Long COVID gut trouble for 3.5 years, improved then relapsed after reinfection
- Condition
- Long COVID
- At worst
- Not stated
- Ill before improving or writing
- 3.5 years
- Last post
- Jun 2026
In their words
- Condition: Long COVID
My gut health was relatively poor beforehand, but a late 2022 Covid infection kicked things off in earnest.
In context ↗ - Now: Relapsed
a subsequent October 2025 Covid infection ... Everything has been different since then.
In context ↗ - Began after: COVID
a late 2022 Covid infection kicked things off in earnest
In context ↗
Read from 9 of their posts and comments; links to the 8 this page draws on
Summary
A late-2022 COVID infection started about 3.5 years of gut trouble, and the user reached a positive turning point in August 2025 after Xifaxan, Alinia, s. boulardii and PHGG. A late-October 2025 COVID reinfection wrecked those gains, leaving reactive nerve pain, s. boulardii-triggered flushing and itching, loss of the gut mucus layer and ongoing PEM. Careful eating helped only partly.
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What they tried
What they credit
Also tried
Their words about each treatment
- Xifaxan · Helped a lot
I experienced dramatic symptom relief with xifaxan + nitazoxanide pre-relapse
In context ↗ - s. boulardii · Helped
The positive turning point was in August 2025, when I took Xifaxan, Alinia, s. boulardii (9 billion CFU), and PHGG
In context ↗ - TUDCA · Helped
TUDCA helps--I notice lessened reactivity after a few days of taking it
In context ↗ - Vitamin D3/K2 · Helped
Vitamin D3/K2 (5,000IUs) also helps, but I've been taking it for too long now
In context ↗ - pomegranate peel + codonopsis (Researched Elements) · Worse
oddly enough, by pomegranate peel + codonopsis (Researched Elements) and cold-brewed chamomile
In context ↗ - careful eating (primarily vegetarian, low choleretic) · Helped
the symptoms do improve with careful eating (read: primarily vegetarian, low choleretic)
In context ↗ - high-fiber high-polyphenol smoothies (dragon fruit, acai, cranberries) · Helped
started drinking high-fiber high-polyphenol smoothies daily
In context ↗ - psyllium · Helped
I found both to be helpful in very small doses (1/8 tsp and 100mg, respectively) but irritating in higher concentrations.
In context ↗ - artichoke extract, inulin, dandelion, berberine · Worse
artichoke extract, inulin, dandelion, berberine...any choleretic 100% spikes symptoms
In context ↗ - undecylenic acid · Helped
The only antifungal I've reintroduced has been undecylenic acid, which usually helps (re: stress).
In context ↗ - nystatin · Not said
It's most common after a few days on a. nystatin, b. bismuth subsalicylate, c. a fungal-balancing probiotic (Dysbiosis AZ2, Researched Elements), or d. after taking/ingesting pomegranate.
In context ↗ - l. plantarum · Worse
I take l. plantarum, too, which sometimes causes itching, but doesn't seem to be as stimulatory.
In context ↗
Approaches: Antibiotics · Other drugs and medicines · Supplements
Their path
They say too little about how ill they were at each step to draw it on the severity scale, so the steps are listed as they describe them. Dates are when they posted.
| When | What happened | After |
|---|---|---|
| late 2022 | a late-2022 COVID infection starts gut and systemic troublea late 2022 Covid infection kicked things off in earnestIn context ↗ | |
| August 2025 | positive turning point after antibiotics and probioticsThe positive turning point was in August 2025In context ↗ | Rifaximin / Xifaxan |
| October 2025 | crashed after COVID reinfectiona subsequent October 2025 Covid infection ... Everything has been different since then.In context ↗ | |
| June 2026 | still struggling with reactive nerve pain and PEMI currently have PEM bigtime.In context ↗ |
Adverse events
- Probiotics and fermented foods“I feel terrific anxiety + doom, experience flushing in my cheeks/sinuses/face, and notice an itchy rash of deep red spots on my sternum ... deep muscle/nerve pains in random limbs” In context ↗ Side effects
- Probiotics and fermented foods“I take l. plantarum, too, which sometimes causes itching, but doesn't seem to be as stimulatory.” In context ↗ Side effects
- Probiotics and fermented foods“The nerve weather is \*worsened\* by bile / bile-stimulants; by probiotic species that adhere to the intestinal wall (i.e. s. boulardii + l. plantarum)” In context ↗ Nerve pain
- Artichoke extract, Dandelion (root, extract, juice), Berberine“artichoke extract, inulin, dandelion, berberine...any choleretic 100% spikes symptoms.” In context ↗ Made symptoms worse
- Chamomile tea“The nerve weather is \*worsened\* ... by pomegranate peel + codonopsis (Researched Elements) and cold-brewed chamomile.” In context ↗ Nerve pain
- “Since starting with higher polyphenol intake, certain symptoms (like stool formation, motility, bloat) have improved, but the pain has actually \*worsened.\*” In context ↗ Made symptoms worse
- Psyllium husk (Metamucil), Probiotics and fermented foods“I found both to be helpful in very small doses (1/8 tsp and 100mg, respectively) but irritating in higher concentrations.” In context ↗ Side effects
- Nystatin“It's most common after a few days on a. nystatin ... I often get strange body reactions (twitching in my right hand, for instance? weird)” In context ↗ Side effects
Symptoms mentioned
Their words about their symptoms
- Post-exertional malaise
I currently have PEM bigtime.
In context ↗ - Gut problems
rapid bile flushing/diarrhea
In context ↗ - Neuropathy & tingling
I'm still struggling with a strange, deeply uncomfortable symptom: nerve pain.
In context ↗ - Mast cell (MCAS) & allergies
experience flushing in my cheeks/sinuses/face, and notice an itchy rash
In context ↗ - POTS & dysautonomia
I experience mild dizziness from time to time
In context ↗ - Anxiety & low mood
I feel terrific anxiety + doom
In context ↗
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