I am grateful to Dominica Alicia Collis for writing the article below. She is a medical herbalist, naturopath, nutritionist, author, and educator. She has a lifelong devotion to herbs and the profound healing intelligence of the natural world. She blends ancient herbal traditions with modern functional science to help people uncover the root causes of their health challenges and reconnect with their innate ability to heal.
In terms of qualifications, she holds the following:
- an MSc in Personalised Nutrition
- a Postgraduate Diploma in Herbal Medicine, Naturopathy, and Homeobotanicals
- a Certified International Health Coach qualification
More about Dominica: Wellness Alchemy
The encouraging news is that researchers are finding real, measurable changes in how the
body produces energy and regulates immunity. Recovery looks different for everyone; there are
practical ways to understand the difficulties and provide gentle, individual support.
Understanding the energy problem
Dr Sarah Myhill has spent decades working with people affected by ME/CFS and postviral
fatigue. Her 2024 book, co-written with Craig Robinson, also considers Long COVID. Her
central idea is simple: fatigue (as well as many other symptoms associated with LC) can arise
when the body cannot produce and deliver enough energy for what it is being asked to do.
Think of the body like a car. Food provides fuel; tiny structures inside our cells called mitochondria act as the engine; sleep and rest allow repair; and activity uses energy. In Long COVID, some of these systems may not work as efficiently as they once did.
Her approach focuses on supporting the whole body. This is a useful way of thinking about
symptoms, although no single explanation applies to everybody with Long COVID.
Four gentle foundations of support
- Respect the energy budget. Activity includes thinking, conversations, emotions and
movement. If symptoms worsen hours or even a day later, pacing means doing less and
allowing time to recover, rather than pushing harder. - Nourish rather than restrict. Regular meals, adequate protein, large variety of plant foods
(at least 40-50 different ones during a week, and this includes fruits, vegetables, nuts, seeds,
herbs) and enough fluids support everyday repair. An overly restrictive diet is not automatically
helpful. - Look for treatable contributors. Sleep problems, digestive symptoms, dizziness on
standing, iron or vitamin deficiencies and thyroid problems may deserve assessment. - Make changes one at a time. Nutrients or herbs may be considered where appropriate, but
more supplements do not necessarily mean better results. The plan should match the individual.
What newer research is discovering
Energy changes are real. A July 2026 study found that muscle and energy-use changes in
people with Long COVID could not be explained by prolonged inactivity alone. This is an
important step towards understanding why everyday tasks can feel so difficult.
The gut is part of the picture. In a small 2026 clinical trial, a specific multi-strain probiotic
improved fatigue and brain fog more than a placebo over four weeks. It is an early result, but
encouraging for research into the gut–immune connection.
Nutrition remains an area of study. Researchers are investigating how nutrients and energy
metabolism relate to symptoms. Some early findings are promising, but supplements and
special diets have not yet been shown to cure Long COVID. Although they successfully help
manage it.
What Dr Myhill considers in her approach
Her book discusses a low-carbohydrate, paleo-ketogenic eating plan (although I don’t
particularly agree this approach is right for everyone); supporting digestive function; and
nutrients involved in cell energy production, including magnesium, B vitamins, CoQ10 and
carnitine. She also gives importance to sleep, breathing and careful pacing. These are possible
areas to explore, not a list of treatments everybody should start.
Useful links if you would like to read more
Dr Myhill’s book: Diagnosis and treatment of Chronic Fatigue Syndrome, Myalgic Encephalitis and Long Covid THIRD EDITION
Dr Myhill discusses Long COVID in a 51-minute interview: 118 – Dr Sarah Myhill shares her experience of treating ME/CFS & Long COVID
2026 Muscle and Energy Research: Skeletal muscle properties in long COVID and ME/CFS differ from those induced by bed rest | Nature Communications
Gut and probiotic study: Supplementation improves fatigue in long COVID: results from the DELong#3 randomized placebo-controlled trial
There’s at least 10 different studies happening right now exploring different approaches and
focusing on various symptoms associated with LC. Unfortunately, none of these are currently
taken into consideration by NHS specialists.
Related content
Living with Long COVID
Long COVID is finally lifting!
Surviving COVID and the after-effects
Hearing issues with Long COVID
