Traditional Chinese Medicine Approach to Treating Long COVID
This is my personal experience managing patients with long COVID, or post-COVID syndrome, as a Traditional Chinese Medicine doctor.
As if getting sick with COVID-19 wasn’t bad enough, some people continue to suffer symptoms more than a month after their infection, earning the unwanted label of long-hauler. The symptoms of long COVID are wide and varied, including fatigue, poor concentration and memory, headaches, shortness of breath, cough, fast heartrate, joint pain, menstrual cycle changes, altered smell or taste, anxiety, depression, and digestive symptoms such as diarrhea, nausea, and stomach pain.
We’ve gained a lot of new vocabulary related to this pandemic, so we could easily think chronic post-viral illness is also a new thing. But there are lasting effects caused by many viruses, including the Epstein-Barr virus (EBV) that causes mononucleosis, the varicella-zoster virus that causes chickenpox and shingles, and the herpes simplex virus that causes oral and genital herpes. Furthermore, as viruses have been present for billions of years, many others have also found ways to locate hiding places in our bodies, leaving us not acutely sick, but also not well.
Gu Syndrome
Traditional Chinese Medicine (TCM) doctors have long diagnosed and treated protracted illnesses following infections by viruses, bacteria, fungi, or parasites. In fact, the ancient diagnosis for this was termed gu syndrome. The word gu essentially translates as “possession,” and the Chinese character is an image of three worms inside a vessel, symbolizing how lingering pathogens can cause lasting symptoms.
One of the most useful pieces of information to assist in the diagnosis of gu (lingering pathogen) syndrome is that patients often communicate that they’ve never felt quite right ever since they got over a particular cold or flu. While those health issues never received an official medical diagnosis, that’s largely because we’ve not had many modern global pandemics. But today, a large majority of the worldwide population has been personally affected by COVID, so treatment of gu syndrome is more important than ever.
There are two main types of gu syndrome: brain gu and gut gu. Brain gu affects the nervous system, causing symptoms like headaches, pain, anxiety, and depression. Gut gu affects the digestive system with symptoms of bloating, gas, diarrhea, constipation, loss of appetite, stomach or abdominal pain, and heartburn. Gut and brain gu commonly occur together, and either can cause fatigue and feeling foggy headed.
Treating Long COVID
A TCM practitioner treating someone with long COVID must first get a diagnosis by asking, listening to, observing, and palpating their patient. These low-tech methods and TCM’s own diagnostic language have allowed practitioners to treat long COVID since before it had a name.
While there are some common patterns to long COVID, one patient’s experience of an illness can be quite different from someone else’s, so TCM treatments are personalized. As a result, it’s very difficult to create treatment protocols that are effective for everyone. However, acupuncture can be very useful to help relieve pain and calm the nervous system, while herbs are generally needed to strengthen the body and attack the lingering virus. Chinese herbs are offered as formulas, rarely as single herbs, as the combination of herbs can better address the whole person with a wide range of issues, rather than treating a single symptom or concern.
With long COVID or any lingering pathogen, it’s important to change up the treatment periodically because, like any living organism, coronaviruses adapt. As a result, while a TCM practitioner does not change the whole formula, they might swap out a few herbs for others. Plants have their own defensive mechanisms and compounds, so we can use them to fight our battles.
A Case Study
Jennifer* is a 41-year-old woman who caught COVID-19 in April 2022. She was sick in bed for three days, and while she recovered from most of her symptoms within a week, six weeks later she was still struggling with fatigue, difficulty concentrating, shortness of breath, weak voice, chest pain, no appetite, nausea, and weight loss. She was already thin to start, so her further loss of about ten pounds left her underweight and weak.
Her medical doctor had given her antibiotics, just in case, and an inhaler, and she had chest x-rays taken. Her blood test results showed nothing to note, the inhaler wasn’t helping, and the chest x-rays were clear. That’s when she decided to see if Traditional Chinese Medicine might help her, as she had consulted me in the past for other health issues.
In addition to asking a lot of questions, I also looked at her tongue and felt her pulse. TCM practitioners check the tongue colour, coating, shape, size, and any markings to get an idea of how the body is doing, especially the digestive system. A healthy tongue should be pink, have a thin white coating, and be appropriately sized for the mouth. Hers looked pale, swollen, had scalloped marks at the sides (from being oversized and pushing against the insides of the teeth and leaving impressions), and had a thicker white coating.
I assessed her as having both brain and gut gu syndrome. We did acupuncture and I gave her an herbal formula to take. A week later, she returned and most of her symptoms had improved. She was starting to regain her weight and had even played a soccer tournament, against my recommendation. We did another acupuncture session, and she got more herbs. Two weeks later, she returned for treatment. She had run out of herbs and was feeling tired again because she had fully resumed all her activities too soon. We picked up where we left off, with a reminder that recovery takes time, even though resolution of most of her long COVID symptoms and return to exercise and daily activities was comparatively fast. Another two acupuncture sessions and one month more of herbs and she was fully recovered.
Other patients that I’ve seen with long COVID have taken longer to recover, but our bodies are designed to heal. Since viruses have been around for billions of years, and in many ways have the upper hand, it’s nice to know that Traditional Chinese Medicine has been used for thousands of years to support us and help us recover from new illnesses, such as long COVID.
*Name and some of the identifying details of the patient have been changed to protect their identity.