Holistic Medicine for Post-Viral Symptoms and Immune Recovery
It seems as though, since the outbreak of the Covid-19 virus, the intensity and frequency of illness has increased. Perhaps it’s just perception, but at any rate public interest in viruses and how they work has grown. Of particular concern has been what people are calling ‘Long Covid’ - something which was known many years ago to TCM practitioners as ‘latent pathogens.’ In this article, taken from a presentation I completed last year, I explore the idea of post-viral latency and the traditional Chinese methods of treatment.
Post Viral Syndrome is that lingering discomfort you feel after getting sick. Especially after prolonged illnesses, that downtrodden feeling can last for quite a long time. Not much is known about PVS except that it is a consequence of viral infection. Some doctors believe it is caused by a hyperactive immune system’s fight against infection. Other theories believe an influx of pro-inflammatory proteins called cytokines linger in the brain and body, causing fatigue and discomfort. Finally, an overloaded immune system ‘crashes’ and the virus cannot be completely expelled.
It is my belief that all of these are true and that this is a progression. Prolonged viral attack ramps up the immune system, increasing cytokines, and eventually the body becomes exhausted. The consequence is something we see often after a long illness – chronic fatigue syndrome. Many of the symptoms of PVS and CFS are similar.
Here we have the general symptoms of PVS on the left, and symptoms specific to a virus like Covid-19 on the right. Since making this slide, our understanding of ‘Covid Long-Haul Syndrome’ has improved and now includes nearly everything from the left column.
o Right now the expected number of COVID long-haulers will be around 19%. However, lingering symptoms like fatigue are often underreported or attributed to other things. By contrast, a previous coronavirus that struck Hong Kong in 2003 called SARS recorded up to a 40% occurrence of post-viral syndrome. We won’t know the actual numbers for a long time, but we can expect the lingering effects of this pandemic to persist.
o As is true with many syndromes of this type, post viral syndrome – and chronic fatigue syndrome – affects women far more than men at a ratio of 4 to 1. While it appears that women recover from the active virus better, they spend longer recovering from the illness overall.
o In regards to duration of PVS, there is a wide spread. Lingering symptoms can persist for as little as a few weeks to as many as five years. At this point it is usually reclassified to chronic fatigue syndrome and can last for the rest of the person’s life.
Modern medicine is limited in its ability to combat these sorts of chronic diseases. As a result treatment is comprised of three main efforts; manage symptoms, self-care, and support. Symptom management deals with reducing discomfort, but isn’t aimed at eliminating the cause. Especially since there is no agreed-upon reason for PVS. Self care involves lifestyle changes to reduce things that may be contributing to the discomfort and to strengthen the immune system through diet and exercise. Last is support via therapy groups, PT etc.
Due to the challenges of treatment, the focus is on symptom management rather than recovery while they wait for the body to heal on its own. Of these three methods only one is concerned with substantive changes designed to improve foundational health; that is lifestyle adjustments like diet and exercise. These changes, along with outside support, are just one leg of the TCM holistic tripod.
The first leg is manual therapy itself. Acupuncture, Tui Na, cupping and so on is used to break the negative cycle. Interrupting the process of disease gives the patient and practitioner space to make lasting change. Again, these methods utilize the body’s own systems and so avoid the potential side effects of pharmaceuticals.
Second is lifestyle adjustments. Like Western medicine, this involves changes to diet, exercise, stretch routines, mindfulness, breathing techniques etc. After manual therapy interrupts the disease cycle, we replace it with positive adjustments that override what caused the issue.
Finally herbal medicine is used to supplement what the patient may be lacking, or to reduce excesses. These formulas are more impactful on biochemistry and can therefore greatly improve treatment. Unlike modern medicine, however – in which components are isolated and strengthened – herbal medicine utilizes the whole herb. This is generally gentler in action, but reduces side effects. TCM practitioners also contest that using the whole herb includes trace substances which improve efficacy.
The concept of Post-Viral Syndrome is very old in Chinese medicine. It was called ‘latent pathogens’, and the belief was that an illness that wasn’t completely expelled or patients who didn’t fully recover could suffer from the illness for months or even years after they first got it. The concept was first mentioned in one of TCMs very first books where it’s written “If there is damage by cold in the winter (for instance a flu), there will be a warm pathogen disease in the spring.” We recognize this as recurrence, like we discussed earlier. This is reiterated in 270 BCE by Wang Shuhe, who said “If there is no disease, and there is a cold toxin that is stored in the interstices of the flesh, when spring arrives it transmutes into a warm disease.” This suggests that even if you don’t suffer the full throes of a disease, the low-grade viral impact can still affect the immune system and emerge at a later date.
Because of this observation, ancient Chinese physicians have placed a lot of emphasis on strengthening the body after illness and fully expelling any pathogens to avoid recurrence or other symptoms of PVS.
Here is what the science says about complimentary treatment. Each of these are criteria they use to measure a patient’s clinical presentation during post-viral syndrome or chronic fatigue:
Most of these were measured against no treatment, sham acupuncture and conventional treatment. Some were measured with a combination of TCM and standard treatment protocols. Improvements were noted across the board, and persisted at the 3-month and 6-month post treatment checkups.
Finally, recovery and prevention. This is arguably the most important step, since as we’ve seen PVS can develop into chronic fatigue. Treatment can suppress symptoms, but if the immune system isn’t allowed to fully recover we become susceptible to more problems down the road.
Herbal Supplementation – When the coronavirus initially began to spread in China, physicians immediately leaned heavily on herbal medicine as an adjunct to pharmaceutical drugs. The combination was used to great effect and certain formulas are still taken daily as a preventative step, especially for the elderly. They’re available over the counter at any corner drug store.
Diet - Something to consider in your diet is how much effort your body requires to eat certain foods. Salads for instance may be low in calories, but it demands a lot to heat up and break down the raw material. Oily foods promote inflammation and tend to sit in the gut. The best foods to eat after an illness are relatively bland, easy to digest and nutritious – things like porridges, soups, boiled vegetables etc.
Exercise – Fatigue makes it difficult to summon the motivation for exercise, but even a light walk is beneficial. It helps digest your new nutritious diet, D3 is integral for immune function, and the promotion of blood flow supports organ function. With exercise, fatigue improves.
Finally, some general Do’s and Don’ts:
If you suspect you may be suffering from PVS, speak with a health care provider and review your options. There are tools that can be used to recover from syndromes that have lingered for years. Start by paying close attention to how your body reactions to environment and stimuli, like diet.
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