Phlegm in my throat and post nasal drip after Covid

I also have the same issue for 4 years now, have tried several things
Nasal spray with steroid, reducing milk, avoid gluten, antihistamine, lots of water, tea, nothing works
Interesting thyme video… will certainly give that a go

Hi all.

I have to start by saying I'm sorry that everyone is also experiencing this sensation and hope whatever is causing it can be treated! However, I've never tested positive for COVID, and not sure that I've suffered from it. Reading your comments makes me wonder otherwise now though. I do suffer with this globus sensation and it's driving me insane.

It started September 2024. I weighed ~225lb, randomly felt this "thing" in my throat and a week after I became pretty sick with upper respiratory virus or something. Ever since then, if I fall ill it lasts for weeks. By January 2025 I weighed 175lb. Fast forward to today, weight is 150, constantly have a temperature of 99-100 without nsaids (manageable with nsaids), dealing with globus sensation daily that makes it difficult to swallow, at times difficult to get a full breath unless I look up to straighten my airway and if not it feels like my head fills with pressure.

I'm still being dismissed by doctors. Yesterday, I went to a scheduled US on my neck, but they only checked my thyroid and the tech would only do what was ordered, understandably. My issue is higher up under my lower jaw. Does any of this relate to anyone here? I'm really struggling mentally and struggling to find any kind of relief physically as well.

Any and all advice is greatly appreciated!

@rdt94
Few things to try ( both thin the mucus so swallowing easier)
chewing gum (produces normal saliva)
peppermint oil (rubbed on temples - produces tears which helps mucus higher up)
applesauce (helps to swallow anything that might get stuck- learn as you go which food needs help)

@rdt94 Your symptom of the 'pressure' in your head caught my attention. I had the phlegm/drainage. After 2 years my diagnosis: blockage in the sphenoid sinus cavity and the left and right maxillary sinus turbinates. Phlegm was a thick yellowish drainage. When I bent over I felt like I was drowning. It took 2 MRIs and 2 CTs to find the issue. Blood T-Cell lab work confirmed my immune system continued to see the invasion of spike cells so it was in overdrive for 2 years sending in anti-bodies but they couldn't kill the attached spikes. Sinus micro-surgery stopped the phlegm. Now no pressure when I bend over and no 'long strands' of yellow tubes of infection when I irrigate the nasal passages. The sphenoid sinus drains the brain so there is about 2 gallons a day draining down the back of the throat and it was all thick yellow mucus. This material also tested positive for Covid but docs knew I was not spreading Covid. This drainage caused problems with my GI trac. Gastro Doc helped restore my immune system. Hope this gives you support for options.

I can relate to you. I had the same problem since 2020 when I contracted Covid. I drank so much liquid trying to wash it down. Coughing so hard my throat became so sore, it was hard to swallow. I was also getting alot of sinus and ear infections. After getting tired of steroids, antibiotics, variety of nasal sprays, I asked my PCP and Pulmonologist what else cold I do since the infections keep coming back so quickly. The suggested seeing an Allergist to see what I am allergic to and start allergy shots. While being tested for the multiple things, the doctor heard me coughing, and came in to talk to me.

After my exam and talking to me about symptoms, he suggested I see a Vocal Dr. He said he heard me straining to talk and my voice cracking. Come to find out, all my coughing strained my vocal cords. After meds from the Vocal Dr and finding out the long list of things I am allergic to, and starting allergy shots. The sinus draining, infections, coughing, and taking more multiple meds have stopped. I made it through the winter with just a little cold that did not last but a day or two.

You may need to see multiple specialist to find cause and relief. Don't give up stay strong and don't stop looking for relief.

@earthangel During my long Covid phase I was sent to various specialists, and it seemed like each one had a new pill I could take 'forever'. I saw an allergist, and he determined I was allergic to EVERYTHING - dogs, cats, house dust, wheat, conifers, molds... I used inhalers and Mucinex, one pill I don't recall -and Afrin ( that one off and on, it made my nose bleed).
All the other cough and sneeze-inducing things just disappeared pretty much when the other symptoms faded 2 1/2 years in. I personally think it was all driven by my gut being unhappy.
I can only tell you I now have no big issue, other than the 'house dust' reaction (our old carpet keeps that going). I think Covid left me with some lifelong reminder, besides taking 10 years off my life span.

@kako35 Despite being vaccinated 3 times, I've had COVID 7, yes, 7 times in the past few years. The symptoms between doses varied, between feeling like a bad flu to being totally wiped out & unable to function. I'm still extremely exhausted, have no energy for exercise, apart from swimming, & have a post nasal drip & a constant ball of phlegm stuck at the base of my throat. This in turn is causing me to wheeze & constantly cough, although I cannot seem to clear the phlegm. I wake up several times at night either coughing or snoring as everything gets blocked at night. I'm wondering if I'm getting sleep apnea now too, as I never snored or stopped breathing before COVID. I don't know what to do...but I'm slowly going crazy...& piling on weight as I just cannot find the energy to exercise. If coughing & blowing my nose, which takes a huge amount of energy & effort, counted as exercise, I'd be a few stones lighter. Can anyone recommend a course of action please? The country in which I live don't seem to have much information on Long COVID or lingering effects. Thanks

FINALLY A SOLUTION! I've commented a couple of times on this thread as I've dealt with this as well since late 2022. I have visited an ENT as well as pulmonologist many times, yet the persistent symptom of phlegm in my throat and mucus hyper production has been consistent. Tried everything on this forum with limited improvement. However, in the past three days I have had dramatic relief. If you have the means to afford the ingredients in this neti cocktail (the Manuka honey is the most expensive), I believe it is the game changer, at least for me. I think my culprit may be unresolved fungal or bacterial biofilm causing persistent local inflammation, goblet cell hyperplasia, and mucus hyper-secretion with hyper-viscosity, which this neti rinse obliterates! Disclaimer - if you are allergic to honey or bees, consult your doctor first.

Here's what I did:

In collaboration with AI, I made a "NETI-BOMB" solution that I use morning and night. Here is the recipe.

You will need a gram scale and some sort of sterile kitchen thermometer - Infrared thermometers work well.

First half - put directly in neti pot-
4 fluid ounces of room temperature distilled water
1 packet NeilMed sinus rinse with xylitol
7g NutriBiotic Sodium Ascorbate (Vitamin C) Powder
1/4 teaspoon NOW brand NAC pure powder
1/4 teaspoon Sodium Bicarbonate (baking soda)

Stir this together well - this will have a chemical reaction and will bubble a little bit.

Second half:
Microwave 4 fluid oz distilled water in a GLASS measuring cup to around 150 degrees F. - This is about 30 seconds in my microwave.
Stir in 1 level tablespoon high UMF (15+ or 20+) Comvita Certified UMF Manuka Honey.
Stir until fully dissolved 30-60 seconds.

Final mix and heat:
Pour the honey solution into the neti pot mixture and stir
Check temperature with a sterile or infrared thermometer.
If temp is below 98.6 deg. F (probably will be around 90 deg) Heat in very short bursts in the microwave until temp is close to 98.6 degrees F.

Rinse through nostrils/sinuses morning and evening daily.

The solution may sting just a slight bit, but this mixture seems to be adequately buffered with the Baking soda (bicarbonate) and comfortable for me.

Some important notes on why following this method exactly is important:

Xylitol, NAC, and Sodium Ascorbate can be damaged by high temperatures, and this method protects that from happening.

The MGO in manuka is the active agent and is safely heated to 150 degrees F for short periods. This method allows easy dissolution of the thick honey without overheating other ingredients.

I can finally eat again without food getting stuck in the back of my throat! I am also truly hoping for relief for all of you from this nightmare in slow motion! Let me know if you try this out and it helps you like it did me.

Read my post below if you are interested in the mechanisms involved and why this may work for you.

To clear days ahead,
Mike

Here's a quick rundown of why I think the above neti solution works :

Mechanism of each ingredient:

1. Salt (Sodium Chloride from NeilMed Packet)
• Role: Creates osmotic pressure and supports mucociliary clearance.
• Biofilm: Osmotic shock dehydrates bacterial cells embedded in biofilm, weakening the extracellular polymeric substance (EPS) matrix.
• Hypersecretion: Mildly stimulates ciliary beating, helping physically sweep away excess mucus before it accumulates.
• Viscosity: Draws water osmotically into the mucus layer, thinning it.
• Goblet cell (Mucus-producing cell) hyperplasia: Indirectly reduces chronic irritation that drives goblet-cell proliferation by improving clearance.

2. Xylitol from NeilMed packet
• Role: Sugar alcohol with strong anti-biofilm properties.
• Biofilm: Inhibits bacterial adhesion (especially Staphylococcus and Pseudomonas) by interfering with quorum-sensing and EPS production; also makes biofilm more porous so other agents penetrate better.
• Hypersecretion: Reduces bacterial-triggered inflammation that signals goblet cells to overproduce mucus.
• Viscosity: Lowers mucus viscosity by disrupting biofilm-mucin cross-links.
• Goblet cell hyperplasia: Decreases chronic bacterial signaling that upregulates MUC5AC gene expression in goblet cells.

3. Sodium Ascorbate (buffered Vitamin C)
• Role: Antioxidant and pH buffer, Improves Viscosity.
• Biofilm: Generates hydrogen peroxide in the presence of transition metals, which oxidatively disrupts biofilm matrix and kills embedded bacteria.
• Hypersecretion: Scavenges reactive oxygen species (ROS) that trigger inflammatory cascades leading to excess mucus production.
• Viscosity: Breaks disulfide bonds in mucin proteins via its reducing power and supports activation of CFTR channels in cells to increase water content in mucus making mucus less sticky.
• Goblet cell hyperplasia: Reduces oxidative stress and NF-κB activation (inflammation) that promote goblet-cell metaplasia and proliferation.

4. NAC (N-Acetyl Cysteine)
• Role: Potent mucolytic and glutathione precursor.
• Biofilm: Cleaves disulfide bonds in the biofilm EPS matrix, dispersing established biofilms and preventing new formation.
• Hypersecretion: Boosts intracellular glutathione, down-regulating inflammatory pathways (NF-κB) that drive mucus overproduction.
• Viscosity: Directly breaks the disulfide bridges that hold mucin glycoproteins together, dramatically thinning thick mucus.
• Goblet cell hyperplasia: Reduces chronic oxidative stress and inflammation that cause goblet-cell hyperplasia and MUC5AC overexpression.

5. Manuka Honey (MGO-rich)
• Role: Natural antimicrobial and anti-inflammatory.
• Biofilm: Methylglyoxal (MGO) disrupts bacterial cell walls and inhibits biofilm formation/adhesion; also prevents quorum-sensing.
• Hypersecretion: Suppresses local cytokine production (IL-6, TNF-α) that stimulates goblet cells.
• Viscosity: Osmotic effect draws water into mucus while MGO reduces bacterial contribution to viscosity.
• Goblet cell hyperplasia: Anti-inflammatory action (via NF-κB inhibition) limits chronic irritation that drives goblet-cell (mucus producing cell) proliferation.

6. Sodium Bicarbonate (baking soda – the buffer)
• Role: pH neutralizer and mild mucolytic.
• Biofilm: Raises local pH, making the environment less favorable for acid-tolerant biofilm-forming bacteria.
• Hypersecretion: Neutral pH reduces acid-triggered irritation of sensory nerves that reflexively stimulate mucus glands.
• Viscosity: Weakens ionic interactions in mucin gels, making mucus easier to clear.
• Goblet cell hyperplasia: Prevents low-pH-induced epithelial stress that promotes goblet-cell metaplasia.

Overall Synergy of ingredients:
Each ingredient attacks a different part of the biofilm-mucus-hyperplasia cycle:
• NAC + Xylitol + Manuka → direct biofilm disruption
• Sodium ascorbate + NAC → viscosity reduction
• All of them together → reduced inflammation that drives goblet-cell hyperplasia
• Bicarbonate → makes the whole mix comfortable (less acidic) without reducing its efficacy, so you can use it consistently.

For those techies wondering if the chemical reaction of the bicarbonate with the other ingredients renders them altered and less effective, it doesn't...here is what is happening:

NAC has a carboxylic acid group (–COOH) that can donate a proton (H⁺).
The simplified reaction is:
R–COOH (NAC) + NaHCO₃ → R–COONa (sodium salt of NAC) + H₂O + CO₂↑
• R represents the rest of the NAC molecule (HS–CH₂–CH(NHCOCH₃)–).
• The –COOH group loses its acidic proton.
• The proton combines with the bicarbonate ion (HCO₃⁻) to form unstable carbonic acid (H₂CO₃), which immediately breaks down into water and CO₂ gas — that’s the fizz you see.
• The thiol group (–SH) that gives NAC its mucolytic and antioxidant power is completely unaffected.
• The final product is simply the sodium salt of NAC, which is more soluble and actually the form used in many pharmaceutical NAC solutions

Manuka honey contains several weak organic acids (mainly gluconic acid, acetic acid, and smaller amounts of other carboxylic acids).
General reaction for any carboxylic acid in the honey (written as HA):
HA (acid in honey) + NaHCO₃ → NaA (sodium salt of the acid) + H₂O + CO₂↑
• Examples:
• Gluconic acid: C₆H₁₂O₇ + NaHCO₃ → sodium gluconate + H₂O + CO₂
• Acetic acid: CH₃COOH + NaHCO₃ → sodium acetate + H₂O + CO₂
• Again, the CO₂ is what bubbles out.
• The key active compound in Manuka — methylglyoxal (MGO) — is not an acid and is not involved in this reaction at all, so its potency is untouched.
• The enzyme glucose oxidase (which produces peroxide) is mildly heat- and pH-sensitive, but the short contact time and final neutral pH actually help stabilize the overall rinse.

To clear days ahead,
Mike

I have the same issue. I seem to think it is related to the vaccine. I never had this thick phlegm in the back of my throat until after I took the vaccine. I had Covid in 2019 and 2020 and did not take the vaccine until 2021 when I was going to go on mission trip out of country. My sister-in-law has the same phlegm problem. She is in health care and was mandated to take vaccine. Never had problem until after shot. My grandson who is cross country runner now has POTS. Dr. Says it is from covid. I believe it is from vaccine. Has there been any research done on the side effects of mrna vaccines?