What is Long CoVid?

Have you ever suffered brain fog, chronic fatigue, lack of concentration, menopause or even toxin exposures like perfume giving you a headache? Find out how supporting the glymphatic system may help with those symptoms and recovery from fatigue. There is growing interested in symptoms resembling chronic fatigue syndrome or myalgic encephalomyelitis in people with CoVid 19 and chronic fatigue patients.  


Common symptoms during the acute phase of COVID-19 are fatigue, headaches, sleeplessness and tiredness; however, in post-viral syndrome, there is a constellation of symptoms that include fatigue. Fatigue symptoms are common in other infections like glandular fever, Ross River Fever and shingles. Authors have observed that the predominant symptom of long Covid is fatigue which can be ongoing for 16-20 weeks post symptoms onset or the start of infection. 


There to date is no set diagnosis for the symptoms of fatigue post viral infection, and the definition of Long Covid has not been established. When investigations show no underlying clinical causes of fatigue and symptoms like muscular pain, joint pain, feeling heavy, loss of energy and cognitive impairment for more than three months, symptoms are termed chronic. Post-infective-fatigue syndrome or Chronic Fatigue Syndrome may be considered by a Doctor when no clinical assessments are identifying an underlying cause. 

Here I take a closer look at the lymphatic system, its relationship with our immune system, and the influence of these systems associated with fatigue and post-infection symptoms.  

The Glymphatic system= good housekeeping


our brain does its housekeeping


A reasonably new concept in the health science world is creating some excitement around brain detoxification and fatigue understanding: the Glymphatic system. The Glymphatic system belongs to our brain and central nervous system (CNS). When we sleep, all the detox action starts then and is one of the mainstays of feeling refreshed on waking -our brain has experienced a deluxe wash.

That’s not to be confused with brainwashing; our brain uniquely keeps specific substances out and lets some particles or molecules in. Did you know that folate and vitamin C diffuse into the brain through the cerebrospinal fluid and that the covering of our brain (the meninges) communicates with the brain? This means that our brain, the meninges and the central nervous system collectively share.

Selectivity of our brain means that it is very particular about housekeeping and gatekeeping who comes in and out. This housekeeping helps with mental clarity, energy, immune health and recovery from illness. When we have long periods of disrupted sleep, our lymphatic system and brain cleanse are disrupted, potentially affecting mental clarity the next day.

Our brain, eyes and central nervous system contain a unique detoxification process called the glymphatic system. This detoxification system differs significantly from our lymphatic system, which parallels our blood circulation and is our human body’s plumbing and sweeping systems. Our central nervous system is the only organ lacking well-defined lymphatic vessels and tissues, although the meninges have specialised lymphatic vessels. 


The glymphatic system

The glymphatic system (GS) is a series of tiny channels (perivascular cells) formed by astroglial cells to detoxify larger molecules, soluble proteins and toxins of our nervous system. The glymphatic system is the waste removal system that maintains balance across our lifespan and also delivers glucose, fats, amino acids, and neurotransmitters is another role of the GS.


How the glymphatic system works -a snapshot

  • Channels of the glymphatic system  (glial cells) fill with cerebrospinal fluid.
  • Cellular toxins, protein molecules and waste products are collected in the cerebrospinal fluid.
  • Our body then removes the fluid to drainage points, eventually released to detoxification points like the liver, kidneys, digestive system, urine, sweat and faeces.  

Suppose there is Impaired clearance of (interstitial solute); slow brainwashing by the glymphatic system or its compromised function can contribute to various central nervous system diseases. In that case, scientists are looking at the glymphatic system and dementia and Alzheimer’s. 


What causes chronic fatigue?  


Scientists and researchers are working on understanding conditions like fatigue, post-viral fatigue and chronic fatigue causes, which are poorly understood to date. There are some working theories on fatigue causes, and observations (neuroimaging) of some chronic fatigue sufferers have found slight structural changes in fatigue patients’ brains.

Astonishingly, cerebral spinal fluid drainage has been suggested as one possible treatment. The natural medicine approach is to support our body and the glymphatic/immune system to improve these systems and detoxification, a gentler option. No studies on natural substances support the glymphatic approach to recovery. However, I find there is a multitude of herbal medicines and nutrients which help support brain health.    

Other hypotheses of post-viral chronic fatigue syndrome are hinged on damaged olfactory sensory neurons causing a reduced outflow of cerebral spinal fluid leading to congestion of the glymphatic system; toxins subsequently build up in the CNS. 


Can we support the glymphatic system?  


Turmeric Latte

The understanding of our glymphatic and immune systems is growing, yet in science and health terms, we are just at the beginning of research and knowledge of these incredible systems and their role in health. More research on the impact of fatigue on our central nervous and immune systems is evolving, the lymphatic system is a relatively new area of research, and I hope it will bring solutions to “long CoVid syndrome”. There are no studies of natural prescription medicine and substances that enhance the glymphatic system.

Natural medicine research and traditional herbal medicine have used medicinal herbs for thousands of years to help support brain health and cognitive function in supporting better energy and recovery from fatigue. Some lifestyles and substances support our brain health and cognition and may beneficially impact improved energy; here are a few ways to improve our cognitive health and support immune health.  


Support better sleep


Good sleep supports our glymphatic system.


One of the main functions of sleep is that the brain’s glymphatic system is switched on, and the brain clears itself of neurotoxins and waste products. 

Sleep (1) is restorative, supports immune health, our metabolic health and is also when the glymphatic system functions most. Dr Charles Nicholson, PhD ( New York University  Logone  Medical Centre) “These are dramatic changes in extracellular space.” These changes in spaces between brain cells happen when we sleep, and the glial cells control the flow through the glymphatic system of delivery of nutrients and clearing toxins or metabolic wastes”. 

When sleeping, a brain and nervous system cleanse is our body’s way of clearing toxins and infections out of our nervous system. Is there such a thing as regular sleep times? For ages 3-18, sleep declines from 9 to 7.4 hours sleep nightly. 


The American Academy of Sleep recommends more than seven hours of sleep over 7-9 hours. My recommendation is to aim for 8 hours of sleep. The quality and quantity of sleep may vary depending on what you do during the day. Also, consider the type of foods consumed over the day and medication on the effects of sleep. 


How to improve sleep


  • Set up a sleep routine and aim to go to bed and wake up at the same time most nights.
  • Block light from your bedroom because light can influence wakefulness and our brain’s perception of daytime.
  • Try Chamomile tea throughout the day to help calm our nervous system and ease sleep onset at night. 
  • Avoid caffeine throughout the day; some clear caffeine more slowly from our body than others, subsequently stopping us from sleeping well.
  • Try a beautiful relaxing meditation 10 minutes before bedtime; sleep meditation helps to bring overall relaxation and can make it easier to get to sleep. 
  • Chat with a qualified herbalist about herbs that help with sleep onset or quality. There are many excellent herbal remedies to support better sleep.
  • Hungry at bedtime? Try a banana with yoghurt, a small glass of milk, nut milk, or chamomile tea before bedtime. 


Should we use sleep trackers?


 Are we tracking data too much? We can track sleep duration, quality and heart rate. The mechanisms and algorithms for monitoring sleep depend on the gadget and its company. There are no standards of accuracy in measuring these markers.

Some papers say sleep trackers underestimate sleep disruption and overestimate sleep efficacy (2) and duration. We recommend clients track their sleep by journaling and emphasise good sleep hygiene practices to achieve better long-term sleep. We can achieve better sleep duration and quality by using Sleep hygiene techniques; these are proven strategies for getting better quality and quantity of sleep. We are improving sleep to support our glymphatic system. Why sleep so much when we fall sick? 


Two other ways we can support cognition

Turmeric -Curcuma longa

Turmeric has been used as a spice and herbal medicine for thousands of years and has an extended traditional use in Ayurvedic Medicine. Turmeric is one of my clinical mainstay herbs because of its anti-inflammatory, anti-oxidant and gut-healing actions; we use turmeric to relieve pain and provide potent digestive soothing activities. If we step back and think about fatigue having a low-grade inflammatory effect on the body, I suggest turmeric to help reduce that inflammation. 

Research shows that turmeric reduces oxidative stress, systemic inflammation and the pathways perpetuating inflammation. Turmeric improves long-term memory, visual memory and attention compared to the placebo in research on cognitive function. We can include turmeric in our diet at least three times a week in a traditional curry with good fats, pepper and spices. In that case, we will help harness the anti-inflammatory benefits of turmeric as a food. In my research, we need higher doses of turmeric to enjoy the health benefits of this ancient herb.

Fishy oils-omega three fatty acids


Over the twenty-odd years in health practice, I have seen diet’s profound and subtle effect of diet on our health. Looking at our family history and the chronic disease of our family heritage, we can help stop that trajectory and support healthier living by making healthier food choices. Omega three fats from algae or fatty fish have been shown to improve brain function and help reduce cognitive decline.

Omega three fatty acids are found in higher quantities in fatty fish like sardines, mackerel, salmon and anchovies; they can also be found in vegan algal omega-three supplements. We have heard about the anti-inflammatory effects of omega three fatty acids; they also help reduce serum triglycerides.


Serum triglycerides have been associated with poor metabolic health and disruption of innate and adaptive immune responses. Authors note that hospitalised Patients with Covid in death or ICU had significantly higher levels of triglycerides. Omega three fatty acids are effective as a monotherapy in reducing triglycerides in cases of high triglycerides at doses of 4 g/day. As always, I recommend speaking with your doctor and qualified natural medicine practitioner for your advice on supplementation and health issues.     

There are more pieces to this puzzle of improving brain health, looking at our immune and lymphatic systems, which I am excited to share in my next blog; I m looking forward to sharing with you soon. Please leave a message if you found this blog helpful or reach out for personalised up-to-date natural medicine support. 

Alison Millican originally wrote this article at Lighthouse Naturopathy.