Over the course of the past few years, I have noticed a startling and worrisome trend — the age range of my patients has declined from the early 40s to the early 30s. And they share many of the same symptoms, including brain fog, impaired concentration, post exertional fatigue, and day-to-day exhaustion.

I hesitate to attribute this trend to COVID-19, Long Covid, or Long Vax (Long post-COVID Vaccination Syndrome) based solely on my own clinical evidence. Too many variables exist, and too much has happened over the past five (5) years to draw such a hasty conclusion.

Emotional stress alone can cause many of these symptoms, and we have no shortage of that. Combine that with increased challenges to the immune system, toxins in our environment and in our diet, and an increasingly sedentary lifestyle, and it should be no surprise that younger people are starting to show signs of physical, mental, and emotional exhaustion.

Graphic for Pillars of Battling the Lingering Effects of COVID-19

To some degree, the problem matters less than the solution, and the cause matters less than the cure. Changes to my patient demographic may be the result of the above-mentioned symptoms. Or they may be due to anxiety over politics, personal finances, employment, relationships, or other issues. Whatever the cause, these patients are struggling with the same cluster of symptoms. And they respond positively to a similar treatment protocol personalized to each patient’s unique health history (and family health history), biology, and symptom profile.

In this post, I focus on solutions. Here I lay out the five (5) pillars that are key to recovering from Long Covid and other conditions that trigger chronic inflammation, deplete your reserves, and impair your body’s self-healing and self-repair mechanisms. What you will find is that these five pillars are familiar concepts for health, with added medicinal tools to push the body to reduce inflammation and build resilience.

Pillar No. 1: Use synthetic peptides from a trusted and reliable compounding pharmacy.

Synthetic peptides mimic the peptides often found in your body. They are small proteins that signal the release of hormones, reduce inflammation, and repair tissue naturally. Peptides are made in compounding pharmacies and require a prescription. Low side-effect profiles and the benefits they provide in healing inflammation are what make them a valuable tool in fighting Long Covid and similar conditions.

(If you’re unfamiliar with peptides, please read my post The Healing and Rejuvenating Power of Therapeutic Peptides here on the PROVOKE Health blog.)

At PROVOKE Health, we use a combination of peptides and cofactors from a trusted compounding pharmacy. Based on each patient’s unique history and symptom profile, we may prescribe one or more of the following peptides:

Please keep in mind that while peptides have shown remarkable potential in the treatment of complex, chronic, and even recently undiagnosed health conditions, their use should never be approached as a one-size-fits-all solution. These bioactive compounds influence many biological functions, including immune regulation, tissue repair, and inflammation control.

However, without proper medical oversight, they can be misused, leading to unintended consequences or masking underlying conditions that require deeper investigation. At PROVOKE Health, we recommend that peptides should only be used when medically indicated, as part of a doctor-supervised plan of care that considers your full medical history, current health status, and individualized treatment objectives.

Warning About Purchasing Peptides: Do not purchase peptides online. Most, if not all, come from China and are not subject to the stringent testing protocols required by law in the United States If you can get the peptides without a prescription in the U.S., that’s good reason not to trust them.

Pillar No. 2: Improve sleep. When you are asleep, your body’s self-repair, self-healing, and detox mechanisms go into overdrive. If you are struggling to fall asleep or are tired soon after waking up, you are not getting the restorative sleep you need. At PROVOKE Health, we ensure that our patients are getting the sleep quantity and quality required to promote healing and build resiliency.

One of the ways we do this is through the use of Epitalon to promote thymus function, support healthy immune function, protect the brain, regulate sleep, increase glutathione (a powerful antioxidant), and improve insulin sensitivity. Studies have shown that Epitalon can reduce the impact of chronic conditions associated with aging by increasing telomere length and reducing inflammation. (Telomeres prevent the ends of chromosomes from becoming frayed and tangled, much like the plastic tips at the ends of shoestrings; longer telomeres are associated with a lowered biological age.)

Other sleep-promoting tools we may recommend as part of a medically-supervised plan of care include Magnesium Glycinate Complex, an amino acid with sleep-promoting effects, and Cortisol Manager to balance cortisol levels, support a healthy stress response, and promote relaxation and restorative sleep.

Pillar No. 3: Exercise. As difficult as it may be to exercise when feeling completely exhausted, exercise is essential to recovery. You will likely need to change your exercise habits to either increase or decrease both timing and intensity, and we can help you navigate those changes.

Long Covid and similar conditions present serious challenges to the mitochondria, which are responsible for energy production in all your body’s cells. Impaired mitochondrial function is largely the reason why people feel low energy and experience brain fog.

Mitochondria function best with a combination of rest and exercise, the latter of which stimulates the mitochondria to produce energy. For optimal mitochondrial health and function, we recommend exercise to induce mitochondrial replication (also known as mitochondrial biogenesis) and peptides to help increase mitochondrial DNA repair and homeostasis.

Ask About MTOS-c: Ask your PROVOKE healthcare provider about MTOS-c, a peptide that may improve mitochondrial health and function. MOTS-c is used to help patients improve exercise performance and post-exertional fatigue (the experience of feeling poorly following physical or mental exertion). Current patients can use their Patient Portal account to request the PROVOKE Health Fact Sheet on the MOTS-c Peptide.

Pillar No. 4: Evaluate and adjust diet. Even if you are eating healthy overall, you may benefit from adjusting your diet. Many of our patients with Long Covid and similar conditions have specific food sensitivities or metabolic dysfunctions that respond well to changes in what and when they eat.

Some people require increased protein intake. Others, due to losses in their ability to regulate blood sugar (which results from inflammation) have developed insulin resistance or hypoglycemia, both requiring different mealtime planning and macronutrients (protein, carbohydrates, and fats). If you feel lightheaded between meals, you are either insulin resistant or hypoglycemic:

  • If you are tired directly after the meal, that’s a sign of insulin resistance.
  • If you feel better after eating, you are more likely hypoglycemic.

Blood work does not always show the insulin resistance or hypoglycemia if you are at a more functional stage where the body is trying to but cannot adapt and handle blood sugar properly. In later stages, the distinction becomes more apparent on labs. Don’t let the lack of a lab finding fool you or your doctor. The symptoms tell the problem; the labs tell you whether it’s chronic.

I would rather not have a lab finding that confirms insulin resistance or hypoglycemia, because, at that point, the condition is harder to correct than during the early phase when symptoms indicate a problem but the labs do not.

Pay attention to your symptoms and share them with your provider. At PROVOKE Health, we will review your diet and recommend specific changes to optimize your efforts to recover and build resilience. The right diet is not a one-size-fits-all approach. I have Long Covid patients who have improved with fasting and one who gets worse from it.

Pillar No. 5: Retrain the autonomic nervous system.

In patients diagnosed with Long COVID, high levels of inflammation and spike protein have a negative impact on many of their automatic bodily functions. This may be true of patients experiencing Long Vax, as well. We see increased cases of postural orthostatic tachycardia syndrome (POTS) and dizziness, lightheadedness, blood sugar imbalance, and low energy, all associated with autonomic nervous system (ANS) dysregulation.

The vagus nerve plays a key role in ANS regulation, which is responsible for the body’s parasympathetic (rest and digest) response, as opposed to the body’s sympathetic (fight or flight) response. Using vagal exercises, such as deep breathing, singing, and gargling, you can improve ANS function. We can recommend exercises and other interventions to tone your vagus nerve.

All five work together to restore resilience and enable the autonomic nervous system to reacclimate. In other words, as you reduce inflammation, balance the immune system, and restore energy, the autonomic nervous system begins to recover.

Do Not Settle for Less Than Feeling Your Best

If you are not feeling your best, realize that effective treatments are available. Don’t look for quick fixes such as medication. Those merely target symptoms. Instead, pursue treatments that restore health and build resilience. Such treatments often require diet and lifestyle changes, increased physical activity, and stress management, along with medication and supplements that address underlying imbalances and dysfunctions.

Your plan should start with a comprehensive physical exam and patient and family history, along with targeted testing to determine what is wrong. You should then receive a personalized treatment plan, not merely a prescription. Your plan should include steps you can take to improve your health. It should not treat you as a passive recipient of treatment.

If you’re not getting a diagnosis that makes sense to you or a personalized treatment plan with recommendations for what you can do to play an active role in your recovery, you should strongly consider changing doctors. We recommend seeing a doctor trained in functional and integrative medicine. If you are in or near Tampa, Florida, or would like us to serve remotely in a consultative role with your current provider, please contact us to schedule your comprehensive evaluation.

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About the Author: Dr. Matthew Lewis, D.C., DACBN, CFMP® is the founder of PROVOKE Health (previously Functional Healthcare Group) — a Tampa, Florida-based functional medicine and integrative healthcare practice that is committed to motivating, guiding, and supporting patients on their journey to regaining their confidence, resiliency, and health. By creating and co-managing highly personalized treatment plans that address complex health problems, Dr. Lewis and the team at PROVOKE Health repair patient’s confidence, resiliency, and health.

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Dr. Matt
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