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.