Dealing with post-viral fatigue after having been infected with COVID-19 or other severe viruses can be debilitation and frustrating. Getting back to your pre-virus energy levels and vitality may be challenging, but there are things you can implement to help your body along the road to recovery.

There is still so much to learn about COVID-19 and the symptoms that may linger long after having caught the virus. However, combining what is currently available in the research on COVID-19 with established research on other more well-known viruses can give us some valuable clues on how to treat post-viral symptoms.

Inflammation and COVID-19

With any viral infection, the immune system responds by launching an attack on the invading virus by releasing immune cells, which cause inflammation in the body. In severe cases of COVID-19 disease, the immune system overreacts, and it is the elevated immune response and inflammation (not the virus itself) that makes some people suffer more severely from the disease than others. People with pre-existing conditions that cause inflammation such as obesity, diabetes, and lung disease to mention a few, may be at a higher risk since they have pre-existing high levels of inflammation in the body.

Post-viral fatigue treatment

COVID-19 is largely a respiratory disease, but newer evidence suggests that the gut also plays a role. 70-80% of the immune system resides in the gut and the state of the gut microbiome may affect the ability to respond appropriately to the virus, as well as impacting the recovery time. Treating the whole body with diet, lifestyle modifications, and supplements following a viral infection can help speed up recovery.

The gut and COVID-19

Emerging evidence on post COVID-19 symptoms points to an alteration in the gut microbiome that can lead to dysbiosis, gut permeability, or what is commonly referred to as ‘leaky gut”. The intestinal permeability then allows undigested foods, viruses, and bacteria into the circulatory system, which further exacerbates the systemic inflammatory response.

How to improve immunity through gut health

There are two aspects to gut health:

1. The microbiome
2. The gut lining

The microbiome

The microbiome is made up of microbes composed of bacteria, bacteriophage, fungi and protozoa and viruses, when there is a healthy ratio of beneficial bacteria to bad bacteria you tend to have a healthy microbiome.

The beneficial bacteria will enhance your immune system, improve digestion, optimise nutrient absorption, and overall strengthen your ability to combat viruses and bacteria when they are presented to your system, which by the way, they are daily. Ideally, the microbiome and the immune system manage to kill off any unwanted invaders before you even notice.

Including foods that contain prebiotics and probiotics will help you achieve a healthy microbiome.
Prebiotic fibre is found in foods such as onion, garlic, Jerusalem artichokes, leek, legumes, berries, asparagus, and dandelion greens. Probiotics are found in kefir, sauerkraut, yoghurt, miso, tempeh, natto and kimchi
If these foods are not included regularly in your diet or they tend to cause bloating when you eat them, you can take a reputable pre and probiotic supplement to help boost the microbiome.
It is worth considering probiotics that also have an antibiotic effect, meaning they can kill off viruses and bacteria. Soil-based probiotics and Saccharomyces boulardii have this dual capability.

The gut lining

As mentioned above when the gut lining is compromised or ‘leaking” undigested foods, viruses and bacteria will seep through the gut lining into the bloodstream causing inflammation.
Repairing and nourishing the gut lining ongoing is imperative in reducing inflammation as well as strengthening the immune system.

The building blocks for repairing the gut lining are Aloe vera, glutamine, collagen, licorice, and zinc. Some of these nutrients can be found in broths and seafood, grass-fed meat, red cabbage, oysters, and nuts. Alternatively, look for a complete gut lining supplement that contains some of the above building blocks.

Diet

Implementing an anti-inflammatory diet high in antioxidants and low in processed and sugary food is key.
Increase vegetables and oily fish, nuts, and seeds. Use anti-inflammatory herbs such as turmeric, coriander, and ginger in your cooking as often as possible. Eat grass-fed meat only (less inflammatory) and increase superfoods in your diet such as Chlorella, spirulina, Dunaliella salina, Maqui berry just to mention a few.

Smoothies are an effective way to get a lot of antioxidants and anti-inflammatory foods into your diet.
Blending a superfood powder with prebiotics and probiotics, plus possibly some berries and chia or flaxseeds for some extra omega 3 fats, polyphenols, and vitamin C. This will give your body a boost of vitamins and minerals to help heal and renew the cells as well as that extra antioxidant and anti-inflammatory boost. I like to add a protein or collagen powder for blood sugar balance, gut health structure, and repair.

Green tea is a potent antioxidant and has prebiotic properties. It has been shown to reduce inflammation as well as having the ability to improve the microbiome by increasing the Bifidobacterium species.
To have a therapeutic effect drink 3-4cups per day or consider taking green tea as a supplement.

Sleep and stress

Sleep is important because during sleep the body can repair the cells. Implement a good ritual before bed to let the body know it is time to wind down; take a bath, make a sleep tea, dim the lights, prep the bedroom, journal, or meditate. Try to go to bed at the same time every night and ensure there are no lights in the bedroom and avoid blue lights (all screens) an hour before bed.

Supplements that contain magnesium glycinate, Lavender oil, Californian poppy, and Passionflower can help with falling asleep and staying asleep.
Adding magnesium salt to your bath and/lavender oil can be helpful too.

Stress is difficult to avoid these days, but cortisol (a stress hormone) can be counterproductive to recovering from a virus. We are all different so try to find something that works for you, maybe reading a book, watching a movie, taking a walk in nature, meditate, cooking, singing, or speaking to a friend/partner.

If stress is part of your life and hard to get away from you could consider a set of herbs called adaptogens, they support the body’s response to stress and nourish the nervous system. I prefer Ashwagandha and Rhodiola but there are many more.

Supplements

Anti-inflammatory nutrients

Dill, broccoli, onions, capers, apples, and berries all contain quercetin. Quercetin is a flavonoid that appears to bind to the coronavirus spike protein, suppress inflammatory pathways, and prevent infected cells from replicating. Taking it as a supplement may the an option to ensure high enough amounts

In addition, fish oils, turmeric (curcumin) and CoQ10 are potent anti-inflammatory supplements.

Vitamins and minerals

Insufficient levels of zinc and selenium are associated with worse outcomes from viral infections. Good sources of zinc include oysters, hemp seeds and pumpkin seeds, beans, nuts, and animal protein; sources of selenium include mushrooms, Brazil nuts, and seafood.

If you are eating a wholefood diet packed with superfoods, greens, and oily fish you may not need a multivitamin, but if you know this is not a daily thing, it is worth considering a multivitamin that contains activated Bs, beta-carotene, minerals such as zinc, iron, copper, and selenium to boost your body’s levels of these important nutrients.

Although there is as yet no direct evidence indicating that vitamin C is beneficial specifically against COVID-19, we know that vitamin C can be helpful in reducing the severity of viral and bacterial infections and have proven effective in reducing inflammation. Kiwis, lemons, oranges and superfoods such as Kakadu plum, acerola and Maqui berry are high in vitamin C

While there are some conflicting results reported, the consensus is that vitamin D has a host of immunomodulatory effects which may be beneficial in the context of COVID-19, and that low levels of vitamin D can result in dysfunction of crucial antimicrobial effects, so getting out in the sun or taking a vitamin D supplement is a good idea for boosting that immunity.

Summary

The strategies for recovering from post-viral fatigue and other post viral symptoms are to implement an anti-inflammatory and antioxidant diet plus ensuring lots of rest and managing stress levels. Looking after your gut health by repairing the gut lining and feeding the microbiome pre and probiotics. Including lots of superfoods, turmeric, ginger, and green tea the diet or as supplements. Ensuring adequate levels of vitamin D as well as adding in anti-inflammatory supplements especially quercetin, curcumin and/or fish oils. Supplementing with zinc and selenium can be highly beneficial as we may not get enough of these minerals even when eating a relatively healthy diet.

This article was created for The Facialist by Clinical Nutritionist and Naturopath, Pernille Jensen. Founder of The Gut Co.

References

Cytokine Storms: Understanding COVID-19
(Immunity) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321048/

Make-up of gut microbiome may influence COVID-19 severity and immune response. (BMJ) https://www.bmj.com/company/newsroom/make-up-of-gut-microbiome-may-influence-covid-19-severity-and-immune-response/

Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19 (BMJ) https://gut.bmj.com/content/70/4/698

Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19 (NIH) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7804842/

Role of Gut Microbiome in COVID-19: An Insight Into Pathogenesis and Therapeutic Potential (Front. Immunol.)
https://www.frontiersin.org/articles/10.3389/fimmu.2021.765965/full

Protective Effect of Epigallocatechin-3-Gallate (EGCG) in Diseases with Uncontrolled Immune Activation: Could Such a Scenario Be Helpful to Counteract COVID-19? (International Journal of Molecular Sciences) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7404268/
Effects of green tea consumption on human fecal microbiota with special reference to Bifidobacterium species (Microbiol Immunol) https://pubmed.ncbi.nlm.nih.gov/22924537/

Vitamin C and COVID-19 (Front. Med)
https://www.frontiersin.org/articles/10.3389/fmed.2020.559811/full