2 years later:
I have been pregnant, which resolved the issues entirely. A solid ten good months post partum. One month, coinciding with return of menses not so great. Second month has bad bloating, bad fatigue after meals, and a UTI (second one in my life).
Niacin seems to help some of my issues. Circulatory issues run in the family. Several have Reynauds, high cholesterol, etc. I definitely feel better when taking it (keeps me from being frigid cold all the time). I had to start the ketoconazole shampoo again a few months ago due to itching. No thrush yet though. I stay on a probiotic now. Going to change back to bacillus coaguluns.
My official diagnosis last time was hormones leading to SIBO. Going to start on low dose pill and see if that resolves.