Statins and Neuropathy in Long Covid

Scientific inquiry continues into post-acute sequelae of SARS-CoV-2 infection (PASC). Many practitioners are seeing patients suffering with Long-Haul or Post-Covid syndrome. 

Functional Medicine’s focus on bio-individuality provides an ideal lens through which to effectively address Long-Haul COVID.

Peripheral and central neuropathy are quite common in PASC cases – most likely as a result of the oxidative stress and damage that is a hallmark of COVID disease, affecting some individuals more than others.

You may be interested in this study exploring the pathogenesis of oxidative stress in Long Covid. And this review on the role of oxidative stress in COVID-19-induced mitochondrial and endothelial dysfunction. The authors conclude: 

“Oxidative stress has been suggested to play an essential role in the pathogenesis of COVID-19, and determining free radical levels in patients with coronavirus infection may provide an insight into disease severity. The generation of abnormal levels of oxidants under a COVID-19-induced cytokine storm causes the irreversible oxidation of a wide range of macromolecules and subsequent damage to cells, tissues, and organs. Clinical studies have shown that oxidative stress initiates endothelial damage, which increases the risk of complications in COVID-19 and post-COVID-19 or long-COVID-19 cases.”

Nerves are vulnerable to free radical damage that occurs in cases of excessive oxidative stress – especially because they are rich with mitochondria. 

Check out this video for insights on a clinical case featuring a 45-year-old male suffering from new onset peripheral neuropathy post-COVID. Several high-value interventions for this condition did not bring much improvement. But the addition of one more made all the difference: discontinuation of statin therapy.

The patient’s recent LDL level was 33 mg/dL, and the practitioner in this case knew of associations between low cholesterol and poor nerve health.

To explore this topic further, you may enjoy the following:

• This one for a look at the association of low cholesterol levels and diabetic polyneuropathy.
• And this review points out the possible paradoxical effects of statins. The authors state: 

“In animal studies, statins appear to reduce neuropathic pain but in humans, lowered cholesterol has been observed in association with increased neuropathic pain. Impaired mitochondrial transport has been implicated as playing a role in the development of neuropathy…”

Clinical PASC cases affirm a key principle of functional medicine:  for sustainable relief, we must identify and resolve the unique root cause dynamics at play in a specific patient’s imbalances in order to promote downstream relief and symptom resolution. 

I invite you to consider the possible role of medications in your patients’ and clients’ complex disease dynamics.  For other common imbalances at play in long-haul COVID, you might be interested in the following:  

• An exploration of Histamine’s role in long-haulers
• A look at how Tryptophan metabolism can go awry post-COVID
• A discussion on adrenal considerations in both acute and long COVID
• Considerations of how Zinc and Copper balance can become dysregulated