I have followed the world of vitamins, minerals, and herbs for decades. And one recurring criticism of these alternatives is that it constitutes “shotgun medicine.” That is worth discussing.
The implication from these critics is that there is usually one silver bullet which goes directly to the target, and someone has that bullet, and that people should be using that bullet and not wasting their time and money with so many alternatives. Sometimes that view is correct. If there is an acute infectious disease like MRSA, the best option is to treat that one type of bacteria with an antibiotic, and recovery typically follows. If a person’s appendix just ruptured, get them into surgery to repair it, and then deal with the infections that were probably started with the rupture.
The anti-shotgunners warn about the dangers of doing too many things; they are pretty quick to criticize anyone who takes more than a daily multivitamin. Strangely, they are less critical of polypharmacy and the fact that so many people are on 5, 10, or 15 prescriptions… and some of the prescriptions are to counteract the side effects of the earlier prescriptions. Maybe that isn’t shotgun medicine - the term “Rube Goldberg” medicine might be in order, in honor of the guy who built incredible complex contraptions.
But a silver bullet is simply not available for many conditions. While some diseases can be traced to a single factor that is possible to treat, many of the major health problems facing the westernized world are complex lifestyle diseases. Heart disease, for example, is the major killer across much of the world.
And what lifestyle prescriptions will a good doctor dispense to try to prevent or reverse heart disease? Start exercising. Lose ten pounds. Cut the salt, reduce saturated fats, get more fiber, eat more fruits and vegetables. Stop smoking, and reduce alcohol levels to rather low levels if you do drink. Get regular sleep. Control your stress. That isn’t one simple thing — it sounds a lot like “shot-gun” medicine. “Just tell me the one thing I need to do, doc, but don’t overload me.” Unfortunately, health doesn’t always work that way.
I’m not saying that there is no place for medicine to control cholesterol or high blood pressure. There are cases where that makes sense, there are many patients who absolutely should be on those medicines. My point is that there are a dozen things a person needs to be addressing if their goal is really to improve cardiovascular health. Maintaining health is not about one factor and a silver bullet, it is about doing lots of things.
In the case of Long Covid, I hope that something like a silver bullet is found. Maybe a simple and highly effective treatment will be discovered, and it will give people back their lives overnight. Bonus points if it has almost zero side effects, bonus points if it is affordable. But there is no guarantee such a therapy will be developed. Long covid starts from a single thing (the SARS2 virus) but that glitches up the human organism in many ways. Recovering from Long Covid might best be described in terms of cleaning up and repairing after a hurricane or tornado.
So if a person is deficient in Vitamin D, if they are low on zinc and magnesium, a reasonable supplement makes sense. Correcting these issues may not solve every problem. But they are worth doing - who wants multiple nutritional deficiencies? And other supporting therapies like amino acids, or herbs may be rational, even if they are not a silver bullet. And physical exercise, or singing to rebuild a body that has been deconditioned by disease may be appropriate and necessary. The mind cannot be ignored; learned limitations need to be unlearned, and attitudes that were reshaped by months of disease also may need to be addressed to return to normal health.
It is more likely that long haulers will get a variety of things that sorta help. And the road back will require work. It will require the body to adapt and regain function in many areas that are disturbed. Recovery is not a singular thing; it requires a variety of responses for different dimensions of health.