10 Natural Treatments for Long Haulers (2023)

As of June 19, 2023, federal data published by the US CDC found that 15.7% (National Estimate) of adults who previously had a COVID-19 infection are currently experiencing symptoms of long COVID. Females tend to have a relatively higher risk as compared to males.

If you’re still coping with symptoms three months or more after being infected with COVID-19, you’re considered a COVID long-hauler.  As we learn more about post-COVID syndrome, however, the definition has been refined to be more accurate and useful:
  • Subacute or ongoing COVID-19 (post-acute COVID-19 syndrome): symptoms continuing beyond four weeks from acute infection, up to 12 weeks.
  • Post-acute sequelae of COVID-19 (PASC): symptoms persisting beyond the four weeks after acute infection.
  • Post-COVID-19 syndrome (long COVID, long-hauler’s syndrome): chronic ongoing COVID-19 symptoms beyond 12 weeks from acute infection.
With 200-plus symptoms linked to long COVID, treatment starts by pinpointing specific medical conditions and referring patients to the right clinicians. These might be lung specialists, heart specialists or brain rehabilitation experts. Patients need a carefully designed but flexible long haul COVID treatment protocol tailored to their particular symptoms and needs.



In this Article:
  • Long Haulers Symptoms
  • Natural Treatments
    1. Nattokinase
    2. Resveratrol
    3. Vitamin D
    4. Probiotics
    5. Melatonin
    6. Vitamin C
    7. Omega-3 fatty acids
    8. N-Acetyl-L-Cysteine (NAC)
    9. Quercetin, EGCG and Curcumin
    10. Zinc
  • FLCCC I-Recover Protocol

Long Haulers Symptoms

While the CDC tracks (updated Dec 16, 2022) the prevalence of 26 common post-COVID conditions affecting a significant body system, more than 50 long-term effects, particularly fatigue, headache, attention disorders, shortness of breath and hair shedding, are now attributed to long-hauler’s syndrome (R).

The global prevalence of post-COVID syndrome four months after the infection is now estimated at 49% of all patients (Journal of Infectious Diseases, November 2022). About 54% of hospitalized patients had long-hauler symptoms and about 34% of non-hospitalized patients had symptoms. This is a very important point to note i.e. a severe disease tend to lead to long COVID as opposed to a mild disease.

Among those who were hospitalized, only 26% fully recovered after five months (R), and nearly half still had symptoms one year later (R). Those who needed mechanical ventilation were 58% less likely to heal fully; obese people were half as likely to recover fully (R). At the two-year mark, 55% of hospitalized patients had at least one COVID-19 symptom, compared to 68% six months after infection. Patients generally had poorer health two years later and still experienced pain, fatigue, problems with sleeping and mental health issues. They went to a doctor more often, had ongoing difficulty exercising, and experienced poor quality of life (R).

Although those hospitalized for COVID-19 are at greater risk of long-hauler’s syndrome, moderate, mild or even asymptomatic illness can also lead to debilitating post-COVID symptoms.

Although numerous reports describe the epidemiology and clinical features of post-COVID syndrome, studies evaluating treatment options are glaringly sparse. In general, while ‘Long COVID treatment” should be individualized, the following supplements may have a role in the treatment of this disorder. 

Nutraceutical Therapy by Mode of Action

Natural Treatments for Long Haulers

We will cover some of the best natural supplements below, that may have a role in the treatment of this disorder. Please take note that the purpose of this article is to educate and to assist you in doing your own research. Before you take any supplements, it's best you find a doctor to discuss with.

1. Nattokinase, Lumbrokinase and Serrapeptase

If you’ve had COVID-19, especially if it was a severe case, be aware that blood clots and heart problems, including heart attack, can occur for 90 days or more. It’s believed that remnants of the virus remain in the nervous system, the lungs, the heart and other organs.

If the symptoms include major shortness of breath, cough with blood in it or pain on one side when you take a deep breath, it could be due to a late pulmonary embolism or a blood clot going to the lungs. 

Nattokinase (NK) is an enzyme derived from a traditional Japanese food called natto, and it is thought to help lower cholesterol, reduce inflammation, and improve circulation. 

A safer and likely equally effective alternative to aspirin, nattokinase dissolves blood clots by directly hydrolyzing fibrin and plasmin substrate. It converts endogenous prourokinase to urokinase (uPA). It also degrades plasminogen activator inhibitor (PAI-1) and increases the level of tissue plasminogen activator (t-PA). (Source

Furthermore, a study has also suggests that daily NK supplementation is an effective way to manage the progression of atherosclerosis and potentially may be a better alternative to statins which are commonly used to reduce atherosclerosis and further to prevent cardiovascular attack and stroke in patients.

In this clinical study (Chen 2022) involving 1,062 participants, the objective was to examine the efficacy of NK (nattokinase) in atherosclerosis and hyperlipidemia and safety at the dose of 10,800 FU/day after 12 months of oral administration. 

Authors found that NK at a dose of 10,800 FU/day effectively managed the progression of atherosclerosis and hyperlipidemia with a significant improvement in the lipid profile. The lipid-lowering effect of NK was more prominent in subjects who smoked, drank alcohol, and subjects with higher BMI. Regular exercise further improved the effects of NK. 

Co-administration of vitamin K2 and aspirin with NK produced a synergetic effect. In conclusion, the data demonstrate that atherosclerosis progression and hyperlipidemia can be effectively managed with NK at a dose of 10,800 FU/day. The lower dose of 3,600 FU per day is ineffective. Some lifestyle factors and the coadministration of vitamin K2 and aspirin lead to improved outcomes in the use of NK. The findings provide clinical evidence on the effective dose of NK in the management of cardiovascular disease and challenge the recommended dose of 2,000 FU per day.

Tanikawa et al. (2022) examined the effect of nattokinase on the COVID-19 spike protein. In the first experiment, they demonstrated that spike was degraded in a time and dose-dependent manner in a cell lysate preparation that could be similar to a vaccine recipient. The second experiment demonstrated that nattokinase degraded the spike protein in SARS-CoV-2 infected cells. This was reproduced in a similar study done by Oba and colleagues in 2021.

Lumbrokinase and Serrapeptase (Alternatives)

Lumbrokinase and serrapeptase are alternatives to nattokinase. You can alternate between these enzymes — one day take nattokinase and the next take lumbrokinase or serrapeptase — because you’ll need to be on it for about three months and you can develop a sensitivity to them over time.

Anyone who had COVID-19, especially with significant symptoms, should consider taking digestive fibrinolytic enzymes to be sure you don’t have any clotting. An alternative to determine if clotting is occurring is a test called D-dimer, although it can be pricey. D-dimer is a protein fragment produced by the body when a blood clot dissolves.

It’s typically undetectable or present only at very low levels, buts its level may significantly rise when the body is forming and breaking down blood clots (R). If your d-dimer test is low, then you don’t need to take the enzymes. Likewise, if you had a very mild, cold-like case, of COVID-19, you probably don’t need them.

2. Resveratrol

Resveratrol is a polyphenol with anti­oxidant and anti-inflammatory effects that’s found in red grapes, red wine, ­peanuts, and some berries. It’s also available as a supplement.

Leo Galland, MD, a functional-medicine internist in New York City, has found it to be particularly helpful in restoring his COVID patients to health. “Resveratrol has a number of beneficial effects on coronavirus infection,” he notes. “It supports ACE-2 function, it inhibits the growth of the deadly MERS coronavirus through multiple mechanisms, and it diminishes the kind of inflammation associated with coronavirus infection.”

Galland treated a physician in her 60s who’d been sick with COVID for six weeks, continuing to run daily fevers with brain fog and fatigue. He prescribed a combination of herbs and supplements, including resveratrol, and her symptoms resolved within a couple of weeks.

He recommends long-COVID patients supplement with 200 mg of resveratrol twice a day.

3. Melatonin

Melatonin has anti-inflammatory and antioxidant properties and is a powerful regulator of mitochondrial function [R]. It also supports the gut lining, which promotes healthy immune function.

Supplementing with 1 - 2 mg of melatonin at bedtime might benefit those whose sleep–wake cycles have become dys­regulated with long COVID.

Melatonin is also one of the optional adjunctive therapies of the FLCCC i-Recover protocol for long haul syndrome. FLCCC has launched a new version of i-Recover protocol for post-vaccine syndrome which include melatonin as one of the important first line treatments.


4. Probiotics

COVID can wreak havoc on the gut microbiome, but research on specific probiotic strains that can best restore balance following the syndrome’s particular damage is in its infancy. Leo Galland, MD, a functional-medicine internist in New York City, is looking into soil-derived bacteria of the genus Bacillus because it may have natural antibiotic properties, though there’s not yet enough data to make specific recommendations.

One Swedish study demonstrated that taking probiotics for 14 days could help alleviate some of the symptoms of long COVID, namely muscle soreness and brain fog. We also recommend optimizing your gut microbiome by avoiding processed vegetable oils, processed foods and conventionally raised meats in animal products.

Probiotics is one of the first line therapies of the FLCCC i-Recover protocol for post-vaccine syndrome.

Eating fermented foods, such as sauerkraut, yogurt, kefir, and kimchi, can help fortify and support the gut’s microbiome. And in the event of ongoing gut disturbances, working with a functional-medicine provider to design a well-rounded prebiotic and probiotic protocol can help bring the microbiome back into balance.

As reported in this short news clip, research evidence shows that probiotics may help reduce long-haul symptoms after COVID-19. Some people experience symptoms for weeks or months after a COVID-19 infection has resolved. When these symptoms persist for four weeks or more, they are known as long COVID, long-haul COVID, chronic COVID or long-haul syndrome.


5. Vitamin D

Vitamin D3 is essential for supporting healthy immune system function. It works hand in hand with your body to modulate both innate and adaptive immune responses which regulate everything from reactivity to antigens and pathogens.

Maintaining good vitamin D status should be a priority even as a preventive measure, and may help restrain inflammation from elevating during COVID in the first place.

The majority of those with post-COVID-19 syndrome continue to have low levels of vitamin D in their bodies.

Vitamin D is also one of the recommended treatments in FLCCC's i-Recover protocol for post-vaccine syndrome.

According to FLCCC's i-Recover protocol for Long COVID, the majority of those with post-COVID-19 syndrome continue to have hypovitaminosis D (low vitamin D level). See tables 1 or 2 for vitamin D supplementation below.


6. Vitamin C

Vitamin C has important anti-inflammatory, antioxidant, and immune-enhancing properties, including increased synthesis of type I interferons. [R] Avoid in patients with a history of kidney stones. Oral Vitamin C also helps promote growth of protective bacterial populations in the microbiome. 

Vitamin C inhibits histamine. Healthcare professionals are administering vitamin C intravenously to deliver it directly into their patient’s bloodstream to be immediately available. Liposomal vitamin C is the next best option. It’s the most bioavailable form of vitamin C on the market today. The liposomal form can survive the digestive process to be up to 135% better than traditional oral vitamin C.

Long-COVID patients can supplement with liposomal vitamin C 500 mg twice a day. 

The Italian nationwide multi-centre LINCOLN study (L-Arginine and Vitamin C improves Long-COVID) results, published in Pharmacological Research in September 2022, was the first to show the beneficial effects of the combination of L-Arginine and Vitamin C in Long-COVID.

L-Arginine and Vitamin C in Long-COVID

 

7. Omega-3 fatty acids

Vascepa, Lovaza or DHA/EPA 4 g day. Omega-3 fatty acids play an important role in the resolution of inflammation by inducing resolvin production. [RefRef

Evidence: Two peer-reviewed randomized, controlled trials suggest that omega-3 fatty acids help hasten recovery from COVID, and when given to ICU patients may make them six times more likely to survive.

Omega-3 is also part of the first line treatments of the FLCCC i-Recover protocol (below).

8. Quercetin, EGCG and Curcumin

Quercetin has broad spectrum anti-inflammatory properties. These natural flavonoids inhibit mast cells and have been demonstrated to reduce neuro-inflammation. 

Flavonoids have broad spectrum anti-inflammatory properties, inhibit mast cells, [R] and have been demonstrated to reduce neuroinflammation. [R] Due to the possible drug interaction between quercetin and ivermectin (see below) these drugs should not be taken simultaneously (i.e., should be staggered morning and night). 

Quercetin is found in dill, broccoli, onions, capers, apples, and berries. 

Quercetin appears to bind to the spike protein of the coronavirus, inhibit inflammatory pathways, and block replication of infected cells. It is also antiviral and completely safe. In addition to getting sources of quercetin from diet, long-COVID patients can supplement with 250 - 500 mg a day. 

Other phytonutrients such as EGCG (epigallocatechin gallate, a polyphenol found in green tea) and curcumin (found in turmeric) can also decrease inflammation and rebalance the immune system. 


9. N-Acetyl-L-Cysteine (NAC)

NAC is an amino acid that the body uses to create glutathione, the body’s master detoxifier. Glutathione is your master detoxifier and the most powerful free radical scavenger produced by your body.

Eating plenty of cruciferous vegetables (such as kale, broccoli, and cabbage), as well as avocado, okra, spinach, and alliums, can help bolster levels of gluta­thione, as can supplementing with NAC.

2017 paper found NAC has potent thrombolytic effects, meaning it breaks down blood clots once they've formed.

Importantly, NAC may also protect against other problems associated with COVID-19, including the hypercoagulation that can result in stroke and/or blood clots that impair the ability to exchange oxygen in the lungs.

Many COVID-19 patients experience serious blood clots, and NAC counteracts hypercoagulation, as it has both anticoagulant and platelet-inhibiting properties.

Aaron Hartman, MD, founder of the Richmond Integrative and Functional Medicine clinic in Richmond, Va., describes one patient, a 26-year-old woman, whose symptoms — persistent low oxygen and shortness of breath — following a bout of COVID resolved after treatment that included NAC as well as omega-3 fish oil.

“NAC is one of the more important nutrients for people who get shortness of breath with COVID, because of its ability to break down those really, really small blood clots called micro-emboli,” explains Hartman.

10. Zinc

Zinc is essential for healthy immune function. A 2020 review published in the International Journal of Infectious Diseases has found that zinc deficiency can increase the risk of poor outcomes in viral infections, including COVID-19.

Foods that are rich in zinc include meat, poultry, shellfish, eggs, dairy, seeds, nuts, legumes, sweet potatoes, quinoa, and green leafy vegetables. 

FLCCC I-Recover Protocol

Due to the marked overlap between long COVID and post-vaccine syndrome, please refer to the I-RECOVER Post-Vaccine Treatment protocol below for detailed treatment strategies.

The I-Recover protocol has been updated and below is their latest version (Feb 10, 2023). 

Treatment must be individualized according to each patient’s presenting symptoms and disease syndromes. It is likely that not all patients will respond equally to the same intervention; a particular intervention may be life-saving for one patient and totally ineffective for another. Early treatment is essential; it is likely that the response to treatment will be attenuated when treatment is delayed. 

Patients with post-vaccine syndrome should do whatever they can to prevent themselves from getting COVID-19. This may include a preventative protocol (see I-PREVENT) or early treatment in the event you do contract the virus or suspect infection (see I-CARE). COVID-19 will likely exacerbate the symptoms of vaccine injury.

Once a patient has shown improvement, the various interventions should be reduced or stopped one at a time. A less intensive maintenance approach is then suggested.

The core problem in post-vaccine syndrome is long-lasting “immune dysregulation.” The most important treatment goal is to help the body restore a healthy immune system — in other words, to let the body heal itself. Our recommended treatment strategy involves two major approaches:
  • Promote autophagy to help rid the cells of the spike protein
  • Use interventions that limit the toxicity/pathogenicity of the spike protein
FLCCC recommend the use of immune-modulating agents and interventions to dampen and normalize the immune system rather than the use of immunosuppressant drugs, which may make the condition worse.

There are also some important cautions and contraindications that should be carefully reviewed within the more comprehensive and detailed document called “An Approach to Managing Post-Vaccine Syndrome” and which should be discussed with a qualified provider as well.

First Line Therapies

(Not symptom specific; listed in order of importance)
  • Intermittent daily fasting or periodic daily fasts
  • Ivermectin (Stone 2022)
  • Moderating physical activity
  • Low-dose naltrexone
  • Nattokinase (Tanikawa 2022)
  • Aspirin
  • Melatonin
  • Magnesium
  • Methylene blue
  • Sunlight and Photobiomodulation
  • Resveratrol

Probiotics/Prebiotics/Adjunctive/Second-Line Therapies

(Listed in order of importance)

  • Vitamin D (with Vitamin K2)
  • N-acetyl cysteine
  • Cardio Miracle™ and L-arginine/L-citrulline supplements
  • Omega-3 fatty acids
  • Sildenafil (with or without L-arginine and L-citrulline)
  • Nigella sativa
  • Vitamin C
  • Spermidine
  • Non-invasive brain stimulation
  • Intravenous Vitamin C
  • Behavioral modification, relaxation therapy, mindfulness therapy, and psychological support

Third Line Therapies

  • Hyperbaric oxygen therapy
  • Low Magnitude Mechanical Stimulation 
  • “Mitochondrial energy optimizer” with pyrroloquinoline quinone, glycophospholipids, CoQ10, NADH, and other nutrients (e.g., Life Extension Energy Optimizer, Restorative Solutions Mitochondrial Nutrition PQQ, Researched Nutritionals ATP 360® and ATP Fuel® and PureEncapsulations Mitochondria-ATP
  • Hydroxychloroquine 
  • Low-dose corticosteroid 

Note about anesthesia and surgery:

Patients should notify their anesthesia team if using the following medications and/or nutraceuticals, as they can increase the risk of Serotonin syndrome (SS) with opioid administration: Methylene blue Curcumin Nigella Sativa Selective Serotonin Reuptake Inhibitors (SSRIs)

About Ivermectin

Ivermectin is a well-known, FDA-approved drug that has been used successfully around the world for more than four decades. One of the safest drugs known, it is on the WHO’s list of essential medicines, has been given over 3.7 billion times, and won the Nobel Prize for its global and historic impacts in eradicating endemic parasitic infections in many parts of the world.

Review the totality of supporting evidence for ivermectin: https://c19ivm.org.

It is likely that ivermectin and intermittent fasting act synergistically to rid the body of the spike protein.

It appears that vaccine-injured patients can be grouped into two categories: i) ivermectin responders and ii) ivermectin non-responders. This distinction is important, as the latter are more difficult to treat and require more aggressive therapy.

For ivermectin responders, prolonged and chronic daily treatment is often necessary to support their recovery. In many, if the daily ivermectin is discontinued worsening symptoms often recur within days.

Ivermectin is best taken with or just following a meal, for greater absorption.


Related:

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Ingredients:
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Z-Dtox is more powerful than Z-Stack. It has EGCG instead of Quercetin, NAC, and higher dose Zinc. It is more appropriate for higher risk patients. For example, those people that have a dysfunctional immune system, risk of blood clots, older people and those with chronic medical conditions.

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