Long COVID patient or post-acute COVID-19 cases are defined as the presence of symptoms extending beyond 3 weeks from the initial onset of symptoms. LongHaul Syndrome is reserved for chronic COVID-19 symptoms extending beyond 12 weeks.1
In April 2020, I saw my first adult patient with persistent and debilitating symptoms 3 weeks after her initial COVID-19 infection. Her symptoms were fatigue, muscle aches and pain, headache, and shortness of breath. Since her case, I have consulted with more than a dozen Long Haulers.
I think alternative therapies, such as Chiropractic, Acupuncture, and Physical Therapy, have a lot to offer these patients. The symptoms I hear from long-haulers include (in no particular order):
Other common symptoms are pain or tightness in the chest, chills or sweats, brain fog, palpitations, light-headedness, concentration challenges, confusion, and memory problems. I’m used to treating the “good day, bad day feeling” patients but Long Haulers exhibit a new level of that.
After talking to enough of these people you get the sense that it’s not just “I’m tired”, it’s overwhelming fatigue; it’s not just “I’m out of breath”, its breathlessness even during mild activities; it’s not just “difficulty concentrating” its short term memory loss and cognitive challenges. I get the sense they feel okay one minute, and then 10 minutes later - they feel run over by a car.
The most commonly reported symptoms after acute COVID-19 are fatigue and dyspnea (shortness of breath). Other common symptoms include joint pain and chest pain3.
My current thinking about these persistent symptoms is related to three possible sources: Lack of oxygen (hypoxia) throughout the body due to respiratory problems during the acute infection. Hypoxia is insufficient amounts of oxygen reaching the tissues. Mitochondria need oxygen to create ATP. ATP is the energy required for cells to carry out their specific functions: Nerve impulses, tissue repair, muscle contraction, the synthesis of biochemical agents within cells, and more — all these actions require ATP. Any movement or metabolic process needs ATP. They have an ATP problem.
COVID-19 is a direct viral attack on blood vessels, joints, and nerves. There is an overreaction of the immune system. The body’s inflammatory response to the virus causes some secondary complications. The immune system gets turned on to fight this, and it’s hard to get it turned off again.
Early on I felt that it was a widespread blood vessel dysfunction. It was clear that it especially targeted the overweight, obese, diabetic, and high blood pressure patients. Therefore my goals included proper diet and supplements to improve blood vessel health and metabolic dysfunction. A few priorities were vitamin D, zinc, and nitric oxide optimization. An increase in nitrate intake can augment circulating nitrite and nitric oxide. This may lead to lower blood pressure and improved vascular function.
Targeted treatment:
• Anything Chiropractic: For me, this includes hands-on therapy (mobilization, manipulation, and modalities), laser treatments, pulse therapy, vibration/percussion, lymph therapy, SCENAR therapy.
• Diet: High-fat whole foods, plant-rich diet (ketogenic, intermittent fasting).
• Nutrient optimization: Omega-3’s, vitamin D, methylation, B’s, etc. Eat lots of green leafy vegetables throughout the day, include spinach, arugula, lettuce, beets, celery, broccoli, and tumeric, etc. at every meal. These are rich sources of nitrate and will help create less arterial stiffness.
• Stress reduction: Prioritize rest and relaxation, avoid pushing yourself; balance activity and breaks; meditation.
• Sleep: I insist patients get more sleep and will do everything I can to help these patients improve deep and REM sleep.
• Energy optimization: Blend together mitochondrial support, exercise, and limit the hours of work per day.
• Exercise: The best thing is to listen to your body. If you know that something’s pushed you over the edge in the past, then don’t repeat it. Do something active, but for less time or less strenuously. I start my patients with “marching in place” and moving the arms overhead. This allows patients to do this at home or outside but certainly stay close to home. I literally start with 2-minute bouts. If that goes well they increase the 2-minute march in place to several times a day. I monitor steps on smartphones.
• Topical cream: Every patient gets either a CBD like Phyto Zol or a menthol base. These can help with aches and pains and work on a microvascular level.
• Cognitive optimization: Get the brain active.
• Hormonal optimization: Check the thyroid, adrenal, and sex hormones.
• Gut optimization: Heal the leaky gut, include probiotics, eat more diverse foods.
• Detoxification: Sweat, mobilize and excrete toxins.
• Immune/inflammation optimization: Everything above and specific herbs/nutrients the patient might need.
Please don’t miss out on where we could be helping these people.
Dr. Jeffrey Tucker is the current president of the ACA Rehab Council. The Rehab Council will have its annual conference March 13-15, 2020 in Tempe, AZ. The website to register is www.ACARehabCouncil.org. Dr. Tucker practices in Los Angeles, CA. His website is www.DrJeffreyTucker.com
References
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