Refuelling the Long Covid Brain: A Promising Dietary Approach to Neurological Long Covid

Long Covid is estimated to affect 65 million people worldwide, with a profound personal and economic impact. This week we explore the widespread and devastating neurological, brain health and mental health impact of Long Covid and a potential therapeutic dietary approach.

Neurological Symptoms of Long Covid

While Long Covid can affect various organs in the body, the neurological symptoms are often the most persistent and debilitating. These include:

• Brain Fog:  mental cloudiness that hinders concentration and cognitive clarity.

• Debilitating Fatigue: a profound sense of exhaustion that persists even after adequate rest.

• Cognitive Dysfunction:  memory problems, reduced attention, language difficulties, and poor executive function.

• Physical Symptoms: Even symptoms that seem more rooted in the body, such as pain and post-exertional malaise, often result from nerve dysfunction, particularly in the autonomic nervous system.

• Mental Health Impact: Long Covid can lead to increased anxiety, depression, and post-traumatic stress disorder (PTSD)

Potential Causes and Mechanisms

So 3.5 years on – what do we know about the mechanisms behind neurological Long Covid?  Researchers still don’t have all the answers – and my experience certainly has been that that this will not be the same for everyone - but suspected mechanisms include:

• Immune Activation and unresolved inflammation – in the brain this is called neuroinflammation and involves the microglial cells (the brain’s immune cells) moving into a pro-inflammatory state. This ongoing dysregulation of the immune system would also explain the hypersensitivity of many clients – with significant histamine reactions and ongoing mast cell activation

• Mitochondrial dysfunction – Viral diseases, like Covid, are known for their ability to hijack and destabilise the environment inside the cell, creating conditions that are favourable for their replication. The mitochondria – our cell batteries responsible for energy production - are highly susceptible to insults, including viral infection.

• Viral Persistence:  in some cases viral particles may persist in the brain or other parts of the nervous system, perpetuating ongoing symptoms.

• Autoimmunity:  there is emerging evidence of autoimmune involvement - autoantibodies that interact with nerve cells in Long Covid patients, potentially inciting persistent immune activity and possibly a picture of neurological autoimmunity.

Emerging Solutions...

Whilst conventional medicine seems to be focused on management of Long Covid symptoms through pacing strategies, in my clinic I am finding that in most cases diet is critical to enhance and accelerate successful recovery.

Dietary approaches I recommend to my Long Covid clients include:

• Anti-inflammatory diet this is really foundational – removing inflammatory foods such as sugar, refined grain, processed meat, artificial ingredients, and adding in the good stuff – colourful fruit and veg, omega 3 fats, wholefoods.

• Low histamine diet – especially if symptoms flare up with histamine-rich foods or if there is increased sensitivity to foods. Symptoms of histamine include flushing, racing heart rate, GI symptoms, migraines, nasal congestion and headaches.

• Ketogenic diet – a potentially transformative strategy for mitigating the neurological impact of Long Covid. It is this diet I will be focussing on today.

Keto Diet for Neurological Long Covid

This is a therapeutic diet characterised by high fat, low carbohydrate intake. Its primary objective is to instigate a state of nutritional ketosis in the body. But what precisely is nutritional ketosis, and how does this diet function at a cellular level?

Nutritional ketosis is a metabolic state where the body predominantly relies on ketones as an alternative energy source instead of glucose. Ketones are generated when the body transitions from carbohydrate metabolism to fat metabolism. This metabolic shift plays a pivotal role in the ketogenic diet's mechanisms. It is very much like a hybrid car switching to electric – notably ketones are also a much ‘cleaner’ fuel.

Why the ketogenic diet for Long Covid?

I started tentatively recommending the keto diet to clients with neurological symptoms of Long Covid when I saw that their symptoms seemed to very much reflect a kind of neuroinflammation characterised by extreme fatigue and brain fog. It was almost as if their brains were starving.

A ketogenic diet is not suitable for everyone – but in those that tried it the results were rapid and dramatic in many cases with an improvement in neurological symptoms and dramatically improved energy.

Promising results:

After some successes in my 1:1 clients - I rolled the keto diet out to a small group over a 6 week period.  In my Long Covid Brain Rescue program, I guided a small group of participants through the implementation of a healthy keto diet with promising results. Improvements after just 6 weeks included a 30% reduction in fatigue and improvement in energy, a 37% improvement in memory and cognition, a 32% improvement in sleep, a 35% improvement in mood. Though this was only a small group, and results were not continually monitored after the 6 weeks, it was very promising.

So why is the keto diet likely to be helping? There are several possibilities:

1.  Powerfully anti-inflammatory  - the ketogenic diet, when done the right way - with plenty of colourful vegetables and healthy fats - has potent anti-inflammatory properties that may help in dampening this chronic immune response.

2.   Impact on Mitochondrial Health:  ketones play a pivotal role in supporting mitochondrial metabolism, the energy powerhouses of our cells. Impaired mitochondrial energy is likely to play a large role in Long Covid – so fuelling the cells via a different pathway makes a difference.

3.  Shift in Microglia Activation: In the brain, microglia are immune cells responsible for maintaining neural health. The ketogenic diet may induce a shift in microglia from a pro-inflammatory state to an anti-inflammatory state. This shift can alleviate brain inflammation, potentially addressing cognitive dysfunction and other neurological symptoms.

4.  Antiviral: Recent research suggests that the ketogenic diet may boost antiviral immunity by affecting viral replication and enhancing the production of protective T cells.

5.  Metabolic Flexibility: The ketogenic diet encourages metabolic flexibility, allowing the body to efficiently switch between fuel sources. This adaptability may be particularly advantageous for individuals with Long Covid, as it may help them overcome the energy crashes and fluctuations often experienced.

In summary, the ketogenic diet offers a multifaceted approach to mitigating the neurological effects of Long Covid. Its anti-inflammatory, immune-regulating, and metabolic benefits make it a promising strategy for those grappling with the prolonged consequences of Covid-19.

Please do share with anyone you think may benefit.  And if you are struggling with the neurological effects of Long Covid and are interested in experiencing the benefits of a ketogenic diet with guidance then check out my Long Covid Brain rescue program on demand - HERE.