Long Covid Podcast 201 - Lily Spechler - Fuel Before You Fix
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Jan 21, 2026 Lily Spechler, a registered dietitian and long-hauler, shares her journey into long COVID nutritional care. She emphasizes that weight changes are more about metabolism than willpower. Lily discusses the importance of stabilizing blood sugar before making dietary adjustments. She highlights the risks of calorie restriction in worsening symptoms and provides practical tips, like adding 10–15% above BMR and using high-calorie, low-volume foods. Her insights on managing glucose spikes and prioritizing protein offer a fresh approach to long COVID care.
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Weight Change Is A Metabolic Problem
- Weight changes in long COVID are metabolic and not simply willpower or pure calories in/out.
- Cutting calories can worsen symptoms because the body responds to perceived energy scarcity by altering metabolism.
Blood Glucose Tied To Dysautonomia
- Dysautonomia often links tightly with abnormal blood glucose responses, even without food intake.
- Stress and upright posture can trigger liver glucose release, causing spikes then drops that worsen symptoms.
Glucose Spikes On Standing: A Client Story
- A client with type 1 diabetes showed massive glucose spikes upon standing before breakfast.
- This revealed that posture and stress, not food, triggered glucose surges in dysautonomia cases.