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Update on Diagnosing and Treating Long-Haul COVID-19

Are you starting to think COVID-19 will never go away? Are you afraid that mask mandates, vaccines, and mandatory shutdowns will continue to plague us for the rest of our lives?

Leaky Gut Therapy Tampa FL

For people with long-haul COVID, that feeling is far more personal and poignant. For these unfortunate, “never going away” means continuing to struggle with persistent and often debilitating symptoms for months after their immune systems have defeated the virus.

A mild to moderate case of COVID-19 typically lasts about two weeks, maximum. Approximately 30 percent of people who get infected show no symptoms.

In contrast, about 25–33 percent experience lingering health issues after they’ve recovered from the acute phase of the illness. In other words, they continue to experience symptoms even when the virus is no longer active — when they would test negative for the coronavirus.

This syndrome has been described by many names, including: 

  • Long-haul COVID-19
  • Post-acute sequelae of SARS-cov-2 (PASC)
  • Post-COVID syndrome
  • Long COVID
  • Long-term COVID

People suffering from it are often referred to as long haulers.

We have written about long-haul COVID-19 in the past, specifically in July 2021, “Treatments for COVID-19 ‘Long Haulers’ in Tampa,” and August 2021, “The Leaky Gut Connection for COVID-19 Long Haulers.”

And now we’re revisiting the topic in this post to keep our patients and the community current on symptoms and treatments and to encourage long haulers to seek treatment — because effective treatments are available.

To review, there are more than 25 symptoms of long-haul COVID, which we’ll cover in the next section.

Symptoms of Long-Haul COVID

Common symptoms of long-haul COVID include the following (note that most are related to the brain and the body’s nervous system):

  • Cognitive dysfunction
  • Cold or pain sensations in extremities
  • Difficulty processing tasks/focus
  • Difficulty speaking/communicating at times
  • Fasciculations — uncontrolled muscle movements (twitching)
  • Fatigue
  • Headaches of all types
  • Insomnia — poor sleep
  • Lost sense of taste or smell
  • Numbness
  • Post-exertional malaise (feeling exhausted after exercise, for example)
  • Short- and long-term memory loss
  • Tingling
  • Tinnitus (ringing, buzzing, or whistling in the ear in the absence of any external stimulus)
  • Vertigo — dizziness
  • Weakness in extremities

Additional long-haul COVID symptoms include these:

  • Anxiety
  • Depression
  • Dysautonomia or post orthostatic tachycardia syndrome (POTS) — dysfunction of the autonomic nervous system responsible for regulating involuntary body functions, such as heartbeat, blood flow, breathing, and digestion.

    A fast heartbeat is characteristic of POTS. Many symptoms of POTS mirror those of long-haul COVID, including dizziness, headaches, brain fog, fatigue, and poor sleep. (For more on this syndrome, please read “Living with Postural Orthostatic Tachycardia Syndrome (POTS)” here on our blog.)

  • Lightheadedness upon standing
  • Joint pains/muscle aches
  • Night sweats/hot flashes
  • Skin changes/sensitivity
  • Temperature dysregulation
  • Urinary frequency issues
  • Menstrual changes

Exploring the Link Between COVID and Dormant Viruses 

A virus can go dormant only to reactivate later when the body is in a weakened or stressed state. For example, the varicella-zoster virus, which causes chickenpox, goes dormant when we recover from the initial infection as children and then may reactivate decades later, causing shingles.

Altered immune function and inflammation triggered by the virus that causes COVID-19 — the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus — may reactivate one or more dormant viruses, including the Herpes Simplex Virus (HSV), Herpes Zoster Virus (another name for the varicella-zoster virus), Epstein Barr Virus (EBV), or Cytomegalovirus (CMV).

In other words, some lingering symptoms of long-haul COVID may be attributed to the reactivation of other viruses.

Linking COVID to Mast Cell Activation Syndrome (MCAS)

Mast cell activation syndrome (MCAS) appears to be triggered in some patients post COVID. Mast cells release a variety of cytokines and other chemical mediators such as tryptase and histamine, which can cause symptoms similar to those of allergies or asthma.

Someone with MCAS can experience a severe allergic reaction to a variety of triggers, including any of the following:

  • Alcohol
  • An allergen
  • A chemical substance
  • A food item (which varies among individuals)
  • A fragrance (such as a perfume or cologne)
  • A medication
  • Exposure to sunlight
  • Heat or cold
  • A heavy metal
  • Infection (bacterial, viral, or fungal)
  • Mold/fungus

Asthma can be of new onset following COVID, or aggravated in a person who has a history of asthma. To find out more about MCAS, read our previous post “Mast Cell Activation Syndrome and Its Connection to Toxic Mold.”

Testing for Long-Haul COVID

Because long-haul COVID symptoms can be caused by various contributing factors, testing is key to selecting the right treatments. While one patient may require treatments that address reactivation of a virus, another may benefit more from therapies that calm the immune response and inflammation.

Here at BioDesign Wellness, we tailor testing to each patient, based on the symptoms the patient is experiencing. Testing may include one or more of the following:

  • Complete blood count (CBC) with differential and platelet count
  • Standard blood chemistries including liver function tests
  • D-dimer — a marker of blood-clotting activation
  • C-reactive protein (CRP), which is a marker for ongoing inflammation
  • Early morning cortisol level — to assess adrenal function
  • Thyroid stimulating hormone (TSH) level to check for or rule out thyroid disease
  • HbA1C test, which measures the amount of blood sugar (glucose) attached to your hemoglobin — the part of your red blood cells that carries oxygen from your lungs to the rest of your body
  • Troponin to check for or rule out cardiac disease — troponin is a type of protein found in the muscles of your heart. Troponin isn’t normally found in the blood. When heart muscles become damaged, troponin is sent into the bloodstream. As heart damage increases, greater amounts of troponin are released in the blood.
  • CMV, EBV, HSV serology to check for or rule out viral reactivation 
  • Vitamin D level
  • Autoantibody testing to check for any autoimmune conditions

Treating Patients with Long-Haul COVID

Based on each patient’s test results, we develop a personalized treatment plan to restore health and function. Treatments typically include one or more of the following:

  • High-dose vitamin C delivered intravenously to reduce oxidation and inflammation and boost the immune system — COVID and viruses drain the bodies of vitamin C
  • Mast cell stabilizing medications that calm the immune system 
  • Nebulized glutathione to support lung health and function
  • Supplements that support anticoagulation (reducing blood clots)
  • Low-dose naltrexone (LDN) to calm immune system and mast cells 
  • Peptide therapy to support immune system health and function

However, test results may call for additional treatments; for example, treatments for adrenal or thyroid dysfunction, low vitamin D, blood clots, MCAS, and damage to heart tissue.

What’s important is to start with a thorough exam and testing to identify the root causes of the symptoms you’re experiencing.

Long-haul symptoms may go away on their own, but they may pose a threat to your long-term health, causing additional damage to your heart, lungs, kidneys, or other organs or to other systems of your body.

If you’re still experiencing symptoms after having recovered from your initial infection, we strongly encourage you to schedule a consultation with a functional and integrative medical practice.

Don’t suffer unnecessarily and risk your future health when effective treatments are available. If you’re in the Tampa, Florida, area, contact us to schedule an appointment.


Disclaimer: The information in this blog post about long-haul COVID-19 is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from the medical staff at BioDesign Wellness Center, Inc., nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.