Here's a roundup of Covid and long Covid treatments and preventions I've run across. Many of these are difficult to find with just a web search. I update this list as needed.
(For newcomers: Masking in public, and around anyone who isn't Covid-safe, is obviously a given. (I'll get to masks below.) Absolutely nothing listed here is a substitute for masking! We add mitigation strategies together; we do not replace them. I've broken this down into four categories. The top item spans at least three of these.)
There is evidence that certain antihistamines can: Improve Covid outcomes; reduce long Covid symptoms; protect against Covid infection; and increase the efficacy of vaccines while also reducing their side effects.
Treatment: "... immediately begin taking both a h1 (Claritin, Allegra, Zyrtec) and h2 (Pepcid) antihistamine available over the counter as soon as you test positive." More options are given in the article.
The best guess from what evidence we do have says you will most likely get the best results from at least:
* 10mg of cetirizine twice daily
* 20mg of famotidine twice daily
https://synecdochic.dreamwidth.org/805203.htmlThe article cites several sources. More corroborating sources are
here,
here,
here,
here, and
here.
I've also read, "Allergist's instruction: Morning: 20mg famotidine, 10mg loratadine; evening: 20mg famotidine, 10mg cetirizine."
This info applies to both MCAS and Covid!
(Note that Pepcid is also an antacid (you'll find it shelved that way at the pharmacy), and can affect your digestion. If you're concerned and just trying to preventatively reduce vaccine side effects, you can skip it and stick with h1 antihistamines.)
On long Covid treatments:
The Visible: Pacing For Illness app is a great help for people suffering ME/CFS, post-exertional malaise, and other symptoms caused by exercise as a result of long Covid. It correlates cumulative heartrate data with how you're feeling, so that you can figure out how much energy you can safely spend before you risk exacerbating your symptoms. It works best with a proprietary armband, but in a pinch can gather pulse data from your phone's camera. It will aid you in functioning and exercising just enough, without overdoing it.
https://www.makevisible.com/A large increase in electrolytes, including salt, has helped many people who suffer neurological effects of long Covid (tachycardia, neuropathy, dysautonomia, brain fog, etc). This mirrors the increased salt and fluid requirement for sufferers of MS, which also involves demyelination. Damage to the kidneys and GI tract from Covid can also cause fluid and electrolyte disturbances.
https://www.cuimc.columbia.edu/news/what-have-we-learned-about-long-covidhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060100/Low dose nicotine patches have shown mixed success. Nicotine can dislodge the SARS-CoV-2 virus from certain important receptors, allowing those receptors to start working again, and allowing those viruses to be cleared from the body. This must be carefully weighed against two issues. First, nicotine is addictive. Second, nicotine can make someone feel more energetic, which can cause a Long Covid patient to accidentally overexert themselves without realizing it, causing a later flare-up or worsening of symptoms. Proceed carefully, and monitor your heart rate. Some people have seen lasting improvement, even after quitting the nicotine. Others have felt better for a few weeks, then returned to baseline.
https://linktr.ee/thenicotinetesthttps://link.springer.com/content/pdf/10.1186/s42234-025-00167-8.pdfhttps://www.ncbi.nlm.nih.gov/research/coronavirus/docsum?text=nicotine%20patchesThe Patterson protocol is a commercial venture that has helped some people recover from Long Covid, but which overhypes its successes and will continue to string along everyone else, milking patients for money as long as they can. They do seem to be on to something: The basic idea is to use tests to differentiate between Long Covid caused by continuing damage from spike proteins, and Long Covid caused by reactivation of other pathogens such as Epstein-Barr virus. Statins (particularly atorvastatin which crosses the blood-brain barrier) can dislodge cells containing spike proteins from the walls of blood vessels, allowing the body to clear them. Antivirals such as Maraviroc and Truvada are used against remaining viruses. These medications can be had without consulting Patterson; consult your doctor or the Internet. (You may have to educate your doctor (if possible) and ask for a prescription.) Some people do not tolerate these medications well.
Post-Covid recovery clinics that deal in non-pharmacological treatments often emphasize learning to pace yourself, and finding types and amounts of exercise that can build stamina (and stave off the ill effects of being sedentary) without taking it far enough to trigger post-exertional malaise (being totally wiped for a long time after exercise). Puzzles and memory exercises are also used.
https://health.usnews.com/conditions/coronavirus-and-your-health/articles/long-covid-treatmentsOld or small results that may need revisiting:
A 14 week course of valacyclovir (an antiviral typically used to suppress herpes) and celecoxib (an NSAID) offered significant improvement to a group of female patients who had had long Covid for an average of two years. The study is based on the hypothesis that dormant herpes viruses inside one's tissues are activated after a Covid infection, causing some long Covid symptoms. Unstated in the article, but common in the literature, is evidence linking symptoms to immune response induced inflammation of neural and other tissues: Presumably hence the NSAID.
https://respiratory-therapy.com/disorders-diseases/infectious-diseases/other-infections/valacyclovir-celecoxib-combo-shows-promise-long-covid-symptom-relief/Three Florida patients who were given monoclonal antibodies for current Covid cases or exposures suddenly had their already existing long Covid symptoms greatly reduced or completely cured.
https://www.mdedge.com/icymi-covid/article/267176/long-covid/monoclonal-antibodies-new-treatment-long-covidEight out of twelve long Covid "brain fog" patients responded well to a combination of guanfacine (an ADHD drug, available by prescription) and N-acetylcysteine (NAC) (available over the counter). The doctor working on this has also seen improvements in individuals with other post-disease (Lyme and MS) cognitive issues.
https://www.yalemedicine.org/news/long-covid-brain-fog-treatmentA combination of particular prebiotics and probiotics alleviated long Covid symptoms in some patients:
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00685-0/fulltextMicroclots (which may affect any organs; lungs and brain/nerves are of particular note here) were treated with anticoagulants in a handful of patients, who were closely monitored for bleeding. Several were helped.
https://www.science.org/content/article/what-causes-long-covid-three-leading-theoriesSome folks have been helped by lion's mane mushroom extract. A component of it is shown to help regrow neurons. Two of its components together improved spatial memory and object recognition in mice. (
Edit: Many people have had bad reactions to lion's mane! The
Lion's mane recovery subreddit warns you to never try it. Until we know a lot more about the likely risks and benefits, I'm going to advise, at the very least, not starting it if you aren't already comfortably taking it long term.)
https://onlinelibrary.wiley.com/doi/10.1111/jnc.15767Aderall (an ADHD drug) can help with brain fog.
https://www.scientificamerican.com/article/long-covid-now-looks-like-a-neurological-disease-helping-doctors-to-focus-treatments/Some folks report success with anticoagulant dietary supplements. Erin Rackham (who has seen sudden benefits with pain, brain fog, and energy) lists hers: Beet root (2000 mg 2x/day), danshen (salvia root) (1200 mg 2x/day), black pepper extract (10 mg 1x/day), turmeric/curcumin (1500 mg 1x/day), 1 low dose aspirin (2x/day). (I'm out of steam for tracking down the validity of this. It looks like Dr. Keith C. Ellis is selling a related supplement based on so-called "triple anticoagulant therapy," a phrase whose search results are largely medicinal rather than herbal. Anecdotes are no substitute for a study, but it's an accessible intervention to try.)
https://www.tiktok.com/@erinrackham/video/7306518121483914542The one researcher with an acidosis hypothesis, who supposedly cured herself through a fad alkaline diet and breathing exercises, was not a convincing data point.
On prevention of long Covid:
Many (not all) long Covid symptoms constitute a form of ME/CFS. The ME/CFS community has been clear on the correlation between resting as much as possible during and after the initial illness, and eventually healing from the condition. This is not a perfect correlation: There are no guarantees.
https://www.meaction.net/stoprestpace/A metastudy found: Initial vaccination reduces the chance of long covid by 19%, over no vaccination. Further vaccination, over just initial vaccination, then further reduces the chance by 23%.
https://www.medrxiv.org/content/10.1101/2024.11.19.24317487v1Dehydration during the acute phase of Covid is predictive of developing long Covid. Drink plenty of fluids while you're sick.
https://siderea.dreamwidth.org/1817150.htmlA two week course of Metformin (a cheap diabetes drug), started within the first week of Covid symptoms, has been shown to reduce the chance of long Covid by 42%, regardless of vaccination status. Participants who started earlier did better on average.
https://www.webmd.com/covid/news/20230309/diabetes-drug-helps-prevent-long-covid(Metformin similarly
reduced the incidence of severe outcomes of the initial infection.)
On Covid treatments:
Nasal irrigation is tremendously effective. A study of patients 55 and older using twice daily saline nasal rinses saw hospitalizations reduced from 9.47% to 1.3%, and zero deaths in 79 subjects.
https://www.sciencedaily.com/releases/2022/09/220913110403.htmTake Paxlovid as soon as possible: The sooner you start it, the better it works.
Paxcess can help you find a way to pay for it, if needed. Note that Covid rebound happens occasionally, with or without Paxlovid. This study found no notable difference between rebounds after treatment with Paxlovid and with Molnupiravir (which is less effective than Paxlovid):
https://www.medrxiv.org/content/10.1101/2022.06.21.22276724v1The probiotic Streptococcus salivarius K12 colonizes the mouth as tablets are slowly sucked and dissolved in the mouth (not swallowed), twice per day. This alters the microbiome in the lungs, improving outcomes in Covid patients. (I have also seen K12 touted as a preventative measure against respiratory infections, but the study described was not cited well enough for me to find it easily. I will gladly accept help here!) Products include
ThroatGuard Pro and
OralBiotic.
https://www.mdpi.com/2076-2607/10/10/1926Old or small results that may need revisiting:
A single injection of peg-interferon lambda greatly reduced severe outcomes of Covid-19. (Not yet approved in the U.S. and Canada, as of the 2/8/2023 article.)
https://www.ctvnews.ca/health/new-one-and-done-therapy-can-help-curb-severe-covid-19-infection-canadian-led-study-1.6265716Among patients hospitalized with Covid, cannabis smokers had better outcomes. (The mechanism has not yet been determined, but cannabis' anti-inflammatory properties seem a very likely candidate.)
https://www.forbes.com/sites/ajherrington/2023/10/13/study-finds-cannabis-users-had-better-covid-19-outcomes/See here for statements of what not to do.
On Covid prevention:
If possible, don't get Covid. Each additional infection carries additional risk of brain damage, disability, and death. See my safety practices from 2022. (Addenda: I've added the P100 mask to my repertoire since then. Rapid tests have become less reliable. Grocery shopping unmasked has become more unsafe.)
https://blimix.dreamwidth.org/169251.htmlGet vaccinated. No matter what you've heard about vaccines, they are tremendously more likely to help you than to harm you. Vaccination will reduce the risk and likely severity of infection, but you still need to layer other protections on top of that, to stay safe. If you want to fine tune your vaccinations for maximum effectiveness, get them every four months. Get a variety of updated vaccines, and get each one twice: The second one helps you produce memory B cells for long term effectiveness. The Moderna and Pfizer mRNA vaccines have slightly higher initial efficacy. Novavax gives longer lasting protection and is much gentler with the side effects. (You can also reduce side effects by hydrating, by moving your arm around a lot, by having a light and early dinner that night (with plenty of upright time to digest before bed), and by using certain antihistamines as described above.) saRNA (or sa-mRNA) vaccines produce a long lasting immune response with a much lower dose. As of late 2024, one (LUNAR-COV19 from Arcturus Therapeutics, effective against many variants) is approved in Japan.
Whenever you are around people who are not Covid safe, use a high quality mask ("respirator") such as N95, KN95, P100, Readimask, etc. Make sure it seals to your face, so that you breathe through it, not around it. Check especially around the straps, your chin, and the sides of your nose. Different masks work best for different faces. Paper/surgical masks, cloth masks, and gaiters provide very little protection. I have info here on masks that fit particular needs:
https://www.blimix.com/covid/Fresh air is far safer than air that other people have been breathing. Carbon dioxide buildup both indicates stale air and allows the virus to survive longer in acidified aerosol droplets. If you can afford an
Aranet4 or an
AirFanta G2, it can tell you a lot about the relative safety of indoor air. That said, you can be infected even outside by the modern Covid variants. Avoid crowds and any symptomatic people, and limit face-to-face interactions with strangers.
https://x.com/ukhadds/status/1794819866370969620High quality air filtration can reduce the amount of virus (as well as allergens, smoke, mold spores, etc.) in the air. Many people
build their own Corsi-Rosenthal boxes out of furnace filters (MERV13 or better) and a box fan. These are relatively cheap and highly effective. For smaller and quieter commercial products, you can try
Nukit,
Clean Air Kits, the
AirFanta 3Pro (which collapses for travel), and others. You can bring the
AirFanta 4Lite to blow clean air directly at you in spaces too big or too occupied to clean the air for the whole room. Some commercial filters also offer far-UVC to disinfect an area. The efficacy and safety of consumer grade far-UVC has evidence, but is still open to question regarding some products and situations.
More on far-UVC. Turn off any ion generators (such as in the Winix C545): Those make ozone, which "purifies" the air but also makes it harder to breathe and can kill pet birds.
Probiotics offer some protection from respiratory infections. An early study on unvaccinated people showed that lactobacillus reduced the chance of contracting Covid after an exposure. The study was smaller and shorter than planned due to vaccines becoming available, so we can't be as sure of the results as we would like.
https://www.futurity.org/probiotics-covid-infection-viruses-vaccines-3011132/It is possible that vegetarian and flexitarian (only occasional meat) diets reduce Covid incidence. A study found a strong correlation. They adjusted for some risk factors, but correlation is not causation: It could simply be that people who exhibit thoughtful, careful behavior tend to both eat less meat and practice better Covid safety.
https://twitter.com/EricTopol/status/1744873872942657545Nasal sprays have been popular. But as of early 2025, the studies that seemed to support their efficacy have turned out to be deeply flawed in ways that undermine their results. We have no good evidence that they are effective either as preventions or treatments. Nor, in many cases, that they are even safe to use. That said, we have known since 2020 that a properly moistened nose is more resistant to infection than a dry nose is. There's nothing wrong with using a regular saline spray. Just don't use it in place of other mitigations.
https://old.reddit.com/r/ZeroCovidCommunity/comments/1iv64oi/there_is_no_convincing_evidence_that_nasal_sprays/https://www.instagram.com/p/DHuJrTwy_X7/There is no evidence that using CPC mouthwash will protect you from catching COVID, but it may reduce the chance of you spreading it. Mouthwash containing CPC (cetylpyridinium chloride) inactivates SARS-CoV-2 in saliva, greatly reducing its infectivity. That is, if you have Covid and absolutely must be around other people, then in addition to other mitigations (e.g., masks, fresh air), using CPC mouthwash will reduce the viral load that you're breathing/spitting into the air. (Note that CPC mouthwash will kill off K12 probiotics in your mouth; you'll have to start over. But your lungs will still have whatever beneficial probiotics have colonized them so far.)
https://pubmed.ncbi.nlm.nih.gov/34282982/
I owe unlimited thanks to all my friends who have shared articles, studies, leads, and other info. We are doing our best to save lives.
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