Supplements for post-COVID recovery

The post-COVID stack — practical and layered

Foundation (weeks 1–4)

Vitamin D3 to a 25-OH-D target of 30–50 ng/mL (2,000–4,000 IU/day if deficient). Omega-3 EPA+DHA 1–2 g/day. Magnesium bisglycinate 200–400 mg elemental in the evening for sleep and recovery. Zinc 15–30 mg/day during acute symptoms; stop within 4 weeks (chronic high zinc lowers copper).

Get bloodwork at week 4–6 if symptoms persist

CBC, ferritin, 25-OH-D, B12 with methylmalonic acid, TSH, ALT, fasting glucose. Low ferritin (<50 ng/mL) is common after acute infection and worsens fatigue. Low B12 is common in vegetarian/PPI users and presents similarly to long-COVID symptoms. Address deficiencies in target-driven fashion rather than blanket-dosing every nutrient.

Sleep, fatigue, and exercise pacing

Graded reintroduction of exercise — recumbent first if exertional symptoms (palpitations, post-exertional malaise) are present; this matches the Levine POTS protocol. Pushing too hard too soon worsens post-exertional symptoms in users developing long COVID. Sleep hygiene fundamentals.

If symptoms persist beyond 12 weeks — escalate

Persistent fatigue, breathlessness, cognitive symptoms ("brain fog"), or autonomic symptoms (postural tachycardia, dizziness) beyond 12 weeks meet provisional long-COVID criteria. See a long-COVID clinic if available. The supplement layer at this point is genuinely adjunctive to specialist care that includes graded exercise, cognitive rehabilitation, and pharmacological options for specific syndromes (POTS, MCAS, dysautonomia).

NAC and antioxidants

NAC at 600 mg b.i.d. has small mechanism-based rationale (glutathione repletion during post-infectious oxidative stress) and is generally well-tolerated. Effect sizes in published post-COVID trials are modest. Reasonable 4–8 week trial; stop if no perceived benefit.

Gut recovery after antibiotic course (if applicable)

If antibiotics were used during acute illness: Lactobacillus rhamnosus GG or Saccharomyces boulardii ≥10 billion CFU/day for 2 weeks after antibiotic completion. Otherwise skip the broad-spectrum probiotic.