Transcript

Kylie: [00:00:00] Hello, hello and welcome back to the Hormone Hub. It is going to be another fantastic episode today. Now I have noticed and I’m sure we are all very well aware of Covid, you know, little virus that popped up a few years ago. And you know, it’s the conversations that I’m having with clients, in our community is, you know, long covid and what that means.

And today I am very grateful and very excited to introduce you to Carla Wrenn. Carla is a naturopath and herbalist and nutritionist with over 20 years experience, and she’s very well regarded in that practitioner’s space. She’s a mentor. She runs, you know, lots of training for practitioners such as myself.

So I feel like I’ve, I’ve got the gold standard of, you know, information we’re about to deliver today. So ladies, I would love to introduce you to Carla [00:01:00] Wrenn from the Peninsula Herbal Dispensary. So welcome Carla. Thanks for coming. 

Carla: Thank you so much for that lovely introduction. 

Kylie: It is great to have you. Now, long Covid. It’s, we’re living with it, you know, it’s a thing, so it’s not going away, but you know, it’s definitely something I think all of us as practitioners are starting to see more and more of because, you know, and I think a lot with a lot of chronic conditions, you know, people end up with the, the natural therapists and natural practitioners because, you know, there’s not a lot medically that can be done.

You know, people are frustrated. They’re told their blood works normal, you know, maybe they need a holiday , you know, all of those little gems of advice that, that women are given. So, so today we are gonna just dive into the world of long Covid. Is that okay with you, Carla? 

Carla: I’m excited. I’m super excited. Yes.

Kylie: Great. 

Now, so [00:02:00] what, what makes long Covid different from regular covid. 

Carla: Yeah, so long covid is really defined, and it even took a long time to get a definition. It’s actually the first disease that’s ever really been led as a definition by patients. So, you know, we weren’t really focused on that as a medical profession.

I think even in our own practice as we saw how keen people were to try to avoid getting sick. And certainly in here in Australia, you know, we were some of the slower countries to really see the spread of the virus itself. So everyone was working hard on not getting sick, but what patients in other countries started to notice were that they didn’t recover well.

Yeah. And this was coined as long covid or long haul covid and eventually some big health bodies like the World Health Organization and the CDC caught up with what patients were saying, and a definition was made. And the definition is basically that you have one or more symptoms that for, and they say four to six weeks.

Some definitions say up to 12 weeks after Covid has cleared from your [00:03:00] system, essentially from, from that initial infection. And as practitioners, you know, this is something we’ve seen with other viruses before, so it felt kind of natural to move into this space and exactly like you said, you know, people were experiencing this, but the medicine had only just defined it and no research had been done.

So I got into this space because what was really exciting for me is this made sense with things we already knew about viral or postviral illness. And I also could see some early studies being released from other people around the world who were doing research in what nutrients and herbs and dietary changes we could make for patients who were suffering this new thing, long covid.

Kylie: Yeah. Yeah. Brilliant. And we’re gonna dive into, you know, some of those as well. Yeah. So what, what sort of symptoms are we seeing? And it was interesting, we were chatting before we hit record that, you know, if you are going through perimenopause and menopause and you’re already exhausted, you know, you’re gonna relate to this. [00:04:00] If you have an autoimmune condition, you’re gonna relate to this.

If you have chronic fatigue syndrome or you’ve been, you know, had adrenal issues, you are gonna relate to all of these symptoms. So what are the, some of the things that, you know, we’re seeing in long covid and also in some of these other conditions. 

Carla: Yeah, so I think the initial kind of definition was really around persistent fatigue, post exertional malaise.

So patients would do too much, or not even too much, they’d do their normal life and they’d be exhausted for three days after doing school drop off or something like that. And headaches were another common symptom too. And so there was this really tight group of symptoms, maybe around 40 or 50 symptoms that were initially defined.

The last paper I saw had something like 263 defined symptoms, that I would say every day it grows. And when a patient says that they have a symptom in my long covid clinic, I really just go with it if it fits the timeline, because I think the, the unique thing about Covid as a virus is it is causing such [00:05:00] diverse changes in the body that we pretty much can’t exclude any symptom if the timeline fits.

And so that’s why we see so many problems that mimic so many other stages or health conditions , and it can really be important to remember not to always put the long covid blinkers on, but to make sure we consider it as part of a patient’s picture or our own health picture if you’re not feeling well.

Kylie: Yeah, yeah, that’s right. And, and I think that’s important. You know, don’t put a label on one thing, because then we sort of run the risk of missing, you know, is it thyroid? Is it, you know, is it perimenopause? Is it, you know, your adrenals that we need to, to support as well. So, you know, I think it’s very much we need to look at you as a whole picture.

Yeah. 

Carla: And then we, and I would add, sorry, add to that by saying you may have been someone, and I’m sure you see these patients a lot, and speak to them frequently, on the, on the verge of going thyroid. Do you know what I mean? And that the, the trigger for [00:06:00] that can be lots of things. We know as health practitioners, we’re very good at assessing those things. But one of those things is viral issues. And so we see a big drop into thyroid issues, p ost covid that is part of that long covid picture. But we, you know, we need to tease that out a bit. So timelines I think are so important in all of this.

Kylie: Yeah. Yeah, very much so. Very much so. Okay, so what do, what have we sort of got available, or first actually before we go into that, you know, how do we, how do we get long covid diagnosed? So what’s the process? 

Carla: Yeah, there’s lots of different ways. I think in my patient group, I really see people who have got residual symptoms that are lasting for more than seven days, right up to that 30 day mark or longer who just don’t feel well since, and I think those people really need to take some time and recover and rest.

You know, I often ask my clients, Have you rested enough? And there’s that picture of people who just need to rest more and, and really perhaps their health wasn’t great in the first place. And this has [00:07:00] disrupted it. And those people I think, are one group. Then there’s the people that we see more in our long covid clinic who are very detrimentally, hugely affected, and it’s quite easy to get a diagnosis because since having covid, they’ve pretty much been in and out of hospital or having to be cared for by family members, within a key group of symptoms. And although early on it was very hard to get a diagnosis because GP’s perhaps weren’t upskilled enough to be able to diagnosis it.

Now I think the diagnosis is coming more easily. If a patient has had a set of symptoms since they’ve had covid that haven’t resolved, they’ve pretty much been given that, oh, you’ve probably got long covid. But very often the blood tests are looking normal, and so that’s where that challenge begins because the, the direction and the root for treatment is very limited at the moment. A lot of referrals will send patients out to long covid clinics in hospital settings around Australia. And that’s really looking with working with exercise physiologists and physiotherapists to try and increase their capacity and [00:08:00] return them back to some kind of normal physical level, but unfortunately there’s a lot more to it that’s still, still unfolding. 

Kylie: Yeah. Yeah. So for all my very busy ladies who are listening, who just push through and push through and push through, the message there is rest. If your body is telling you to rest. 

Carla: A hundred percent, it’s the number one thing.

And I really wish, in hindsight, I mean, I’m sure there’s lots in hindsight, we would change about the Covid period and the pandemic period. But in hindsight, I would’ve liked the health messaging to be different. If I could wave my magic wand over some of our fabulous health ministers, I would ask them to say, you are, infected for seven days following that you are still not well and should rest for longer if you can.

Cause that seven day messaging confused a lot of people. And in my long covid clinic, very high numbers of them are women who did exactly what you said. They pushed through. The amount of psychologists, lawyers, professional women that I have are, is very high. They were healthy beforehand. Yeah, and that’s another big key factor.

This is not happening [00:09:00] to sick people. I can’t really think of many patients who were terribly unwell before. This is happening to people in the prime of their lives who perhaps, you know, were pushing it too hard and didn’t rest enough. So resting is always the key. 

Kylie: Yeah, yeah, definitely. And I, you know, I’ll put my hand up like I was, so I’ve had Covid twice now, and the first time, yeah, it was the fatigue that got me and you know, I would think, oh, it’s a virus. 48 hours, I’ll be fine. And then I wasn’t. Another 48 hours and then I wasn’t, and you know, three weeks later, you know, it took a long time. The second time I bounced back a lot quicker. And I think because I did give myself, I was like, right, this is a three, four week game. It’s not a, it’s not a, I’m gonna bounce back in a week time. 

Carla: And that’s even healthy people saying that, you know, and so I think it’s why we really have to listen to our bodies more, and give people space to, you know, if you know someone that’s going through it, offer to help them and, and, and, allow that rest because they think it is so important in [00:10:00] recovery.

Kylie: Yeah, definitely. A hundred percent. So what are some of the things, so if you’ve got sort of long covid, what are some of the things that we can do, you know, with food? You know, we’ve spoken about rest, because yeah, we do have a lot that we can do to sort of nourish our bodies and, and get that recovery or support that recovery.

Carla: Yeah, a hundred percent. And I think in my practice, I’ve never talked more about lifestyle medicine than I have with long covid patients. There are so many tools that you can use at home that have been researched now to help you recover and work through the process. And so really having a good quality diet is so important.

The research on diet has been quite extensive now, and it’s really going back to some of those basic health principles that we would think of even when we are learning about a healthy food pyramid. Not the one that says to eat heaps of bread. The one that’s saying to eat heaps of fruit and vegetables.

 We want our plate, we want our plate to look beautiful and colorful. One of the most successful studies really did that. It was called the Phyto B study and [00:11:00] Phyto B is a supplement that you can get access to from overseas, but I wouldn’t recommend it. We have lots of better things here, but what they’re essentially recommending and researching is if someone took a multivitamin and had lots of colorful fruit and vegetables, did their long covid symptoms reduce? And the answer is yes. So lots and lots of bright colored fruit and vegetables. And I think another reason why that helps is because a lot of researchers looked at the microbiome in long covid and the microbiome takes a very big hit. And one of the things that happens is butyrate reduces.

And butyrate is a really important prebiotic fiber. And one of the ways we can go about increasing butyrate is eating lots of colorful fruit and vegetables. So a really good quality diet is important, and I think this is where it comes to leaning on the people around you or making some, you know, better or, rather than best choices.

It’s, it’s important when you’re feeling unwell to get help to get those things because very often I’ve had patients kind of slip into eating tea and toast or something a bit crappy. You know, when you’re not feeling well, it’s sometimes hard to prepare those foods. Some long covid patients [00:12:00] can’t stand for long enough to prepare those foods, and that’s really when we need to reach out and get support because they show a huge improvement. And the other dietary thing that I think shows another huge improvement, that everyone can do is make sure they stay hydrated. Quite a large group of patients with long covid have a syndrome called POTS which stands for Postural Orthostatic Tachycardia Syndrome.

And essentially hydration is very important. And that hydration might even need to include some electrolytes or, you know, coconut water. And so drinking enough water is another important thing. And the research then goes onto things like the low histamine diet, which is a bit more complex and not for everyone, but it’s good to see lots of research is being done in that space.

Kylie: Yeah, yeah, yeah. Especially for all of my perimenopausal ladies who are all of a sudden very reactive, you know, sinus, hay fever, you know, all of their allergies are sort of coming into play, that can help too. So, yeah, I think you’re right. Sort of keep it simple. And this is where I think, you know, [00:13:00] beautiful, nourishing, nurturing foods like soups and slow cooked meals, you know, we can get a lot of nutrition into, you know, those meals.

And the other thing I think, you know, is important, you sort of, the webinar that I watched was, you know, the, the benefit of herbs and spices because, you know, food is medicine and when, you know, we studied, you know, we were always taught that food is medicine and I think we forget, you know, the, the medicinal benefits of, you know, these beautiful herbs and spices.

so you know, Rosemary, turmeric, garlic, ginger, you know, all of those beautiful aromatic spices and herbs, you know, are so good and, you know, easy to throw, like chop them up and throw them in a soup, throw them in a.. 

Carla: In a slow cooker. It is exactly what I recommend because I think you can, you know, batch cook, those kind of things as well.

And that’s how the original research on herbs came out with long covid before they were actually [00:14:00] researching herbal medicine for long covid, they did a lot of research on like functional foods or food as medicine foods. So parallel to the diet research they were doing, they were also researching if a patient had lots of garlic in their, you know, nutrient-rich diet would they improve faster? Turmeric and there was a whole heap of fenugreek, and lots of different, of those, functional foods or quite medicinally active foods were researched in that way as food, as medicine, to look for improvements. 

Kylie: Yeah. Yeah, absolutely. Absolutely. And I, I just love that, you know, the whole food is medicine idea.

Now we sort of chatted about like the, the physical sort of symptoms, but, you know, we sort of also touched on, you know, like the mental and the emotional impacts of, of long covid. So, you know, what would you sort of say to someone who’s at home, they, they just can’t seem to get over this and they’re starting to, you know, mentally and emotionally sort of, they’re on that [00:15:00] decline.

So how would you sort of support someone there? 

Carla: Yeah, I would really recommend that they do reach out for professionals, to professionals, to start to get some support because I think one of the challenging things with long covid is when you’re depleted physically and, mentally and emotionally, it’s very hard to move in the right direction and get the kind of help you need by yourself.

 The long covid, uh, syndrome can range in mental health changes from just having changes to sleep and subtle mood changes right through to pretty progressed, psychiatric disorders that can develop as part of the kind of stream of symptoms. And so I think it’s worthwhile reaching out to someone, getting some support.

I use a DASS assessment tool on all of my long covid patients to really see where they are. And I think, like we were saying before, if you have perimenopause and you’re already feeling stressed and tired and overwhelmed, it’s a slippery slope when you add long covid on top of it. And you can’t go about the usual self-care things that you do to moderate your mood.

 And so getting enough [00:16:00] sleep, Reaching out to other people are two of the things I think we need to start doing pretty quickly because it is quite a profound effect for some people and can be very isolating too if you can’t do the things you would normally do to support your own mental health.

Kylie: Yeah. Yeah, absolutely. It’s so true and it’s so, you know, just even talking to a friend or asking a friend to come over and help you put the washing on, you know? Yes. 

Carla: Yeah. I think it’s so important. And the other thing I think I to emphasize there is I see a lot of ladies who are acting as carers for long covid patients, and I think they’re always worth mentioning, you know, having a patient, sorry, a loved one who becomes a patient and unable to care for themselves, and you have to become the car er, sometimes quite significantly can have a big impact on their health as well. And I do see a real decline in carers moods and emotions too. 

Kylie: Oh yeah. Yeah, a hundred percent. And, you know, who’s caring for the carer? So, you know, we need to sort of be mindful if you are the carer that you [00:17:00] need looking after too.

And it’s okay to be looked after. 

Yes. 

Carla: And so frightening if that, if that person with long covid is a child too. The number one symptom in children with long covid is actually mood changes. So, if you’ve got a child who you feel hasn’t recovered, then, you know, that’s obviously a terrifying thing for a parent, or a family member.

So, you know, it’s important to, to try and help the whole family. 

Kylie: Yeah. Yeah, absolutely. Absolutely. Alright. This has been very informative and I think will be, you know, really super helpful for a lot of our, our listeners. Now, you actually run a long covid clinic online, so would you like to share sort of a bit more about that and also how people can, you know, can find you if they do need specific help with, with long covid?

Carla: Yeah, sure. Purely because there was such a demand I did set up a virtual clinic called Long Covid Care. You can find us on Instagram or at longcovidcare.co. And it’s a program just to help people recover because I was so inspired by the huge [00:18:00] amount of research around supplements and nutrients and being able to put that into place quite quickly for what I think is a very growing community that is going to need support the, the stats say for 10 years.

So, feel free to reach out. For practitioners I’ve got some training online and there’s lots of new things coming out this year as an industry we’re really stepping up our support for these patients, which I think is really inspiring as well. 

Kylie: No, that’s great. And I’ll make sure all of those links are in our show notes.

So if you would like to, you know, reach out and, you know, work with Carla and get some support for Long Covid, you can access all of those links on our show notes. All right, Carla. Well thank you so much for coming along today. I think this has been, you know, a really good conversation. I think the people who need to hear this will be very relieved to know that, you know, there is support available and you know that you’re not forgotten.

You are not. No. You know, you don’t have to just suffer through and push through. You know, you can reach out and there are, you know, there’s specific support there available for you. [00:19:00] So, and I can say you would be in very good hands with Carla looking after you. 

Carla: Thank you so much. 

Kylie: Thanks Carla. I’ll talk to you soon.

Okay. Thanks everyone for listening and we will see you in the next episode.