Post Viral Syndrome – Part 1

Dr Sandra Cabot and naturopath Margaret Jasinska discuss post viral syndrome, a common condition where people have difficulty recovering from a virus such as influenza or hepatitis. The outline the symptoms that can occur in post viral syndrome such as fatigue and complications that may occur such as organ damage or autoimmune disease.

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DR CABOT: Hello. My name is Dr Sandra Cabot and I’m joined today by naturopath and author Margaret Jasinska.

MARGARET: Hi, Dr Cabot. Thank you so much for inviting me on.

DR CABOT: We’re talking about a subject which is very, very common. And that is post viral syndrome. And what does that mean? Well, that means after you’ve had any viral infection, you don’t recover in a normal period of time. So, you don’t recover quickly enough and your health goes down and you feel generally fatigued and unwell. So, this can apply for any viral infection, but is more common in certain viruses. So, if we’re looking at the type of viruses that typically cause post viral syndrome, it would be influenza, COVID-19, which is a coronavirus Epstein-Barr virus, cytomegalovirus, hepatitis viruses. Even though they can be treated, they can still cause post viral syndrome, even after the drugs have eradicated the virus.

So, we’re going to look at some of the symptoms of that syndrome. So, Margaret, what would you like to add?

MARGARET: Well, look, viral infections are really common. And the ones that you just mentioned, Dr Cabot, the majority of people have had several of those viruses in their life and they recover from the infection. You can feel quite unwell, but then you get better. So, the subject that we’re talking about is people who just don’t really recover. They are never well since they had that particular viral infection. So, they may suffer with overwhelming fatigue. They may get aches and pains in their body. They may have a low mood. They may experience poor sleep quality. They might feel hot and restless and bothered in their sleep. They may even develop an autoimmune disease, if they’re genetically prone to getting an autoimmune disease. Or they could have a flare-up of an existing autoimmune disease. So, these are the people who their body isn’t strong enough to clear the virus well enough in a reasonable amount of time. So, their immune system chronically ends up fighting this virus.

DR CABOT: That’s right. And they have a higher amount of virus in their body. Many viruses will remain in your body. All human beings have a huge amount of viruses that are collected in their body and stay there for their lifespan. It’s called the viral biome, or virome, if you want to shorten it.

MARGARET: That sounds funny. We collect viruses as we go through life.

DR CABOT: Yeah, we do. Collect friends. Unfortunately, we also collect viruses.

MARGARET: Debts we collect.

DR CABOT: Yes. And most viruses are harmless, really. There’s just millions of different viruses. And not all viruses out there have been identified yet. And there’s new emerging viruses all the time. There’s scientists in laboratories doing genetic engineering, developing scary new viruses. So, our body is always going to be challenged with viruses. And we’re always going to have a huge amount of viruses in our body. But it’s when these viruses cause inflammation, they’re causing cell damage that we get problems.

So, our immune system, if it’s healthy, makes antibodies against a virus, which is called acquired immunity. We also have innate immunity, which means our immune cells can actually deal directly with the virus in keeping the amount down. But if the amount of virus is too high, what we call the viral load, then it’s likely that we will get recurring symptoms of the initial viral infection. So, we may have intermittent fevers, we may have swollen glands, we may have rashes, we may have headaches, all sorts of symptoms. Because remember, these viruses live inside ourselves. They’re part of us. And some viruses actually live in our DNA. They’re called proviruses, and they’re retroviruses, so you’ll never get rid of them. They become part of your DNA. But if we have a strong immune system, we can keep the total amount of viruses down and that’s very important. Otherwise, they will really adversely affect our health and cause a lot of inflammation.

MARGARET: Yes. It’s just very unfortunate that a lot of people don’t have a healthy immune system to begin with before they even acquired this virus. Most people have nutrient deficiencies. They’re just not getting enough nutrients, even if they’re eating good food. A lot of people are chronically stressed. That will weaken your immune system. Many people have sleep difficulties, so they’re not getting enough sleep or not good quality sleep. And those things will have a significant negative impact on your immune system and make you more prone to this post viral fatigue.

DR CABOT: Yes. And interestingly, what we’re finding now, since we’ve had 6 months of COVID-19, which is caused by SARS-CoV-2 virus, we’re seeing people with post viral syndrome from this coronavirus. And we’re only just starting to see it because it’s so new. And immunologists are talking about it on the podcast and on the Internet, and they’re saying that there are different versions of it. And it’s common for people who’ve had COVID-19 to have a mild post viral syndrome, which is characterized by being sleepy. You also can put on weight. You can have mood disorder, and just generally feel flat. And the advice to these patients is that it’s going to get better. It’s going to go away, if it’s only mild. And give it 6 months and really look after yourself in that 6 months after you’ve had COVID-19 or indeed any nasty virus.

MARGARET: Yes, exactly. The flu season is approaching in the Northern hemisphere. So many different viruses can cause these kind of problems.

DR CABOT: That’s right. So, the immunologists are saying it’s very important for doctors to acknowledge that this post viral syndrome is physical in most people. It’s not just psychosomatic, even though it can affect your brain, cause brain inflammation and thereby mood disorders. It’s not just the way you’re thinking. It’s not just anxiety.

MARGARET: Yes. However, our patients who currently have chronic fatigue syndrome or currently have an autoimmune disease, it’s particularly worrying for them. They don’t want to catch COVID. They don’t want to get the flu because they’re already feeling very unwell and with significant fatigue at the moment. And getting an infection, a viral infection like this can really cause their health to plummet.

DR CABOT: That’s right. Well, that’s where the wearing of masks and social distancing and not going to really crowded places, where you’re bombarded with a lot of people in a close distance is good. Just take it easy and kind of have a quiet life and be a bit isolated until the epidemic slows down. And practice good hygiene. Always wash your hands because you can pick up a lot of infections from food.

So, we’ve got a book called Corona And Other Dangerous Viruses – What you must know to protect your health. And it’s got a lot of practical tips in it. It’s a really good book, so that it’s very helpful.

So, people with the mild post viral syndrome after COVID-19 generally get better, particularly if they have good holistic care. But there’s another variety of post viral syndrome in people that is quite severe. And this is more common in people who have had severe COVID-19 disease. And this is where the viruses attacked their organs and caused organ injury, typically of the heart, the lungs and the brain and the liver. So, if you have organ damage, it takes a lot longer to get better. So, it’s wise to keep your organs healthy in the first place. Don’t let them become vulnerable. Take care of your heart, your lungs, your liver. And if you have had COVID and you’re not getting better, the things that should make you concerned enough to go and see an immunologist, or another type of specialist in that area, would be if you’re very short of breath and you can’t exercise to the degree that you could before you had the infection. You would definitely need lung function tests and also heart tests. So, an echocardiogram, an ECG, and definitely blood tests to check your immune system. Very, very important. And often what we find in people with post viral syndrome is their white blood cells are not healthy. They have low levels of lymphocytes, which are a type of white blood cell that fights viruses. So, these tests are very important. But I believe that even if you have sustained organ damage and you might have a bit of lung inflammation, which can be fibrosing, in other words, the lungs become scarred, you can get a lot of repair using nutritional medicine. So, you don’t have to think, “Oh, I’ve had organ damage. There’s nothing I can do.” That’s very, very important. And some immunologists out there don’t believe at all in nutritional supplementation. They say, “Oh, there’s no evidence for that.” But I strongly disagree. There’s a lot of studies that show that specific nutritional supplements can help to repair organ damage and particularly liver damage. And the liver is so important when it comes to fighting any viral infection. For example, we know that people with fatty liver have two and a half times greater risk of severe COVID-19 disease.

MARGARET: Yes. And a lot of people have a fatty liver, but don’t know they have one because it might not cause many symptoms at all. You might just be carrying some excess weight around your torso. You might feel a bit bloated after you eat. You might feel tired. That could be your only symptoms, and you have a fatty liver. And now you’re at risk of an adverse outcome from a viral infection.

DR CABOT: Yes. So get your lungs, your liver and your heart healthy. Good exercise program, good diet, good liver formula. And try and get the fat out of your liver by having a lower carbohydrate diet. So, there’s a lot that you can do.

And it’s interesting that you mentioned autoimmunity, which is the process where your immune system starts to attack your own body cells rather than protect you against the virus. And autoimmunity is definitely influential in all forms of post viral syndrome, whether it’s mild COVID, post viral or mild Epstein-Barr virus, which is glandular fever. Or whether it’s severe and you’ve got organ damage. It’s always mediated by autoimmunity, as well as the virus.

MARGARET: Yes. So autoimmune disease is at epidemic proportions. And why does someone get an autoimmune disease? You need 3 things. You need the genetic predisposition. So, from someone, somewhere in the family, you inherited the risk to get an autoimmune disease. It doesn’t have to be the same autoimmune disease, just the genetic predisposition. The second thing, you need a leaky gut to get an autoimmune disease. So, your intestinal lining has become excessively permeable and therefore high levels of intestinal contents, waste products, bacteria, bacterial toxins, fungi, etc., too much of the gut wastes can seep through into the bloodstream. And that is a chronic stress on your immune system to deal with all those waste products. And then the third thing a person needs to get an autoimmune disease is what they call an environmental trigger. So that could be a big stress episode, whether it’s emotional stress or a physical stress on the body, like accident, injury, surgery. For women, getting pregnant, giving birth. Exposure to certain environmental chemicals. Certain antibiotics can trigger autoimmune disease. And then we’ve got infections. So viral infections, bacterial infections, almost any infection. There is research linking it to increased risk of specific autoimmune diseases in people who are genetically susceptible. The Epstein-Barr glandular fever virus, that’s a known potential trigger of 33 different autoimmune diseases. A bad cold, a bad flu, or COVID-19 infection. Any of those things can be a trigger of autoimmune disease. Or if you’ve already got an autoimmune disease and it’s under control, it could trigger a flare-up.

DR CABOT: That’s right. So, if you do have post viral syndrome, make sure you ask your doctor to check your liver function with a blood test. Have a full blood count, have a CRP, which stands for C-reactive protein (CRP), to see if you’ve got ongoing inflammation in your body. Check your adrenal glands. Have a blood cortisol that should be done in the mornings. And specifically look for your level of white blood cells, whether it be lymphocytes or neutrophils that could be low. Very important to see what’s going on. And what we’re going to do is going to do another podcast and telling you how to overcome post viral syndrome.

MARGARET: Yeah, exactly. The ways that you can make your immune systems stronger so you’re less likely to develop this. Or if you’ve already got it, how to get on top of it.

DR CABOT: That’s right. That will be our next podcast. So, thanks for listening.

MARGARET: Thank you. Bye bye!