While post-viral symptoms have gained increasing attention in recent years as individuals recovering from viral infections report lingering health issues that persist beyond the acute phase, this phenomena is not only seen with COVID. I have worked in Functional Medicine for over a decade and we have seen patients report lingering symptoms after having EBV/mono, influenza, and now COVID to name a few of the common viruses. The Center for Disease Control estimates that over 30% of hospitalized individuals experience post-COVID related symptoms for 6 months or longer after infection  Understanding the complex interplay between the immune system, viral infections, and lingering symptoms is crucial for developing effective strategies to alleviate post-viral complications.

The symptoms encompass a broad range of health issues that persist after the resolution of the initial viral infection. While these symptoms can vary widely among individuals, common manifestations include:

  • Persistent fatigue
  • Cognitive impairment (often referred to as “brain fog”)
  • Joint and muscle pain
  • Sleep disturbances
  • Headaches
  • Mood swings and anxiety
  • Shortness of breath
  • Loss of taste or smell

These symptoms can significantly impact the quality of life for those affected, making it imperative to unravel the underlying causes.

Potential Causes of Post-Viral Symptoms:

Several factors contribute to the development of post-viral symptoms, and understanding these mechanisms is crucial for effective treatment. The following are some potential causes:

a. Viral Persistence:

Certain viruses can establish persistent infections within the body, evading the immune system and leading to chronic symptoms. Examples include the Epstein-Barr virus and cytomegalovirus. The ability of viruses to remain dormant or reactivate can contribute to the prolonged nature of post-viral symptoms. For example, an individual gets COVID and now their immune system is fighting a reactivated EBV and now COVID. In simple terms, it puts a larger burden on our immune and inflammatory cascade.

b. Immune Dysregulation:

Viral infections can disrupt the delicate balance of the immune system, leading to long-term immune dysregulation. This dysregulation may result in chronic inflammation and an overactive immune response, contributing to the persistence of symptoms. We are now digging into the role histamine tolerance and mast cell activation disorder plays in these presentations. One of our favorite therapies to help with this that is safe and cost effective is low dose naltrexone. You can book an appointment with one of our providers to see if this may be an option for you!

c. Autoimmunity:

In some cases, post-viral symptoms may be associated with the development of autoimmune reactions. The immune system, primed to fight the initial infection, may mistakenly target healthy tissues, leading to a range of symptoms such as joint pain, fatigue, and cognitive dysfunction. At STAT Wellness, we look at this connection very closely. We like to do a comprehensive autoimmune test called an AVISE test to make sure nothing autoimmune is developing. This test is only 2 tubes of blood and assesses for lupus, sjogrens, hashimotos, scleroderma, mixed connective tissue, rheumatoid arthritis, vasculitis, and more.

d. Mitochondrial Dysfunction:

Viral infections can impact the function of mitochondria, the energy-producing organelles within cells. Mitochondrial dysfunction may result in reduced energy production, contributing to the fatigue and muscle weakness experienced by individuals with post-viral symptoms. We always say- where do you have the most mitochondria? The brain, heart, and muscles. No wonder we see more brain fog and decreased exercise tolerance with post viral syndrome.

e. Neuroinflammation:

Viral infections can trigger inflammation in the central nervous system, leading to neuroinflammation. This inflammatory response may contribute to cognitive impairment, headaches, and mood disturbances observed in post-viral syndrome.

Natural Treatment Approaches:

Given the complex nature of post-viral symptoms, a holistic approach to treatment is often necessary. Natural treatment strategies aim to support the body’s innate healing mechanisms and address underlying imbalances. The following are key natural approaches for managing post-viral symptoms:

a. Rest and Sleep Hygiene:

Adequate rest and quality sleep are essential for recovery from any illness. Establishing a consistent sleep routine, creating a comfortable sleep environment, and practicing relaxation techniques can promote better sleep quality, aiding in the restoration of overall health.

b. Nutrient-Rich Diet:

A balanced and nutrient-dense diet is crucial for supporting the immune system and overall health. Incorporating a variety of fruits, vegetables, whole grains, and lean proteins provides essential vitamins and minerals necessary for recovery. Omega-3 fatty acids, found in fish, flaxseeds, and walnuts, possess anti-inflammatory properties that may help alleviate symptoms. We would argue one of the other most important things to do to support a healthy immune system is to cut out processed sugar or minimize as much as possible.

c. Supplements:

Certain supplements are known for their immune-modulating and anti-inflammatory properties. Echinacea, astragalus, and elderberry are examples of herbs that may support the immune system during and after viral infections. We also evaluate the need for specific nutrients such as vitamin C, zinc, copper, and vitamin D. We are also big proponents of NAC and quercetin to help with oxidative stress and to work as a natural anti histamine. However, it’s important to consult with a healthcare professional before incorporating any supplements, as they may interact with medications or have contraindications.

d. Stress Management:

Chronic stress can exacerbate post-viral symptoms by contributing to immune dysregulation and inflammation. Stress management techniques, such as mindfulness meditation, yoga, and deep breathing exercises, can help regulate the stress response and promote overall well-being. At STAT Wellness, we like to monitor cortisol, pregnenolone, and DHEA to evaluate your body’s stress resilience. We will see low DHEA and high (or low) cortisol often in patients with post viral syndrome. DHEA is a critical hormone for a healthy immune system.

e. Physical Activity:

While excessive exercise may exacerbate symptoms, gentle and regular physical activity can have positive effects on mood, energy levels, mitochondria and overall recovery. Activities such as walking, pilates, yoga, and tai chi can be particularly beneficial. It is important to listen to your body and make sure any activity you are doing is making you feel better and not worse; it is not normal to need to take a one hour nap after a workout 🙂

g. Gut Health:

The gut microbiome plays a crucial role in immune function and overall health. Probiotics and prebiotics, found in fermented foods and high-fiber sources, can support a healthy gut microbiota, potentially aiding in the resolution of post-viral symptoms. We like to test our patients gut microbiome through comprehensive stool test to make sure it is as healthy as possible – this allows us to tailor the treatment plan more specifically.

h. IV/Injection protocol:

At STAT Wellness, we have worked with several patients with post viral syndrome and have seen a lot of improvements with IV and injection therapy so we decided to formalize into a “Post Viral Bundle”. This includes a super immunity IV which is basically a multi vitamin in a bag with a little extra vitamin C and zinc for immune health, 4 glutathione IVs spaced out every 1-2 weeks for reducing oxidative stress (also great for any lingering lung or liver dysfunction), and 8 NAD injections for mitochondrial function (administered 2x per week for 4 weeks). We have found NAD+ to be game changing in our depressed/brain fog patients post viral load. This is critical since it is reported that 30-40% of patients will experience depression post COVID.

Learn more about our Post Viral Bundle HERE.


Post-viral symptoms pose a significant challenge to individuals recovering from viral infections, requiring a comprehensive and nuanced approach to treatment. The purpose of this article is to shed light on potential causes and natural treatment approaches but is not replacing medical care. If you are suffering with any of the above symptoms, please make sure to meet with a healthcare provider at STAT Wellness or discuss with your Primary Care Provider . As our understanding of the underlying mechanisms continues to evolve, the integration of holistic and evidence-based strategies is crucial for supporting those navigating the complex landscape of post-viral recovery. Further research is needed to refine and expand our knowledge, with the goal to ultimately improve the outcomes and quality of life for individuals grappling with post-viral symptoms.

Book a free 15 min consult with one of our functional medicine providers HERE or you can call/text 404-254-5905 at any time.

In good health,

Kristin Oja, DNP, FNP-C, IFMCP

Founder + CEO of STAT Wellness