What causes Long COVID? The disruption of the immune system, causing it to turn on itself, and leading to post COVID complications weeks, months and years after being exposed to the spike protein in the virus or the vaccine.

Updated January 7, 2025

COVID disrupts our immune response system, particularly the white blood cells with mast cell activation syndrome (MCAS). MCAS leads to the overproduction of histamines that lead to inflammation of nerves, vessels and organs.

This is why over the counter antihistamines - H1 blockers (seasonal allergy medicine) and H2 blockers (antacids like Famotidine) are so effective in the treatment of Long COVID symptoms. Also why it is so important to look at low histamine diets and new food sensitivities & food allergies during your recovery.

If you've been checked out and nothing is urgently wrong medically, the next step is to figure out what you can do at home. Consider MCAS, histamine, inflammation, low histamine diet, breathwork, self care, antihistamines, H1 & H2 blockers, vagus nerve, along with dysautonomia and pacing. It is also a good idea to start a food-symptom-activity journal to identify symptom triggers. Gluten/wheat, soy, dairy, alcohol, smoked and fermented foods, preservatives, smoking/vaping and sugar are all common triggers. Here are some additional articles that will help you understand what Long COVID is, and what you can do to speed up your recovery.

Medication protocols for long COVID prevention and treatment

Talk to your doctor about the top 4 concerns: Histamines, Inflammation, Depression, and Blood Clotting

The antihistamine protocol: Seasonal allergy medicines like Allegra or Zyrtec (H1 blockers) and antacids like famotidine or Pepcid (H2 blockers) to counter the histamine cascade.
The anti-inflammatory protocol: Such as steroids in severe cases, or NSAIDs like ibuprofen or other prescription medications to reduce inflammation, pain, and the risk of damage to nerves and organs.
The antidepressant protocol: SSRI and SNRI medications to reduce depression, anxiety or fatigue.
The anticoagulant protocol: Aspirin, baby aspirin or prescription medications to prevent micro-clotting or deep vein thromboses (DVT) that can cause neural damage, organ damage, or stroke by blocking the flow of blood to vital organs.

Helpful recovery tools

A wearable pulse oximeter is an excellent tool that can track your oxygen and heart rate and alert you to oxygen dips.

Breathwork is essential in COVID recovery, and you may benefit from a respiratory muscle training program to address low oxygen levels.

Hyperbaric chamber treatment effectively increases the available oxygen. Many CCG followers report marked improvement after several sessions.

You may need consults with a vascular surgeon, cardiologist or pulmonologist. Physical, occupational and speech therapists will be able to help restore your physical conditions in your recovery.

For more information on oxygen levels and long COVID, visit the covidCAREgroup.org blog page and search keywords MCAS, inflammation, vagus nerve, cranial nerve, oxygen, self-care and more.

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 set backs.
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.