Dealing with Long Covid Basics
Read This First
The information on this page is the foundational supportive-care stack for Long Covid. It is what most informed clinicians and patient communities have converged on for managing the disease: reducing inflammation, breaking up micro-clots, calming mast cell activity, and supporting the immune system. It works. A lot of people feel meaningfully better on this stack and it is a solid floor to build from.
It is not a cure. The basics manage the disease, often indefinitely. Most people who rely on this approach end up on a permanent stack of medications and supplements they cannot taper, because the underlying drivers (viral persistence in nerve and vascular tissue, mitochondrial damage, suppressed thyroid axis) have not been addressed. Stop the medications and the symptoms return.
The Scorch Protocol is the more effective and more permanent solution. It is designed to remove the root cause through deep autophagy (dry fasting), restore metabolic capacity (T3 therapy), and rebuild from the ground up so you can come off the medication stack entirely. Use the basics on this page while you build toward the protocol, or as a starting point if you are not yet ready for fasting. Then graduate to the real fix.
For the recovery roadmap see the Decision Logic Tree, the Dry Fasting page, T3 Therapy, and the Viral Reactivation deep-dive.
First-Line Daily Foundations
These are the items most patients with Long Covid benefit from starting first. They are well-tolerated, broadly anti-inflammatory, and address the three main mechanical drivers (immune dysregulation, micro-clotting, oxidative stress).
The Daily Stack
Daily Intermittent Fasting16:8 or one-meal-per-day eating window. The single most powerful lever you can pull before extended fasting. Triggers low-level autophagy and reduces systemic inflammation. Free.
Ivermectin0.2 to 0.3 mg/kg daily, taken with a fatty meal for absorption. Binds spike protein and aids in its clearance. Independently anti-inflammatory. Many patients require chronic daily dosing rather than short courses.
Low-Dose Naltrexone (LDN)1 to 4.5 mg daily, taken at night. Anti-inflammatory, neuromodulating, and pain-modulating. Often improves sleep on its own. Requires a compounding pharmacy and a prescriber willing to script off-label.
Nattokinase100 to 200 mg (2,000 to 4,000 FU) twice daily, on an empty stomach. A fibrinolytic enzyme that breaks down the abnormal micro-clots associated with spike protein persistence. Hold 48 hours before any surgical procedure.
Melatonin1 to 5 mg before bed (some protocols use higher slow-release doses up to 20 mg). Strong antioxidant, anti-inflammatory, and sleep-restoring. Slow-release form is preferred for sustained overnight effect.
Magnesium200 to 400 mg daily. Glycinate or threonate forms have the best tolerability and brain penetration. Stabilizes the nervous system, supports sleep, reduces muscle tension.
Vitamin D + K2Vitamin D 5,000 IU per day, K2 (MK-7) 100 to 200 mcg per day. Modulates immune function and supports calcium handling. Test 25-OH vitamin D every 3 months and target 60 to 80 ng/mL.
Low-Dose Methylene BlueHighly individualized. Start very low (0.5 to 1 mg). Mitochondrial electron-transport support. Avoid combining with SSRI antidepressants (serotonin syndrome risk).
Resveratrol or Combination Flavonoid250 to 500 mg per day. Anti-inflammatory and sirtuin-supportive. Quercetin combinations (often with bromelain) are interchangeable here.
Probiotics + PrebioticsDaily. Multi-strain probiotic plus a prebiotic fiber source. Repairs gut barrier function, which is commonly disrupted in Long Covid and feeds back into systemic inflammation.
Sunlight / Photobiomodulation30 minutes of midday outdoor sunlight, at minimum 3 times per week. Free, well-established mitochondrial signal. Red-light therapy panels work as a substitute when sunlight is unavailable.
Movement, Capped at HR <110 bpmNo exercise that triggers post-exertional malaise. Walks, gentle yoga, and stretching only until your symptom load improves. Pushing past your tolerance reliably crashes you for days or weeks. Pacing is a non-negotiable discipline.
Symptom-Specific Add-Ons
Layer these on top of the daily stack based on which symptoms are dominant for you. Most patients have several of these clusters active at once.
Targeted Support by Symptom
Mast Cell Activation / Histamine FlaresH1 blocker (cetirizine 10 mg or loratadine 10 mg daily), H2 blocker (famotidine 20 to 40 mg twice daily), quercetin 500 mg twice daily, luteolin if available. Trial a low-histamine diet for 2 to 4 weeks. Symptoms include flushing, hives, food sensitivities, racing heart after meals.
Micro-clots / HypercoagulabilityNattokinase (already in daily stack) plus bromelain 500 mg twice daily. Lumbrokinase is an alternative if nattokinase causes stomach upset. Add omega-3 (EPA/DHA) 2 to 4 g per day.
POTS / DysautonomiaSalt loading (3 to 5 g extra daily), oral electrolytes, compression garments to mid-thigh, slow position changes (sit on edge of bed for 60 seconds before standing). Gentle vagal exercises (humming, gargling, cold face splash). Discuss ivabradine or a low-dose beta-blocker with a cardiologist if tachycardia is severe. See the
Decision Logic Tree for fasting considerations specific to POTS.
Brain Fog / Cognitive SymptomsLow-dose methylene blue (already in stack), Lion’s Mane mushroom 1 to 3 g per day, omega-3 at higher doses (3 to 4 g EPA/DHA). Hyperbaric oxygen if available (third-line tier below). Sleep quality matters more than any nootropic.
Fatigue / Post-Exertional MalaisePacing with strict heart-rate cap is the most powerful intervention. Add CoQ10 100 to 200 mg per day (ubiquinol form preferred), magnesium (already in stack), and a daily fasting window. Resist the urge to push through good days.
Sleep DisruptionSlow-release melatonin, magnesium glycinate, LDN often improves sleep architecture on its own. Standard sleep hygiene (consistent schedule, dark room, no screens 1 hour before bed, cool bedroom) matters more than any supplement.
GI Symptoms (Bloating, IBS, Sensitivities)Probiotics + prebiotics (already in stack), bromelain with meals, low-FODMAP trial for 4 to 6 weeks if bloating is dominant. Always address mast cell activation in parallel because the gut and mast cells drive each other.
Second-Line Adjuncts
When the first-line stack has been in place for 6 to 8 weeks and progress has plateaued, layer in these second-line items.
Adjuncts for Stalled Progress
N-Acetylcysteine (NAC)600 to 1,800 mg per day. Glutathione precursor, mucolytic, anti-inflammatory. Useful when oxidative stress markers are elevated or persistent respiratory symptoms remain.
Omega-3 Fatty Acids (Higher Dose)2 to 4 g EPA/DHA per day. Anti-inflammatory baseline. If already on for micro-clots, this is the same dose, not additive.
L-Arginine + L-CitrullineNitric oxide support. Improves endothelial function and microcirculation. Avoid if active herpesvirus reactivation is present (arginine fuels viral replication, see the
Viral Reactivation page).
Sildenafil (Off-Label, Low-Dose)Endothelial repair and microcirculation. Requires a willing prescriber. Often paired with L-arginine/citrulline above.
Vitamin C1 to 3 g per day oral, divided doses. IV vitamin C in severe cases via specialist clinic.
Spermidine250 mg per day, or wheat germ as a dietary source. Supports autophagy at a low daily level.
Black Seed Oil (Nigella sativa)500 mg twice daily. Broad anti-inflammatory and mild antiviral activity.
Nervous System RegulationVagal exercises, breathwork, polyvagal therapy, daily meditation. Non-pharmacological and consistently underrated. The autonomic nervous system drives a lot of the worst symptoms (POTS, sleep, GI, anxiety) and direct training meaningfully shifts it.
Third-Line / Last-Resort Tier
Reserved for refractory cases when the first and second-line tiers are insufficient. These options require specialist supervision, significant time, and significant cost.
Refractory-Case Tier
Hyperbaric Oxygen Therapy (HBOT)40 sessions at 2.0 ATA. Best evidence for brain fog, fatigue, and microvascular healing. Time and cost intensive. Worth considering when cognitive symptoms dominate.
Low-Dose CorticosteroidsPrednisolone or methylprednisolone 10 mg per day for 6 weeks if an organizing pneumonia or persistent inflammatory pattern is present on imaging or bloodwork. Short courses only. Not a long-term strategy.
HydroxychloroquineReserved for refractory inflammatory phenotype, prescriber managed, eye exam at baseline and annually. Not first-line for most patients.
Non-Invasive Brain Stimulation (tDCS / TMS)Specialist clinic only. Some emerging evidence for cognitive symptoms and mood when conventional approaches have failed.
Why This Is Not the Full Answer
The Ceiling of the Basics, and the Path Past It
Everything on this page reduces symptoms and inflammation. Almost none of it addresses the root drivers: viral persistence in nerve and vascular tissue, mitochondrial damage, the suppressed thyroid axis that locks the whole system in a low-energy state, and the lack of deep autophagic clearance. Symptom management can hold you steady, but it cannot finish the job. You either stay on the stack or the symptoms come back.
The Scorch Protocol is built around removing those root drivers:
- Dry fasting drives the deepest autophagy the human body is capable of, clearing viral reservoirs and damaged mitochondria from the inside out.
- The water fast bridge and controlled refeed close the vulnerability window so the cleared reservoirs do not get re-seeded.
- Antiviral coverage (lysine, monolaurin, acyclovir, ivermectin) holds the line during the transition.
- T3 therapy restores the suppressed thyroid axis and the cellular energy floor, so the immune system can finish its repair work.
- hGH therapy rebuilds tissue at the structural level once the inflammation has cleared.
If you start with the basics on this page, you are doing the right thing. Just understand the ceiling. When you are stable enough, the protocol is the next step. Most patients who complete it taper off the entire daily medication stack within 6 to 12 months. That is the difference between management and recovery.
Start with the Decision Logic Tree to see where you are in the protocol and what your next step should be.
Medical disclaimer: this page is educational. None of it is medical advice. Discuss any new medication, supplement, or major dietary change with a licensed healthcare provider familiar with your case before starting.
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Visit DryFastingClub.comThe information on this site describes a personal health protocol and is provided for educational purposes only. It is not medical advice. Consult a qualified physician before modifying your diet, fasting practice, or any medication regimen.