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Does gut health play a role in long-haul COVID?

COVID + Gut Health

As the COVID-19 Pandemic has progressed reports that some people continue experiencing symptoms several weeks or months after their initial coronavirus infection has become more prevalent. Post-acute COVID-19 syndrome, commonly known as long-haul COVID, can affect anyone, including children. And, it can develop in people regardless of whether they had asymptomatic, mild or severe COVID-19.

What is long COVID?

Because COVID-19 can target the function of a various organs in the body, symptoms can vary greatly from one individual to another. Long COVID can manifest as persistent respiratory issues, neurological, cardiac and psychological problems. For example, some of the neuropsychiatric symptoms reported include headache, fatigue, brain fog, insomnia, anxiety and depression.

A recent study in the U.S. found that approximately one-third of people who had COVID-19 reported at least one persistent symptom up to nine months later. The Centers for Disease Control and Prevention (CDC) calls these cases “post-COVID conditions,” and notes that these patients experience a range of “new, returning, or ongoing health problems” four or more weeks after clearing the initial phase of illness.

Emerging evidence supports the potential role of gut dysbiosis (presence of viruses, parasites, bacteria, yeast) in the severity of COVID-19 infection and new findings suggest an individual’s gut microbiome profile may affect their susceptibility to long COVID.

Gut health and your immune system

Increased intestinal permeability is associated with systemic inflammatory conditions. Research has shown that the cause of many immune reactions is due to a compromise in the integrity of the gut barrier, which increases the entry of undigested antigens or food particles into the circulation. 

The immune system then becomes reactive to these antigens resulting in the production of pro-inflammatory cytokines and antibodies which further contribute to leaky gut syndrome or increased intestinal barrier permeability.

Your body then responds with an over active immune response and an ongoing increase in chronic systemic inflammation, and multiple inflammatory cytokines. This eventually leads to a condition in which the body’s immune system starts to attack itself.

People with long COVID often have raised levels of autoantibodies. The virus has triggered an antibody response to the patients’ own tissues. They also have reduced levels of gut bacteria that help regulate the immune system, regulatory mechanisms that should stop immune responses from targeting the patients’ own tissues.

Studies done in Hong Kong and the United Kingdom show indications that imbalances in the gut microbiome may be an important factor in whether a person develops long COVID. What research has begun to show is that the healthier your gut is the greater ability you have of fighting off COVID symptoms and fully recovering.

Researchers found that people with long COVID suffer from a disruption in the ratio of friendly to unfriendly bacteria in the gut, called dysbiosis.

In a Hong Kong study done in 2020 researchers analyzed stool samples of patients moderately to mildly ill with COVID-19, with 75% of them reporting at least one persistent symptom after six months time. The biggest complaints of the long-haulers were fatigue, memory loss, hair loss, anxiety, and sleep disturbances. Analysis showed patients who didn’t develop long COVID had a gut microbiome similar to people without COVID-19, and the long-haulers had a less diverse and less abundant microbiome.

A major UK study conducted over the course of a year, from May 2020-2021, concluded that treating the gut to a blend of five different friendly bacteria called lactobacillus probiotics, combined with a chicory-rich ingredient known as an inulin, could help with acute and long-term Covid symptoms. Inulin is a prebiotic that helps feed friendly bacteria in the gut.

The study involved 126 people, a third of whom had an acute Covid infection with the majority reporting a wide variety of longer-term symptoms lasting over 100 days. Results showed that cough, fatigue, gut and overall well-being improved in the majority who had been experiencing symptoms for over eight months, especially among those more likely to have had pre-existing gut dysbiosis.

As this new data continues to emerge, it is entirely reasonable to link the composition of gut organisms, and their ability to regulate the immune system, to the duration of COVID symptoms.

How can I protect my gut health?

Microbiome research has already identified several ways in which people can improve their gut microbiome. Maintaining a healthy and balanced gut microbiota via diet, avoidance of antibiotics if possible, exercise, and supplementing with depleted bacteria species, including Bifidobacteria, might be helpful.

4-Flora (Formally Tri-Flora) by IP Formulas is a multi-strain probiotic with Saccharomyces Boulardiiis. It is a unique and effective combination probiotic formula containing a concentrated synergistic spectrum of Saccharomyces boulardii (SB), Lactobacillus and Bifidobacterium.

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Leaky Gut Repair Powder

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4-Flora (Formally Tri-Flora) – Multi-Strain Probiotic

Inflammation can cause leaky gut syndrome, and leaky gut syndrome can also contribute to inflammation. Helpful lab tests to discover if you have leaky gut syndrome, intestinal permeability or contributory factors that we currently offer are the Cyrex Array 2 Intestinal Permeability Screen and the GI Effects Stool Analysis Profile.

Cyrex Array 3X - Wheat/Gluten Proteome Reactivity & Autoimmunity

Cyrex Array 2 Intestinal Permeability Screen

gi effects stool analysis profile

GI Effects Stool Analysis Profile

Our last bit of free advice to protect your gut health: you have to follow a lifestyle known to keep it in balance. That includes exercise, good sleep, and reduction of stress.

Research  studies:

Gut microbiota dynamics in a prospective cohort of patients with post-acute COVID-19 syndrome

Multiple early factors anticipate post-acute COVID-19 sequelae

Six-month follow-up of gut microbiota richness in patients with COVID-19

The Influence of a blend of Probiotic Lactobacillus and Prebiotic Inulin on the Duration and Severity of Symptoms among Individuals with Covid-19

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Meet Dr. Dave

Dr. David Scheiderer MD, MBA, DFAPA, is the Chief Medical Officer and Director of Education for Integrative Psychiatry, Inc. 

An accomplished clinician, educator, and lecturer, Dr. Dave has established himself as a key opinion leader in the fields of both mainstream psychiatry and functional medicine. Dissatisfied with the patient outcomes using only conventional treatments, he began treating his patients by addressing biological imbalances with lifestyle improvements, nutrition and nutraceuticals to get better outcomes. His integrative approach provided much improved results. Dr. Dave is passionate about helping the community he serves by personalizing treatments and educating the public about mental health and healthy aging. He has formulated several of our supplements and sat on the advisory board for many others, ensuring the products we carry are based on science and experience and have the best efficacy rates and highest ingredient quality available.

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