What treatments are there?

Here we have categorised treatments in order with things at the top being best, and low down the worse.
Getting into basic colour codes. Green, Amber and Red.

Green it works, and is something all long covid patients should aim to do.

Amber, potential treatments that might work, there is a small amount of evidence for, and relatively low risk

Red, we know this doesn’t work and/or it has risks that outweighs any potential benefit. AVOID!

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This list will be continually updated as more evidence comes available. Please contact us for corrections, additions and suggested improvements.

What Works?

These are general lifestyle changes that definitely help your long covid symptoms.

This is an ordered list higher up the list are things that are more effective, lower in the green are still effective but a lower priority.

Prioritise

DO LESS.

Work out what is important, what can wait, and what you can stop doing.

On a good day do 50% of what you think you can do. This helps avoid burn out.

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Rest

Plan regular rests during your day. 

Sit down and rest whenever you can, (Watching TV doesn’t count).

Try to stop and rest before you feel tired. Break activities down into smaller chunks.

Avoid Alcohol

Alcohol is a depressant, it will make you more tired, sleep worse, increase anxiety and depression, therefore likely make long covid symptoms worse. 

Hangovers + long covid = A sure fire way to a BAD day.

Alcohol is trap, it convinces you that it is short term benefit, but it only does you harm. Really this is true for everyone. With long covid it is even more important to avoid alcohol.

Very promising results for the use of synbiotic supplements against long covid. This is the most promising data I have seen so far for anything against long covid.

SIM01 is a synbiotic preparation of three lyophilised Bifidobacteria strains and three prebiotic compounds.

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Improve sleep

Remove all screens from the bedroom, including your phone.

Try to set a regular routine and have a wind down time prior to bed.

Get more sleep, you probably need significantly more, now you have long covid.

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Diet

Eat a varied diet, mostly of fruits and vegetables. 

Don’t over consume calories. Everything in moderation. 

(Mediterranean diet is very close to optimal – lots of fruits, vegetables, nuts, legumes, fish, some meat, and heart healthy fats (like olive oil).)

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Get moving again

Start slowly and build up gradually. Increase a little, if that is ok after a week or two, slightly increase again.

Short walks are now exercise, standing up more often and more steps per day is great progress.

Exercise at low rate where you are able to have a conversation. Get a smart watch to track your extrusion

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What Might work?

These things have shown some promise, and might be worth trying with caution.

This is an ordered list more promising towards the top, nearly worth trying. Less potential towards the bottom

Paxlovid

There is weak evidence that some long covid is caused by residual virus in your system, so an anti viral drug might help.

You should take Paxlovid if you catch Covid again, (if you can get Paxlovid where you live)

One double blinded trial showed excellent results, for post fatigue. However, this was post covid fatigue, on average 3 weeks after negative Covid-19 test, not long covid (greater than 12weeks)

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Low Histamine diet

A patient led study with 812 long haulers showed significant improvements for long haulers on a low histamine diet. This is not high quality evidence, but with some caution and planning this diet might be worth a try.

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The evidence to support HBOT is weak, any benefit is likely short term and very expensive. Probably best avoided unless better evidence comes along.

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long-term high-dose immunoglobulin
therapy.

A study with only six people received treatment,

"all have had a significant to remarkable clinical benefit."

So promising but very preliminary. Essentially only an extended case study.  Approximately 25% of patience experience negative side effects from this treatment, including renal failure and thromboembolic complications. 

More informationSide Effects

A only a temporary (probably random) decrease in perceived general fatigue over three months. However after six months no improvement is shown, and patients taking creatine got worse, and the same as the placebo group. 

However, creatine supplementation is said to be safe, and this study was very small and although negative, we haven’t completely discounted it.

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What to Avoid?

This is an ordered list, towards the top could plausibly help, but there is little to no evidence to support. 

In the middle is stuff that doesn’t work

Towards the bottom stuff does more harm than good.

Very little evidence that it works and significant concerns about developing a very harmful tabasco addiction, therefore best avoided until better evidence comes to light

More informationOne case study with four people

Naltrexone

Currently only very evidence that it is effective. One small study, observational, unblinded, with subjective measures, 

One very weak study

Acupuncture

Minor risk, but completely ineffective.

Just get a friend to stick needles in you, it will do just as much good

Acupuncture is Awful

Ivermectin

Significant risks involved and very little chance that it could work.

All evidence shows it is ineffective for covid and long covid.

The Ivermectin vs Covid Calamity
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This list will be continually updated as more evidence comes available. Please contact us for corrections, additions and suggested improvements.