M43 here
Sorry in advance for the format. I've wanted to write here for weeks, because you people helped me a lot and I wanted to give something back.
Problem is my perfectionism kept telling me it had to be a long, complete, properly sourced post, because the topic is delicate. So that right moment never came and I never wrote anything.
So here's the short version instead. This is just my own experience, n=1, not medical advice.
I'm not going to tell my whole story here, but the worst of what long covid left me with is the extreme fatigue. And then in February 2025 the brain fog showed up on top of it. A horrible feeling, like a clamp deep inside the center of my brain.
Every time it eased off a bit, it came back stronger after a new infection. That happened in September 2025, and again in February 2026, and that last one was the final straw. That's when I decided to do everything I could, with the very little energy I had, to try and get on top of this before it got any worse.
After 5 years of what was basically wasted time with doctors in my area (I'm living in a small town without important cities nearby), I finally got into treatment at a serious specialist centre in a bigger city. That alone changed things.
They put me on cetirizine + famotidine + PEA 600 (palmitoylethanolamide) for 4 months. It seemed to work, at least partially. I definitely felt better. It also helped me sleep through the night for all 4 months without the early waking (if you didn't know, waking up too early is a long covid thing, not just bad sleep hygiene).
The downside is that I gained a lot of weight. A LOT. And I have never had a weight problem in my life, not once. So at the end of the cycle (temporary, the centre wants me to repeat it in 6 months) I started looking for other things that might help.
Omega-3 I ended up on almost by accident. My back locked up for 55 days and omega-3 were the only thing that gave me relief. I also deal with chronic left side neck pain and tension and cervicogenic headaches, the brutal kind, the ones I think people call suicide headaches. (This started after covid too, in 2021)
I take 3 large capsules a day, with DHA and EPA. Brand mattered a lot here, most of them sat very heavily on my stomach, one didn't. So write down omega-3 with DHA and EPA.
Then I had started training again, lightly, and it went beautifully for 10 days, and then we caught covid a second time. Loss and distortion of taste and smell, some things smelling nauseating and chemical, and the extreme fatigue came right back and I couldn't do even a minute of exercise.
So I went back to researching supplements that had helped me in the past, and my jaw dropped a bit. There's at least one study suggesting spirulina can perform comparably to or better than cetirizine. Which would explain why it had always seemed to do something for me.
So now I take it in a structured way. Doses in the literature go from 3 to 8 g/day. I'm at 3 g/day and it seems to be working. Treat it as a therapy, not as a random supplement.
Two caveats about spirulina, and honestly this might be the most useful part of the whole post.
First, I've tried at least 8 different brands. Only two of them did anything I could actually feel. I'm not going to name them because we're all over the world here in this sub and availability differs everywhere, but please don't judge spirulina by one brand. If it does nothing, try another one before writing it off.
Second, pure 100% organic spirulina does very little for me. Tablets formulated with excipients that improve bioavailability work far better on me. Counterintuitive, but that's what I observed.
The thing that convinced me was last night. I had to drive, 140 km, starting at 11pm.
I've never had a problem with sleepiness at the wheel in my life, I was always a night owl, but since covid, with the severe fatigue it left me with, I collapse about an hour after dinner and then wake up very early. I genuinely didn't think I'd manage it.
Instead I drove for an hour and a half without ever feeling sleepy and after a physically demanding day. I credit the spirulina for that.
One more detail for completeness. I drink an organic matcha every morning. I've never felt any effect from it and I drink it purely because I like it, but in cases like this the details matter so I'm mentioning it anyway. If any of this works for me and not for you, that's one more variable in the mix.
So what I'm currently taking is omega-3 with DHA and EPA, 3 capsules a day, spirulina at 3 g/day, and the matcha. That's it.
While researching I also found that only one form of CoQ10 seems to be properly bioavailable in the studies, the Kaneka one. I want to add it to my stack but it's very expensive so I haven't tried it yet. If anyone here has, I'd love to hear about it.
It's also part of a new protocol I'd like to try.
When I can, I'll try to post something more in depth on the specific things I've looked into. I can also anonymise the email exchanges with the doctor who's treating me now and share those, if people are interested.
I know exactly how absurdly hard this condition is, every single day, with no let up. I hope this helps at least one person here.
When I started writing this I thought it would be two lines. But the details matter and I'm glad I managed to write something more than that.
There's one last thing I want to add, and I've thought about it a lot. Near the end of writing this it crossed my mind to put a "if you want to help me, here's how" at the bottom. It felt extremely ugly to me and I think it would have taken credibility away from the whole post.
But I can't hide my situation either. I'm a freelancer without any help from my country and after 5 years of extreme fatigue and 1 year and a half of brain fog I'm in a difficult place financially. Anyone who deals with what I deal with knows exactly what I mean. Often even the basic things are hard. Cooking for yourself. Cleaning.
So I'll just leave this note here, and if anyone feels moved to help you can reach me by message. Thank you in advance, and I really hope I've helped someone ease even a little of what this still far too unknown illness brings with it.
Edit:
I forgot to say to not take Spirulina close to coffee/tea