Can Naturopathy Help with Long COVID?

Supporting the Body Systems with Naturopathy

Although research is ongoing, very little can be offered by medicine at the moment other than evaluation and attempting to relieve symptoms like shortness of breath, blood pressure disturbances or headache. While this is disappointing, when definitive treatments of the underlying issues aren’t available (and when the underlying issues are poorly understood) it makes sense to approach this problem from natural first principles, and support the body’s natural healing and regulatory mechanisms, to help patients regain their health and quality of life.

For example, while pathology reports of your blood work report that the numbers are in the “normal range”, they may actually be abnormal. Naturopaths consider your results not just against the Australian average, but also take into account what the result should be for healthy individuals, often finding subtle discrepancies and sub-optimal levels that might indicate issues, or require support. Pathology reference ranges are based on a group of “healthy” people which can be a slippery slope. Who should define normality and using which criteria? Traditional lab results also use broad ranges to define what is “normal,” but this can miss small variations that affect health.

When I assess blood work, I take a critical eye to the normal ranges, and I aim for optimal health rather than just avoiding disease. I search for patterns and values within the normal range that may hint at early imbalances or deficiencies that may be associated with poor immune regulation and long COVID symptoms.

Inflammation & immune dysregulation

Research shows that inflammation & immune dysregulation may last up to 8 months post-initial infection of COVID and other viruses. Pro-inflammatory cytokines and the lack of T and B cell function may disrupt the immune system and reactive other viruses such as Epstein-Barr. Therefore, utilising nutrients that target immune dysfunction and down-regulate inflammation is vital, and these include Vitamin D, C, A and zinc.

I love to use Rice bran arabinoxylan compound (RBAC) in my clinic when supporting clients with symptoms of long COVID, as it has strong immunomodulatory effects, including the modulation of cytokine production. Medicinal mushrooms also deserve to be spotlighted, due to their immunomodulating effects. They are also great for modulating the stress response which may help to keep you calm and collected.

Improving fatigue & mitochondrial health

One of the underlying mechanisms of fatigue in long COVID is mitochondrial dysfunction. Remember back in biology during school? The mitochondria is a kidney shaped membrane bound organelle inside the cell, and is described as “the powerhouse” is the cell. The mitochondria’s responsibility is to produce ATP and cellular energy, but it can become dysfunctional in the presence of inflammation and cytokine production. Remember the last time you had a fever, and how fatigued you felt? That lack of energy is driven by cytokines (cellular messengers) and inflammation.

How do we support mitochondrial function? Some nutrients I love to use for mitochondrial health include ubiquinol (COQ10), acetyl-l-carnitine, Vitamin D and C, B vitamins and probiotics. Magnesium is also a key player here, being a key nutrient for mitochondrial function. Because most Australian’s are magnesium deficient, this could be driving a lot of mitochondrial dysfunction and fatigue in long COVID. And let’s not forget herbal medicine for fatigue– my favourite herbs for long COVID include medicinal mushrooms, rhodiola, Siberian ginseng, and licorice (just to name a few).

Fatigue is a major symptom holding those with long COVID back. One specific herbal medicine called Astragalus has shown promise in research on natural approaches to COVID due to its property of reducing fatigue. Polysaccharides from astragalus are key bioactive compounds that boost innate and T-cell adaptive immunity, and have antioxidant, antiviral, and anti-inflammatory effects. And they are also thought to affect the growth of microorganisms in the gut, which helps regulate the immune system.

Gut health and long COVID

Finally, I’ve seen many cases of COVID-19 affecting the gastrointestinal system. This seems to be due to increasing dysfunction in a specific enzyme called ACE2. This enzyme is well known to be disrupted by COVID-19 virus. By using specific probiotics and prebiotics, it may help to improve the immune system and reduce cytokine production.

Are you dealing with long COVID?

If, since having COVID for the first (or second, third or fourth) time you are experiencing a weird and growing list of frustrating symptoms like fatigue, brain fog, pain, headache, anxiety, sleep disturbance, gut issues, breathing problems and all the rest, it is important to be fully assessed for non-COVID underlying causes. But, if like so many other Australians long COVID is the cause, and no answers other than “you’re not dying of anything” are forthcoming, I would encourage you to seek out assessment by a Naturopath. We approach your case holistically, assessing not only the symptoms you are complaining of, but delving deeply into your overall health and help you set goals and address underlying issues that maybe keeping you from properly recovering.

References

Banihashemi, Z. S., Azizi-Fini, I., Rajabi, M., Maghami, M., & Yadollahi, S. (2024). Chronic fatigue syndrome post-COVID-19: triple-blind randomised clinical trial of Astragalus root extract. BMJ supportive & palliative care, spcare-2023-004595. Advance online publication. https://doi.org/10.1136/spcare-2023-004595

Chen, T. H., Chang, C. J., & Hung, P. H. (2023). Possible Pathogenesis and Prevention of Long COVID: SARS-CoV-2-Induced Mitochondrial Disorder. International journal of molecular sciences, 24(9), 8034. https://doi.org/10.3390/ijms24098034

Davis, H. E., McCorkell, L., Vogel, J. M., & Topol, E. J. (2023). Long COVID: major findings, mechanisms and recommendations. Nature reviews. Microbiology, 21(3), 133–146. https://doi.org/10.1038/s41579-022-00846-2

Lee, C. Y., Nguyen, A. T., Doan, L. H., Chu, L. W., Chang, C. H., Liu, H. K., Lee, I. L., Wang, T. H., Lai, J. M., Tsao, S. M., Liao, H. J., Ping, Y. H., & Huang, C. F. (2023). Repurposing Astragalus Polysaccharide PG2 for Inhibiting ACE2 and SARS-CoV-2 Spike Syncytial Formation and Anti-Inflammatory Effects. Viruses, 15(3), 641. https://doi.org/10.3390/v15030641

Manrai, A. K., Patel, C. J., & Ioannidis, J. P. A. (2018). In the Era of Precision Medicine and Big Data, Who Is Normal?. JAMA, 319(19), 1981–1982. https://doi.org/10.1001/jama.2018.2009

Roman, P., Carrillo-Trabalón, F., Sánchez-Labraca, N., Cañadas, F., Estévez, A. F., & Cardona, D. (2018). Are probiotic treatments useful on fibromyalgia syndrome or chronic fatigue syndrome patients? A systematic review. Beneficial microbes, 9(4), 603–611. https://doi.org/10.3920/BM2017.0125

Schwalfenberg, G. K., & Genuis, S. J. (2017). The Importance of Magnesium in Clinical Healthcare. Scientifica, 2017, 4179326. https://doi.org/10.1155/2017/4179326

Smatti, M. K., Al-Sadeq, D. W., Ali, N. H., Pintus, G., Abou-Saleh, H., & Nasrallah, G. K. (2018). Epstein-Barr Virus Epidemiology, Serology, and Genetic Variability of LMP-1 Oncogene Among Healthy Population: An Update. Frontiers in oncology, 8, 211. https://doi.org/10.3389/fonc.2018.00211

Zhang, D., Zhou, Y., Ma, Y., Chen, P., Tang, J., Yang, B., Li, H., Liang, M., Xue, Y., Liu, Y., Zhang, J., & Wang, X. (2023). Gut Microbiota Dysbiosis Correlates With Long COVID-19 at One-Year After Discharge. Journal of Korean medical science, 38(15), e120. https://doi.org/10.3346/jkms.2023.38.e120

Yin, K., Peluso, M. J., Luo, X., Thomas, R., Shin, M. G., Neidleman, J., Andrew, A., Young, K., Ma, T., Hoh, R., Anglin, K., Huang, B., Argueta, U., Lopez, M., Valdivieso, D., Asare, K., Deveau, T. M., Munter, S. E., Ibrahim, R., Ständker, L., … Roan, N. R. (2023). Long COVID manifests with T cell dysregulation, inflammation, and an uncoordinated adaptive immune response to SARS-CoV-2. bioRxiv : the preprint server for biology, 2023.02.09.527892. https://doi.org/10.1101/2023.02.09.527892

Seo JW, Kim SE, Kim Y, Kim EJ, Kim T, Kim T, Lee SH, Lee E, Lee J, Seo YB, Jeong YH, Jung YH, Choi YJ, Song JY. Updated Clinical Practice Guidelines for the Diagnosis and Management of Long COVID. Infect Chemother. 2024 Mar;56(1):122-157. doi: 10.3947/ic.2024.0024. Epub 2024 Mar 13. PMID: 38527781; PMCID: PMC10990882.

https://www.aihw.gov.au/reports/covid-19/long-covid-in-australia-a-review-of-the-literature/summary

https://www.aph.gov.au/DocumentStore.ashx?id=54413018-123c-417d-84c7-a258d113d561&subId=726017.

Disclaimer: Before taking any herbal medicines or nutraceuticals, it is essential to check for potential interactions with any pharmaceutical medications you are currently using. For any other questions or concerns, please consult your naturopath, doctor, or health practitioner.