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Long-Hauler Phenomenon

Written by

Michael Swail


Functional Medicine, Holistic Therapies, homepage, Pharmacy, supplements

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As we learn more about the impact of COVID-19, one aspect that requires additional focus is the long-term, lingering symptoms that many suffer. This is commonly referred to as Long-Hauler Phenomenon or Long-Hauler Syndrome.

Various studies indicate that for some, symptoms linger for many months post recovery, and are present in more than 10% of those that have been infected. The reality is that we do not know the cause or treatment for long-haul symptoms and more research is needed.

That said, long term symptoms are common with viral infections. We can learn from this experience as we look for answers to long-haul syndrome specific to COVID-19.



The most common symptoms reported by long-haulers are:

  • Fatigue
  • Insomnia
  • Depression
  • Anxiety
  • Diminished lung function

There are likely different causes of these symptoms and we can look to root causes of similar health conditions to support people in their recovery process.


Natural Approaches

From a functional, integrative approach, it seems likely that a major contributor to the long-hauler symptoms is inflammation caused by an overactive immune system. Add to that the negative impact of stress and lifestyle changes many have experienced associated with the pandemic.

There are a number of natural approaches that one might try to help mitigate these symptoms.


The immune system’s natural response to fight a virus is inflammation. Simplistically, inflammation is both necessary and protective. Lingering (chronic) inflammation, however, results in the body eventually attacking itself, which manifests as many different symptoms often similar to those felt by long-haulers.

There are a number of ways to fight inflammation. The most common supplement protocols include:

Immune System

While an infection may have passed and the virus is no longer present in the body, the response to fight the virus may keep the immune system in a heightened, overactive state.

Supplement protocols that help regulate and support a healthy immune system include:

  • Vitamin C: 1 gram / day
  • Vitamin D: 5,000 – 10,000 IU / day (check your levels and adjust dosage accordingly)
  • Zinc: 30 – 60 mg / day
  • NAC (n-acetyl cysteine): 1,000 mg / day
  • EGCG (epigallocatechin gallate): 100-250 mg / day
  • Probiotics: varies, but a good standard is 20-100 billion CFU lactobacillus and bifidobacterium / day


There are many aspects of what you eat and drink that can impact your body’s response to an active viral infection or lingering symptoms. While there is no one “right” diet for everyone, there are a few things you can avoid to ensure your body has the best chance to fight any long-haul infections.

Fast food. Avoid as much as possible. If you must, focus on eating only the proteins (e.g. grilled chicken, hamburger patties, etc) and vegetables, and avoid the starches and simple carbohydrates (french fries, hamburger buns, etc)

Vegetable and seed oils. These can cause serious inflammation in the body. Choose coconut oil, avocado oil, olive oil and animal fats instead.

Refined sugar. It seems like everything we buy in the grocery store contains sugar. Do your best to avoid products with added sugar. To satiate a sweet tooth, choose fruits or honey. Any time you are eating sweets or simple carbs try to include a protein like nuts with it.

Processed foods. Our body has a hard time digesting and metabolizing highly processed foods. Focus on whole foods as much as possible. Shop the edges of the grocery store.

Alcohol. Consumption of alcohol is way up, causing many types of lingering health effects. Try limiting consumption to one drink per day, or pick only certain days that you allow yourself to have a drink – like Friday and Saturday only.


Exercise: regular movement and exercise is a key component of a healthy immune system. That said, it can be challenging to return to exercise if symptoms of fatigue or shortness of breath persist. Listen to your body, take it slow. Incorporate activities of lower intensity: yoga, walking outdoors and sauna.

Sleep: we often overlook or de-emphasize getting high quality sleep. Try to get 7-8 hours each night – or more if you are dealing with long-haul symptoms. Avoid electronics 1 hour before bed to improve sleep quality.

Stress: persistent stress exasperates health concerns. Incorporate activities every day that calm your system and clear your mind – breathing exercises, meditation, reading, drawing, etc.

Community: one of the biggest contributors to depression is loneliness. As humans, we need connection with other humans. While this is more difficult than normal, make it a priority to connect with friends and family in a safe way.

Much more research is needed to fully understand long-haul syndrome, including who’s most likely to get it, preventive methods and best treatment practices. In the meantime, there are centers opening up around the country that specialize in treating long-haulers. Speak with your doctor immediately if your symptoms become severe.


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