Phlegm in my throat and post nasal drip after Covid

@mikedod
Thank you!!!! I’ll try 😊

@ccbwell Really interested to know if it is helpful for you. I hope it is!

@rdt94 The constant junk in your throat is so terrible. Find a good laryngologist who is familiar with and treats LPR . Maybe Use AI to find the top one in your area. If this were me I'd tell them "I'd like to be evaluated for suspected LPR caused by post-viral vagus neuropathy." They can do something called a pH-impedance test that can definitively diagnose it. LPR is also called "silent reflux" because you don't feel it happening at all. The vagus nerve is also very important for relaxing you after a stressful event, so if that's damaged it's understandable that you're feeling a little more anxiety, etc. One thing that has helped me is something called coherent breathing. You can look it up on YouTube. See if you can find that doctor that is good for you and get that test. I'm doing this in a few weeks so I can have a definite answer.

@mikedod
Thank you!!!
Looked up Vagus Nerve & Covid. Now what I have experienced for the last 3 yrs. makes sense. I always thought the virus "screwed up"
something in my throat / respiratory system.

@lmr29
Sure thing! This has been a long journey for so many of us and doctors have been so completely clueless about what is going on, which has been really tough. One thing you can do is try reducing/completely removing acidic foods and drinks in your diet for a while. What happens is when you have a silent reflux event, the pepsin from your stomach that is inactive gets absorbed into the cells of your throat and stays inactive. Then, when you have foods/drinks that are even slightly acidic, the pepsin starts to activate and digest your throat cells! This sends them into alert mode for good reason and they create a ton of mucus.

Another easy thing to try is getting a tube of Reflux Gourmet on Amazon. Take one (or two) teaspoons after eating anything. It is natural and creates a physical barrier in your stomach that greatly reduces silent reflux events. You can take it as many times a day as you eat anything and then take it before bed. Try to notice if these things create any improvement over the course of about one week, and this will be a good indication that this condition, which I would call “Post-viral vagus neuropathy-mediated Laryngopharyngeal Reflux (LPR)” is playing a big part. Once you're diagnosed properly, there are medications that doctors can prescribe that will be helpful as well and put you on the path to complete recovery.

@mikedod May 06, 2026, thanks for that, I found the opposite -- if this info. helps anyone. Ph balance changes over time. Some do not have acid reflux, and acidic foods actually HELP. My ENT agrees with me. When I get phlegm that rises to the level of real bother, I drink about 1/4 cup of vinegar. Or cut up cucumbers and put vinegar on them and it it. Phlegm stops. Reflux medication did zero for me, counterproductive. Exercise and a lot of fluids also helps. AND, of course, weight loss.

Precious Folks, This thick phlegm in the back of my throat lasted 2 years after COVID. I got choked on it at night. I also had a lot of mucus on my tongue in the a.m.. I scraped my tongue daily. I went to 5 doctors and they were perplexed as how to treat this.

What worked best was, cool mist humidifier, salt water rinses, elevate your head when sleeping, stay hydrated with water, keep your mouth extremely clean with extra flossing and mouthwash, NAC (Thorne Brand on Amazon)....I only took a half one), Lemon Ginger tea is a mucus thinner. If you want to thin out the mucus, Guafenesin (Amazon) helps. I did not take the Guafenesin with the NAC as they are two different things. Guafenesin is a mucus thinner and NAC is for inflammation and works more like an antihistamine to dry up the mucus. Vitamin C, D & Zinc as well. Also, Astelin spray (Prescription) works great
as an antihistamine.

I came to the conclusion (along with my Dermatologist) that COVID had attacked the mucosa and my salivary glands.

Yes, I have GERD, so we had to bump up my reflux med as COVID did a number on that too.

I empathize as this stuff can be miserable. Praying for all of you that are battling this.

@anonymous620
Yea, if your condition gets better by eating or drinking more acidic things, I suspect it is not LPR.

LPR reflux is commonly NOT acidic in nature and many times gaseous like a mist, so many people (like me) don't even know it is happening, and they attribute it to respiratory symptoms (instead of the GI tract) because it often has onset after a respiratory virus like COVID due to vagus nerve damage. Unless you have perceptible reflux, GERD or the feeling of burning acid coming up, medications to reduce acid in the stomach - PPIs like Omeprazole, or even Pepcid (Famotidine) may do very little because the issue isn't acid in your stomach making its way up, it is often non-acidic pepsin making its way all the way to your upper throat.

I think LPR is pretty hard to diagnose definitively diagnose, especially because most GI doctors perform a pH impedance test only in the esophagus, and LPR reflux is often non-acidic, and needs to be detected in the throat. For LPR episodes to be detected, the probe has to have a sensor placed in the pharynx/hypopharynx and use HEMII-pH which is combined impedance and pH monitoring. I think this is the most accurate way to diagnose LPR. Visualizing the vocal folds via scope also gives some good indication of whether reflux is occurring. This article kind of summarizes the current situation in LPR diagnostics: https://pmc.ncbi.nlm.nih.gov/articles/PMC9181144/

I think the easiest thing that most people can try to self-diagnose at home is to order a salivary "peptest" that detects pepsin in the saliva, and you can just mail it back for analysis. Not as accurate a test as HEMII-pH, but much more accessible.

Bottom line, if pepsin is in your throat, acid will absolutely be detrimental, because pepsin is activated at pH 6 and below, and when it is active, it starts digesting proteins in your throat cells.