← Return to Phlegm in my throat and post nasal drip after Covid

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@mimioto

Cromolyn sodium liquid update; this is good news! Finally after cardiology, pulmonary, ENT, primary (repeatedly) and GI the most effective treatment by a huge long shot is the cromolyn sodium oral solution that was prescribed by a specialist in a clinic for from a specialist in ALLERGY/IMMINOLOGY (this even makes sense, why oh why did it take so long!). At my first appointment I, practically begging, said “you are my last resort, please help me”! In short she ordered a slew of allergy tests (nope I’ve never been concerned about allergies) and some bloodwork but the biggie was the rx for cromolyn sodium. Yes there are some allergies, mostly low grade, and they have little to nothing to do with my issues. Anything I eat has caused the severe reaction, acid reflux that H2 blockers and PPIs didn’t phase (and it took forever to diagnose because it was silent), the head congestion and chest phlegm, cough, chest pain etc etc., we all know these symptoms.

Three weeks of 10ml CS dissolved in water 4x daily on an empty stomach is simply WOW, it’s working!

It was the one guy (physician) who got in here and talked about the CS nasal spray , H1 & H2 blockers he trialed that seemed effective at first but not long term that got me going on this. Long COVID research indicates the mast cell involvement and my two systems, respiratory and gastric did seem to respond somewhat to ‘his’ therapy. But not entirely, not even close.

The immunologist listened and by the end of our first visit said “I think I can help you”. YAY! The feeling of hope … finally! Now getting the stuff was another story. 4 days on , woo hoo - fantastic results, then the availability problem, 4 days off, right back to square 1. Then 4 days on , 4 days off and finally the pharmacy got a better supply so 2 1/2 weeks of regular use and I’m thrilled. I’d say 75-80% cured! This in addition to H1 & H2 blockers, my faves are Benadryl for H1 ( even though she prefers either Claritin or Zyrtec (long acting), and cimetidine - Tagamet for H2. I have learned in the last week that I might even be okay dropping the H2 blocker after simply forgetting it a couple of times. Today I will consciously forget it and see.

So a FU last week with immunologist and an rx refill for 3 months. My Q to her was will this end or will I be dealing with it for life. And of course she could not definitively say. Some patients get over it and some are still relying on CS. Like I’m not the only one she’s treated for this? Amazing right? After all the other specialists treating me like I was either crazy or just not following their directives.

Hope this helps!

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Replies to "Cromolyn sodium liquid update; this is good news! Finally after cardiology, pulmonary, ENT, primary (repeatedly) and..."

I omitted some points. The labs she ordered were to ID or rule out MCAS: IGE and Tryotophase. Both were in normal range although she put in another order for tryptopase that I can do in the event of a flare up. This was at my request since I had the first labs done early morning and fasting whereas the problem intensifies following a meal.
She also gave me an rx for a different inhaler because symbicort took a major toll on my voice and it really was just not working for me. Too pricey to fill but she does think the stomach problem started first and caused the respiratory problem so that’s a wait and see situation and so far so good. Some phlegm but greatly reduced, very little cough, much less in chest and Benadryl takes care of the head stuff.
She gave me a preliminary diagnosis of mast cell gastritis. Basically those mast cells have been on a nearly 2-year partying spree. The cromolyn sodium is settling that party down!

Interesting, I have suffered with this for over two years. I started changing out things like toothpaste, stopping drinking my fav bourbon, and finally the type of coffee I drink. Lo and behold my symptoms have all but disappeared. I was fine before Covid shots. Don’t know if my body now considers some of the above as allergens. I’m just so pleased the heavy phlegm is gone. I also found that delta 9 brings it all back. I was taking that as a sleep aid. I know the above sounds simplistic- it was driven by total frustration that nothing was working. Just an fyi to this group.

So happy to hear that the cromolyn nasal spray recommendation put you on this track. I will now follow your lead and try the Cromolyn oral solution. I am currently still using the nasal spray as well as Claritin and Zantac 360 for H1 and H2 blockade. I will change to Zyrtec which is a stronger H1 blocker. Phlegm symptoms have improved but still present. My phlegm is also much worse after eating so I eat a very small breakfast and lunch so I can make it through the day talking to patients. I will also see an allergist. I have seen a long covid specialist with pulm background who also had not heard of this phlegm issue after covid.

You may find this article interesting which connects long covid with mast cell activation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166245/

I hope I have the same 80% improvement you have experienced and we can all get back to just enjoying life.

Peter