In this introductory video Dr. Ray (Dr. A), a veteran integrative and naturopathic clinician, outlines the four primary symptom clusters observed in long COVID—fatigue, brain fog, pain syndromes, and broader neurological manifestations (including peripheral neuropathy, taste/smell changes, sleep disruption, anxiety, and depression). He proposes a stepwise clinical pathway that first rules out organic pathology (renal, hepatic, cardiovascular, pulmonary, autoimmune, or neuropsychiatric disease) before addressing functional abnormalities. The bulk of the talk focuses on self‑care strategies that patients can implement: (1) restoring normal sleep using wearable trackers (e.g., Oura Ring, Whoop) to monitor quantity and quality; (2) graded movement and re‑conditioning, emphasizing “baby steps” tailored to the individual’s baseline fitness, with an explanation of how skeletal muscle activity reduces systemic and brain inflammation; (3) dietary modifications that eliminate processed and high‑sugar foods, prioritize high‑fiber, low‑insulinogenic plant foods, and adapt to personal cultural or ethical preferences; (4) aggressive hydration to support cellular waste clearance and reduce inflammation, drawing parallels to tumor‑biology research. Dr. Ray stresses patient agency while offering professional counseling for those needing personalized guidance. The video concludes as part one of a series, inviting viewers to subscribe and await a follow‑up Q&A.
Chapters
On this one, I want to talk about the top symptoms that we get or we see with long COVID, and then what kind of a pathway should we go through in trying to deal with long COVID? Hey, I'm Dr. A. I've been teaching and researching in the integrative and naturopathic medical communities for 30 years now, and I've been seeing patients for a long time, and I use this channel to answer questions. One of the areas that we got a ton of questions on were the long COVID videos. Obviously, there's a lot of people dealing with this. And there's a lot of questions around long COVID. So I want to take a little bit different turn with this, and I'm going to do this video and then a follow-up to it to answer the majority of the questions. So let's get into this one. As far as top symptomatic areas or top presentations, there's 4 big ones, and then they can break down into a bunch of other ones. First one is fatigue. A lot of people will liken long COVID to, you know, chronic fatigue syndrome. CFS has a lot of the same features. The next The first one, which is very disturbing, is what we call brain fog. Now, a lot of people have experienced brain fog from certain drug therapies. They might get it from chemotherapy or certain other things. But if you weren't having slow mentation brain fog before, and now you have long COVID and you feel like you have brain fog, it's very, very frustrating because it's a lot like the feeling as if you got a concussion or something. Your brain is not working like it ought to. The next are pain syndromes, and this can be either peripheral pain where my muscles hurt or my digestive system is achy, Or it can be central pain where my pain apparatus in the brain is just thrown off because of inflammation. My pain threshold has changed, so I hurt more than I used to. And then the last one, which is a large area, would be other neurological symptoms. Now, this could break down into direct neurological problems, meaning things such as peripheral neuropathy or changes in taste and smell or other things like that. Or it could break down into more of a neuro— neuroemotional type of the change where now you're not sleeping well, or now you're more anxious, or now you're more depressed, or any number of other things, neurological things. And what I want to look at here in the first video is when somebody comes, either, you know, I am directly working with them or I'm consulting in clinic or teaching them, you know, what's the pathway to go through here? The first thing that we do, and it's stepwise, the first thing is to rule out pathologies. So for whatever reason, it might not even have anything to do with COVID But people are allowed to have more than one reason for medical problems. What we know is people with long COVID can have pathological dysfunction. So the first thing is to rule out pathologies, meaning let's make sure your kidneys are functioning. Let's make sure your liver is functioning. Let's make sure you haven't developed some new autoimmune disease. Let's make sure your cardiovascular system and your pulmonary system are not suffering in some way pathologically, because we don't want to launch into treating a whole bunch of other things which may still need to be treated and overlook the fact that you have suffered lower kidney function or overlook the fact that you have a neuropsychiatric disorder that's pretty hardcore that we need to get under control or overlook the fact that you have some restrictive disease in your lung or something like that. But a lot of people come to other providers because they are frustrated and they say, well, thank heaven I don't have any hardcore pathology. My kidneys, liver, heart, lungs, brain, they're all supposedly working great based on the test, but I still feel horrible. So then what do we do? Well, obviously if there's a pathology, we're going to start treating that. And then if there's functional or other things in the labs, we're going to start treating that. But then there's things that we can do for ourselves that you might get really frustrated and say, well, this didn't help me, or it doesn't seem very strong or whatever, but it's going to help anyway. So these are things that we can work on, either you work on on your own or we work on together to help out. The first is trying to restore normal sleep function. And nowadays, this used to be really hard to track with people because the sleep monitors were these giant things people would have at home and they wouldn't use them. Now you can use an Oura Ring or you can use a Watt. Are they perfect? No, they're not. But you can get a general idea of how long am I actually sleeping? You might be unconscious for X amount of time, but you may not be going into good, you know, deeper sleep and all that. So that's really good to look for and look at. Now you might say, if you're fatigued, well, I'm sleeping all the time. Then sleep normalization is getting you some energy back. The next thing is movement. Now people will say, well, does this really make a lot of difference? Actually, it does. And you don't have to do a ton. The first thing about movement is the most important thing for you to move are your skeletal muscles that move your body. So your legs are huge. And then the core muscles that move you around. The next thing about movement is you don't have to do a ton to make an impact. It's getting the muscles moving. The next thing is you start where you're at. So let's say you're on one end of the spectrum and you were super athletic and you were doing weightlifting and aerobic training all week long, and you were really there. And now you got long COVID and you're fatigued and you're, you're at 25% of your previous capacity, you know, at the gym. Well, we start at 25%, so you don't have to go back to 100%. You're going to fatigue yourself more. You do baby steps. And in the beginning, the baby steps are very long. So it's just a little bit more every day. What about the other end of the spectrum? Let's say you've not worked out ever. And basically need to work out. You feel like you need to work out, but you feel horrible because of long COVID and you're way out of condition, you're deconditioned, et cetera. Well, then we're starting with that. You're deconditioned. We're going to just do enough to get your muscles moving for maybe a month or two. And that might be, what's your normal activity during a day? Person might say, well, I go up and down the stairs 4 or 5 times. I walk to the mailbox. I do all these things. And that, that's about all I can handle. We might just add one thing, make another loop to the mailbox, make another trip up the stairs. And here's the thing, if you're that far deconditioned, that one thing you add might need to be added, and that's the only extra thing you do for 1 to 2 months because the reconditioning is much slower. And then when that becomes normal, then maybe we add a couple more trips up and down the stairs, or maybe we do other things, right? But it's all baby steps. Yeah. I don't care if you were super conditioned and now you're at 25% capacity. If you go back to 100% capacity of workouts like you did before, you're going to exacerbate your fatigue and everything else. So you want to do baby steps towards 100. If you're totally deconditioned, you're going to do baby steps towards something. Well, the actual movement Muscle does a number of things. One is it changes your biochemistry and your signaling so that you have less inflammation. Number 2, and this is some newer work done early in COVID where the neurological research has shown that moving the skeletal muscle actually heals the brain inflammation that happens. And this brain inflammation, a huge reason for long COVID. Diet. Now we could do hours on diet, et cetera, but here's the bottom lines of diet. Number 1, make sure that the food that you're eating has the least amount of added junk to it. Take out processed foods, take out convenience foods essentially that have a bunch of additives, eat real food, all of that. So the first thing is just take the junk out. The next thing is that we want to remove empty calories. So that would be high sugar drinks or high sugar candies, sweets, stuff like that. The next thing though is that you want to add in more high fiber plant material because that's going to help you on a number of levels. So you're going to add in plants, but we want to kind of minimize starchy plants and maximize high-fiber plants. You could think of things, you know, like broccoli and cabbage. And then the next thing is, is that we want a low insulinogenic diet. And so a lot of people know you can look up online a low glycemic diet and it gives you, you know, a list of foods range from low to high glycemic. You can also look up low insulin stimulating foods. But why insulin? Why do we want to tame insulin? It's because if we can tame insulin in our diet, then we have less insulin being pushed out by our pancreas and we lower our inflammation. inflammation just naturally by doing that. Also, it helps the brain, it helps lots of stuff. We clean up the diet, we add more high-fiber types of plants, we get a low insulinogenic diet going on. And then everything after that would be more specific things like, certainly if you're sensitive to a food, don't eat it. If you have a particular way that, you know, you eat culturally or traditionally, if you are a vegetarian or a vegan, or if you eat certain types of like a Mediterranean type eating or whatever, you can morph all of this into a healthy type of a diet. The diet's huge. And then the last thing goes with diet, and that's hydration. Most people are dehydrated, and you think, oh yeah, hydrate, drink more water, blah, blah, blah. But there's actually research now, and it's sort of one of those things that's like, well, this makes so much sense, why'd they even research it? But they did. A lot of it comes from the tumor biology world where if a human is dehydrated, then exclusive of all the other things with cancer that can go on, you don't have as much fluid pushing into the extracellular space and into the cell. And that means you don't have as much fluid taking the garbage out and putting it back in the venous system to remove it. Well, A lot of cancer production in the body is very much sensitive to not taking the trash out of the cell. And so when you look at this, it doesn't have to be cancer. That can be just your whole body's inflamed. The more hydrated you are, the better that transfer goes. Now, there's a million other things you can do too. Those are just places to start. The other thing is you, you have agency over generally what you're eating and sleeping and drinking and all of that. But if you need help, You can get specific counseling in those areas. All right, so this is part one. I'm Dr. Ray. Thanks so much, all you new subscribers. Thanks, all you guys who've been around a long time. Subscribers, please do like, share, subscribe if you haven't, and I'll see you all on the next video.
