Post Viral Fatigue

The first time I heard this phrase was years after I went through a physically and mentally crushing bout of mononucleosis. I endured the acute symptoms of swollen lymph nodes, razor sharp sore throat and full body rash, followed by months of debilitating fatigue, body aches, brain fog and poor concentration. I once had a doctor call my symptoms “lazy teenager syndrome” which were instead clinically identifiable symptoms of Post Viral Fatigue (PVF). 

Thankfully medical literature on this subject has grown since then and the relevancy of Post Viral Fatigue has quickly regained traction in the global public health arena. Friends, family and patients have all professed their lingering phase of “unwell symptoms” following the pandemic variants.  

The main symptom of PVT is debilitating fatigue un-relived by rest. Other symptoms my include temporary loss of smell or taste, depression, poor concentration, swollen lymph nodes, muscle aches, joint pain, heaviness in the limbs and irritable bowl syndromes. From my own experience and the observations of the collective, it feels as though your brain and body are massively out of commission and under a thick, hazy and gloomy fog. 

These symptoms can persist for weeks or months after any other viral infections too! Influenza, Epstein-Barr virus, mononucleosis, Lyme disease, herpes virus, SARS and coronavirus.

Microbiome and pathogenic “Damp”

PVT is multi-factorial involving the nervous system, immune system, endocrine system and musculoskeletal system. From a cellular level there is loss of function in energy production. 

PVF is not entirely understood yet however some key theories in post viral fatigue point to inflammatory cytokines and gut dysbiosis. In Chinese medicine theory it is the presence of pathogenic damp that correlates to a lingering pathogen. Pathogenic damp effectively “blankets” the nervous system, “dampening” the organs and decreasing their function. 

Damp is sticky, heavy and turbid like a swamp. Microbes accumulate and fester in this environment creating an imbalance in the intestinal flora. This type of dysfunction primarily affects the organs of digestion leading to dysbiosis; the imbalance of good and bad gut bacteria. 

Dysbiosis and pathogenic damp can describe a myriad of symptoms. Fatigue, loose stool, cloudy urine, tiredness after eating, nausea, abdominal bloating, depression, heaviness of the limbs and brain fog.

Just as a wetland or marsh creates a “film” on the top of the water due lack of movement from the river, our guts take on this “film” or dampness due to the loss of energy production, movement and Qi. Our digestive organs (SP/ST/LV/LI/SI) are unable to transform, extract, transport and excrete nutrients and wastes.

The relationship of Post Viral Fatigue and gut dysbiosis is key to understanding and recovering from long haul symptoms. From an ancient viewpoint and modern science, both agree that the microbiome is a major player in the immunological, cognitive and neurological picture here. 

“In some experts’ opinion, the microbiome, with all its genetic information, metabolism, physiology and pathophysiology as well as trans-plantability should be considered a separate organ.”

Treating the microbiome like a separate organ allows us to consider it as a living, functioning thing. We know that there are “heart healthy foods” and “brain boosting foods” so it’s easy to include “microbiome supportive foods” when grocery shopping and planning meals.

35-90% of people with post viral fatigue experience symptoms that are associated with irritable bowel syndrome. Research out of Stanford has found that post covid individuals can shed viral genetic material in their stool for up to seven months after being ill stating that, “SARS-CoV-2 viral proteins can hide out in the hidden reservoir’s of the body.”

We know that the accumulation of pathogenic bacteria in the gut impairs the immune system, metabolism and neurological health. Treating the microbiome like a separate organ and cleaning up the gut is logically and clinically the most relevant step to “clearing out” post viral fatigue. 

Acupuncture and PVT

Speaking of hidden reservoirs, Acupuncture utilizes a subset of points for cleaning out these accumulations. Named the antiquity points these points are used to address the path of Qi as it moves into the layers and hidden crevices of the body. Joint capsules are often one of these places and many acupuncture points for dampness are indicated at or near the joint lines of the four limbs.

Points like Yinlingquan (SP9) and Fenglong (ST40) resolve damp accumulations in the middle Jiao (SP/ST) while other points like Zusanli (ST36) and Pishu (UB20) support the Qi and boost the function of the organs. 

Acupuncture points located at the base of the skull, Fengqi (GB20) and Tianzhu (UB10) are especially noted for releasing the Taiyang, which refers to the exterior portion of the body and the first layer of immunity defense. These points benefit the head and neck while soothing the parasympathetic nervous system, allowing for rest and repair at a cellular level.  

Ear Acupuncture (Auricular Therapy) has been well research by the esteemed Terry Oleson, PhD supporting the vital organs and nervous system. Points like “Point Zero”, “Thalamus”, “Sympathetic” and “Shenmen” are needled to stimulate vagal tone and reduce stress on the body. 

Herbs and Supplements

Superfoods, anti-viral’s, anti-oxidant’s, anti-inflammatory herbs and supplements can be highly effective in treating the onset of illness as well as the lingering symptoms that can persist after. 

Common kitchen herbs can be utilized as potent remedies such as basil, oregano, ginger, sage and turmeric. Herbal teas and fresh culinary herbs added to your cooking have an immune boosting benefit as well as create more diversity of good gut bacteria.  

East Asian Medicine utilizes Huang Qi (Astraglaus root), Yi Yi Ren (Jobs tears), Ling Zhi (Reishi), Huang Qin (Scullcap), Pu Gong Ying (Dandelion), Rou Gui (cinnamon bark) and Gan Jiang (Ginger) to boost immune function, reduce inflammation and drain pathogenic damp. 

While there are several patent herbal formulas for treating various stages of an illness, recent findings suggest that herbal formulas such as Ren Shen Bai Du San, Jing Fang Bai Du San, Yu Ping Feng San and Xiao Chai Hu Tang were found to be highly effective in the various stages of the pandemic variants.

Always consult your Licensed Acupuncturist and herbalist to ensure a formula and treatment strategy are right for you. Herbs are highly individualistic according to your constitution and symptoms, therefore not a one size fits all.

Massage and Bodywork

Craniosacral and Lymphatic Drainage are key modalities to improving the function of the fluid network. Lymphatic fluid cleanses the blood and lymph nodes are the primary sites of filtering bacteria and viruses. Body aches, swollen joints and general malaise are key symptoms of a sluggish lymphatic system. Self-massage techniques are great for at home treatments targeting lymph in the neck, under-arms, abdomen and inner thighs. Using a circular motion with your palm and fingers, massage these key lymph sites to help to stimulate the fluid metabolism and detox function.

Cranio-Sacral therapy addresses the fluid of the cerebral spinal column and brain through “still point induction” holding specific regions of the cranium to mobilize fluid and enhance neuron connectivity. This is great for poor memory, brain fog and headaches. 

Find a bodywork practitioner in your area specializing in lymphatic drainage, Swedish or Cranio-sacral therapy to help mobilize the fluid and circulation. Special focus on abdominal massage lymphatic drainage will help to resolve those lingering GI symptoms. These bodywork modalities are incredibly beneficial after any illness, surgery or trauma. 

While there is so much we can do to support your body’s natural defense with Acupuncture, bodywork & botanical medicine, remember; Food is Medicine.

What we eat following an illness absolutely matters! Stay tuned for tips on what to eat when recovering from an illness.

*This article is not intended to diagnose or treat, it is a review of my independent research. See sources below and always consult your health care provider.

Resources:

1. https://doi.org/10.3389/fimmu.2021.628741

2. https://www.frontiersin.org/articles/10.3389/fimmu.2021.628741/full

3. https://med.stanford.edu/news/all-news/2022/04/feces-covid-19.html

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320866/

5. https://pubmed.ncbi.nlm.nih.gov/3063394/

6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320866/