Support for Long Covid with Functional Medicine
Do you suspect you’re suffering with Long Covid? Read below how Functional Medicine can help support you.
How Can Functional Medicine Help with Long Covid?
Long COVID, also known as post-viral fatigue or post-acute sequelae of SARS-CoV-2 (PASC), is a condition where symptoms persist for weeks or months after the initial COVID-19 infection has resolved. For many, it can feel like the body never fully “resets,” leaving them with a confusing mix of symptoms that affect daily life and wellbeing.
It’s now estimated that over 65 million people worldwide are living with Long COVID. The condition can show up differently depending on the individual. Factors like age, sex, genetics, prior health history, and even how severe the original COVID infection was can all influence what Long COVID looks like. In those who were hospitalised or severely affected, symptoms may stem from lasting tissue damage, particularly in older men. For others—often younger women aged 36–50—even a mild infection may have triggered widespread physiological changes that linger long after the virus is gone. 1
Scientists are still uncovering the underlying causes, but several mechanisms have been proposed:
- Organ damage from the original infection (especially to the lungs, brain, or heart).
- Autonomic nervous system disruption, affecting things like heart rate, digestion, and temperature regulation.
- Immune dysregulation, including ongoing inflammation or autoimmunity.
- Blood vessel dysfunction, affecting blood flow and vessel integrity.
- Viral persistence, where traces of the virus may linger in the body.
- Blood clotting changes, leading to circulation and oxygenation issues.
- A prolonged Cell Danger Response, where the body remains “stuck” in a protective state long after the initial threat has passed.
Because Long COVID can impact multiple systems at once, it can feel unpredictable and exhausting. And many people are told their test results are normal—even while they’re living with very real, daily symptoms.
At Embracing Nutrition, we take a functional medicine approach that looks beneath the surface. We work with you to understand what’s driving your symptoms and create a personalised plan to support your healing journey—step by step.
What is Long Covid?
Long COVID is a multi-system condition that can affect the immune, neurological, cardiovascular, respiratory, and digestive systems. Common symptoms include 1:
- Fatigue that doesn’t improve with rest
- Brain fog, memory issues, or difficulty concentrating
- Shortness of breath or chest tightness
- Muscle and joint pain
- Headaches or dizziness
- Digestive issues (bloating, nausea, diarrhoea)
- Sleep disturbances
- Anxiety, low mood, or heightened stress response
- Heart palpitations or postural dizziness
- Sensitivity to light, sound, or exertion
These symptoms can fluctuate and often worsen after physical or mental activity—a phenomenon known as post-exertional malaise.
What Causes Long COVID?
Several mechanisms may be at play in the development of long COVID including:
- Immune dysregulation and chronic inflammation. 2
- Mitochondrial dysfunction, affecting energy production. 3
- Viral persistence or reactivation of latent viruses like Epstein-Barr (EBV). 4
- Autoimmune activity, where the immune system mistakenly targets the body’s own tissues.
- Gut dysbiosis and increased intestinal permeability (leaky gut).5
- Brainstem or vagus nerve dysfunction, affecting autonomic regulation. 6
- Mast cell activation, contributing to histamine-related symptoms. 7
- Hormonal imbalances, including chronic stress and excess oestrogen. 8
- Cell danger response, where the body remains in a prolonged state of threat detection after the initial infection. 9
- Environmental factors, such as mould exposure or toxin burden.10
- Nutrient deficiencies, especially B vitamins, selenium, zinc, and CoQ10. 11
Conventional Treatment for Long COVID
Conventional medicine is still evolving in its approach to Long COVID. Current strategies may include:
- Symptom-specific medications (e.g. pain relief, antihistamines, antidepressants)
- Pulmonary or cardiac rehabilitation
- Cognitive therapy for brain fog
- Graded exercise therapy (though this may not be suitable for all, especially those with post-exertional malaise)
While these can offer some relief, many people find that a more holistic, individualised approach is needed to truly support recovery.
How Can Functional Medicine Help?
We take a personalised, whole-body approach to Long COVID that includes:
Comprehensive Testing
We may recommend advanced testing to assess:
- Gut health and microbiome balance
- Mitochondrial function and oxidative stress
- Nutrient status and detoxification capacity
- Hormonal and adrenal function
- Immune markers and viral reactivation (e.g. EBV, CMV)
- Inflammatory markers and autoimmunity
- Environmental toxin exposure (e.g. mould, heavy metals)
Targeted Nutrition
Many people benefit from an anti-inflammatory, nutrient-dense diet that supports immune balance and energy production. This is centred around:
- Whole, unprocessed foods
- Blood sugar regulation
- Gut-healing foods and nutrients
- Elimination of inflammatory or reactive foods
Lifestyle & Stress Support
Long COVID often affects the nervous system’s ability to regulate stress and energy. We’ll help you explore:
- Nervous system regulation (e.g. vagus nerve support, breathwork)
- Pacing strategies to avoid post-exertional crashes
- Sleep hygiene and circadian rhythm support
Natural Support for Recovery
We may recommend supplements to support mitochondrial function and energy production, immune system modulation, mast cell stability, gut integrity and microbiome balance, and nervous system resilience depending on your individual needs.
Living with Long COVID can feel isolating and unpredictable, but with personalised support, it’s possible to reduce symptoms, restore balance, and feel more like yourself again.If you’re navigating Long COVID and looking for answers, we’d love to help you explore the next steps.
Tests we may recommend
References
- Yong SJ. Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infect Dis (Lond). 2021 Oct;53(10):737-754. doi: 10.1080/23744235.2021.1924397. Epub 2021 May 22. PMID: 34024217; PMCID: PMC8146298.
- Kallaste A, Kisand K, Aart A, Salumets A, Kisand K, Peterson P, Lember M. Long COVID and Biomarker Dysregulation-A Shift Toward Immune Exhaustion? Medicina (Kaunas). 2025 May 28;61(6):996. doi: 10.3390/medicina61060996. PMID: 40572685; PMCID: PMC12195428.
- Molnar T, Lehoczki A, Fekete M, Varnai R, Zavori L, Erdo-Bonyar S, Simon D, Berki T, Csecsei P, Ezer E. Mitochondrial dysfunction in long COVID: mechanisms, consequences, and potential therapeutic approaches. Geroscience. 2024 Oct;46(5):5267-5286. doi: 10.1007/s11357-024-01165-5. Epub 2024 Apr 26. PMID: 38668888; PMCID: PMC11336094.
- Chen B, Julg B, Mohandas S, Bradfute SB; RECOVER Mechanistic Pathways Task Force. Viral persistence, reactivation, and mechanisms of long COVID. Elife. 2023 May 4;12:e86015. doi: 10.7554/eLife.86015. PMID: 37140960; PMCID: PMC10159620.
- Yu LC. Gastrointestinal pathophysiology in long COVID: Exploring roles of microbiota dysbiosis and serotonin dysregulation in post-infectious bowel symptoms. Life Sci. 2024 Dec 1;358:123153. doi: 10.1016/j.lfs.2024.123153. Epub 2024 Oct 23. PMID: 39454992.
- Eastin EF, Machnik JV, Stiles LE, Larsen NW, Seliger J, Geng LN, Bonilla H, Yang PC, Miglis MG. Chronic autonomic symptom burden in long-COVID: a follow-up cohort study. Clin Auton Res. 2025 Jun;35(3):453-464. doi: 10.1007/s10286-025-01111-1. Epub 2025 Feb 5. Erratum in: Clin Auton Res. 2025 Jun;35(3):543. doi: 10.1007/s10286-025-01123-x. PMID: 39907931.
- Weinstock LB, Brook JB, Walters AS, Goris A, Afrin LB, Molderings GJ. Mast cell activation symptoms are prevalent in Long-COVID. Int J Infect Dis. 2021 Nov;112:217-226. doi: 10.1016/j.ijid.2021.09.043. Epub 2021 Sep 23. PMID: 34563706; PMCID: PMC8459548.
- Ortona E, Buonsenso D, Carfi A, Malorni W; Long Covid Kids study group. Long COVID: an estrogen-associated autoimmune disease? Cell Death Discov. 2021 Apr 13;7(1):77. doi: 10.1038/s41420-021-00464-6. PMID: 33850105; PMCID: PMC8042352.
- Lage SL, Bricker-Holt K, Rocco JM, Rupert A, Donovan FX, Abramzon YA, et al. Persistent immune dysregulation and metabolic alterations following SARS-CoV-2 infection. medRxiv [Preprint]. 2025 Apr 17:2025.04.16.25325949. doi: 10.1101/2025.04.16.25325949. PMID: 40321289; PMCID: PMC12047922.
- Kostoff RN, Briggs MB, Kanduc D, Dewanjee S, Kandimalla R, Shoenfeld Y, Porter AL, Tsatsakis A. Modifiable contributing factors to COVID-19: A comprehensive review. Food Chem Toxicol. 2023 Jan;171:113511. doi: 10.1016/j.fct.2022.113511. Epub 2022 Nov 28. PMID: 36450305; PMCID: PMC9701571.
- Schloss JV. Nutritional deficiencies that may predispose to long COVID. Inflammopharmacology. 2023 Apr;31(2):573-583. doi: 10.1007/s10787-023-01183-3. Epub 2023 Mar 15. PMID: 36920723; PMCID: PMC10015545.