Long COVID, Diet and Hormones 

For the full article, please download our booklet, explaining poor gut health, its effects on the microbiome and Long Covid.

We also outline what can be done to improve your gut health through practical advice, including a dietary strategy for patients with histamine intolerance.

There are currently 1.5 million people living with Long COVID in the UK, and this number is predicted to rise as the virus continues to circulate. Long COVID is associated with symptoms that affect multiple organ systems. 

Many people with Long COVID are unable to go about their daily lives in the usual way, and their ability to care for their family and work is often affected. 1 in 5 Long COVID sufferers have not returned to work since they contracted COVID-19, and many more have only been able to return to work in a reduced capacity.

As yet, there is no cure for Long COVID, so a broad approach is used that targets several different factors influencing individual symptoms and the amount or rate of recovery achieved by an individual. These factors include hormone imbalance (which can be effectively treated with hormone replacement therapy) poor gut health, poor sleep, mood disturbance, overwork and overexertion. 

People with Long COVID are often advised to optimise their ‘gut health’ to improve their chances of recovery. But what does this actually mean? Why does it matter, and what can be done to improve the health of your gut?

Poor gut health also occurs in the peri/menopause; Women at this stage of life are the group most likely to get Long COVID and are therefore at higher risk of having poor gut health. This is why taking steps to improve your gut health is particularly important if you are peri/menopausal and have Long COVID.

The health of your gut is also important because, along with the menopause, poor gut health is associated with long term health conditions such as cardiovascular disease and dementia.
Making healthy changes to your diet and taking HRT will not only improve your Long COVID symptoms, they both bring long term health benefits.  

The human microbiome is the complex ecosystem of microorganisms that lives on and inside your body. Within your gut, there are approximately 100 trillion different microbes, mainly bacteria, that have many important functions, such as:

A healthy microbiome consists of a large number of different types of bacteria, particularly beneficial bacteria that perform the functions listed above.

An unhealthy microbiome is less diverse, has fewer beneficial or ‘friendly’ bacteria, and has a higher number of ‘unfriendly’ bacteria. This unhealthy combination is known as dysbiosis, and it can cause symptoms such as constipation, diarrhoea, bloating and flatulence. It has also been linked to many long term health conditions including obesity, diabetes, heart disease, inflammatory bowel disease, arthritis, certain cancers, autism, depression and Alzheimer's disease. 

Your diet has a major effect on the composition of your microbiome – your own unique mix of friendly and unfriendly bacteria. Plant-based ingredients are generally high in fibre, which nourishes the friendly bacteria. Plant-based ingredients also contain phytochemicals (chemicals that give food its colour, taste and aroma).

Phytochemicals have antioxidant and anti-inflammatory properties, and they positively influence the gut microbiota. A typical ‘western’ diet is low in fresh plant-based, fibre-rich ingredients but high in sugar which feeds the ‘unfriendly’ bacteria and high in processed foods – both of which can lead to dysbiosis.

Smoking, a lack of exercise and certain drugs such as antibiotics can also cause an unhealthy gut microbiome.

Estrogen and the gut microbiome are closely linked. The estrogen produced by your ovaries is metabolised by gut bacteria that help the hormone be reabsorbed and re-circulated in the body. Plant-derived estrogen and the 17-β estradiol type that is produced naturally in the body promote a healthy gut microbiome. After the menopause (if HRT is not taken), the lack of estrogen can cause gut dysbiosis.

Lastly, an unhealthy gut microbiome can result from infections, such as COVID-19.