Struggling with severe brain fog, insomnia, migraines, or POTS symptoms after a viral infection? You’re not alone. In this episode, Dr. Alison shares her personal experience with post-viral cognitive dysfunction and breaks down the science behind long COVID neurological symptoms, chronic fatigue, and nervous system dysregulation.

Discover evidence-based strategies for brain recovery including:

• Research on immune dysregulation and neuroinflammation after viral infections
• Clinical trials for long COVID cognitive symptoms (baricitinib, low-dose naltrexone, metformin)
• Essential nutrients for brain health: NAC, CoQ10, omega-3s, vitamin D, B-vitamins
• Why Lions Mane and nootropics help some people but worsen ADHD symptoms in others
• Dopamine support and saffron spray for post-viral mood and cognitive issues
• Nicotine patches for neuroinflammation (watch: https://youtu.be/S9PHDJCncUI)
• Game-changing functional neurology brain exercises that rewire your nervous system
• Mitochondrial support, phosphatidylcholine, and anti-inflammatory protocols

Whether you’re dealing with long COVID, Epstein-Barr reactivation, post-viral MCAS, or POTS, this episode provides actionable recovery strategies grounded in current research. Learn why post-viral brain symptoms persist for months or years and what you can do about it today.

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Transcript:

Hey everyone, welcome back to Functional Wellness with Dr. Alison. Before we dive into today’s topic, I’ll be totally honest with you since last week I was completely taken out by some viral combination, and what hit me hardest wasn’t the typical cold symptoms – it was what happened to my brain.

I’ve experienced this before, and maybe you’re familiar with it too – that deep, debilitating brain fog where you literally cannot read or focus on anything. I had to save up every ounce of brain function just to see my patients for the day, and then I would completely collapse afterward. I had to move my book club back a week because I couldn’t read even a few pages! And true to form with viral infections for me, the insomnia kicked in hard. I found myself doom scrolling on my phone, waiting for my brain to come back online, knowing I had patients to see in just a few hours.This experience reminded me how real and how devastating post-viral neurological symptoms can be – not just for long COVID patients, but for anyone dealing with viral reactivations, Epstein-Barr, or any infection that decides to set up camp in your nervous system.

So today we are going to talk about what the current research is showing for pharmaceutical support, herbal and nutritional support, diet and food choices, nootropics for your brain health, touch on nicotine again, and most importantly the brain exercises you need to actually see the difference in your brain health. You should not wait to get started with these protocols.

So if you’ve been struggling with brain, nervous system, or even nerve issues after a viral infection – whether it’s COVID, mono, the flu, or any other virus – and you’re dealing with new migraines, unrelenting head pressure, chronic low-grade fevers or feeling feverish without an actual fever, new light sensitivity that makes it hard to be in bright spaces, brain fog so thick you can barely form sentences, the inability to stay awake during the day no matter how much coffee you drink, insomnia that leaves you wired and exhausted at the same time, or the opposite problem where you’re sleeping 10+ hours per day and still waking up exhausted…If your joints and body hurt in ways they never did before, if your heart rate has changed and you feel dizzy when you stand up – maybe you’ve even been diagnosed with POTS – or if you’ve developed MCAS alongside all of this with new food sensitivities, hives, or histamine reactions you never had before…you are probably living with infections that have taken up home literally in your brain and in  your nerves.

What Research Tells Us

Let’s talk about what’s actually happening in your brain and nervous system. The research on long COVID neurological symptoms gives us incredible insight into post-viral brain dysfunction in general. These symptoms are real, often persistent meaning they are hard to get rid of and are happening daily, and likely stem from a combination of several factors:

First, there’s immune dysregulation and changes in your T-cell and B-cell profiles. This chronic inflammation is what underlies symptoms like brain fog and crushing fatigue. Your immune system is stuck in overdrive, constantly sending inflammatory signals to your brain and also within your brain creating more inflammation.

Second, many patients show autonomic nervous system dysfunction which is abnormal regulation of heart rate and blood pressure. This is why so many people develop POTS-like symptoms or feel like their body can’t regulate itself properly anymore. Plus IBS and digestive issues.

Third, studies have linked higher levels of brain inflammation and elevated stress hormones with cognitive symptoms after viral infections. Your brain is literally inflamed, and that inflammation interferes with everything from memory to processing speed to your ability to regulate emotions.And here’s what’s really important to understand: symptoms can persist for months or even years in a significant number of people. This isn’t something that just resolves on its own for everyone.

Overall, post-viral brain issues are multifactorial, meaning there isn’t one single cause or one single treatment that works for everyone and if you had these underlying issues before you got sick, you might not have even known they were there but the immune overload activated everything from genetics to immune dysregulation.

Medical and Clinical Approaches

Let me walk you through what’s currently being studied and used clinically. I want you to understand the landscape of treatment options, even though – full transparency here – there’s no universally accepted cure yet. Various pharmaceutical and clinical trials are underway. Long COVID drug trials testing medications are being expanded to specifically look at cognitive and cardiovascular symptoms. Anti-inflammatory and immune modulators like low-dose naltrexone are showing promise in reducing brain fog and fatigue in small trials by modulating inflammation or neurotransmission pathways.

Interestingly, metformin as well as GLP’s given early in acute infection has been associated with reduced likelihood of later cognitive symptoms, possibly due to its anti-inflammatory effects. And there’s increasing clinical interest in neuromodulation techniques like targeted brain stimulation, though these are still experimental.We’re also seeing that addressing underlying deficits – hormonal imbalances, sleep disorders, thyroid dysfunction – can significantly alleviate cognitive symptoms.

This is why the functional medicine approach of looking at the whole person is so critical.

Nutritional and Supplement Support

Now let’s talk about nutritional strategies. I want to be very clear upfront: no nutrient or supplement alone is a magic cure. But certain nutritional approaches have solid biological rationale and some supporting evidence. And really, we are focused on building a foundation of support for the brain and immune system so that way you recover more easily from future infections as well. Starting with the basics that we need but often overlook because we want something different: vitamins and micronutrients – Vitamin D is crucial for immune function and brain health. Deficiency is incredibly common, and supplementation is suggested if your levels are low. B-vitamins are critical for nervous system function and energy metabolism, and a B-complex may support cognition if you’re deficient. Vitamin C, especially high-dose or intravenous in clinical settings, is being explored for its antioxidant and anti-inflammatory effects. And don’t overlook magnesium, zinc, selenium, and iron – deficiencies in any of these can worsen fatigue, headaches, and cognitive symptoms.

For antioxidants and neuroprotective nutrients, N-acetyl cysteine or NAC as well as NAD or the precursor form of NMN have antioxidant and neuroprotective mechanisms, and small studies show potential cognitive benefit. Coenzyme Q10 supports mitochondrial energy production and may reduce fatigue, indirectly helping cognitive function. Acetyl-L-carnitine may support nerve health and mood. Omega-3 fatty acids – EPA and DHA – are essential brain membrane components with anti-inflammatory properties. As well as PEA, which is being investigated for reducing neuroinflammation.

The brain needs its own specific support. Think about it – your brain requires massive amounts of energy, specific fats for membrane integrity, and targeted mitochondrial support. This is why we focus on things like omega-3s, phosphatidylcholine, and CoQ10 specifically for brain recovery.

Brain-Specific Nutrients: Lions Mane and Nootropics

Now I want to talk about something important regarding brain-supporting supplements like Lions Mane mushroom and various nootropics. This is where personalization becomes really critical.Lions Mane and GABA are often touted as a miracle brain supplement – and for some people, it truly is amazing. It supports nerve growth factor production, can help with focus and memory, and has neuroprotective properties. But here’s what I’ve seen clinically and experienced in my practice: if you have ADHD or tend toward anxiety, Lions Mane or GABA can sometimes make things worse instead of better. Some people report feeling more scattered, more anxious, or experiencing increased brain fog rather than clarity.The same goes for many nootropics. What works beautifully for one person might be completely wrong for another based on your neurotransmitter balance, your genetic makeup, and your specific type of brain dysfunction.

So my recommendation? If you want to try Lions Mane or any nootropic, start with very small doses. I’m talking a fraction of the recommended serving size. See how your brain responds over several days. If you feel worse – more scattered, more anxious, more angry or sleepy- that supplement probably isn’t right for you right now. If you feel better – clearer, more focused, more present – then you can slowly increase to find your optimal dose. This trial-and-error approach might feel frustrating, but it’s far better than jumping in with full doses and feeling terrible for weeks while you figure out what went wrong.

My Favorite Brain Support Supplements

Let me share some of my favorite targeted brain health supplements that I’ve seen work really well for post-viral cognitive issues.Saffron spray has been a game-changer for many of my patients. Saffron has research supporting its use for mood, memory, and overall cognitive function. The spray form allows for easy absorption and dosing flexibility. I particularly love it for patients dealing with both cognitive symptoms and mood changes after viral infections.

For dopamine support – which is often depleted in post-viral states – I focus on nutrients that support dopamine production and function. This includes targeted amino acids like L-tyrosine, along with cofactors like iron, vitamin B6, and methyl-folate that your body needs to actually make dopamine. Many people with post-viral brain fog are dealing with dopamine depletion, which shows up as lack of motivation, inability to feel pleasure, difficulty initiating tasks, and that feeling of just being flat emotionally.I also frequently use phosphatidylserine for supporting brain cell membrane health and reducing cortisol, especially in patients dealing with both cognitive issues and stress dysregulation. And acetyl-L-carnitine, which I mentioned earlier, can be particularly helpful for nerve health and supporting mitochondrial function in brain cells.

The key with all of these is starting low, going slow, and really paying attention to how your brain responds. Your brain will tell you what it needs if you listen carefully.

Nicotine as a nootropic

Now I want to address something that might surprise you – nicotine. And no, I’m not suggesting anyone start smoking cigarettes. But there’s fascinating research emerging around nicotine patches and post-viral cognitive recovery. Studies have shown that nicotine can have neuroprotective effects and may help reduce neuroinflammation. Some long COVID clinics are actually using low-dose nicotine patches as part of their treatment protocols, particularly for patients with severe cognitive symptoms and brain fog. The proposed mechanism is that nicotine may help regulate cholinergic pathways in the brain that are disrupted after viral infections. It can potentially improve attention, processing speed, and reduce some of the cognitive fatigue that’s so debilitating in post-viral syndromes.

If this is something you’re interested in exploring, it absolutely needs to be done under medical supervision. We’re talking about very low-dose patches which are 7mg, carefully monitored, and typically used short-term as part of a comprehensive recovery protocol. This is not something to try on your own, and it’s definitely not appropriate for everyone – particularly anyone with cardiovascular issues, anyone who’s struggled with addiction, or anyone who’s pregnant or breastfeeding.

But I mention it because the research is interesting, it’s being used clinically, and I personally use and recommend the patches for nervous system support. I have a whole podcast and youtube video that goes deeper into the science and I will tag that in the description for you.

Metabolic and Dietary Approaches

Looking at metabolic support, ketogenic approaches or medium-chain triglyceride supplementation are being explored. The hypothesis is that when your brain’s glucose utilization is impaired after a viral infection, giving it alternative fuel sources through ketones might help. This doesn’t mean everyone needs to go full keto, but some people find that MCT oil or a modified ketogenic approach helps their brain feel clearer. Or simply starting keto and getting into a ketogenic state and then having more metabolic flexibility so your diet can expand out a little further.

I usually recommend a blood ketone monitor so you can know what state your body is in that day and then dial in your diet around that.

Anti-inflammatory dietary patterns – like a Mediterranean-style diet – may reduce systemic inflammation and support cognitive recovery. This isn’t sexy or exciting, but consistently eating a diet rich in vegetables, healthy fats, quality proteins, and low in processed foods and sugar can make a real difference in how your brain functions. And we can’t ignore the gut-brain axis. While we don’t have definitive clinical trials yet, the research showing altered gut microbiota after COVID suggests that supporting your gut with the right probiotics and prebiotics may be helpful for brain recovery. Remember from my ebook on mold and MCAS – be careful with histamine-producing probiotic strains if you’re dealing with MCAS alongside your neurological symptoms.

The Game-Changer: Functional Neurology Brain Exercises

Now, here’s where I get really excited, because this is where I’ve seen the biggest clinical changes: functional neurology brain exercises. Over the years, so many programs have come out promising to rewire your nervous system. And honestly? They work. But they’re incredibly pricey – we’re talking thousands of dollars – and they’re long and complicated. So I developed a protocol based on these techniques because the truth is, the foundational exercises are actually simple.

Let me give you an example. My Phase One exercise – the one I start almost every patient with – is this: Hold your hand out at arm’s length with your thumb up. Keep your eyes focused on your thumb. Then gently rotate your head side to side while maintaining eye contact with your thumb. That’s it. Simple, right?But here’s what’s happening: This exercise supports your parietal and cerebellar brain regions, which control eye coordination, focus, and balance. These are often the exact areas that get disrupted after viral infections, which is why you’re experiencing brain fog, dizziness, and difficulty focusing.

Functional neurology teaches us something profound: the test is the treatment. What this means is that if a particular exercise feels difficult, confusing, or fatiguing, it is likely revealing an area of the brain that needs more attention. The more challenging an exercise feels, the more your brain will benefit from it. Essentially if you suck at math, you need to do more math. If your handwriting is sloppy, you need to slow down and practice. If you have trouble with balance and coordination, you need to do more balancing exercises.

And I see this play out clinically all the time. Some patients can only start with being able to do one or two rotations before their brain fatigue hits hard. They have to stop, rest, come back to it later. But after time and practice, they build up to 10 rotations, then 20, and eventually they can do the exercise with ease. And as they build that capacity, their other symptoms improve too – the brain fog lifts, the dizziness decreases, their ability to focus and read comes back.After completing a few phases of these exercises, my patients consistently report improvement. Some tell me it’s the single most impactful thing they’ve done for their recovery.

And what I love about this approach is that you’re not just taking something or doing something to your body – you’re actively retraining your brain. You’re creating new neural pathways and strengthening areas that the viral infection weakened.

Lifestyle and Supportive Strategies

Beyond supplements and brain exercises, several lifestyle interventions can make a significant difference. Improved sleep hygiene is crucial because poor sleep absolutely worsens cognitive symptoms. This means consistent sleep and wake times, reducing blue light exposure before bed, using migraine glasses or rose colored lenses during the day, creating a dark and cool sleep environment, and addressing any sleep disorders that might have developed. Physical rehabilitation with graded activity planning is important to avoid post-exertional malaise. This is particularly critical if you’re dealing with fatigue alongside your cognitive symptoms. You need to find your energy envelope and work within it, gradually expanding what you can do without triggering crashes.

Stress reduction through mindfulness and cognitive behavioral strategies can reduce symptom severity. I know this might sound dismissive – like “just relax and you’ll feel better” – but the research actually shows that techniques that calm your nervous system can reduce inflammation in your brain and improve cognitive function. This isn’t about your symptoms being “all in your head” or caused by stress. It’s about using stress reduction as a tool to support your recovery from a very real physiological condition.

Speech-language and cognitive therapy can be incredibly valuable, especially if you’re dealing with significant deficits in memory, processing speed, or executive function. These therapists can give you specific strategies and exercises to rebuild cognitive skills that have been affected.

Before we wrap up, I need to give you some important disclaimers. Many supplements and off-label therapies are not FDA-approved specifically for long COVID or post-viral syndromes, and they can interact with medications or medical conditions. You absolutely need to discuss any supplements or interventions with a clinician before starting them.I also want to address something I see constantly on social media: anecdotal stories about vitamins, diets, hyperbaric oxygen chambers, and various other treatments. Some of these stories are compelling, and some of these interventions may genuinely help some people. But personal stories are not substitutes for medical evaluation and evidence-based care. What worked for someone on Instagram might not work for you, or might even make you worse, depending on your unique situation.

This is why I’m such a strong advocate for working with a practitioner who understands post-viral conditions and can help you create a personalized protocol based on your specific symptoms, lab work, and health history.

Key Takeaways

Let me summarize the most important points:

First, post-viral neurological symptoms are real and often persist for months or years. Research points to immune dysregulation, inflammation, and metabolic changes as core drivers.

Second, no single treatment works for everyone. Many clinicians, myself included, adopt a multimodal approach combining lifestyle modifications, therapeutic interventions, nutritional support, and rehabilitative strategies. This is why comprehensive functional medicine approaches tend to work better than just throwing a supplement at the problem.

Third, targeted supplementation is most useful when rooted in laboratory-confirmed deficiencies. Get routine blood testing for vitamins D and B12, magnesium, iron, and thyroid function. This can guide safe and effective supplementation rather than just guessing.Fourth, the functional neurology brain exercises I mentioned can be absolute game-changers, and they’re something you can start today while you’re working on other aspects of your recovery.And finally, emerging therapies like immune modulation, neuromodulation, and specific antiviral strategies are under active study and may become more integrated into standard care as evidence grows. This is a rapidly evolving field, and there’s real hope for better treatments in the near future.

If you’re struggling with post-viral brain and nervous system symptoms, I want you to know that recovery is possible. It might not be quick, and it might not be linear, but there are real, evidence-based interventions that can help you reclaim your cognitive function and your life.In my practice, I work with patients dealing with exactly these issues – creating comprehensive, personalized protocols that address the immune dysfunction, the inflammation, the nervous system dysregulation, and the metabolic changes that are keeping you stuck. If you want support on this journey, visit littleblackbagmedicine.com to learn about working together.Until next week, be gentle with yourself, trust your body’s ability to heal, and remember: medicine for the body, heart, and soul.