Phlegm in my throat and post nasal drip after Covid

Iḿ so impressed by your persistence across the specialists, because seeing all of these will be a profoundly educational process even if it does not quickly result in a package of therapies that together address your cluster of symptoms/disorders.

And today, the lines dividing rheumatology, neurology, and immunology, for example, are starting to blur. One way in which this manifests is the emergence of the field of Functional or Mitochondrial Medicine. Practitioners in this field enthusiastically embrace the blurring of the lines, and if you were to work with one of these, s/he might, for example, see your whole picture as one of someone who has dysautonomia, which used to be considered a neurological disorder, but which, today, includes auto-immune tendencies, nutritional malabsorption disorders, and yet other classes of illness, some of which are hereditary. And the great news is that really good Functional Medicine doctors are not intimidated by hereditary disorders, because they are schooled in nutritional supplementation and other kinds of therapies that can compensate for heredity.

My pain-rehab doctor is actually cross-trained in Functional Medicine, but I think one can, today, find fully dedicated Functional Medicine practitioners in most regions. Have you seen the work of the UK naturopath Eric Overton, perhaps? He offers a massive collection of online materials designed to educate laypersons regarding functional medicine. In the UK, he is has been allowed to get certified in that specialty, whereas here, the norm is for M.D.s to pursue this specialty. I can tell you, though, that the levels of seriousness and talent across Functional Medicine practitioners in the U.S. varies wildly, but I do believe that if you got at least superficially familiar with Eric Overtonś materials and approach, you would be able quickly to spot who the good ones here.

Sjogrenś was ruled out, for me, by SSA- and SSB-negative tests, but I never had a lip biopsy or saliva volume test, probably because I never had dry mouth to match my severe dry eye. Ultimately, moreover, my Schirmerś tests spontaneously became nearly normal, and eventually it became very clear that the problem, for me, was my 0-second tear film breakup time (TBUT). My meibomians were shot, in other words. BUT BUT BUT, after 9 years of having to wear goggles or moisture chamber glasses (the latter are a MUST for people with low TBUT -- They help TREMENDOUSLY), I went into near-100 per cent remission of my dry eye (as a result of both the passage of time and reliance on one or another helpful MGD treatments). My dry eye came back in 2022, but by then, I had a brilliant optometrist on board, who got me through that flare with good old-fashioned Muro ointment and a non-IPL procedure to re-activate my meibomians.

Back to the main point, though: We have to think outside the box in order to make it to what will work as our care plans, in my view. Being outside the box may include working with a really good Functional Medicine doctor who also thinks outside of boxes and is in command of the already well-proven treatments for the various PIECES of an overarching dysautonomia diagnosis (e.g., cromolyn for mast-cell activation syndrome (MCAS), low-dose naltrexone for chronic fatigue and/or encephalic myalgia, B1 protocol for B1 malabsorption disorder or deficiency, cholinergic strategies for age-exacerbated disorders, etc.) Btw, I definitely have dysautonomia (with mitral valve prolapse syndrome) and at least one lab-confirmed autoimmune disease (Graves Disease -- now in remission). But to date, no one doctor is treating me as a whole person who has these 2 or more probably-related issues (along with my new ENT problem), because I haven´t yet found a Functional Medicine doctor who seems as skillful and well-trained as Overton. So I am temporarily resorting to self-help with input from my approving and compassionate primary care internist. But still, there may already be some progress. . .and my search for a one-stop healer will continue.

B12 is, as you know, difficult to absorb even sublingually from supplements, and thatś why, in refractory or severe cases, it is supplemented by injection. In addition, the dose you have been on is not near the maximum level available OTC, but your doctor will know exactly what to do to bring your level up and evaluate for the cause of the low level, if possible.

In a nutshell, I am finding that the more I look for a unifying cause for all the ailments that have plagued me, over a lifetime, the more optimistic I feel about getting past them all at some point. And don´t ever, for a minute, buy into the idea that itś important to avoid developing ¨false hope.¨ There is NO SUCH THING. Doctors, as laudable as most are, to date understand only a tiny fraction of what makes some of us sick. And they are stuck in algorithms that are paralyzing. As patients, we have tremendous potential to nudge our doctors to join us in thinking outside of boxes, and we should always favor only those doctors who are interested in being challenged and in challenging the conventional wisdom.

On your suggestion I am now taking Oral Cromolyn. Too soon to say if it's making a difference.

Mimioto, are you symptoms still better and are you still taking it?

I think it's important to take on empty stomach prior to eating. Eating lunch or dinner really triggers an immediate mucus response that takes around an hour to settle down. I hope that if I can remember to pre-medicate with Oral Cromolyn these symptoms will improve.

Thanks for taking my suggestion on cromolyn to address mast cell activation as a type of long conid and taking it a step forward.

Peter

Hi, yes I am still taking it. And yes from what I understand it binds to the first thing it comes into contact with so if that is food it’s wasted. On an empty stomach it will bind to the mucosal cells. I can say that I’m better now after two months but still dealing with upper respiratory, throat and head phlegm and congestion with some foods more than others but still in the process of narrowing down real triggers. Soy is a definite. Nuts except almonds. Skin allergy tests were crazy, indicating typical foods that don’t seem to bother me and negative on some foods that do. I never had allergies before. Yesterday I had an endoscopy and the doc biopsied 10 ulcers in my stomach and one in my upper esophagus. A week or so for those results. This is two years for me next month. I never had heartburn and it took me quite some time to convince doctors there really was a problem and that I had followed meds and diet instructions but it didn’t really matter what went into my stomach I reacted in the same way. Once it went into constant nausea I was taken a little more seriously.

I hope it can be resolved and I hope yours does too. Good luck to you. Thanks for following up.

I contracted SARS-CoV2 and had CoViD-19 in the spring of 2021. It was a hawaiian variant I was exposed to by a young child who had it. My whole family sat next to the child and her mother and spent a week in Waikiki quarantined. Its now 3+ years later and I still have phlegm in my throat (its actually very viscous and sticky clear (crystal clear) mucous, I have no other symptoms but this is very annoying and has formed a habit of clearing my throat. If I don't I feel like something is obstructing my airway. This is VERY VERY annoying to everyone around me. Has anyone solved this issue?

I didn’t have your version of covid, just regular variant, but I do have that phlegm issue. It’s concerning, frustrating, annoying and confusing.

Same here. Pulmonologist prescribed med after med and nothing helped. He then passed me off to the ENT who also prescribed med after med with no relief. Living with this chronic condition is so hard. There’s a never ending feeling of phlegm in my throat that just keeps replenishing when cleared.

While I am not cured of this phlegm in the back of my throat and slimy saliva, it's better after 2 years. I use 1/2 capsule of NAC supplement every other day (I find taking it daily is too drying to my eyes) and I also am taking a child's dose of Zyrtec at night of 2.5 ml. Antihistamines are helpful for long COVID and this saliva. IF I get any kind of upper respiratory infection such as sinus infection, this mucus picks up again in the back of my throat and the slimy mucus in my mouth worsens. I drink a lot of water as well. I no longer have to scrape my tongue every morning like before...only when I have a flare up from an upper respiratory infection. I use Peroxyl by Colgate, rinse and then scrape my tongue. This also helps to get the mucus out of the back of the throat. You do not gargle with it, just swish and rinse.

I was getting choked on this stuff at night. That is no longer happening.

I realize that you have to be careful with antihistamines as too much which can cause dental problems.

Praying for you all. I know how frustrating this can be.

I additionally have frequent runny nose. Just pours water a lot. My ENT prescribed a spray, but it’s drying. I also have dry eye that predates covid. So Zyrtec is not feasible. I’m going to consult with an allergist.

Same here - terrible for over a year - I call it the "Covid Slime." Docs don't understand what it is. It isn't asthma or any normal respiratory disease that they have defined. I tried absolutely everything over the past year. Here are the 3 things that have worked somewhat: 1. Carbocysteine 750mg by mouth 3 times per day (OTC in Israel/Ireland, Rx in EU, unavailable in USA/Canada) 2. NAC 1200mg/day 3. Nebulizing 1 gram Sodium Ascorbate dissolved in 10 gram distilled water (this one worked surprisingly well).

Can you please share which brand of acid-resistant serrapeptase you have tried? Is it the Enzymedica Immune Defense? I saw it had serrapeptase, but was hard to tell if it was acid-resistant. I already suffered from chronic sinus infections my whole life and dry eyes. COVID threw all that for a loop in addition to a slew of other side effects (severe PMS symptoms, worsened PCOS, increased migraines, chronic fatigue, etc.). I am dependent on Zyrtec-D to feel halfway decent.