You don’t read much about Covid anymore. Despite the virus’ ever-presence – a new strain of SARS-CoV-2 was reported in the UK this autumn – and the NHS still reeling from the aftershocks of past peaks, the pandemic feels like a world away. We’re all returning to what feels like the ‘old normal’ in 2023: many offices are calling workers back in full-time and the London leavers are now being forced to return from their seaside getaways.
But for long Covid sufferers, the virus never went away. The media might have moved on, your friends may be less sympathetic, and even workplaces may be less tolerant towards the effects. But an estimated two million people in the UK are still living with long term symptoms.
The NHS defines long Covid as “signs and symptoms that develop during or after Covid-19 and continue for more than 12 weeks and are not explained by an alternative diagnosis”. In reality, long Covid sticks around for, well, longer. And it often manifests as a multi-symptomatic illness.
“Covid-19 causes a catastrophic overreaction of our immune system and that damages tissue. There’s no tissue that is safe – it can affect the brain, muscles, the liver, the heart or your endocrine system,” Federica Amati, medical scientist and nutritionist, tells me. It’s a silent illness too: it might not show up as black and white on blood tests. Which is why so many people struggle to get adequate treatment – or even acknowledgement.
I first contracted Covid-19 in 2021, pre-jab, and my life has never been the same since. I developed asthma and chronic breathlessness (I’ve avoided the stairs for years), reactive hypoglycaemia, debilitating fatigue, vertigo, food intolerances, and brain fog to the degree of forgetting huge chunks of my memory. And, as these symptoms collided, I started to experience dissociative seizures. My brain decided to shut down rather than cope with the stress. My partner became a carer aged 27: cooking and cleaning for me, and even escorting me to work.
I had no help. Every time I spoke to my GP I was informed long Covid was an enigma and there was not much that could be done. I underwent myriad tests, but they usually came back ‘normal’. I was rejected from the NHS’ long Covid clinics twice.
When the case was ‘closed’ and the only recommendation was therapy, a suspicion of medical misogyny started to creep in. I was essentially told that my symptoms were mental health. I started to question my own sanity, which created a chicken-and-egg situation. What came first: my sheer frustration and subsequent depression, or the symptoms? Anyone with outside perspective could have easily answered that question, but when you’re in the depth of despair, clarity is hard to find.
I wasn’t wrong to think my gender was impacting my care. It’s no secret that women have been deemed hysterical for centuries (Google ‘the rest cure’ if you need some visceral reminders), with their supposed delicate sensibilities blamed for physical ailments. But the truth is: we are biologically more likely to suffer from long-term illness. “Women generally suffer with more autoimmune conditions and have more reactive immune systems. We think it’s mediated in part by oestrogen,” Amati says. “So, women are also much more likely to suffer with long Covid than men.”
There are clear statistics to back this up. A study published in 2021 concluded that “female gender was associated with a threefold higher risk of long Covid”. Medical bias is a very real issue, with systemic racism and sexism impacting research for years. No wonder, then, we’re not getting to the bottom of long Covid fast enough.
I finally received the support I needed when I moved to a different London postcode and met a female GP who had experienced long Covid symptoms herself. I am receiving one-to-one care and rehab in a long Covid clinic, where they’ve confirmed all of my mysterious symptoms are indeed a direct result of the virus. The course is helping, but being believed alone was enough to lighten my load. The hard truth to swallow is that some of the unluckiest sufferers will live with these symptoms for years, or life. Still, I’ve learnt a few tricks along the way to manage and ease my symptoms.
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Get to grips with your gut health
There’s only a half truth to the saying “you are what you eat”. Genetics, environment, antibiotics use and illness are all factors that play into your gut health. These can influence your mental health, metabolism and immune system.
“We know with certainty that Covid alters the gut microbiome, and the intensity of the Covid is proportional to the intensity of the change within the microbiome,” Dr Will Bulsiewicz, gastroenterologist and author, tells me. This explains why a huge amount of long Covid sufferers develop diabetes, IBS and skin symptoms like rosacea as a result. “If we shift the microbiome, it can expose food intolerances and it also can manifest with dysbiosis.” Which, simply put, equals: ‘fewer good guys, more bad guys’.
Here, fermented foods are your friend: look to incorporate things like kimchi, sauerkraut, kefir, kombucha, miso and tempeh into your daily diet. You can build up your microbiome resilience with the help of probiotics too. But do your research – store-bought capsules rarely reach your gut alive. Medical professionals recommend Symprove or Optibac, and new brand Artah has also garnered great reviews.
A daily dose of probiotics will help give you a boost, but diet is still the number one priority. There’s no catch-all advice when it comes to eating, which is why taking every new study or fad weight loss scheme as gospel is likely harming you more. The Zoe app, however, is a diet plan medical professionals recommend, as each food recommendation is unique to the individual and based on rigorous testing. “Inflammation is one of the drivers of long Covid and the Zoe approach tries to reduce this,” says Amati.
If you’re not familiar with this process, developed by Tim Spector and his team of scientists, it’s a three day test you take at home which measures your blood sugar and blood fat responses, and your gut health via a stool sample, then creates a tailored food plan by scoring your foods so you can build healthy meals via the app. The Zoe starter kit costs £299.99 and membership starts at £24.99 per month.
It’s a life changer – I discovered I had developed reactive hypoglycemia through these tests – and helped me realise how damaging getting your health and diet advice from social media really is. Forget everything you thought you knew about calories: tracking how inflammatory your food is, and preventing blood sugar spikes is the future. “Diet is not the only factor in improving our health but it’s something that we can change,” Amati concludes.
Zoe’s aim is to reduce inflammation through diet. But if you don’t want to do the test, you can reduce inflammation in other ways. Add plenty of plants into your diet, limit ultra-processed foods and balance your blood sugar (Jessie Inchauspé’s Glucose Goddess books give you all the building blocks you need and her Instagram feed has loads of tools and tips).
“Stress is also a big factor,” Amati says. “Try to integrate things into your life that help you relax, whether that’s walks, yoga, massages, or breathing exercises. When cortisol comes down, that’s really key to bringing inflammatory down.”
A quick-fix some people swear by for reducing inflammation is CBD. “CBD is gaining a lot of attention for its anti-inflammatory properties, which could be a massive breakthrough for people dealing with long Covid or chronic pain,” Dr Rashid Bani says. I tried many oils along the way and found Orange County’s to be the most potent. The brand also offers a fast-acting topical gel for those experiencing muscle aches and joint pains – another common symptom.
The NAD+ intravenous drip
Speaking of quick fixes… One of the biggest things that helped me was the NAD+ IV drip. NAD, which stands for ‘Nicotinamide Adenine Dinucleotide’, is a coenzyme that influences key cellular functions, including metabolic pathways, DNA repair, chromatin remodelling and immune cell function.
“NAD+ is thought to give cells the energy to successfully metabolically function, thus hopefully making long Covid patients feel better. This drip has proved popular with those struggling with brain fog, low energy, poor concentration, mood disorders, and more,” explains Dr Matthew Calcasola, Chief Medical Officer at Get A Drip.
I first forayed into NAD+ with Dr Vali, whose clinic is in a futuristic looking egg on the second floor of Selfridges. Her team of nurses brings you in for consultation, then intravenously administer 1500mgs of NAD+ in stages, incrementally increasing the dosage over three days. It’s a strange sensation and, if rushed, can cause nausea and dizziness, but the team at Dr Vali are pros.
Within the first day I felt energy come back to me. I went from being able to walk no more than 15 minutes at a time to strolling for two hours. I felt happier, my brain fog completely lifted, and I felt the urge to exercise (something chronic fatigue sufferers will know is rarely appealing). This feeling lasted around three months, dwindling as time went on.
Prices for this full dose at Dr Vali’s costs £1,688. There are more affordable and convenient options on the market – Get A Drip, which offers a standard dose of 500mg for £400, can be found in London shopping centres and offer home visits – but I have found smaller doses to be less effective.
The jury’s still out on whether supplements are truly effective. And while Tim Spector insists that diet is the key to vitamin intake, those suffering with chronic illness can reach for some extra help to support their nervous system. There’s no need to go overboard, but the few I swear by are vitamin D, a hormone-like vitamin which plays a vital part in the absorption and use of calcium within the body; Omega 3, fatty acids which help protect the heart and blood vessels from disease; and magnesium, a mineral which helps with muscle and nerve function, regulating blood pressure, improving sleep and supporting the immune system.
Most supplements on the high street are not good quality. In fact, we can’t really guarantee what these long life pills are being laced with. Beauty Pie, Artah and Wild Nutrition are my go-tos for decent vitamins (just make sure to keep your omegas and oils in the fridge). And if you know you’re bad at consistency, or you want results fast, a vitamin shot every few months is a guaranteed way to top up your levels.
“Unlike oral supplements, intravenous drips allow 100 per cent of the vitamin to be used, as they enter directly into the bloodstream and therefore pumped around the body, meaning all your cells can use the vitamins effectively,” Dr Calcasola explains.
Take it from the professionals
When you feel like your long Covid is out of your control, it does best not to obsess too much. If, like me, you’ve been guilty of frantically Googling your symptoms, you’ll known how easy it is to be overwhelmed by all the contrasting information out there.
The same goes for social media: I learnt the hard way that Instagram does not have the answers, and that unofficial ‘nutritionists’ with their radical methodology (I followed the Keto diet via Instagram to great detriment to my health) can do more harm than good.
With that said, it’s still clever – not to mention comforting – to swat up when it comes to your health. Just leave the advice to the professionals.