve your health. Part 1 of this 2-part series covered what it is, possible causes, and how to reduce your risk. Working with a functional medicine practitioner and receiving an individualized treatment protocol is always the best option. However, these tips should help you get started on your recovery journey if you are unwell from COVID. Here is what I recommend:

Eat Anti-Inflammatory Nutrition

As with any chronic health issue, diet is always the first step. Following an inflammatory diet high in processed foods and low in whole foods can increase inflammation and further disrupt your immune system. Following an anti-inflammatory, nutrient-dense, whole foods diet, on the other hand, can support your immune system and recovery (25, 51). 

I recommend removing inflammatory foods, such as refined sugar, refined oil, artificial ingredients, additives, and highly processed foods. Follow a nutrient-dense whole foods diet instead. Eat plenty of greens, vegetables, fruits, herbs, spices, sprouts, fermented foods, grass-fed meat, pasture-raised poultry and eggs, and wild-caught fish. Choose organic whenever possible. 

Follow a Healthy Lifestyle

Following a lifestyle that supports your immune system and helps to lower inflammation is critical.

• Reduce your stress levels and learn to cope with stress better. Try meditation, breathwork, journaling, and yoga. Spend plenty of time in nature and get some sunshine (21, 22).
• Move your body regularly throughout the day and exercise regularly. If your long hauler symptoms are severe, look for low-impact activities, such as light walks, restorative yoga, stretching, Tai Chi, Qi Gong, or swimming, as you can tolerate it (24). 
• Get 7 to 9 hours of restorative sleep daily. Honor your body’s need for rest (23).
• Reduce your exposure to environmental toxins. Don’t smoke or stop smoking and avoid exposure to second-hand smoke. Choose natural, organic, and homemade cleaning, body, and beauty products over chemical-filled conventional options. Reduce the use of plastic, especially BPA. Use a high-quality air filtration and water purification system (52, 53). 

Try Intermittent Fasting

Intermittent fasting or time-restricted eating is a way of eating the cycles between a period of not eating (fasting) and a specific time-frame reserved for meals within one day. Intermittent fasting may offer some fantastic health benefits. Intermittent fasting may help to stimulate autophagy and mitophagy. It may support mitochondrial health and cellular rejuvenation. It may help to rescue chronic inflammation and support immune health (54, 55, 56, 57, 58, 59).

One of the most popular intermittent fasting strategies is the 16:8 fasting method. It involves 16 hours of fasting including your overnight sleep and an 8-hour window for eating your meals. If you are new to intermittent fasting, begin slowly with a 12-hour eating window. Increase your fasting window gradually until you find what makes you feel your best.

Try N-Acetyl-L-Cysteine (NAC)

NAC is an amino acid that is a precursor to glutathione. It helps your body to create glutathione. Glutathione is a powerful antioxidant and ‘master detoxifier’ produced in your cells. Unfortunately, due to poor nutrition, environmental toxicity, stress, and age, glutathione deficiencies are common and you need to support your body to make it. NAC and glutathione may help to reduce oxidative stress and inflammation. NAC may also be particularly beneficial if you are experiencing shortness of breath or other lung or respiratory symptoms as a long hauler (35, 36, 37, 38, 39, 60, 61, 62, 63, 64).

A great way to boost NAC and glutathione levels is by eating avocado, spinach, okra, alliums, and cruciferous vegetables, such as broccoli, cabbage, and kale. Additionally, I recommend supplementing with NAC. You may also benefit from supplementation with liposomal glutathione.

Supplement with Vitamin D

Vitamin D is an essential vitamin that your skin creates in response to sunshine. Living an indoor lifestyle and long months of cloudy, rainy, and snowy weather reduces your opportunity to meet your vitamin D needs through sunshine alone. Though certain foods, such as egg yolks, liver, fish, and red meat can boost your vitamin D levels, it’s still not enough. The only effective option to ensure optimal vitamin D levels is daily supplementation.

Vitamin D is critical for your immune function, brain health, muscle health, and bone health. Deficiencies may increase inflammation, cause mast cell activation, and compromise your immune health. Research has linked vitamin D deficiencies to more difficult recovery and poor outcomes of COVID-19. Supplementing with vitamin D, on the other hand, may help to reduce inflammation and inflammatory symptoms (27, 28, 29, 65, 66, 67, 68, 69, 70). I recommend taking 5,000 IU of vitamin D3 daily.

Add Resveratrol

Resveratrol is a polyphenol found in the skin of red grapes, red wine, certain berries, and peanuts. It offers antioxidant and anti-inflammatory benefits. Resveratrol may help to improve your immune system, reduce oxidative stress, and decrease inflammation. It may help to support lung and cognitive health. Research has shown that it may help to reduce inflammation related to coronavirus diseases (71, 72, 73, 74, 75, 76, 77). You may benefit from eating resveratrol-rich grapes and berries and taking 200 mg of resveratrol supplement twice a day.

Use Quercetin

Quercetin has gained popularity since the pandemic. It is a powerful flavonoid found in many plant foods, including grapes, apples, berries, cherries, black plums, kale, peppers, capers, romaine lettuce, snap peas, onions, asparagus, sprouts, cruciferous vegetables, and many herbs. It offers antioxidant and anti-inflammatory benefits. 

It is also a powerful mast cell stabilizer that may reduce histamine intolerance. Since COVID-19 can activate your mast cells and mast cell activation may play a role in long hauler syndrome, quercetin may be an important nutrient to consider. Quercetin may help to reduce inflammation, lower histamine-related symptoms, and support your immune system (40, 41, 42, 12, 13, 78, 79, 80). I recommend eating quercetin-rich foods and taking 500 mg of quercetin twice a day.

Use Probiotics

Any infection, including COVID-19, can seriously disrupt your gut microbiome. However, gut microbiome imbalance can increase chronic inflammation, resulting in a compromised immune system, and leading to chronic symptoms. Gut microbiome imbalance may be one of the underlying causes of long hauler symptoms (32, 33, 34, 14, 15). 

I recommend improving your gut microbiome with probiotic-rich fermented foods, such as sauerkraut, fermented vegetables and herbs, coconut kefir, coconut yogurt, and kombucha. Additionally, I recommend taking a high-quality probiotic supplement daily for optimal gut support.

Try Melatonin

Melatonin is a chemical that your body creates to regulate your sleep-wake cycle. Beyond supporting your sleep, it offers anti-inflammatory and antioxidant properties. It may support healthy immune function and protects your gut lining (81, 82, 83, 84). Taking 1 mg of melatonin before going to bed may be beneficial if you find that your sleep has been affected by long hauler syndrome.

Consider Additional Supplements

There are many other herbs, vitamins, minerals, and nutritional compounds that may help to support your recovery from long hauler syndrome. Astragalus and Chinese skullcap, for example, may be able to perform the function of the ACE-2 receptor that can be affected by COVID-19 (85, 86, 87). Andrographis may reduce the risk of a virus entering your body (88, 89). 

Omega-3-rich foods, such as wild-caught fish, seafood, algae, hemp seed, flaxseed, and chia seed, and omega-3 fish oil supplements may help to reduce chronic inflammation and inflammatory symptoms (90, 91). EGCG from green tea and antioxidant CoQ10 may help to reduce oxidative stress, inflammation, and chronic symptoms (92, 93, 94, 95, 96). 

I recommend getting guidance from a functional medicine practitioner to receive individualized recommendations on supplementation and other strategies to improve your health and wellness. You may also benefit from emotional support from a counselor, therapist, or support group. Loved ones of those with long hauler syndrome may require similar emotional support. (97, 98, 99, 100).

Next Steps

If you are experiencing symptoms of long hauler syndrome, currently dealing with a COVID-19 infection, or simply want to improve your health to reduce your health risks, I welcome you to start a functional medicine consultation with me for further personalized guidance to improve your health. You may book your consultation here.

Check out my Histamine Intolerance Course here.  Learn on your own time, from anywhere. Get an inside look at the most helpful functional medicine tests for pinpointing imbalances, ways to identify and manage the most common (and sometimes surprising) mast cell triggers, including viruses, and learn what to eat, what to avoid, and why.