Establishing a Healthy Gut/Brain Axis Post-Covid – Dr. Leo Galland at the 4th Long Covid Congress

Dr. Kamal Dua, a distinguished pharmaceutical and drug delivery researcher from Australia, introduces the session and highlights the significance of international collaboration in addressing neuro-Covid. Dr. Dua's research focuses on chronic inflammatory diseases, particularly respiratory conditions, using novel nanocarriers to deliver therapeutic molecules.

Dr. Dua introduces the first speaker, Dr. Leo Galland, a pioneer in the study of gut microbiome, intestinal permeability, and their impact on health and disease. Dr. Galland has received international recognition for his innovative nutritional therapies targeting autoimmune, inflammatory, allergic, infectious, and gastrointestinal disorders. He is a graduate of Harvard University and NYU School of Medicine and has been listed among America’s top doctors.

The Gut-Brain Axis and Long Covid

Dr. Galland begins by noting that in the past 10 days, several major studies have emerged that he has incorporated into his presentation, highlighting the dynamic nature of research in this field. His work is based on literature reviews and practical strategies he uses in treating patients with Long Covid.

He presents a roadmap to reestablish a healthy gut-brain axis after Covid-19, detailing the disruptions caused by the virus and the necessary steps to reverse them:

1. Stopping Viral Proliferation in the Gut

2. Reducing Epithelial Cell Inflammation

3. Reversing Gut Bacterial Dysbiosis

4. Restoring Tryptophan Metabolism

5. Restoring the Mucosal Layer and Tight Junction Integrity

6. Detoxifying the Intestines

7. Building a Microbiome that Supports T-Cell Memory Function

Persistent Viral Infection and Long Covid

Dr. Galland highlights a Harvard study showing that spike proteins were found circulating in the plasma of people with Long Covid up to 12 months after infection. This suggests that a chronic viral reservoir exists, continuing to drive Long Covid symptoms.

A study at Northwestern University found that people with neuropathic symptoms from Long Covid exhibited impaired T effector memory cells, suggesting chronic antigenic stimulation.

To prevent ongoing viral replication in the gut, Dr. Galland suggests:

• Natural antiviral compounds like quercetin, curcumin, baicalin (from Scutellaria baicalensis), and glycyrrhizin (from licorice)

• Antibiotics like amoxicillin, which studies indicate might be effective against bacterial-phage interactions related to Covid

• Oregano oil, known for both antibacterial and bacteriophage-inhibiting properties

Caution with Stevia: A study indicated that the natural sweetener stevia may promote the activity of bacteriophages, increasing their impact on bacterial hosts. Given the unknowns, he advises caution with stevia for people recovering from Covid.

Addressing Gut Inflammation

Inflammation in the gut alters the microbiome, increasing nitrate production, which in turn fuels pathogenic bacteria while inhibiting beneficial ones. This creates a vicious cycle of inflammation and bacterial imbalance.

To reduce epithelial inflammation, he recommends:

• Quercetin

• Mastic gum (from Pistacia lentiscus)

• Curcumin (from turmeric)

• Omega-3 fatty acids

• Magnolia bark

• Bovine serum immunoglobulins

These have been shown in controlled studies to help restore gut balance.

Reversing Gut Bacterial Dysbiosis

A major study found that the gut microbiome at disease onset predicts the development of Long Covid.

Key findings include:

• Fecalibacterium prausnitzii, a major butyrate-producing bacteria with anti-inflammatory properties, is depletedin Long Covid patients.

• Ruminococcus gnavus, a pro-inflammatory bacteria, is elevated in Long Covid patients.

• Butyrate-producing bacteria protect against Long Covid.

Butyrate is a critical postbiotic that:

• Supports gut lining integrity

• Has anti-inflammatory properties

• Enhances brain function by activating genes that promote neuroplasticity and recovery from neuronal damage

Restoring Gut Health with Diet & Probiotics

To restore butyrate levels, Dr. Galland recommends:

• A high-fiber, polyphenol-rich diet

• A Mediterranean diet, which has been shown to elevate F. prausnitzii

• Prebiotics, such as:

  • Oligosaccharides

  • Fructooligosaccharides (FOS)

  • Galactooligosaccharides (GOS)

He also highlights specific probiotic strains that increase F. prausnitzii:

1. Bifidobacterium longum BB536

2. Bacillus coagulans GB130

Additionally, resveratrol inhibits the growth of Enterococcus faecalis, a bacteria associated with worse Covid outcomes.

Impact of Gut Bacteria on the Brain

A recent study revealed that Ruminococcus gnavus produces neurotoxic metabolites linked to cognitive decline.

• Tryptophan metabolism is disrupted in Long Covid due to damage to ACE2 receptors, which play a role in amino acid absorption.

• This leads to reduced serotonin and melatonin production, affecting mood, sleep, and brain function.

To restore tryptophan balance, Dr. Galland suggests:

• Enhancing ACE2 activity with vitamin D, curcumin, resveratrol, and omega-3 fatty acids

• Tryptophan supplementation

• Encouraging the growth of Clostridium sporogenes, which produces Indole-3-propionic acid (IPA), a compound with neuroprotective effects

Detoxifying the Intestines

Post-Covid gut health studies have found fungal overgrowth (e.g., Candida species) in stool samples of Covid patients, persisting after discharge. Additionally, fungal beta-glucans were detected in the blood of people with Long Covid, suggesting systemic fungal toxins.

To address this, Dr. Galland recommends:

• Activated charcoal

• Antifungal herbs

• Gut detox protocols

Boosting T Effector Memory Cells

T effector memory cells are critical for immune recovery and protection against future infections. Their function is impaired in people with Long Covid.

To restore these cells, Dr. Galland recommends:

• Fermented foods like sauerkraut and kimchi

• Lactobacillus plantarum, found in fermented foods and supplements

• Mitochondrial support, as mitochondrial dysfunction is a common issue in Long Covid

Q&A Discussion Highlights

• Are multi-strain probiotics better?

  • No. Just taking more strains does not necessarily improve gut health. Instead, focus on key bacteria like F. prausnitzii and use diet to shape a balanced microbiome.

• Should people take polyphenol supplements or get them from food?

  • Food is always preferred, but supplements can help if dietary intake is difficult due to gut symptoms.

• How long does the virus persist in the gut?

  • Without treatment, spike proteins have been found in the gut up to 12 months post-infection.

• Can polyphenols be taken with antibiotics like amoxicillin?

  • Yes, but some antibiotics may have interactions with certain polyphenols.

Final Thoughts

Dr. Galland emphasizes that individualized treatment is key. Patients should listen to their bodies and adjust based on their responses to different dietary changes and supplements.

His approach to post-Covid recovery focuses on restoring gut health, reducing inflammation, detoxifying the intestines, and supporting immune resilience.

This presentation provides a comprehensive roadmap for managing Long Covid through gut health interventionsand advancing the understanding of the gut-brain axis in post-viral recovery.