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Checklist: What to do if you have Long Covid (or think you might)

I'd hoped to add more to this article, but for now, here are some tips to get started.

Get Educated

Enroll in a Post Covid care clinic ASAP

If you suspect you may have Long Covid symptoms, enroll in a Post Covid care clinic. Many of these clinics offer telehealth appointments, accept insurance, and will work with your existing doctor. It's best to apply as soon as you suspect post Covid symptoms because there are already long waiting lists to speak with a doctor.

It's important to note that some of these clinics are more effective at others. Because this is a relatively new syndrome, the scientific data is still incomplete. There may not be a quick fix.

Watch Your Immune System

Your immune system may be hypersensitive. If you have existing allergies or sensitivities, you might notice they're more pronounced  -- and you may notice new ones. This should be temporary, but for now it's vital to keep them under control as much as possible.
  • Take over-the-counter antihistamines or nasal sprays that have worked for you before.
  • Avoid irritants and foods that make you react, even just a little. Pay attention to redness and other changes to skin color.
  • See the section below about the role of histamine.

If you have brain fog or feel dizzy or faint

  • Ask your doctor to be evaluated for POTS syndrome, Orthostatic Tachycardia, OCHOS syndrome or other types of orthostatic intolerance.
  • Try these workarounds, including wearing compression clothing and taking salt supplements. These measures can help blood circulate to all your organs, including your brain. (Check with your doctor before adding salt supplements.)

Watch for signs of thrombosis

If you've been exposed to Covid, keep an eye out for signs of deep vein thrombosis (DVT). Possible clues include leg swelling, pain, cramping, soreness, redness or feeling of warmth in one leg. If pulmonary embolism or blood clot develops in a blood vessel it can travel to a lung artery where it suddenly blocks blood flow. If you catch it in time, you can get treatment before it becomes potentially dangerous.
  • If you notice swelling in one leg, notify a healthcare provider immediately.

Take this probiotic

Researchers are finding that Covid can disrupt your gut bacteria. Multiple studies have shown that Covid infection can significantly reduce the presence of Lactobacillus Rhamnosus, a "friendly" bacterial strain, and this can have many downstream effects. Research suggests that taking a course of this probiotic can help modulate your immune system and reduce inflammation.

This probiotic is widely available with a well-established safety profile, spanning many years.

It's important to read the ingredients to ensure Lactobacillus Rhamnosus specifically is in there. (Any brand should work, but check ingredients carefully because there are many other types of the Lactobacillus family.)

  • Order Lactobacillus Rhamnosus from your local store or online.
  • If you have issues with digestion, gas or other irritable bowel symptoms that don't go away, read more about probiotics and gut bacteria analysis for Covid recovery.

Learn about microclots

Research suggests that Covid can cause microclots, which impairs blood flow to all the parts of your body.

Food Matters

It may sound cliché, but food really matters in Covid recovery. I'm learning firsthand that food additives can really agitate your immune system.
  • Include fresh fruit and vegetables in your diet as much as possible.
In my post-Covid recovery I've found that sugar, wheat and sometimes dairy caused my symptoms to get worse. You may notice that you're sensitive to these, or other foods that you never had problems with before. This is probably a temporary phase that might last a few months; these sensitivities are clues that your immune system is overstimulated.

The role of histamine

After getting Covid, you may go through a period of histamine intolerance. It's really annoying, but it's probably not permanent.
  • Cut foods that increase your histamine levels for a couple months. These include bananas, tomatoes, citrus fruits, cheese, wheat, yeast and chocolate. Note: it's not practical or healthy to stay on an ultra-low histamine diet long term.
  • Read about the possible link between Covid and histamine.
  • Consider taking H1 and H2 antihistamines.

"Radical rest"

Be proactive. Some long Covid symptoms appear many weeks after initial infection.

Get in some daily movement, even if it's just stretches, yoga, or short walks around the block. But do NOT push too hard. "Overdoing it" can cause a crash, with a delay of anywhere from 1 hour to 3 days.

A  few more important things:

  • Watch 10 Top Tips for Recovering from Coronavirus (12 min).
  • Focus on getting good sleep.
  • If you use a CPAP, be sure to keep using it. Blood oxygen levels are critical to healing. If you think you might have sleep apnea, talk to your doctor about getting evaluated.
  • Learn what you can do when you have a crash day.

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