The top six things that helped accelerate my long covid recovery

Removing dietary triggers

Prior to getting sick, I thought I was eating as healthily as one could. I ate a plant-forward diet with plenty of lean protein, regularly consumed “green” smoothies with kale, pea protein, nut butters, and berries, and typically avoided “junk” foods such as processed foods and sweets. I regularly avoided bread and dairy, and if I ate fast food, it was at Sweetgreen. It wasn’t until digging into the literature that I realized how much room there was to improve.

To start with, I cut out oat milk, pea protein, and nut butters, as I followed the autoimmune protocol guidance and removed both potential allergens and processed foods. I soon adjusted to aim for a low-histamine diet as well, given the evidence linking long covid with MCAS.

Lowering my histamine intake really moved the needle and started alleviating some of my symptoms almost immediately. From this new, improved baseline, I was able to identify that I was reacting to lectins as well. Finally, following a pattern of signs, I learned that I was also sensitive to oxalates and began lowering those.

These changes reduced or completely resolved some of the day-to-day issues I was struggling with. While most of these changes weren’t permanent (and weren’t intended to be), they helped me get to a better baseline from which I could begin to heal before reintroducing foods.

While I have gone back to consuming lectins and foods slightly higher in histamine, I still aim to minimize consumption of non-A2 dairy, foods with high levels of oxalates, and seed oils, due to their pro-inflammatory nature.

Addressing deficiencies

For the first year of my illness, any supplement intake was essentially a crapshoot. There are a number of ME/CFS or long covid supplement “guides” and a set of generic recommendations provided by long covid specialists, but given that my blood tests didn’t show much of interest on this front, my practitioners did not provide recommendations specifically targeted to me.

This changed in May of 2021 when I received my first Metabolomix test results from Genova. After more than a year of mostly normal blood tests, these tests provided evidence of some very specific things that were not going well with respect to my digestion and nutrient assimilation. They showed significant deficiencies, despite the fact that I had been eating a whole foods diet rich with high quality protein, healthy fats, and fruits and vegetables, in addition to supplementing with vitamins, minerals and probiotics for over a year. This included low pancreatic elastase, fat malabsorption, impaired detoxification, metabolic imbalance, and severe oxidative stress. These were imbalances which I could now work on addressing.

It was from here that I learned that I was glaringly deficient in both B1 and B12 (among other things), despite supplementation. There were some bumps along the way, no doubt, but introducing these vitamins in a targeted manner resolved some of my worst symptoms.

Stabilizing my glucose

The summer of 2022 was one of the lowest points for me over the past three and a half years. I couldn’t walk much more than 10 minutes at a time without fearing a relapse, and had to take the bus, an uber, or an electric scooter to get anywhere that was further than that. I had near-consistent sleep apnea, which would get worse with the slightest provocation, such as a 15-minute walk or 20 minutes in the sun. The apnea left me constantly fatigued and barely able to do my work.

During this time I was not consuming any of the foods that are commonly understood to be unhealthy, such as refined grains, refined sugars, or processed foods. As I was on a fairly strict diet which consisted entirely of whole, unprocessed foods, I thought I was eating the healthiest I possibly could. What I realized later was that the natural sugars I was consuming (i.e. in the form of fruit) was taking my blood glucose on a roller coaster ride.

In September, I began reducing my fruit intake and eliminated coconut water. Almost immediately, my symptoms began to improve. A few months later, I purchased a subscription to continuous glucose monitoring to take this a step further. What I found then was that my glucose still wasn’t stable due to the timing of my foods. Because I was eating fruit before (vs. after) my protein and fat, my glucose was still consistently spiking. The glucose monitor allowed me to further refine my intake in order to ensure a glucose-stabilizing diet.

While variable blood glucose can result in a great deal of unseen damage (read more about this here and in the resources here), stabilizing my glucose had the following immediate noticeable impacts:

• Better sleep. My apnea became less frequent, and my fatigue (which I had tracked on a scale of 1-5) reduced by 20%. Given how much the apnea had been impacting my ability to function, this improvement alone was significant.

• Ability to walk longer distances and a reduced need to rest. Despite the fact that summer would be the time when I would be naturally out doing things more, my average daily step count nearly doubled after stabilizing my glucose, without placing any specific focus or emphasis on it.

Finding the right balance of macronutrients

Over the past 3.5 years, I experimented with many different diet types, from strict keto to high-carb. What I found was that I don't do well on high-carbohydrate diets (see above), but I also fare poorly on diets where my carbohydrate intake regularly falls below 100g per day.

After feeling so much better upon flattening my glucose curve, I went too far in the opposite direction. I increased the amount of fat I was consuming and consistently consumed fewer than 70-80g per day. My cholesterol slowly inched up until it was in an non-ideal range, and I began experiencing hair loss and other undesirable symptoms.

I then learned the importance of the thyroid in clearing LDL cholesterol and the importance of carbohydrates for thyroid function. I brought my carbohydrate intake back over 100g per day and some of my symptoms improved immediately.

Supporting my circadian rhythm

Early on, I learned from Cynthia Li’s recovery story that something as simple as maintaining a consistent schedule for meals and sleep allowed a significant step forward for her recovery. While I am not perfect at this, I aim to maintain a consistent meal and wake/sleep schedule, get at least 10 minutes of sun in the morning, and avoid blue lights after sunlight (you can read more from Huberman on the importance of light here).

When my schedule is not as consistent, I do not feel as well.

Pacing

Much has been written about pacing elsewhere, so I won’t attempt to regurgitate it here. I will just say that being conscious of my energy envelope since early on in my illness likely prevented significant setbacks and flares that I would have otherwise experienced.

Taking the next steps

You can learn more about my recovery journey in the blog posts here; all of the resources I’ve found helpful are listed here. Don’t hesitate to reach out if there is something I can help with.