In the wake of the Covid-19 pandemic, Long Covid syndrome is one of the most critical emerging medium and long-term health conditions experienced by people of all ages. Unfortunately, it can come with a high rate of disability and reduced quality of life. Currently there are 2 million people recorded to have long covid, which is likely a significant underestimation of the amount of people suffering from it who have not yet sought help or been diagnosed.

People first started reporting chronic fatigue syndrome (CFS)/ME type symptoms and other neurological symptoms after they had recovered from the acute infection of COVID-19 in late spring 2020. Unfortunately, there are currently no licensed medications to treat Long Covid. However, using the RM toolkit and approach can be helpful – including cannabinoid therapy and other therapies used in treating CFS/ME and other similar conditions to help get your life and health back again.

Symptoms of Long Covid may include:

  • cognitive impairment (problems thinking, focusing and decision making)
  • brain fog
  • fatigue, often disabling
  • other neuropsychiatric symptoms such as mood problems and anxiety
  • muscle and joint aches and pains that move around the body

  • headaches

  • persistent chest pain and shortness of breath

  • Symptoms seem to occur in people who suffered even a mild acute Covid infection and did not need hospital treatment. Data from the UK’s Office for National Statistics show that close to 20% of those infected with Covid may experience Long Covid to some extent.

What causes Long Covid?

Long Covid is a complex disease process of many factors involving the central nervous system. It also affects other major body organs such as the heart, lungs, kidneys and liver.

Some studies show that the virus may affect nitric oxide production pathways, leading to nervous system dysfunction. It is also known that the SARS-CoV-2 virus can enter the brain and nervous system via ACE 2 receptors in the olfactory bulb via the nasal passages. Inflammatory cytokine activation and mitochondrial dysfunction are also likely involved.

In addition to these direct biological effects, the isolation, loss of life, and changes to working life and income that comes with experiencing life during the pandemic – especially for those vulnerable – also have a brain effect that can trigger depression, anxiety or PTSD.


The Resilience Medicine Approach to Long Covid

Diet
Supplements
Medication
mind-body
BioData + Habit Tracking

Diet

  • The Resilience Medicine diet principles can help support healing based on integrative medicine principles vs. a western diet (high in refined carbohydrates, sugar, and saturated and trans fats) may impair the immune’s system response to viruses and worsen neuroinflammation
  • Eliminate caffeine and alcohol due to their effect on mitochondria (especially alcohol which is a mitochondria toxin)

Supplements

Many people find nutraceuticals and botanical supplements used for similar symptoms eg. in CSF/ME may help, including:

  • Liposomal glutathione
  • Lions Mane and other medicinal mushrooms for stress and cognition support
  • Scutellaria
  • Huperzine A
  • Gingko
  • High Absorption Magnesium
  • Vitamin D 3
  • CBD, cannabinoids and terpenes from the cannabis plant, including alpha-pinene, beta-caryophyllene and myrcene.
  • Acetyl L carnitine
  • Liposomal CoQ10
  • NAC
  • Herbal sleep support if sleep is affected
  • Energy support with ginseng family of herbs, cordyceps, ashwagandha, schizandra, liquorice root (avoid if high blood pressure)

Cannabinoids & New Medicines

Medications c also help, particularly:

  • Full spectrum CBD & Medical cannabis
  • Melatonin
  • Medications used to treat CFS/ME (see that page)

mind-body Tools

Many forms of relaxation practices can help decrease brain and body stress and fatigue which supports immune system function as well as improve brain fog over time. These may include:

  • Breath-focused mini-meditation minutes throughout the day, focusing on a longer exhale than inhale and experimenting with a few seconds of holding the breath at the top of the inhale. This can help check in with energy levels and avoid overexertion.
  • Yoga Nidra for deep relaxation done lying down
  • Concentrative meditation techniques
  • Mindfulness
  • Consider psychedelic-assisted psychotherapy for PTSD if present (where available/legal)

Apps, BioData and Habit Tracking:

You can track your core symptoms and other symptoms like mood and fatigue and sleep in the app and see any interventions and resilience tips you have started and if they are helping over time.

The Resilience Medicine App is a free tool developed over a decade of practice treating patients using a quality of life approach. It can help you track how you feel in the four main Resilience Medicine areas of mood, stress/anxiety, energy and mental clarity.

Dr Dani’s Summary:

There are millions of people now suffering from Long Covid syndrome and the current therapies they are being offered by their doctors are not sufficiently meeting their needs or helping with many of their symptoms. A RM approach based on the integrative medicine treatment of similar conditions shows promise and this is an area of medicine I am actively involved with in terms of helping patients and research in my practice. Cannabinoids are showing promise as a treatment alongside a holistic approach that supports the healing of the neuroimmune axis that seems to become dysregulated in long covid similarly to what we see in chronic Lyme and post-infectious CFS/ME so I use a very similar approach.