Addressing The Dizziness And Vertigo Of Long COVID

We know little about Long COVID but thankfully, researchers around the world are working hard to find out more about what it is and how we can treat it.

Symptoms of long covid vary, but many patients complain of persistent dizziness and vertigo. Research is ongoing for the prevalence of dizziness and Long COVID but early studies estimate a prevalence of dizziness in 12% of patients who experience COVID-19 infection. [1]

Although it doesn’t sound that serious or life threatening, it can be really debilitating and affect someone’s quality of life by making things they used to do impossible.

So, what causes it and what can we do about it? Read on to find out more.

What is long covid?

From SARS-CoV-2 sprang COVID-19 and it has changed the way of life for all of us across the world. Its symptoms range from fever, shortness of breath, sore throat, coughing, muscle aches, fatigue, headaches, dizziness, vertigo, brain fog, nausea and vomiting.

Long COVID is a condition in which people present symptoms despite having passed the acute phase of the disease. Specifically, it describes symptoms that extend beyond three weeks and “chronic COVID-19” as symptoms that last beyond 12 weeks.

The reason symptoms can continue may be due to the combination of a cytokine storm and entry of the virus into the central nervous system, causing neuroinflammation. This will cause prolonged, very frequent neurological symptoms and severely decrease the quality of life of those affected. [2]

Preliminary data shows many similarities between long COVID and other chronic illnesses known to be associated with viral and bacterial triggers, including:

• Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
• Lyme and tickborne diseases
• Postural Orthostatic Tachycardia Syndrome (POTS)
• Dysautonomia
• Mast Cell Activation Syndrome (MCAS) [3]

What are post COVID dizziness symptoms?

The most common symptoms related specifically to dizziness and vestibular issues include:

• Generalized dizziness – you may feel like you’ve been drinking alcohol even through you haven’t had any at all
• Lightheaded-ness or a floating feeling
• Vertigo or a spinning sensation, particularly when looking up or down, or lying on your side
• A sensation of swaying or rocking when sitting or lying, or after a quick motion
• Poor balance when standing or changing positions
• Problems walking in a straight line or in busy areas such as a shopping mall
• Nausea or vomiting
• Brain fog
• Issues with vision such as blurring, doubling, trouble viewing screens or issues with fast moving or busy scenes [4]

How long does long COVID dizziness last?

It is very difficult to predict the nature and longevity of long COVID overall. However, it seems that these issues can appear to last for weeks to months and for some unlucky people, even longer. As we continue to understand more about long COVID, we expect to have more information about recovery times and appropriate treatment.

What are the causes of dizziness and vertigo?

In general, dizziness can be caused by a number of different issues. These include:

• inner ear disturbances
• the effects of certain medications
• motion sickness
• prolonged bed rest
• other health conditions

Dizziness is classified as either an issue outside the vestibular system or with the vestibular system. The vestibular system is comprised of several structures and tracts, but the main components of the system are found in the inner ear in a system of interconnected compartments called the vestibular labyrinth. [5] It provides our brain with information about movement, head position and spatial orientation.

Dizziness is divided into four categories: vertigo, disequilibrium, presyncope, and psychogenic dizziness.

Vertigo is a disease of the central or peripheral nervous system and there are two types of vertigo – central origin vertigo may be a life-threatening situation and must be detected as soon as possible because it includes diseases such as stroke, haemorrhage, tumours and multiple sclerosis. Peripheral origin vertigo includes benign diseases, which may be fully treatable such as vestibular migraine, benign paroxysmal positional vertigo, vestibular neuritis, Ménière’s disease, and cervical vertigo.[6]

How does COVID-19 specifically cause dizziness?

Inflammation

COVID-19 causes inflammation which in turn, can cause organ complications, including the inner ear and vestibular centres of the brain. There may also be inflammation of the macula or the formation of microthrombi in the circulation, causing the degeneration and detachment of otoliths. [7]

Immunity

With long covid, you can expect your immune system to be struggling. Vertigo and dizziness may be our body’s way of responding to the virus by causing infection.

Reactivation of previous conditions

Covid is known to reactivate some conditions and those in the vestibular area are no different. It may cause previous issues to re-emerge and become active.

Medications

Some of the medications, such as ivermectin, hydroxychloroquine, interferon, ritonavir and may have a harmful effect on the inner ear.

Prolonged bed rest

Long periods lying prone in bed have been shown to bring on dizziness and vertigo, especially when combined with the above medications.

Ways to treat dizziness and vertigo if you have long covid

In order to treat long COVID effectively, you must treat all the body’s systems, not just the affected areas. As our system’s are all interrelated, treating long COVID in such a way will be more successful than treating each symptom in isolation.

Movement

When you are in the middle of a dizziness attack, stop moving and get yourself somewhere safe – either sitting or lying down. Try to focus on one specific thing in front of you and touch the surfaces around you. Practice deep breathing and remain calm until the dizziness subsides.

Don’t avoid movement or activity altogether. Although you need to be careful not to bring your head up quickly when lying down or get up quickly when sitting, light to moderate activity, practiced slowly and carefully will stimulate the vestibular system and help you to recover more quickly.

You may also find that elevating the legs when sleeping is effective.

Treatment for long covid

There are several issues to look for to treat long COVID generally which, in turn, will help to alleviate all symptoms, including your dizziness or vertigo.

These include:

• Treating reactivated infections such as Epstein-Bar and Cytomegalovirus. These viruses respond well to Vitamin C, herbs such as garlic, astragalus, green tea, ginger, echinacea, black cumin, liquorice, St. John’s Wart, and a Mediterranean diet. [8]
• Research has discovered a link between dizziness and stress and anxiety so reducing stress is a very important factor in recovery. You can reduce your stress through meditation, yoga, or using adaptogenic herbs which can be very useful.
• If we’re lacking the protection of a robust and diverse microbiome, the risks of long Covid are greater. [9] Long Covid is often accompanied by gut imbalance and dysbiosis and this can be treated with several treatments including prebiotics, prebiotics and supplements to restore the gut microbiome.
• Eliminating toxins is key to restoring the body’s balance. With testing to identify mould, yeast or environmental toxins, your Functional Medicine health practitioner can work with you to remove these from your system.
• Focussing on nutrition to restore you overall health and the health of your gut. A plant-based, anti-inflammatory, whole food diet with support you regain your health. Phytonutrients, omega-3 fatty acids and antioxidants will help you to reduce excess inflammation.

Reduce the number of inflammatory foods and drinks in your diet, including caffeine, alcohol, salty and sugary foods and stop smoking if you haven’t already. Drink lots of water to cleanse and hydrate.

Eating small meals is also a good idea to help curb the nausea that comes with dizziness.

Maintain a diet incorporating gut friendly probiotic foods such as:  yoghurt, miso, sauerkraut, kefir, natto, tempeh and kombucha.  Foods that contain prebiotics include the onion family, artichoke (Jerusalem), bananas, pomegranates asparagus, beans especially soybeans, lentils, chickpeas, raw oats, unrefined wheat and barley, honey, pistachios, almonds and more. [10]

• Improve immunity with Zinc, Vitamin C and Vitamin D
• Take Quercetin, which has antiviral effects against influenza and coronavirus, and DNA viruses (e.g., herpesvirus). Quercetin is an antioxidant and anti-inflammatory, modulating signalling pathways that are associated with post-transcriptional modulators affecting post-viral healing. [11]
• Get plenty of good quality sleep.

How we can help

Functional medicine offers people an avenue outside, or alongside, conventional medicine to help alleviate symptoms and improve overall health. The medium- and long-term effects of COVID-19 infections on our general health, well-being, physical function, and ability to return to work has not yet been studied in depth. [12]

We are still finding out common symptoms and how to treat them so as time goes on, we will have a better understanding of the mechanisms of the virus.

At Advanced Functional Medicine, we can support you to build your health and start you on the journey to wellness after COVID with thorough testing and treatment. If you are experiencing dizziness or vertigo, we can find practical solutions and holistic treatments to help you address this distressing symptom and return to your regular life patterns.

Get in touch with us to find out more.