I had a long process with this that mostly manifested as exercise intolerance and general inflammation/discomfort, and sleep struggles. I made no progress for 2 years, lost most of my muscle (I had been very active before) and started thinking "is this how it's going to be forever?". After not finding anything promising from traditional medicine or supplements, I finally made some dramatic life changes. I'm fully past it now (with persistent lifestyle changes), but I really had to rethink my relationship with food.
Ended up doing a paleo diet, avoiding stressors (some of which are not obvious like just being on your phone scrolling, bad posture/circulation/sitting for too long), improving sleep hygiene, and ramping up consistent cardio exercise, with an emphasis on getting up to 4x/week zone 5 cardio without triggering intolerance.
Since then I've discovered a lot of other things that are great for overall health, like HRV-reset breathing and long-duration water fasts (around 3 days is optimal for me). I imagine those would have been very helpful if I had tried them earlier. A water fast is a complete metabolic and inflammatory reset of the body, and it's not as hard as you might think.
Hopefully most affected folks have recovered and are living normal lives by now, but if not, there are things you can do! It seems like the more challenging those things are, the more efficacious.
A non-inflammatory rocket shock diet can certainly aid in symptoms of long covid in many users, often people megadose on antioxidants to dilate their recovery window and not regress. Glad to hear you are feeling better and I totally agree that movement and diet are key in recovering from inflammatory disease.
Maybe a bit of a strange take, but after having dealt with chronic illness personally and talked with a lot of others with chronic illness, I don't think classifying chronic illness by symptoms will help with curing, and in fact I don't think categorizing works at all for chronic illness. We've been trying to classify chronic illnesses for so long, and yet in most cases no pattern emerges.
This has led me to conclude that perhaps in most cases chronic illness is an emergent behavior from a complex system, namely our body. Now tbh this is kind of a cheap take, because it's not that hard to conclude. But gosh darn it, we're programmers and we deal with complex systems all the time! What I want to see is a complete quantitative mapping of human metabolism, so that we can see all the in-between steps, not just the surface levels. That way curing chronic illness is more about comparing metabolite levels against known pathways and seeing what's regulated incorrectly. There's just not enough introspective capability currently.
My vision is some day a person who's been chronically ill can walk into a clinic, take a blood test, and with mass spectrometry get the level of the around 1800 different intermediate metabolites. That gets mapped to a known good metabolic graph, and it's optimized to find what in-between step is off kilter. They're then prescribed a drug that resets the bad state, and it 6 weeks they're back to normal.
I also doubt that AI will substantially help either. It still doesn't bring any more introspection capability, and if we can't figure out why someone is sick, I have little faith that a predictive AI can figure it out either.
I caught this in the Dec 2023/Jan 2024 Covid wave, in a densely-packed Bay Area tech office. I only returned to near-full mental clarity in Jan 2026 - two years later. It's an insidious illness that needs more visibility. Poorly ventilated offices full of sick colleagues in close proximity are ideal conditions for transmitting airborne diseases, and it's far too easy to develop a debilitating chronic illness this way. There should be minimum clean-air standards for open offices to protect workers.
While this seems to validate those syndromes as having real underlying physical causes, I do have to mention that you can treat this (and fibromyalgia) surprisingly well with psychiatric medication, implying there is at least a substantial fake element to it.
Put differently: some people probably get the real thing, but if you can successfully treat a large percentage with SSRIs (which you can, see https://www.nature.com/articles/s41598-023-45072-9), that means they got it by social contagion, like the dancing plague.
That you can see improvements in people with long covid by giving them SSRIs isn’t clear
evidence it’s partly fake or a “social contagion”. Whatever improvements recorded are just as easily explained by the fact that being sick for months is depressing and alienating and a bunch of people think you’re faking it.
On top of that, the SSRI article you linked suggests a biochemical mechanism by which SSRIs might be acting (i.e. not by making something “fake” go away, by actually treating the cause of something real)
>implying there is at least a substantial fake element to it.
The article actually argues against that reading: IgG transferred from patients into mice reproduced the symptoms. Mice don't have a nervous disposition. That points to a physical mechanism.
Every study that suggests viability of SSRIs to treat or prevent Long COVID presents plausible mechanisms for why they might have that effect. And none of them are "the patients are probably just sad and faking it."
Importantly, IgG fractions from the blood of these individuals cross-reacted with several types of mouse tissue in vitro, and transfer of this IgG to living mice reproduced symptoms such as pain, fatigue, coordination problems, temperature sensitivity and more. These effects were not seen with IGg transfer from unaffected patients. It hardly needs pointing out that you cannot transfer a nervous disposition or a persistent bad attitude by transfusing antibody fractions. Long Covid is a real a disease as lupus, MS, Hashimoto’s, or Type I diabetes, all of which are driven by production of antibodies to a person’s own tissues."
> In the first transfer experiment, most patient participants had been vaccinated prior to sampling, whereas the controls were not. Importantly, in our follow-up experiment, we used post-pandemic controls (exposed and vaccinated), and their IgG still did not induce the overt pain phenotype seen with long COVID IgG, suggesting vaccination alone is unlikely to explain the transfer effects.
Given that the major COVID-19 vaccines had a significant protective effect against Long COVID, this is a particularly perverse variation on the conspiracy theory.
Long COVID is much more prevalent among people who’ve experienced severe COVID symptoms, and unvaccinated people have the most severe symptoms. One doesn’t need a PhD to do the math here.
In multivariable analyses, pre-existing health conditions at the time of initial SARS-CoV-2 infection and reporting fatigue, shortness of breath, and cough 3 months post-infection were independent predictors of persistent long COVID.
Age, sex, and number of COVID vaccinations were not significantly associated with persistent long COVID.
which needs to be qualified with an "of course" as W.Australia (3xsize of Texas, small population) was isolated from the world and then almost the entire state got two to three rounds of vaccination at much the same time:
It'd have been interesting for them to discuss it, but from what I understand it looks like MCAS is probably an entirely separate thing (that can also be triggered by COVID), but because of the overlap in symptoms, many people who assumed they have long COVID actually had MCAS. And even after teasing those two out, there may be more conditions in the long COVID bucket.
This is a blog on the root cause. MCAS would be an intermediate mechanism in making you feel sick, but something must have triggered the MCAS. Thats the autoimmune response.
Ended up doing a paleo diet, avoiding stressors (some of which are not obvious like just being on your phone scrolling, bad posture/circulation/sitting for too long), improving sleep hygiene, and ramping up consistent cardio exercise, with an emphasis on getting up to 4x/week zone 5 cardio without triggering intolerance.
Since then I've discovered a lot of other things that are great for overall health, like HRV-reset breathing and long-duration water fasts (around 3 days is optimal for me). I imagine those would have been very helpful if I had tried them earlier. A water fast is a complete metabolic and inflammatory reset of the body, and it's not as hard as you might think.
Hopefully most affected folks have recovered and are living normal lives by now, but if not, there are things you can do! It seems like the more challenging those things are, the more efficacious.
This has led me to conclude that perhaps in most cases chronic illness is an emergent behavior from a complex system, namely our body. Now tbh this is kind of a cheap take, because it's not that hard to conclude. But gosh darn it, we're programmers and we deal with complex systems all the time! What I want to see is a complete quantitative mapping of human metabolism, so that we can see all the in-between steps, not just the surface levels. That way curing chronic illness is more about comparing metabolite levels against known pathways and seeing what's regulated incorrectly. There's just not enough introspective capability currently.
My vision is some day a person who's been chronically ill can walk into a clinic, take a blood test, and with mass spectrometry get the level of the around 1800 different intermediate metabolites. That gets mapped to a known good metabolic graph, and it's optimized to find what in-between step is off kilter. They're then prescribed a drug that resets the bad state, and it 6 weeks they're back to normal.
I also doubt that AI will substantially help either. It still doesn't bring any more introspection capability, and if we can't figure out why someone is sick, I have little faith that a predictive AI can figure it out either.
https://web.expasy.org/pathways/
https://www.cell.com/cms/10.1016/j.it.2025.10.010/asset/0b5a...
This is the corresponding article about this phenomenon, "The lingering shadow of epidemics: post-acute sequelae across history":
https://www.cell.com/trends/immunology/fulltext/S1471-4906(2...
While this seems to validate those syndromes as having real underlying physical causes, I do have to mention that you can treat this (and fibromyalgia) surprisingly well with psychiatric medication, implying there is at least a substantial fake element to it.
Put differently: some people probably get the real thing, but if you can successfully treat a large percentage with SSRIs (which you can, see https://www.nature.com/articles/s41598-023-45072-9), that means they got it by social contagion, like the dancing plague.
On top of that, the SSRI article you linked suggests a biochemical mechanism by which SSRIs might be acting (i.e. not by making something “fake” go away, by actually treating the cause of something real)
The article actually argues against that reading: IgG transferred from patients into mice reproduced the symptoms. Mice don't have a nervous disposition. That points to a physical mechanism.
"
Importantly, IgG fractions from the blood of these individuals cross-reacted with several types of mouse tissue in vitro, and transfer of this IgG to living mice reproduced symptoms such as pain, fatigue, coordination problems, temperature sensitivity and more. These effects were not seen with IGg transfer from unaffected patients. It hardly needs pointing out that you cannot transfer a nervous disposition or a persistent bad attitude by transfusing antibody fractions. Long Covid is a real a disease as lupus, MS, Hashimoto’s, or Type I diabetes, all of which are driven by production of antibodies to a person’s own tissues."
> In the first transfer experiment, most patient participants had been vaccinated prior to sampling, whereas the controls were not. Importantly, in our follow-up experiment, we used post-pandemic controls (exposed and vaccinated), and their IgG still did not induce the overt pain phenotype seen with long COVID IgG, suggesting vaccination alone is unlikely to explain the transfer effects.
Long COVID is much more prevalent among people who’ve experienced severe COVID symptoms, and unvaccinated people have the most severe symptoms. One doesn’t need a PhD to do the math here.
Are there studies for this?
Australian studies show a protective effect (in that the fewer people that got COVID (correlated with vaccines) the fewer got Long COVID)
See Page 8: https://www.aihw.gov.au/getmedia/9592f439-9b96-4589-a55d-6b0... (2022)
Australian studies in W.Australia also show:
which needs to be qualified with an "of course" as W.Australia (3xsize of Texas, small population) was isolated from the world and then almost the entire state got two to three rounds of vaccination at much the same time:* https://www.cambridge.org/core/journals/epidemiology-and-inf... (2025)
( In Pop. Press: https://www.anu.edu.au/news/all-news/more-than-half-of-long-... )
https://www.nature.com/articles/s41467-023-38388-7
https://www.nature.com/articles/s41467-025-65302-0
Do you need even more?
https://www.medrxiv.org/content/10.1101/2023.01.25.23285014v...
Oh sorry, the last one shows that covid increases the likelihood to develop autoimmune disorders.
And of course people can have both.