I’ve hesitated on posting this for a long time, because it’s my own experience (n=1) of one very ill-defined health issue. I don’t want others to think if they follow this formula, they will automatically be well. There are too many variables. I did get better – very much better – but it took over 3 years. I also know people who have had similar ill-defined fatigue issues who have never gotten better. So I don’t want to sugar-coat this or make any promises.
I’ve decided to finally post it because I’ve heard from half a dozen friends in the last week who are still suffering long Covid symptoms. I didn’t have Covid – this was in 2016 – but I had some of the same symptoms, specifically crushing fatigue and exercise intolerance that lasted in different severities for over three years. I also had really whacked blood sugar and cortisol issues. So who knows. Maybe some of this will be useful to others who are still struggling months after being sick, and maybe it won’t. But I wanted to share this just in case.
I’ll also add: having gone through this once, I am doing everything I possibly can to avoid anything like it ever again. Long Covid scares the shit out of me, because it sounds, if anything, worse than what I went through. So I’m all about vaccinations, avoiding being indoors with others, and masking pretty much all the time I’m around other people. I miss being with family and friends. I hate disappointing them by staying away. I’d be losing my mind if I didn’t have my sweetie and my house and my garden. But since I have those things, in my estimation, avoidance is FAR preferable than recovery. I would encourage you to do as many layers of avoidance as you can, too.
How I recovered from post-viral fatigue (aka adrenal fatigue)
In February, 2016, I had a bad case of pneumonia. I was knocked flat for two weeks, and it was two more before I could go to work five days a week. A couple weeks of asthma (steroid inhalers helped), then another bout of something viral in mid-March. Finally, around the beginning of May, I finally felt like I wasn’t actively fighting disease.
But I wasn’t ok. For months – then years – even small amounts of exercise or stress would knock me on my butt for days. For weeks, all I could do was go to work and sleep. Many nights, I couldn’t stand up and chop a couple carrots to go into dinner. Twenty minutes of light garden work on Saturday morning meant I needed to stay on the couch until Monday morning. I did make progress, but it was agonizingly slow. In fact, I wouldn’t be back to my starting levels of energy and ability to do daily tasks until 2019. And I wouldn’t feel good until 2021.
If any of this resonates with you, do what makes sense to you. Don’t do anything that runs counter to what a medical professional has told you. But in these days of long Covid, we’re all shooting in the dark. Maybe this flashlight will point out something useful for you.
My post-viral protocol – the short version
- Slept more than usual (10+ hours/day in the beginning). Laying down for 15 mins mid-morning and afternoon was astonishingly helpful.
- Figured out my safe activity limit and didn’t overdo it.
- Reduced cortisol responses – stress and blood sugar fluctuations
- Ate plenty of salt.
- Took taurine to help balance electrolytes and repair damaged tissues.
Sleep and rest
The first thing that helped immensely was to lie down around 10 and 3 every day for at least 15 minutes – especially during the work day. I was really lucky that my office had an unused sound-room-turned-storage-area and they let me throw a mat and pillow on the floor for my daily rests. I don’t know what it was about being horizontal, but that’s what really helped me make big strides in being able to work full work days in the early months. I did 2x/day for several weeks, then 1x/day, and after a couple months, I didn’t need to do this any more.
I also slept a ton. I’ve always slept a lot compared to most people, like 8-9 hours/night. But when this hit, I slept even more. The best I felt in 2016 was when were were on vacation in Europe. No work, little stress, and between sleeping in and taking a long nap every day, I was sleeping close to 14 hours a day. Paired with several miles of very slow walking each day, I actually felt pretty good and thought I was on the mend. But once I went back to work, I faded. I finally had to make myself head for bed around 9pm every night. Many nights, I would fall asleep on the couch after work, too. It all helped. And if I then found I couldn’t fall asleep at night, I just reminded myself that rest is nearly as good as sleep, and just zoned out for hours until I’d fall asleep.
Figuring out safe activity levels
This was a huge part of actually getting better. I’m convinced if I had figured out how very little exercise was “too much,” I could have cut my recovery time by a year or more. After several months, and the vacation I mentioned where I could actually walk several miles a day, I thought I should be able to get back to my regular activity levels. But I kept taking 2 steps forward and 3 steps back. I learned to be especially wary of days when I felt good – because I’d work in the garden, and go to yoga class, and maybe even more…and the next day, I’d be a wreck and it would take me a week to get back to where I’d started. I finally got a fitness tracker, and used it to track the maximum activity I should be doing in a day. I don’t think I could have figured it out without the gadget – things that I thought were easy, like puttering in the garden – showed up as being extremely taxing on my heart rate.
I’ve put together a PDF with details and some ways for you to figure out a good level of activity. You need some movement to heal, but you can’t overdo it. And if your experience is like mine, you will be shocked how little activity is “safe” at first. You’ll want to push yourself to get back to normal. You’ll be bored and frustrated and annoyed and you’ll want to “do more.” But what I found was that the #1 thing that kept me from healing was to keep pushing myself.
So, I focused on doing exactly the right amount of exercise, because healing is “doing something.” For me, it started with 15 minutes of seated yoga every morning and 15 minutes of exceptionally light gardening (like, harvesting pole beans) per weekend. I did breathing exercises while lying in bed. And I kept my daily activity generally around 50% of what my activity tracker said my goal should be for a sedentary person my age. If I felt good, I’d go as high as 75%, but never two days in a row. Over about 18 months I was able to increase my activity to the point where I didn’t feel limited or like I had to ration my activity.
See this activity tracking PDF for help figuring out your limits. And note that one key is that you can’t just set arbitrary goals for improvement, like “I’ll do 10 minutes of walking every day this week, and next week I’ll increase it to 15 minutes a day.” That’s pushing yourself, and it will keep you sicker, longer, than anything else. This was absolutely the hardest part of recovering for me.
Keep cortisol steady
My doc explained that my endocrine system was completely fried from a combination of work stress and then the pneumonia. (I think the OBC I was on to regulate my cycles also played a part, though he disagreed.) So, it was important to keep my cortisol levels working normally. That largely meant reducing stress and keeping my blood sugar steady.
Stress reduction was hard, but it happened partly automatically because I just didn’t have the energy to worry about a lot of crap. One thing that was very useful, though, was to find something to laugh about every day. Wait Wait, Don’t Tell Me was very therapeutic.
I also found ways to make cooking be less work. My sweetie did more kitchen stuff, and we had a lot of meals that were practically zero work – like a rotisserie chicken, frozen sweet potato fries, and green beans. It was super important to eat densely nutritious foods, because I had to keep my blood sugar steady. One blood sugar crash would set me back for days. I could only go about 6 hours without eating, so I kept a couple pounds of homemade meatballs in the freezer at all times. I’d wake up around 4am, eat a couple meatballs, and go back to bed. I remember when I finally slept through the night every night for a month. It felt like a triumph.
Pasta and white rice…were not good choices. I needed lots of protein, too, but I quickly learned a keto diet was also right out. Drastically reducing carbs might help for a lot of things, but that was definitely not the case for me. Two days of keto sent me into a serious tailspin, which ended almost instantly when I ate some carbs.
I wrote a whole blog post about this, with recipes. Go take a look there for details.
This was a weird suggestion from my doc, but it really seemed to work. Eat a lot of salt. In fact, every time you have a glass of water, put a pinch of non-iodized salt in it. Soup in salty broth is great, too. Apparently, in adrenal fatigue, you need extra salt. Not sure of the exact mechanism (here’s a quick overview), but it helped a lot.
I didn’t figure this one out until 2021, and honestly, I’m not sure it would have helped me earlier. In the early years, I had “paradoxical reactions” to any kind of supplement. Most notable was that the magnesium drink called CALM made me very jittery, like caffeine. Anyway – by 2021, I was basically back to my pre-pneumonia state. I knew I could probably be better, but I didn’t really have any limitations on my activity, I was sleeping through the night, and nothing was really “wrong.”
Except for some heart palpitations. My heart would feel like it was skipping a beat a few times a day…then a few times and hour. I saw a cardiologist, who ran tests and confirmed it was benign, but if it really bugged me, he could give me medication. I passed on the meds, but I’d read that taurine can help palpitations, so I started taking 1000mg/day.
Holy. Mackerel. Not only did the palpitations go away completely in about 4 months, my energy went through the roof. Not in a sketchy caffeinated sort of way, but more like my body could actually heal and recover from exertion and damage. Our bodies are supposed to make taurine, but sometimes we don’t. Why not? Stress. Estrogen wackiness. Past infections. Yeah.
I’m wondering if this was what was missing all along. Taurine basically regulates electrolytes and fluids in and out of cells. So, you can eat or drink all kinds of good things, but if that can’t get where it needs to be, your body doesn’t have the materials to rebuild.
If you’re going to try it, take it in capsule form – not in an energy drink that has sugar, caffeine, and other garbage in it. Start slowly, too. I found I could handle one 1000mg capsule every other day at first. Any more than that had digestive side effects – I assume because it was changing how I metabolized magnesium, which is a known laxative.
After about 7 months of 1000mg/day, I felt amazing. I could work for hours in the garden and feel tired or sore. I could recover from any amount of exertion I cared to do with a good night’s sleep. Eventually, I was so energetic I was feeling a bit hyper at times, so I started staging down my doses.
Then my grandmother died, which was really stressful. It still seems like emotional stress still takes a harder toll on me than physical labor. I’m guessing that’s a cortisol thing. So I’m back to a full dose again. Maybe I won’t need it daily at some point, but for now, I’m still doing 1000mg/day. The good news is, I feel better than I’ve felt in…I dunno, 10 years? WAY better than I felt at the beginning of 2016, that’s for sure.
So that’s been my journey. Like I said, I don’t know how much of it applies to your situation. But I do dearly hope you find something that works as well for you.