Long COVID: What bloodwork and vitamin/supplement recommendations?

NAC is an amino acid (protein) that is an FDA approved drug that has been made an over the counter in the past year. I have been using NAC for my Long Covid and a recent bout of tendonitis. It was helpful. My wife recently had a cold/flu with a bad cough and I had her try NAC. It did help her cough and she would recommend it.
From WEB MD:
N-acetyl cysteine (NAC) comes from the amino acid L-cysteine. Amino acids are building blocks of proteins.
People commonly use N-acetyl cysteine for cough and other lung conditions. It is also used for flu, dry eye, and many other conditions, but there is no good scientific evidence to support many of these uses.

Hello. Thank you for your input.
I'm glad it has helped you (and your wife).
Did it help with COVID fatigue? How long were you on it?
Thank you.

I started on NAC in November for a bout of shin tendonitis. It helped the tendonitis and I have stopped taking it recently but I am feeling mild Long Covid symptoms again and should go back to it.
I have had similar symptoms. Your daughter may be deficient in some nutritional requirements, like I was. I would recommend sublingual (under the tongue liquid) B12 and zinc. Sublingual is better absorbed. I take the zinc in the middle of the night. Try to take zinc 2 hours away from anything else. I take the B12 first thing in the morning. They are better absorbed if taken on a empty stomach.
Zinc helps the immune system fight the long covid and B12 is needed to form the red blood cells to convey the oxygen throughout our body.
Last year, I was taking a small amount of zinc with other supplements, but it was not getting absorbed and my immune system was losing the battle.
I would also recommend keeping a “Health Journal”. I have several on Word. One is a day by day journal on symptoms and what I am trying. The others are special areas, like natural blood thinners to dissolve the microclots caused by Covid. There are natural products and foods that are mild blood thinners, such as berberine that is from pineapple. (If you cut up a fresh pineapple, save the core and put it in a mini-food processor with a little water to grind it up. The berberine supplement makers get berberine from pineapple cores. The rest of the pineapple as some, but the core is highest.) Another natural blood thinners is ginger. I have ginger tea each morning. I put a teaspoon of ground ginger in a mug, add hot water and some citrus juice and use a mini-wisk blender.
I will give you some links for natural blood thinners:
https://www.medicalnewstoday.com/articles/322384#faq
https://draxe.com/health/natural-blood-thinners/
https://curehht.org/wp-content/uploads/2017/11/Blood-Thinning-Foods-to-Avoid.pdf

I will give you a link for an article on the Japanese fermented beans, natto. The nattokinase, K1, is a known blood thinner. I have been “preaching natto” on the blog, but no takers. (I am assuming your daughter is not currently on any blood thinners. No one should do both the meds and natto.)

I make natto with fresh natto from Brooklyn as a starter. (Okay, I am weird.) I have it with olive oil (for absorption) and kimchi, Korean fermented cabbage. The combo is supposed to be a good immunity booster. (I am blood type A which means low immunity and I need a booster.) After all that, I will give you a link:

I hope some of this is helpful and feel free to send a private message at any time.

I will try to relate to your daughter’s sudden onset nerve pain in feet. In mid-November, I had the same condition. I now have minor discomfort occassionaly.
I found online that it was shin tendonitis.

The medical sites said to just rest, elevate the foot and apply ice packs for about 15 minutes and repeat a few times a day. That fights the inflammation.
I also found it helpful to wear a compression sock during the day and take it off while sleeping. That reduces the swelling.

A major help was to have 2 cups of homemade bone broth per day to help rebuild the tendons. Bone broth has the protein collagen that is needed to repair the tendon damage. But I emphasis homemade. The store bought bone broth is water downed and does not have much collagen. I roast a chicken or turkey, cut off the meat when it comes out of the oven and place the bones and scraps in a large pot with water to the top of the bones and simmer for the rest of the day. It does freeze well.

In Australia, (Monash University), they say after a few days of rest, go with light, limited exercise and slowly increase the level of exercise.

In November, I thought the tendonitis was caused by overdoing the fall cleanup in the yard (1/2 acre). I did not blame it on Long Covid. However, after further review, it looks like LC may be the culprit.

From: Your Covid Recovery https://www.yourcovidrecovery.nhs.uk Muscle aches and pains are described as ‘myalgia’. It can involve your ligaments, tendons, soft tissues and it can also cause joint pain. Myalgia can be a common symptom if you have a viral infection such as COVID

Barbering does not come from pineapple. Bromelain come from pineapple.

You are correct, it is bromelain. I will play the brain fog card.

From: Medical and Life Science (published 1/12/24)
"Association between vitamin D supplementation and fatigue"
Fatigue is a common denominator in many autoimmune diseases. Researchers advocate a plasma vitamin D test in patients with fatigue symptoms since low blood vitamin D levels are frequent in these individuals, and treatment resulted in a significant decrease in fatigue severity.
Serum vitamin D levels below 20 ng/mL indicate deficiency, and those between 21 and 29 ng/mL indicate insufficiency. A daily consumption of 600–800 IU of the vitamin provides optimal bone health, but a daily intake of 1,000–2,000 IU is necessary to maintain plasma levels above 30 ng/mL.
https://www.news-medical.net/news/20240112/Association-between-vitamin-D-supplementation-and-fatigue.aspx

I started with my local Doctors and took "the journey of what its not" and recommend you start there too. Ultimately I was diagnosed with Long COVID and went to Mayo Rochester for their program. I contracted LC from my first booster in November '21, here it is January '24 and I feel better after 5 months of executing my Mayo program. Not 100%, but better.

I have learned lots of do this and don't do that along the way which will help me manage my symptoms if I ultimately don't get over them completely.

Thank you very much for your response.
I really appreciate the link you provided also. Thank you.
It seems like there’s not 1 thing COVID does not affect.
My daughter notices that when she gets the foot pain the LC extreme fatigue comes shortly after. She’s seeing a pattern with the symptoms.
She needs to get to a new dr so she can address some of these things but she’s been dealing with her hip issue (a tear in hip labrum from the fall due to COVID dizziness). She can only deal with so much at once (emotionally it’s been extremely difficult). She went back to the orthopedist and he needs to do surgery but not until she can reduce the pain from the 4 bulging discs she also got from the fall. In order to do that she needs to go to a pain clinic. So that is the next step. And Medicaid insists she get that referral from a regular dr instead of the ortho. I don’t understand that but we must jump through the hoops.
My hope is that she can begin to address these other issues when she goes to the regular dr apt.
Again, thank you so very much for your reply.
It is heart-breaking for me to watch her suffer so much with all of these issues. I wish I could take it on for her.

This is extremely helpful information. My deepest appreciation to you!
I am going to include this in my notes for when she sees her new GP. The info on the vitamins and when to take them is particularly interesting. Thank you so much!
I am going to review the information in the links you provided. I have been down sick for a few days so have a lot of catching up to do.
Again thank you.
I’m not sure I know how to private message but I’ll look into how to do that.
Hugs and many many thanks