What Irritates the Gut? Avoiding Long Covid
We have known the gut is implicated in Covid for awhile. New research shows that a healthy gut reduces the risk of developing long COVID. This is a set of symptoms that can show up months after contracting the virus. Post acute COVID-19 syndrome is common with up to 75% of people report at least one symptom six months after recovery from the initial virus. The most common symptoms include fatigue, muscle weakness and insomnia. Poor memory, hair loss, anxiety and gastrointestinal symptoms are common too.
“In summary, altered gut microbiome composition is strongly associated with persistent symptoms in patients with COVID-19 up to 6 months after clearance of SARS-CoV-2 virus.”
What Causes Long Covid?
Although researchers are not yet entirely clear on the cause of long COVID we do know that an exaggerated immune response, cell damage and the consequences of critical illness are contributing factors. The symptoms we see with long COVID can be related with the 100+ autoimmune conditions. Onset of autoimmunity often follows an acute viral infection and poor gut health is usually present. In fact, the disordered immune response to COVID that leads to persistent symptoms may be caused by an imbalance in the gut. This affects the recovery process leading to persistent symptoms or in some cases autoimmune illness.
The researchers tracked changes in the gut microbiome of 106 patients with varying degrees of COVID severity using stool samples. The comparison group was 68 people who didn’t have COVID. Long COVID occurred in 81% of patients at 3 months. This dropped only marginally at 6 months to 76.5%.
Initial viral load isn’t associated with long COVID but the gut microbiome is. Patients with less diversity tend to be at higher risk. The gut microbiome of patients who didn’t develop long COVID was similar to that of those who hadn’t had COVID-19.
The diversity and richness of gut bacteria in patients who subsequently developed long COVID was significantly lower than that of patients who didn’t. This suggests that particular gut microbial profiles may indicate heightened susceptibility, say the researchers.
What Irritates the Gut?
For people with long COVID we often see improvement with an autoimmune protocol (AIP). This removes the most irritating foods from the diet to allow the gut to heal and restore itself. What I see in clinical practice is most people react to only one or maybe two of the food groups. This means a highly restricted diet is not necessary long-term. For example, one patient found that only nuts caused irritation while her husband’s symptoms were related to gluten. Many people cannot tolerate pea protein and so removing their vegan protein drink made a huge difference. A low-lectin diet is usually an excellent starting point. Adding in foods like bone broth and sauerkraut then heal and diversify the microbiome. This approach along with therapies like LDN (low dose naltrexone) have helped people. More evidence-based supports can be found here.
Research and understanding around long COVID is growing. Clinics dedicated to helping people have emerged in response and the information will continue to evolve.