Blood Testing and the Role it Plays in Identifying Post Viral Infection, Inflammation and Associated Fatigue

Personal Experience With Coronavirus 

In October of 2021 I developed a Covid-like viral infection. Initially in the first week I had symptoms of a normal head cold; sneezing, coughing and fatigue. Even though I know health can be deceptive and variable in line with the vagaries of life, which is why I am such a fan of testing clients, I assumed I would shake it off in no time. Therefore I didn’t pay too much attention to it and carried on mostly as normal. I still worked over Zoom and as it happened that week didn’t see any in person clients. Some of my sessions are more fitness than strictly nutrition and lifestyle consultation so there were a variety of lunges and press-ups performed at varying intensities. As the week went on I was feeling even a few repetitions for a demonstration challenging. When you are otherwise healthy I had the arrogance or now the benefit of hindsight and assumed come the weekend and more rest I would shrug it off. 

The survival rate for a SARS-CoV2 infection is 99.7% and the average age of death is 82.5 years in Scotland, the vast majority hospitalised are morbidly obese, have metabolic disorders and over 60. Furthermore in 2021 the data at that point showed the percentage of COVID-19 patients requiring hospitalisation was six times higher in those with preexisting medical conditions than those without medical conditions (45.4% vs. 7.6%) based on an analysis by Stokes et al. of confirmed cases reported to the CDC during January 22 to May 30, 2020. The same study also reported that the percentage of patients who died from the illness was 12 times higher in those with preexisting medical conditions than those without medical conditions (19.5% vs. 1.6%).

At 50, active, slim and when I test my morning fasted blood sugar its in the range of 4.5 mmol/l which is not even pre-diabetic, why would I assume I was at risk of severe infection? It took until my early 30’s before I stopped overtraining or any kind of restrictive dietary practices. I used to compete in boxing and was always dieting and sometimes training two and three times a day. I then ran my first stress hormone test to find out my adrenal glands were no longer coping as well and were producing a too low amount of the major stress coping hormone, cortisol. A blood test showed my thyroid function was also lower than optimal. At the same I uncovered from stool testing a parasitic infection. This drove me to make major lifestyle and nutrition changes as well as providing the motivation to study more advanced clinical nutrition courses.

With greater health knowledge, many years of real world experience with clients and a well developed understanding of my own personal health, I still got ill and far more ill than I ever anticipated.

By the start of the second week I had a fever that lasted the next 7 days, no appetite, almost no desire to take all the supplementation I would recommend to take in advance of feeling this unwell. I was still just and no more walking my dog at a very slow pace, otherwise the fatigue, breathlessness, dizziness with any kind of exertion were getting for me, pretty severe. As a guide although blood pressure and heart rate were on the low side of normal, temperature elevated above normal, my oxygen saturation for large parts of the day was below the normal range of 97-100 and often below 95 which is normal for someone over 70, on occasion it was in the low 90’s more common with someone suffering the chronic lung condition COPD (chronic obstructive pulmonary disease). 

Was It Covid-19?

I decided not to test, partly because as I first got ill I didn’t need a test to tell me I wasn’t well and knowing I was “positive” wasn’t going to change my behaviours. Once I was symptomatic I wasn’t going to visit clients, family or friends. The PCR Covid-19 test is invasive, can damage the mucosal barrier of the sinuses that is your first line of your immune system defences and has toxic ingredients (ethylene oxide or sodium azide in the rapid antigen test). There is strong evidence to show it is medical fraud based on the inability to identify “live” virus, viral load and infectious risk and in addition, specificity and sensitivity for SARS-CoV-2 virus or viral particles present and it has an established significantly high false positive reporting rate especially out of the respiratory viral season.

The tests we use in functional medicine are long established over many years as reliable and specific to the question being asked, for example digestive infections from stool samples and vitamin D from blood. The  numbers of tests run are used by the labs to create expected norms within the testing population. The rt-PCR and Lateral Flow Rapid Antigen Covid-19 tests provide no more than a yes or no answer that is not conclusive, must be matched to symptoms and seldom are and are wide open to inaccuracies or “cheating” for a desired outcome. I couldn’t with a clear conscience ask a client to pay for one of these tests as part of any health investigation we were to carry out. I know in some parts of the UK paying for these is still free. The only way to know if a sample truly has SARS-CoV-2 present is to use Sanger sequencing with nested primer sets so the sequence of the primer sites are known for each result and using a protocol that utilises a cycle threshold below 30.

Personal Health Status 

The William Osler quote comes to mind when working with clients and is definitely relevant when it comes to my own infection experience, “Ask not what disease the person has, but rather what person the disease has”.

In my particular case I would not have expected a particular significant infection. In fact for me I was fairly unwell. I have not had any illness for many years. Can not remember the last time I had the flu. I did have a chest infection that wasn’t clearing in 2008 and I ended up taking antibiotics, I was also about to run a half marathon for charity and with clients and then go on holiday. Normally I would have waited out the infection and taken rest. That is the last time I visited my GP.

Prior to becoming infected I had no symptoms of note and also free of any diagnosed medical condition. Many people that have suffered serious Covid-19 infections are elderly, vulnerable and with more than one co-morbidity.

From the start of lockdown in March 2020 I started working exclusively online and from home. From then until October 2021 I had no symptoms at any point to suggest a Covid-19 infection.

Trained Immune Tolerance

One of the main reasons I believe I eventually became ill was in part due to coming into close contact indoors with several people and at least one person had tested positive and was symptomatic. My children and wife also got ill, then I got ill. 

So I can identify one or two possible sources of exposure. For the almost 30 years I have been in practice I have been at least 5 days a week in constant close contact with admittedly mostly healthy people wanting to get healthy, but a fair percentage were also unhealthy and suffering from a variety of medical conditions. My point being, in the past on a daily basis, training my immune system. I also have been in gyms in close proximity to people heavy breathing, sweating away, some trying to sweat it out saying “this will kill it or cure it”, and touching the very same equipment. Then along comes lockdown and I have lived in an hermetically sealed bubble! Well not quite but an almost 100% reduction in close contacts on a daily basis out with my close family.

Even though I don’t wear a mask (restricting my ability to breathe freelŷ, detoxify and exchange microbes with my external environment) I wasn’t indoors for any prolonged periods with the general public, except at friends houses and even then much less than normal. 

With a functioning immune system, perceived good health, supported by the absence of symptoms and lab tests to back that up, active lifestyle grounded in accepted principles of nutrition, I didn’t believe the risk benefit of an experimental Covid-19 “vaccination” was warranted. 

The example I tend to use is of someone being born in a country with high levels of Malaria and the number of years of repeated exposure to the virus with constant risk of death before a trained immunity is developed. That immunity seems to wane when someone no longer lives in that environment and then returns to a far greater risk. 

When I got ill with what I believe to be Covid-19, my wife and one my of my daughters were symptomatic and tested rt-PCR positive. The symptoms I had to support this were similar to the flu in terms of fatigue, fever, loss of appetite, aches and pains that by the second week seemed to go into a more severe breathless stage and headaches. On measuring my pulse oxygen saturation more than once each day it went to the low 90’s. Normal is 97-99%. I had to use a saline nebuliser for up to 15 minutes to get the levels back to normal.

“Genetics loads the gun and lifestyle pulls the trigger”

Genetic risk for Covid infection

The risks for developing a SARS-CoV-2 infection are similar to suffering ill-health in general and infection disease such as;

1. Demographics – population age, density, family structures
2. Social and lifestyle factors – personal hygiene, close contacts, mass gatherings
3. Medical factors – healthcare system (eg NHS free at the point of access), capacity, general public and individual health (including diet, physical activity and lifestyle)
4. Environment – environmental toxins; chemicals and heavy metal exposures

Infection risk

Having ran the Omnos genetics test I was able to identify my genes and the specific variants known to be involved in more significant antiviral responses and potential for higher rates of infection. For example IL-2, Interleukin-2 a cytokine that helps balance the immune system or IL-10, Interleukin-10 is an anti-inflammatory cytokine. Cytokines are small immune system proteins used as cell signalling molecules. There are several types, there lymphokines made by the white blood cell, lymphocytes and monokines made by monocytes amongst others.

There are pro-inflammatory cytokines that cause an overstimulation of white blood cells that can cause, what many of us will have heard of the “cytokine storm,” which often causes more damage to the body than the infection itself.

Disease outcome

One of my gene variants CYP1A1 when expressed makes an enzyme that helps eliminate toxins (eg. drugs, caffeine, charred meat, vehicle exhausts, cigarette smoke, oestrogen, pesticides, or carcinogens) from the lungs, when these toxins aren’t eliminated oxidative stress can increase. Oxidative stress rises when the body makes more free radical or specifically reactive oxygen species than it can detoxify or make safe. This gene is also involved in the immune response in the intestines. Depending upon the exact version of the gene you have you might break these chemicals fast or slow. If you break down them too quick you can increase the build up of the intermediary chemicals that your liver is trying to make safe, as it transfers the dangerous chemical that the body has stored in fat, now is in limbo before being stored in water for removal from the body. 

Knowing your various genetic weaknesses gives the opportunity to plug the gaps in how your body works but its not always plane sailing and life can get in the way of best intentions. This deeper knowledge of your personal health helps when things do go wrong and direct you to focus on more of what you’re body needs. 

In my case being busier at work likely brought about higher stress and less of a focus on a whole foods, high nutrient diet at the time I was exposed. Based on how my body is designed to cope and currently functions I experienced a larger more inflammatory, innate immune response.

How the Immune System Works 

The immune system has a vital role in protecting your body from harmful substances, germs and cell changes that could make you ill. It is obvious where your digestive is but your immune system is spread across your whole body and made up of various organs, cells and proteins. For the most part your immune system works by stealth and keeps itself to itself. Sometimes through stress that suppresses the immune system, nutritional deficiency, environmental toxins and changes in lifestyle such as lack of sleep, your immune system can weaken or it gets exposed to particularly aggressive germs it struggles to fight you can then get ill. Germs that your body has never encountered before are also more likely to make you ill. Some germs will only make you ill the first time you come into contact with them, chickenpox is s good example and one we all know.

The tasks of the immune system

Without an immune system, we would have no way to fight harmful things that enter our body from the outside or harmful changes that occur inside our body. The main tasks of the body’s immune system are

• to fight disease-causing germs (pathogens) like bacteria, viruses, parasites or fungi, and to remove them from the body,
• to recognise and neutralise harmful substances from the environment, and
• to fight disease-causing changes in the body, such as cancer cells.

How is the immune system activated?

The immune system can be activated by a lot of different things that the body doesn’t recognise as its own. These are called antigens, as in the Rapid Antigen Test. Examples of antigens include the proteins on the surfaces of bacteria, fungi and viruses. When these antigens attach to special receptors on the immune cells, a whole series of processes are triggered in the body. Once the body has come into contact with a disease-causing germ for the first time, it usually stores information about the germ and how to fight it. It makes a memory of its response, thats the role of white blood cells, called memory B-cells or B lymphocytes. Then, if it comes into contact with the germ again, it recognises the germ straight away and can get to work producing antibodies to start fighting it a whole lot faster.

The body’s own cells have proteins on their surface, too. But those proteins don’t usually trigger the immune system to fight the cells. Sometimes the immune system mistakenly thinks that the body’s own cells are foreign cells. It then attacks healthy, harmless cells in the body. This is known as an autoimmune response. In some cases of Covid-19 infection that is definitely an issue.

Innate and adaptive immune system

There are two subsystems within the immune system, known as the innate (non-specific) immune system and the adaptive (specific) immune system. Both of these subsystems are closely linked and work together whenever a germ or harmful substance triggers an immune response.

The innate immune system provides a general defense against harmful germs and substances, so it’s also called the non-specific immune system. It reacts immediately and mostly fights using immune cells such as natural killer cells (anti viral and anti tumour lymphocytes) and phagocytes (cells that eat foreign particles; macrophages, neutrophils). The main job of the innate immune system is to fight harmful substances and germs that enter the body, for instance through the skin or digestive system.

Innate immune system cells;

• Natural killer (NK) cells
• Macrophages
• Neutrophils 
• Dendritic cells
• Mast cells
• Basophils
• Eosinophils 

The adaptive (or acquired, learned, specific) immune system makes antibodies and uses them to specifically fight certain germs that the body has previously come into contact with. As the second line of defence it becomes active over the long term and typically uprefulates it’s activity within the first, 4 days of identifying the presence of an infection. The adaptive immune system is constantly learning and adapting, allowing the body to fight bacteria or viruses that change over time.

Adaptive immune system cells;

• T and B lymphocytes

Effects of viral infection

The outcome of a viral infection is typically influenced by 

• The nature of the virus
• Genetic susceptibility 
• Age
• Viral load or dose
• Route of infection (sinus/throat, mucosal or through the skin or blood)
• The amount of anti-inflammatory cells and proteins produced
• Presence of other infections (eg. herpes, hepatitis, cytomegalovirus)
• Past exposure and cross-reactive antibodies

Symptoms post infection are most commonly fatigue related. The immune system is depressed, a compromised immune system is more susceptible to repeat infections which further damages the immune system and lowers resistance to viral infection. 

Accompanying symptoms include;

• Muscle aches
• Joint pains
• Weakness after exercise
• Headaches
• Swollen glands 
• Digestive disorders
• Inability to concentrate 
• Memory loss
• Depression
• Sleep disturbance
• Light sensitivity 
• Impaired sense of smell/taste
• Vertigo, tinnitus
• Increasing sense of being unable to function 
• Food intolerances 
• Environmental allergies 

As the virus replicates the innate cells secrete pro inflammatory cytokines (chemicals) in an attempt to destroy the virus but also creates tissue damage. The amount of response produced by the adaptive immune system leads to further the amount of inflammation and tissue damage. T cells (eg Th1 or Th17 T Helper cells) identify virus infected cells to be destroyed that can involve cytokines, chemicals that damage cells in areas such as the liver. This can show up as elevated liver enzymes on a blood chemistry test. As the cells are destroyed their enzymes are released into the blood. Additionally T Helper cells and B cells produce antibodies that form what’s immune complexes that are deposited in different areas such as the kidneys and the cells (endothelial) lining blood vessels causing a variety of conditions including arthritis. 

The body has several anti inflammatory responses that under normal conditions minimises the excessive T cell response and blocks the pro inflammatory chemicals in turn lowers tissue damage. When there is an imbalance in the bodies anti inflammatory to pro inflammatory response and tissue damage results the common symptoms we see that an last following viral infection and are seen up to 12 weeks after include;

• headaches
• brain fog/trouble concentrating
• joint stiffness
• muscle pain
• memory/concentration problems
• sleep abnormalities
• recurring symptoms of viral infections, such as sore throat, headache and swollen lymph nodes

Specific to Covid

More commonly referred to as Long Covid, with Covid symptoms to some degree still present two to three months post infection, and commonly can be seen in metabolism and liver function blood test markers. 

There are various degrees of respiratory symptoms and some with digestive conditions that relate to;

• Liver and kidney function (lower albumin and urea)
• Electrolyte (sodium, potassium, calcium, magnesium) imbalances
• Platelet count/coagulation (increased ferritin)
• Full blood count imbalances (lymphopaenia, lower lymphocytes)
• Reduced white blood cell count (specifically low neutrophils) 
• Cholesterol and LDL (lower with more severe disease)
• Glucose (blood sugar)
• T-cell exhaustion (too much immune system stimulation more common in mild infection)
• Inflammatory immune responses (acute to hyper inflammation)
• Latent (hidden) pathogens; bacterial, viral, parasitic or fungal infection 

When it comes to Covid-19 suffering symptoms that seem to continue beyond the acute infection stage have been referred to as Long Covid. That requires a medical diagnosis. My intention with this article was to highlight the effects on blood chemistry that can last following a viral infection such as SARS-CoV 2 and the value in running a blood test to identify these changes that may correlate with your symptoms and then guide steps to take in your own personal healing journey. Therefore I was looking to avoid these test results being used to diagnose a medical condition and subsequently intimate a treatment strategy, and instead highlight possible losses of function and efficiencies in ones individual biochemistry that can be readily remedied by targeted nutrition and lifestyle principles. My suffering definitely lasted several weeks roughly 3-4 weeks after initial infection and although out of the norm for me can not be called Long Covid.

Whether the motivation to run a test is based on suffering a digestive infection or viral infection, stress related, skin, detoxification, brain fog, or fatigue you can learn the impact on your hormone, digestive, detoxification and immune system as we are all a system of systems. Currently everyone is focussed on immune health, part of our ability to clear a viral infection relies on the function of our detoxification system. So we cast the net, run the test, and look for the clues our bodies are letting us know need supported.

As a guide only and with the explicit intention of being used to form a discussion with your primary care physician here are typical, Long Covid symptoms;

• Loss or change of sense of smell or taste may persist
• Heart irregularities
• Breathing problems
• Stomach or digestive irregularities
• Food sensitivities
• Muscle weakness
• Poor coordination
• Dizziness
• Skin rashes
• Generalised pain
• Fatigue 
• Persistent fever
• Psychiatric problems

What can a blood test be used to show?

In a typical blood draw that includes a full blood count we can identity problems in the; 

1. Heart and cardiovascular system
2. Liver and kidneys, detoxification 
3. Digestion function and likelihood of the presence of digestive infections
4. Inflammation
5. Immune system
6. Nutrient, protein deficiencies, Omega 3:Omega 6 balance 
7. Dehydration 
8. Blood sugar control 

Raw Data

Here is my blood test raw data.

You can see all the markers measured and the result alongside the ranges that are used to identify clinical issues. We use ranges that are tighter that are widely used by those practicing functional medicine. For optimal health we want to use ranges that keep us on the straight and narrow and help point to actions we can take to prevent levels rising or lowering to levels that in time can become medically relevant and/or produce symptoms. However when we see levels outside the optimal ranges we can help support and repair loss of function before it progresses to a disease condition requiring medical intervention. Health is not the absence of disease or symptoms or the presence of blood markers within medical ranges it’s about operating at a resilient level where your biochemistry is well controlled with room for manoeuvre. For example you might see the lab test range state 50-100 when the functional, healthy range is 10-60.

What does all this mean?

If we just look at the blood markers in isolation to see what they say about this person the summary is the following;

1. Reduced liver function 
2. Inflammation (including gastrointestinal)
3. Oxidative stress
4. Acute immune response (Covid19 viral infection) and/or possible long term immune response (post Covid-19 viral infection)
5. Nutritional deficiencies 
6. Poor mineral absorption 

The causes for these altered from optimal levels are a combination of stress and lifestyle as well as hidden internal stressors impacting the hormone, digestion, immune and detoxification systems. Put another way, not always the best food, lack of sleep, over working and over or under exercising multiplied inbuilt genetic weaknesses. 

The test doesn’t exclusively point the finger at a viral infection such as Covid-19. However using the table below it would be fair to say there was evidence of an after effect of a viral infection or post viral effects and subsequent recovery. 

We also know that I did have a viral infection that started 8 weeks before the sample was taken and the illness period lasted 2-3 weeks. I always prefer to look at test results with an open mind and ask what does this say about the person and how their body is functioning at that point in time. Then when you form your overview opinion, factor in what you know about them, their signs and symptoms alongside why they contacted you for help. 

So in my case my results show stress on the liver, digestion and immune system and we know that has been exacerbated by the viral infection. 

The Lifespan of Immune System Cells 

In my opinion I am an otherwise healthy, active person that suffered, in the absence of any medical intervention a moderate viral infection and the results show the cost of that and where my body, as a system of systems, was at on its journey to recovery. 

Too much inflammation damages the immune system and hormone system. It can also change how the body breaks down and uses nutrients. It is common after a virus to be suffering an inflammatory response, characterised by tissue damage. The innate (nonspecific) immune response, can be so significant it can reduce the adaptive (specific) immune system. The recovery processes is then about focussing on managing inflammation. Some want to call the post infection recovery phase as Long Covid, and accompanied by ongoing inflammatory symptoms of a viral infection, a prolonged period of 2-3 months where symptoms are significant and prolonged, indicating reduced capacity to recover and repair the body. The long term post Covid-19 health challenges are of a similar scope and magnitude to the recovery seen post flu and pneumonia. Some people can avoid infection and re-infection for long periods of time and some experience no or mild symptoms whereas others suffer severe infection, therefore risk of infection, severity of infection and ability to recover are individual. Knowing your individual strengths and weaknesses is the value of testing and identifying strategies to cope and enhance recovery.

The focus of the recovery period ought to be immune system support and minimising inflammation. The inflammatory activity is impacted by the presence of oxidative stress and the degree of liver inflammation. Knowing the wider implications of the test results helps paint a picture for the longer term healing journey to improve liver function, digestive health to in turn improve absorption and need for the vitamins and minerals that were shown to be low. This is exactly what was seen with my blood results.

I have outlined the symptoms likely to be present as a result of each highlighted test finding to help show the relationship to other aspects of health and strengthen the idea of building health of the person as a whole and not purely focusing on immune health and the presence or absence of a virus, or health is more complex than isolated challenges and therefore how you improve your health offers many steps. At this moment in history it’s hard not to think about the one threat to our health and the only steps to take to combat that are to target immune system support, so the majority of us take vitamin D supplements and medications forgetting we are a system of systems. If our hormones are under pressure from stress that can in turn diminish or liver and detoxification system leading to more inflammation and stress on digestion. The greatest percentage of our immune system cells are created within our digestion so the need to look after ourselves beyond immune health should from the review of this blood test become clearer.

Lowered liver function and possible inflammation 

Symptoms include;

• Chemical sensitivity
• Oedema
• Caffeine or alcohol sensitivity 
• Headaches: front lobe 
• Headaches: base of skull 
• Pain between shoulder blades 
• Burning or itching anus

If you relate to these symptoms and have run a blood chemistry test you can investigate deeper reasons for diminished liver function by running a Hair Tissue Mineral Test for hidden toxic heavy metals and a Urine Organic Acids test like the Toxin Test that evaluates environmental chemical toxins and their impact on your metabolism and that of your liver. I certainly wouldn’t advise diving head first into a detox diet and first of all get all the basics of nutrition and lifestyle in place; good food and exercise, support the nutritional deficiencies and make sure your elimination pathways (breathing, sweating, peeing and pooing) are firing all cylinders then get more specific on liver and detoxification health. You will cope a whole lot better and be more effective.

Nutritional Imbalances 

Indicated related nutritional deficiencies that are partly a result of the bodies attempt to deal with the infection and underlying imbalances that were present prior to the infection. 

• Excess Iron
• Vitamin D deficiency 
• Zinc deficiency
• Omega 3 deficiency 
• Vitamin B6 deficiency

High iron stores

I have an existing predisposition to iron overload seen across historical blood tests and from gene testing so I regularly look at my iron and ferritin levels. Iron levels reflect the amount of iron being transported in circulation. Iron can be consumed in two forms the ferric and ferrous forms. The ferric form needs to be reduced to the ferrous form to be assimilated, which requires stomach acid and vitamin C.

Ferritin is a blood protein that stores iron in the cells and releases it as needed. As ferritin is also a marker for inflammation, it can often be wise to look at additional iron markers to assess if there is more to the story than ferritin alone may suggest. Often serum ferritin will drop before a drop in serum iron levels will be observed, as the body will do what it needs to maintain circulating iron levels normal. The blood test uses additional markers (Transferrin Saturation and something called TIBC or Total Iron Binding Capacity) that can further help us assess the functional use of iron to better understand how iron is truly affecting the body.

Increased iron levels are associated with;

• Liver dysfunction
• Infections
• Conditions of iron overload (haemochromatosis and haemosiderosis)

Increased iron levels, also called iron overload, causes increased levels of inflammation and oxidative stress that can lead to increased risk of cardiovascular disease.

Symptoms include;

• Joint pain
• Cardiac arrhythmia
• Grey or bronzing skin colour 
• Amenorrhea
• Testicular dysfunction or impotence
• Gastrointestinal inflammation 

Oxidative stress occurs normally as part of metabolism where reactive oxygen species (ROS) or what we tend to call free radicals at a greater rate than the body can detoxify or clear them through the production of antioxidants. You can sort of view it as a rusting on the inside of the body where more the bodies capacity for repair is outstripped by the damaging processes that are ongoing.

The challenge with high levels of stored iron is to reduce the stored iron and minimise the absorption of the iron that comes in with your food and at the same time minimise the inflammatory damage caused by the excess iron. Regular blood donation is one route to lower iron levels building up.

When it comes to food many of the foods that help those with iron deficiency anaemia are to be avoided when it’s high for example minimise the following;

• Breakfast cereals (iron added/“fortified”)
• Organ meats (liver, kidney, heart etc)
• Clam, oysters
• Dark chocolate 
• Lentils
• Spinach

This list is a bit of a personal disaster for me as I live on spinach, dark chocolate and liver pretty much daily. When I was a student and training two or three times a day I would have lentil soup several times a week and eating entire boxes of cereal in a day in mistaken belief I was loading up on the calories to train that excessively.

A high antioxidant diet and supplements such as the following can reduce absorption or bind iron;

• Green tea
• Turmeric
• Quercetin
• Resveratrol

Supplements that have been shown to help the body minimise the inflammatory damage include;

• N-acetyl cysteine
• Alpha Lipoic Acid
• Selenium
• Vitamin E

Vitamin D deficiency 

We all know vitamin D deficiency is common and particularly in the West where we mostly live and work indoors, avoid near naked sun exposure in the midday sun, cover ourselves in UV light blocking toxin cream to lower vitamin D production and currently but not traditionally consume a diet low in vitamin D. Depending on skin tone and genetics this can become an even greater challenge. Those in Northern climates, so us Scots, have about a two day annual window to maximise that best of options, sun exposure. Although Scots have been depicted in the media  not to be so heathy savvy, Mars Bar suppers and bottles of Irn Bru put forward as the principle supporting evidence, it can be countered by the fact that one of the most common sayings you will hear in the streets of any major city if you holiday here between the months of March and November is, “taps aff”, which indicates to all within earshot that the sun is out, at that very moment, and it’s therefore time to take your top off to maximise the exposure of unprotected, almost grey skin, to the suns healing and vitamin D producing rays.

Being realistic from those of us in Northern climates the sun isn’t normally a primary source, sadly, so emphasis should be placed on fatty fish; salmon, tuna, mackerel, herring, sardines, also liver and egg yolks. 

Vitamin D has several roles to play in overall health, from osteoporosis to cardiovascular health, but in the context of this article our focus is on its role in the immune system. It acts to modulate the shifts between the innate and adaptive immune system. The evidence indicates it can help minimise the inflammation that categorises more severe forms of Covid-19 disease. There are currently 21 ongoing studies investigating the role of vitamin D in protection from infection and reducing severity of infection. Studies out of Israel. Suggested vitamin D deficiency was linked to a 14 fold increase likelihood of severe infection. I think it would be prudent based on the known existing benefit of vitamin D to overall health to assess your levels and improve them if not normal. A healthier body is less likely to become infected and less likely to become ill. Then if you do become infected and are struggling to recover your health, it would also then be valid to assess vitamin D, to establish if that is a factor you could look to remedy and assist your recovery.  

We can either get information from tests or questionnaires or even how we feel eating and after eating certain foods, in terms of energy, sleep, join pain, skin, digestive issues etc. Finding out you have lower than optimal vitamin D even though you do have consistent sun exposure and eat a diet high in fatty fish this can help provide a clue to greater need and digestive issues that affect absorption. If this is you a stool test to fully investigate digestive infections and gut health may be prudent.

Symptoms include;

• In some there are no symptoms 
• Frequent infections or illness
• Fatigue and muscle weakness 
• Bone and joint pain
• Fractures
• Slow wound healing
• Depression

Zinc deficiency 

Symptoms include;

• White spots on finger nails 
• Decreased sense of smell 
• Decreased sense of taste 
• Prostatitis
• Slow wound healing time 
• Growth development slow 
• PMS

Omega 3 deficiency 

Symptoms include;

• Depression 
• Skin irritation/dryness
• Dry eyes
• Hair loss, thinning, dry/brittle
• Joint/muscle stiffness

Vitamin B6 deficiency 

Symptoms include;

• Anxiety
• Mania
• Seizures, tremors, neurological symptoms 
• Fatigue

Poor mineral absorption 

The cells in our body have membranes that aid them in retaining nutrients inside, and preventing unwanted molecules from entering the cells, specific transport mechanisms are often required to get critical nutrients in the cell. A less commonly known issue is the ability to transport key minerals such as zinc into cells which can often be related to amino acid insufficiencies.

Poor uptake of minerals (eg sodium, potassium, magnesium, calcium, zinc etc) can cause functional issues despite having sufficient intake, the good stuff can go down your throat but it doesn’t mean it ends up where it needs to go and in the right amounts. Methionine and ornithine, that are most abundant in animal foods are two prominent amino acids used to build these transporters and often aid in improving cellular uptake.

Symptoms likely present indicated by test results;

• Fatigue
• Poor mood
• Exhaustion
• Insomnia
• Low libido
• Low blood pressure 
• Low heart rate

If part of evaluating how the virus affected me is based on my overall health I also compared my current blood test to the previous one that was taken just over 12 months previous. That prior test showed the same nutritional deficiencies but the liver and digestive function although an issue needing addressed were less problematic. The current test showed higher levels of dysfunction in the digestive system but the immune system and inflammatory activity also were far higher and significantly out of balance.

Although things could have changed, better or worse, in the time between tests you could argue higher levels of inflammation as indicated by the elevated iron levels and low vitamin D is likely a function of ongoing and historical digestive system issues. This is where stool testing and gut repair protocols come into play. Pre-existing digestive issues could be the precursor to a more significant viral infection and then result in a higher inflammatory or hyper-inflammatory response as shown by dysfunctional blood markers still present 8 weeks post onset of infection.

If both blood tests were evaluated based on markers that relate to immune and inflammatory system function and how many markers were either increased or decreased relative to the first test there were 14 increasing to 16 of 37 markers in the second test. The most significant change between the tests was the decreased white blood cells, decreased neutrophils alongside increased lymphocytes. This would indicate a depressed immune system and nutritional deficiencies to make the white blood cells, an understandable and appropriate outcome from the challenge placed on the body to manage nutritional resources in a time of immune system stress. It’s also worth noting that during the 2-3 week period I was symptomatic my appetite was suppressed I was also intermittent fasting prior to the first test. Intermittent fasting does place pressure on you to prioritise your eating window and ensure natural whole foods and therefore high in nutrients. It’s likely I do not cope well on a lowered calorie intake and exacerbated if not consistently nutrient dense. Lowering your nutritional intake is a further stress and stress can be a powerful suppressor of the immune system. In the lead up to developing a Covid-19 infection I was working long hours with fewer breaks than normal so looking back it’s likely nutrient intake was less than optimal.

Blood Markers Showing Immune System Dysfunction Post Covid Viral Infection

Marker	Typical Covid Result	My Results	Match
White Blood Cells	Decreased	Decreased	✔️
Neutrophils	Increased	Decreased
Lymphocytes	Decreased	Increased
Eosinophils	Decreased	Increased
Platelets (Thrombocytes)	Decreased	Decreased	✔️
Haemoglobin	Decreased	Increased
Albumin	Decreased
Albumin/Globulin	Decreased
ALT (Alanine Aminotransferase)	Increased
Bilirubin	Increased	Decreased
Ferritin	Increased
Total Cholesterol	Decreased
HDL	Decreased	Decreased	✔️
Glucose (Blood Sugar)	Increased

These markers can be dysfunctional for many months post infection, some studies show abnormal blood values up to 10 months afterwards. The more severe the infection the more deranged from normal the result. 

With only 3 of 14 markers typical seen in post Covid-19 infection blood work present in my results 

Acute immune response

Knowing there was a recent viral infection the results support the need to work to reduce inflammation and support the immune system. The following list of symptoms are frequently seen in an acute immune response;

• Fever
• Body aches
• Swollen lymph nodes
• Soar throat
• Cough
• Sputum, especially yellow or green

It is also worth noting the low platelet levels. Platelets are essential to stop any bleeding. Platelets clump together and form a plug to stop the bleeding in small vessels. Platelet count can indicate if you’re at risk for bleeding or clotting, depending on the value. Platelets can be increased if the bone marrow is making too much. It can also occur if there are clogged arteries. Low platelets can occur if there’s stress or infections.

Things to do

With the primary health complaint being fatigue related and the role of the immune system at this stage of recovery there are several lifestyle factors to consider introducing;

• Rest, minimise over working and slowly introduce graded progressive exercise. For example combine gentle walking of 15-20 minutes with intense resistance work lasting 3 minutes increasing by 1-2 minutes per session.
• Stress management techniques eg. Meditation, Qi Gong, Tai Chi, counselling/therapy
• Hydration, drink a glass of water 15 minutes before and after each meal and a glass of water with each sugary or stimulating drink (eg. Coffee).
• Sauna therapy to induce sweating including infrared saunas and blankets
• Lymphatic stimulation: skin brushing, yoga, massage, lymph drainage
• Coffee enemas to stimulate the liver and gall bladder maximising detoxification 

Things to avoid

• Foods high in iron (breakfast cereals, dark chocolate, lentils, spinach)
• Stress at work or home, over exercising
• Excessive alcohol or caffeine
• Dehydration
• Late nights and early rising with inadequate sleep
• Processed and high sugar food or snacks
• Avoid or limit known food sensitivities eg gluten, dairy, histamine etc
• Minimise environmental exposure to chemical toxins and heavy metals eg personal care products, air pollution 
• Medications with side effects that suppress the immune system

Things to take

Anti inflammatory diet – general foods 

• Foods rich in antioxidants: vegetables (artichokes, beetroot, kale, red cabbage, beans, pulses, garlic, ginger), fruits (blueberries, strawberries, goji berries, raspberries), nuts (pecans), dark chocolate 
• Increase protein (especially liver, heart, kidney)
• Foods high in omega 3 fatty acids: fish (if possible raw), flax seeds, turmeric, ginger, garlic

Immune system support – specific foods 

• Vitamin C (citrus fruit, berries, vegetables) 
• Vitamin A (liver, butter, cream, egg yolks)
• Vitamin E (flax, sunflower, dark green vegetables)

Nutritional deficiencies specific foods

• Vitamin D (fatty fish, liver, egg yolks, whole fat dairy)
• Zinc 
• Omega 3
• Vitamin B6

Anti inflammatory support supplements;

• CoQ10,
• Alpha lipoid acid
• Turmeric
• Ginger
• Boswelia
• Garlic 
• Nettle/liquorice and ginseng 
• Proteolytic enzymes

Immune system support supplements;

• Probiotics 
• Prebiotics
• Medicinal mushrooms

Antiviral support supplements;

• Chinese skullcap
• Olive leaf extract
• Pau d’arco
• Colloidal silver
• St. John’s wort
• Cat’s claw
• Oregano oil
• Lemon balm
• Echinacea
• Goldenseal
• N-acetyl cysteine 

Nutritional deficiencies specific supplements;

• Vitamin D
• Zinc
• Omega 3
• Vitamin B6

Many of the foods high in protein also contain vitamin D and zinc. If there was also digestive symptoms in order to maximise digestion and absorption to reverse the nutritional deficiencies I would suggest adding digestive support supplements such betaine hydrochloric acid (to sterilise your food and stimulate protein digestion, pepsin (main protein digesting enzyme). 

Once you know your blood test results, identify the key symptoms from the lists provide in this article (the more symptoms common to you should help narrow down your focus and some symptoms are common to immune system dysfunction and nutritional deficiency), take into consideration your overall health then it becomes easier to know what foods and supplements to prioritise. 

A balanced diet really means a varied diet so consuming several different types of foods would be heathy and understandable. The extensive list of supplements is included to show there is a lot of specific help that is natural that can be taken additional to basic health principles. With several nutritional deficiencies a focus on food, less stress and maximising digestive efficiency should be a primary focus in the post viral infection stage. Then you want to build more robustness in your immune system and repair any inflammatory damage you suffered which would shift your focus to more antioxidants, anti inflammatory support in food and supplements. 

For those with ongoing symptoms whether it’s “Long Covid” or not and especially if you are aware of pre-existing health challenges adding antiviral supplements should also be considered. Eating more nutritiously really means organic vegetables and free range meats which puts up the cost of being healthy so adding supplements adds further costs. 

Stress uses up resources, finance nutritional. So as much as I am a firm believer supplements are essential to build and maintain health the cost of them has to be factored in, so taking all the ones recommended isn’t the point. We all cope differently with different foods and also supplements so is important to options. On the assumption there is a focus on a food first approach 3 or 4 supplements should get layered in one by one, making sure you cope and no further symptoms result from pushing the body too fast and the purely practical aspect of remembering to take the right ones and the right amounts at the right times. There has been studies done looking at over 30 supplements and medications, so the above lists are for guidance to point you in the right direction as there others that could have made the list. Some people are busy or just don’t like taking supplements so only fake them in the morning or last thing at night, and others maybe to help their digestion spread them across the day. 

It’s a huge subject, your immune system, viral infection and blood testing. This article was deliberately lengthy to cover the many negatives we can find but conversely use them to highlight the many positives and action steps you can take, to show you can be in charge and use nutrition and lifestyle to manage and control your health. I have discussed a prevention based approach to minimising infection risk and symptom severity. It was my deliberate intention to avoid discussing specifics on supplementation, how to take each supplement and dosages, I felt that is a subject best addressed on a personal level with the help of myself or someone similarly qualified. The nutritional deficiencies and indicated supplements are specific to my results at that point in time. 

There are early effective medical treatments that have been successfully used and that is a conversation to have with your primary care physician. There are also medical interventions being made available to people that aim to replace the role natural infection places in training your immune system, again thats a conversation to be had with a well informed medical professional. 

I have tried to show that even though I see myself as healthy I still got sick, I clearly wasn’t doing a good enough job and took my off the ball. Health isn’t a destination, its a journey with ups and downs (I think someone famous has already said that?) and something worth striving for. I have used the information from my blood chemistry test to show my strength and weaknesses, and how it helped me, and hopefully help you regain full health and fitness if you suffer a viral infection such as Covid-19.  There is much known about the common cold, flu and pneumonia and much debate that is ongoing about the novel coronavirus, SARS-CoV-2. The situation is further complicated by some that have mild infections and others that have more severe infection which must be factored into the test interpretation and the steps taken by each individual to remedy their personal health. The number of supporting articles and references I have read could be longer than this article, so I have chosen to add a very select few that I believe will be helpful in gaining a wider appreciation for the effects of Covid-19 and blood testing.

Bibliography 

• https://www.nature.com/articles/s41574-020-00435-4
• https://pubmed.ncbi.nlm.nih.gov/34161115/
• https://mcmillanresearch.com/wp-content/uploads/2022/04/624efefdd6ba6eb21993283e_COVIDANALYSISOPENLETTER.pdf
• https://www.goodreads.com/en/book/show/59120042-covid-19-and-the-global-predators
• https://meded.lwwhealthlibrary.com/book.aspx?bookid=2170

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