*This article discusses how low oxygen levels affect the body when silent hypoxia, a condition that occurs during and after COVID infections develops.*

Updated February 14, 2024

When the pandemic hit critical mass, hospitals, physicians, and nurses reported that patients coming to the emergency rooms were presenting with low oxygen levels. It was easy to identify patients that were clearly in respiratory distress, and many progressed to respiratory failure and required mechanical ventilation. Many others went to emergency rooms because they didn't feel well but had no obvious signs of breathing trouble and had dangerously low blood oxygen levels (oxygen saturation) requiring immediate intervention. Countless more people who were asymptomatic or had less severe COVID symptoms experienced hypoxia (hypo=low, oxia= oxygen) well beyond the acute phase of COVID.

All cells of the nervous system, organs, skin, and hair need oxygen supplied by the blood capillaries in the body (arteries and veins). When oxygen intake is impaired, the body's circulatory system has less oxygen available for transportation to the cells in our body. A lack of oxygen affects all cells. Regardless of the severity of the acute COVID-19 infection, hypoxia, especially chronic hypoxia, can result in brain damage, neurologic/nerve damage, organ damage and even hair loss and nail damage.

In the healthy body oxygen saturation levels fluctuate between 97%-100%. This range demonstrates that your brain and organs are getting the oxygen they need, and slight variations in this range are not considered to be a medical concern. When oxygen levels drop and remain below 95%, there is the potential for cell damage. Some common warning signs of low oxygen are brain fog, dizziness, and rapid heartbeat (tachycardia).

Research of long COVID symptoms conducted by covidCAREgroup in July 2021 revealed that respondents experienced these symptoms longer than 4 weeks post-acute infection:

89% Fatigue
80% Brain fog
57.6% Shortness of breath
53.5% Dizziness

When there is a lung infection, mucous blocks the alveoli of the lungs and oxygen (air) cannot be absorbed into the blood stream. Typical infections include pneumonia, bronchitis. These show on x-ray as white or gray areas or ground glass opacities.

In long COVID, mast cell activation syndrome (MCAS) can cause multiorgan inflammatory syndrome (MIS-C, MIS-A). This can include inflammation of the circulatory system including veins, arteries, lungs and heart, so it's important to work with your doctors if you are experiencing symptoms of shortness of breath, fatigue, brain fog, muscle weakness, sleep disturbance, sensitivity to foods or medications, worse or new allergies. People with chronic lung, heart and blood diseases are at higher risk of complications from this issue.

Low oxygen levels can also be caused by allergic reaction, anaphylaxis, pneumonia or other lung infections, lung and diaphragm inflammation, nerve inflammation or damage. Health conditions that place people at higher risk include: asthma, reactive airway disease, chronic obstructive pulmonary disease (COPD).

Other causes may be related to the heart, blood, and circulatory system (veins and arteries), including blood vessel damage and inflammation, low hematocrit levels (anemia), low hemoglobin levels, and damage to red blood cells impact oxygenation. One of the newer discoveries about post COVID syndrome is micro-clotting .

These diagrams show how the blood circulates and carries oxygen through your body. When these systems are interrupted, the body cannot circulate the oxygen it needs.

SYMPTOM MANAGEMENT

It is important to work with your doctor to manage hypoxia. Not all doctors are concerned with oxygen (O2) levels under 95%, so you may have to strongly advocate for yourself on this matter. Antihistamines, inhalers and steroids are common medications used to manage this. There are also some nutritional supplements that can help but be sure to educate yourself and check for mediation interactions before treating yourself.

If your doctors can't identify the cause of the hypoxia, it's time to look at what you can do at home to address the inflammation. Hypoxia related issues can be permanent but are most often temporary. However, they can be exacerbated by things like stress, allergic reaction, histamine release and foods/drinks.

Things you can do to help yourself

Minimizing physical & psychological stressors is essential in recovery from Long COVID.

Nutrition: Try to eat protein and fresh vitamin rich foods daily and avoid chemicals, preservatives, sugars, fast foods, prepared foods and high histamine foods.
Don’t skip meals. Your body needs protein, vitamin C, and vitamin D to heal from any injury or illness. A low histamine or low carbohydrate (sugar) diet is recommended by doctors treating Long COVID (PASC), and many people report a reduction in symptoms within 1-3 days of the diet change, including decreases in sneezing, itching or hives, irritable bowel syndrome, body pain, along with a reduction in swelling and inflammation.
Hydration: A minimum of eight 8 oz glasses of plain water daily is recommended.
Avoid drinks with chemical additives. You can easily make a fresh electrolyte drink yourself by adding a dash of mineral rich Epsom salt and a piece a fruit like a raspberry for flavor instead of spending money on commercial drinks like Gatorade that contain chemicals and sit in plastic bottles for long periods of time. Remember that caffeine and alcohol have dehydrating effects.
Sleep hygiene: Getting 7-9 hours of sleep so your body can repair itself.
You need at least 4 hours of uninterrupted sleep to get into the restorative phase of sleep.
Avoid stimulating activities after dinner like thrilling movies or books, arguments, negative news or frustrating stimuli.
If you wake up frequently or with a startle, you may be experiencing drops in your oxygen level, which signal your brain to release adrenaline to force you to take a breath. This could be a temporary inflammation issue or more enduring sleep apnea. Ask your doctor for a sleep study to evaluate your need for a CPAP or BiPAP, a machine that pushes air into your lungs when it senses an apneic episode (periods of not breathing).
Stress management: Stress affects every component of your life.
The only thing you can control about stress is your reaction to it. Try to avoid or minimize your exposure to stressful situations: Turn off the news, make family visits that end unpleasantly short, wait for the morning to have intense discussions, let go of things that annoy you but don’t really matter in the big scheme of things, avoid intense conversations or entertainment in the evening.
Exercise within tolerance: Pace yourself and do not push your body to extremes in any way.
For some this may mean seated breathing exercises, walking to the mailbox. Rest when your body says to slow down. Gradually build on your activity endurance as your body cues you to progress. This can be hard to gauge, because when you feel good you naturally do more, but if you do too much you may experience symptom flare ups 1-3 days later as the post exertion inflammation builds. Some people describe this as post exertional malaise, others experience severe recovery setbacks.
Breathwork: You can literally stop the fight or flight reaction by taking slow deep breaths.
Deep slow breathing shuts down the adrenaline flow, slows your heart rate, lowers your blood pressure and decreases stress related histamine release. When you do this, your blood reroutes back to your brain and nervous system to allow you to think clearly. It also allows your body to use its energy and oxygen to heal your inflamed nerves and organs.

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Brought to you by covidCAREgroup, connecting the dots of long COVID through education, research and resources.

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