Long COVID Recovery Protocol

Long COVID affects a meaningful share of people after COVID-19. Common symptoms include fatigue with post-exertional malaise, brain fog, dysautonomia, breathing problems, mast cell symptoms and exercise intolerance. Proposed causes include ongoing inflammation, autoimmunity, viral persistence, mast cell activation, mitochondrial problems and autonomic dysfunction, and the picture often resembles ME/CFS. Pacing is central: activity can worsen PEM, so rest is part of the treatment, and heart rate or HRV tracking helps. Low-histamine eating and H1 plus H2 antihistamines help many people with mast cell symptoms. Low-dose naltrexone, CoQ10, D-ribose and B vitamins are used for energy, with small studies. Metformin during acute infection lowered long COVID risk in one trial; ivermectin did not. Hyperbaric oxygen has one small positive randomized trial. Recovery varies widely, from months to years. Your symptoms are real, and a clinician experienced in long COVID can help sort out what is driving them.