🏠︎ | Past Presentations | Advanced Practitioner | Post-Viral Fatigue Syndromes and Long COVID

• Event: IPM Congress 2024

• Date: 8th June 2024

• By: Dr Kristi Morlan-Hughes

• Estimated Read Time: 7–8 minutes

Dr. Kristi Morlan-Hughes delivered a deeply personal and scientifically rich presentation on the third day of the IPM24 Advanced Practitioner Forum. Drawing on her own experiences with long COVID and her extensive expertise in functional medicine, Dr. Hughes highlighted the challenges, complexities, and opportunities in diagnosing and managing post-viral fatigue syndromes. Her session offered a unique blend of narrative and data-driven insights, inspiring healthcare practitioners to adopt a more integrative approach to long COVID treatment.

A Personal Journey Intertwined with Professional Insights

Dr. Hughes opened her session with a candid recounting of her own unexpected journey through long COVID. Despite adhering to rigorous preventive nutrition practices, including supplementation with vitamin D, zinc, quercetin, and glutathione, she found herself battling persistent symptoms after a COVID-19 infection in 2022. Her initial health scare began with the discovery of a breast lump, leading to intensive diagnostic testing, only to reveal a diagnosis of long COVID.

“The story of long haul is in the timeline—it’s not in the labs” she emphasised, illustrating the importance of mapping symptoms, triggers, and antecedents over time to uncover patterns that traditional diagnostics might miss. This personal narrative served as a powerful backdrop for her clinical insights, demonstrating the real-world complexities of post-viral recovery.

Understanding Long COVID: Key Drivers and Mechanisms

Dr. Hughes outlined two primary mechanisms underlying long COVID and related post-viral syndromes:

• ACE2 Tissue Damage

  • SARS-CoV-2 targets ACE2 receptors located in tissues throughout the body, including the lungs, brain, heart, and gut. This leads to systemic inflammation, vascular dysfunction, and persistent symptoms such as brain fog, fatigue, and joint pain.

• Immune Dysregulation

  • Long COVID is often accompanied by immune system challenges, including viral reactivation (e.g., Epstein-Barr virus), autoimmune responses, and cytokine imbalances. These processes contribute to lingering symptoms and complicate recovery.

Dr. Hughes also highlighted the “dance” between dormant infections and new viral exposures, explaining how these interactions exacerbate post-viral fatigue syndromes. She cited her own experience of Epstein-Barr virus reactivation, which reignited her COVID symptoms months after her initial infection.

Symptom Clusters and Patient Experiences

Long COVID manifests in diverse symptom clusters, underscoring its systemic nature. Dr. Hughes provided a detailed breakdown of common symptoms:

• Neurological Symptoms: Brain fog, memory loss, and neuroinflammation.

• Cardiovascular Challenges: Microvascular damage, clotting tendencies, and impaired endothelial function.

• Gut Dysmotility: Leaky gut syndrome, endotoxemia, and persistent digestive issues.

• Exercise Intolerance: A significant decline in physical capacity, even among elite athletes.

• Dysautonomia: Conditions such as Postural Orthostatic Tachycardia Syndrome (POTS), driven by vagus nerve dysfunction.

These symptoms often overlap and evolve, making patient timelines a critical diagnostic tool. Dr. Hughes stressed the importance of listening to patients’ stories and identifying key antecedents, triggers, and mediators.

Innovative Strategies for Recovery

Dr. Hughes shared advanced clinical strategies rooted in functional medicine to address the complexities of long COVID:

1. Healing the Endothelial Glycocalyx

The endothelial glycocalyx, a protective layer inside blood vessels, plays a critical role in immune regulation and vascular health. Damage to this layer is a hallmark of long COVID. Strategies to restore glycocalyx integrity include:

• Nutritional support with rhamnan sulfate (derived from algae) and essential fatty acids.

• Anti-inflammatory protocols to mitigate oxidative stress and support vascular recovery.

2. Vagus Nerve Stimulation

Vagus nerve dysfunction is a key driver of dysautonomia and neuroinflammation in long COVID. Dr. Hughes highlighted the benefits of vagus nerve stimulation devices and practices such as:

• Using vagal sprays and pulse-setto devices.

• Incorporating dietary and lifestyle changes to support gut-brain communication.

3. Mitochondrial Support

Long COVID often leads to mitochondrial dysfunction, resulting in fatigue and cognitive decline. Dr. Hughes recommended targeted interventions, including:

• Supplementation with CoQ10, essential fatty acids, and pro-resolving mediators.

• Nutritional strategies to enhance ATP production and energy metabolism.

4. Gut Microbiome Restoration

The gut-brain-immune axis is crucial for recovery. Dr. Hughes emphasised the role of:

• Spore-based probiotics and prebiotics to restore microbiome balance.

• Dietary interventions tailored to individual nutrigenomic profiles.

• Testing for leaky gut, lipopolysaccharides, and candida to guide treatment.

The Role of Collaborative Medicine

Dr. Hughes underscored the need for collaboration among healthcare providers to tackle long COVID effectively. She highlighted the work of Ovation Lab, a multidisciplinary team pioneering research and treatment protocols for post-viral syndromes. Resources available through Ovation Lab include:

• Comprehensive clinician training programs.

• Patient education materials, such as handouts and dietary guides.

• Tools for implementing post-COVID recovery programs in clinical practice.

A Call to Action for Practitioners

In closing, Dr. Hughes urged practitioners to adopt a holistic, patient-centred approach to long COVID care. She advocated for:

• Treating the whole person, not just symptoms.

• Using detailed timelines to uncover hidden patterns and antecedents.

• Leveraging integrative strategies to address immune dysregulation, endothelial damage, and other root causes.

“This is an era where we’re pioneering once again” she concluded. “The work we do today will shape the future of healthcare for post-viral conditions.”

Resources and Next Steps

Dr. Hughes invited attendees to join her Facebook group, “Life of the Long Hauler” for ongoing updates and discussions. She also encouraged practitioners to explore the tools and resources available through Ovation Lab to enhance their clinical practice and support patient recovery.

Final Thoughts

Dr. Kristi Morlan-Hughes’ presentation was a powerful blend of personal testimony and professional expertise. Her insights into the mechanisms and management of long COVID offer a roadmap for practitioners navigating this challenging and evolving field. By embracing integrative approaches and fostering collaboration, healthcare providers can play a pivotal role in helping patients reclaim their health and quality of life.

Further Reading

For those interested in exploring Dr. Kristi Morlan-Hughes' extensive work in functional medicine and integrative health, here are some recommended articles and resources:

• Gut Health with Kristi Morlan-Hughes
  In this blog post, Dr. Morlan-Hughes discusses the importance of gut health, sharing insights into gut barrier function and its role in overall wellness.

• Unlocking Vascular Health: How Supporting the Glycocalyx Complements Wellness Programs
  In this webinar, Dr. Morlan-Hughes explores endothelial health and its significance in wellness, providing strategies to support vascular health in clinical practice.

• For more resources and information on Dr. Kristi Morlan-Hughes' work, visit her professional website:
  https://www.docerevita.com/doctor-kristi

For more resources and transcribed sessions from the Advanced Practitioner Conference, visit our Advanced Practitioner Conference page.

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