Nikhil Prasad Fact checked by:Thailand Medical News Team Feb 14, 2026 2 hours, 30 minutes ago
Medical News: A remarkable new clinical trial has revealed that natural flavonoids extracted from cacao—the key ingredient in dark chocolate—can dramatically reduce chronic fatigue and inflammation in individuals suffering from long COVID. The discovery could represent a major breakthrough for millions worldwide who continue to struggle with persistent exhaustion, weakness, and poor quality of life long after recovering from the initial SARS-CoV-2 infection.
Dark chocolate flavonoids help restore energy and reduce chronic fatigue in long COVID patients
The study was conducted by scientists from Clínica de Especialidades Indianilla at the Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE) in Mexico City, the VA San Diego Health Care system in the United States, and the Escuela Superior de Medicina at Instituto Politécnico Nacional in Mexico.
Their findings provide strong clinical evidence that cacao-derived flavonoids may help restore physical function and energy in long COVID patients.
Long COVID Fatigue Remains a Major Health Burden
Long COVID is now recognized as a serious medical condition affecting a significant percentage of COVID-19 survivors. One of the most common and debilitating symptoms is chronic fatigue, which can persist for months or even years.
Scientists believe this fatigue is driven by ongoing inflammation, impaired mitochondrial function, and damage to the endothelium—the delicate inner lining of blood vessels. These disruptions reduce oxygen delivery and impair cellular energy production, leaving patients feeling persistently weak and exhausted. This
Medical News report examines how cacao flavonoids may help reverse some of these underlying biological disruptions.
Clinical Trial Tested Epicatechin Rich Cacao Supplement
The randomized, placebo-controlled clinical trial involved 46 adults with long COVID and chronic fatigue. The participants had an average age of approximately 52 years and had experienced fatigue symptoms for at least six months following infection.
Participants were divided into two equal groups. One group received capsules containing cacao flavonoids enriched with epicatechin twice daily for 90 days. The other group received placebo capsules.
Researchers evaluated fatigue severity, muscle strength, quality of life, inflammatory biomarkers, and markers of endothelial damage before and after the treatment period.
Fatigue Levels Dropped Dramatically
Patients receiving the cacao flavonoid supplement experienced a striking 51 percent reduction in fatigue levels. In comparison, the placebo group showed only modest improvement.
Participants also reported meaningful improvements in overall quality of life, including reduced breathlessness, improved mobility, and lower levels of discomfort and emotional distress.
These improvements sugges
t that cacao flavonoids directly target the biological causes of long COVID fatigue rather than simply masking symptoms.
Muscle Strength Significantly Improved
Muscle weakness is another common feature of long COVID. To evaluate physical function, researchers measured handgrip strength, which is widely recognized as an indicator of overall muscle health.
Patients receiving cacao flavonoids showed significant increases in muscle strength. In contrast, those in the placebo group showed little to no improvement.
This increase in strength suggests that cacao flavonoids may help restore muscle energy metabolism and physical performance.
Inflammation And Blood Vessel Damage Reduced
Blood tests revealed major reductions in key inflammatory markers, including IL-1β, IL-6, and TNF-α, in patients receiving cacao flavonoids. These inflammatory molecules are known to contribute to chronic fatigue, tissue damage, and prolonged illness.
Researchers also observed significant reductions in syndecan-1, a marker of endothelial damage. This indicates improved health and repair of blood vessel linings, which are essential for delivering oxygen and nutrients to tissues.
Improved blood vessel function likely plays a crucial role in restoring energy levels.
How Cacao Compounds Help Restore Energy
Cacao is rich in a unique group of plant compounds known as flavonoids, particularly flavanols. The most important of these include epicatechin, catechin, procyanidins, and oligomeric proanthocyanidins. These phytochemicals are powerful antioxidants and cellular protectors that play multiple roles in restoring energy and reversing damage caused by long COVID.
Epicatechin, one of the most abundant and biologically active flavonoids in cacao, has been shown to enhance mitochondrial biogenesis, which means it helps cells produce more mitochondria. Since mitochondria are responsible for generating cellular energy in the form of ATP, increasing their number and efficiency directly improves energy production.
Epicatechin and related flavonoids also improve endothelial function by increasing nitric oxide production. Nitric oxide helps blood vessels relax and widen, improving blood flow and oxygen delivery to muscles and organs. This improved circulation ensures that cells receive the oxygen and nutrients needed for optimal energy production.
Procyanidins and catechins found in cacao further protect mitochondria from oxidative stress and damage caused by inflammation. These compounds neutralize harmful free radicals and prevent cellular damage, allowing mitochondria to function more efficiently.
In addition, cacao flavonoids help preserve and repair the glycocalyx, a delicate protective layer lining blood vessels. Damage to this layer is common in long COVID and contributes to poor circulation, inflammation, and fatigue. By protecting the glycocalyx, flavonoids help restore vascular integrity and improve oxygen delivery.
These phytochemicals also suppress inflammatory signaling pathways, reducing the production of harmful cytokines such as IL-6 and TNF-α. Lower inflammation reduces tissue stress and allows the body’s energy systems to recover.
Collectively, these mechanisms improve mitochondrial efficiency, enhance oxygen delivery, protect blood vessels, and reduce inflammation—allowing the body to regain strength and energy.
Conclusions
The findings from this clinical trial provide strong evidence that cacao flavonoids, especially epicatechin, can significantly reduce fatigue, improve muscle strength, enhance vascular health, and lower inflammation in individuals with long COVID. By targeting mitochondrial dysfunction, endothelial damage, and chronic inflammation, these natural compounds help restore the body’s energy production systems. While further large-scale studies are needed, cacao flavonoids represent a promising, safe, and natural therapeutic approach that could transform the management of long COVID fatigue and improve recovery outcomes for millions of patients worldwide.
The study findings were published in the peer reviewed Journal of Clinical Medicine.
https://www.mdpi.com/1422-0067/27/4/1849
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