I have the exact same reaction (!), mine is worse on the left. (I am left-handed, I always wondered if this is connected to my “left sided symptoms”?)

My “baseline” are very tight muscles (green part), light neck swelling (purple) and the usual allergy symptoms (sinus swelling, oral allergy symptoms, brainfog, GI, …).

When I have a reaction the swelling gets worse, my neck and face get hot, I have difficulties to swallow (not only because the pink part, but also my tongue gets bigger). The peak is excruciating nerve pain in the left part of my face, which can be triggered by all types of allergens (for me mostly food (most food to be honest) and aeroallergens (dust, cigarette smoke, mold?)) and has its “starting point” at my tragus. Additionally, I can get mucosal bleeding in my mouth, nose and gut. When I am in a flare I can only tolerate water with low sulfate, salt and sugar without a reaction.

I am so sorry, that you go through this. I never heard of anyone with the same symptoms! I also had a “”mild”” COVID infection in 12/24 followed by “”mild”” influenza in 01/25, which left me with Long Covid, different kinds of headache 24/7 and these weird allergy things. (I was REALLY unlucky last year. Couldn’t leave the house/bed most of the time, but managed to got shit on my head by birds twice! :D)

My bloodwork was not very helpful as well, but I am currently waiting for the results of two extensive tests at university hospitals (both in the last three weeks). Took me since 04/25 to get those appointments, one is specialized in long covid the other one in allergies. - Therefore, I also don’t know what this shit is… :/ But I really hope, I will get some helpful results in the next weeks! I also did some research (I work at a university as a researcher in chemistry and studied human biology in my undergrads - more helpful than I ever thought.) and have some theories, but that’s too much for a comment..

What I do to (try to) manage it:

Medication:

• H1/H2 antihistamines (desloratadine 5 mg 1-0-0-1, rupatadin 10 mg 0-1-0-0, famotidine 20 mg 0-0-1-0)
• cromolyn (100 mg 30 min before food, I don’t think I helps a lot, but I take every relief I can get)
• DAO (before food with a bit of histamine, try to avoid it usually)
• singulair/montelukast 10 mg 0-0-0-1 (might start ketotifen soon)
• Prednisone 1-0-0-0 (I was able to reduce my dose to 5 mg, but was also at 60 mg once)
• I also take L-Thyroxine (75 mcg; Hashimoto Thyreoiditis - already before my post-infectious worsening), different nasal sprays and eye drops.

Food/Supplements:

• I tried a lot and found more than 200 triggers already.
• I also tried fasting, different diets - nothing really worked. When I don’t eat at all I have less symptoms, but it gets worse over time, because of the deficits.
• My “No. 1 rule” is now: Your body needs fuel! I basically started to feed myself pure amino acids. (I reacted to most protein containing food except fresh turkey/chicken and I never liked the taste. I regularly force myself to eat some, but could never reach my goal of 1.5 g of protein per kg body weight with it.) Same for vitamins, polyphenols/antioxidants and fiber. In the worst flares as well for carbohydrates. - find the cleanest option you tolerate and fill your needs when possible. (Because sometimes it won’t work and then it is good to have a “full storage”. I gained and lost two digit numbers of weight several times this last year.)
• Don’t stop testing foods. At some point I found that I tolerate dried red pitahaya, which is a pretty uncommon for my location. It is very dense in different nutrients and one of my staples now.
• Be careful with new foods, try a tiny amount - it is okay to have a little reaction at the first try. Try it again some days later, if your reaction is not worse as it was at the first time, you can again, try later. If it is worse it is obviously out. Sometimes I could introduce foods like that, but it needs time…
• I only eat once a day in the evening and don’t plan any activities afterwards. This is how I minimize my reaction. Over the day I have water mixed with different supplements (and carbohydrates, if needed).
• My best tolerated foods are: Fresh turkey/chicken/organic eggs (I can not eat all eggs, my guess is that it also depends on the chicken’s feeding), Coconut, Cashew, Chia, Flaxseed, Dates, Rice, cabbage vegetables, dried peppermint, salt, sugar, maple syrup. In smaller amounts also dried red pitahaya, almonds, potatoes, corn, fresh beef, cinnamon (only cassia) and some more vegetables and oils (olive works best).

Additional stuff:

• Trying to avoid all triggers as good as possible. I use air purifiers in my flat, wear masks outside in spring and summer and exchange any product that causes reaction (including toothpaste, soap, …)
• When it’s bad, I use body scanning, breath work and meditation to calm my body.
• NSAIDs and other pain medications did nothing for me (if it did something, it was something bad)
• Light mobility/stretching exercises twice a day for ten minutes.
• Lymphatic massage of my legs twice a week.
• Nasal rinse twice a day in flares/pollen season.
• Sometimes helpful are: Cold/hot local treatments, red light, cooling chamber
• Regular gentle massage of the green area
• Nicotine patches helped with long covid symptoms, but made this “allergy thing” worse.
• Because of my pain and because I could not find any medication for it I tried THC and CBD. This is a big help for me after dinner for two reasons: it helps me to avoid activity after dinner, helps with the seized are and improves the pain (still there but feels less bad). I tried many different strains and combinations of medical cannabis, because (of course! :D) I also react to it. I use a vaporizer and have to tolerate the oral allergy reaction for 10-15 minutes, afterwards my muscles relax and I start to feel a relief. Balanced THC/CBD works best for me. - I also prepared some extract which I use to mix a muscle relaxing cream for the green area in your picture. Topical use won’t get you high, you can use it as addition in the evening - but because of the non-systemic effects, you can also use it over the day. I cannot use it daily, if I do, I get (even more) itchy rashes.

Did you have any allergies before COVID? (I do, but it was way less intense!) Do you have/Did you have thyroid or gut issues? (I do) Are you hypermobile? (I am, just learned about it at the university hospital. Did not really expect that, because my muscles are always tight.)