I’ve also written a book about it: see my YouTube video for more.
What does your phlegm colour say about your health? And what does this mean from the point of view of Chinese medicine?
More important, what does Chinese medicine suggest you do about it?
I hope you’ll find this page useful, but if you want more information, a lot more!, I’ve written a book “Yuck! Phlegm!” about the best ways to deal with each kind of it, including an analysis of many of the different suggestions made elsewhere on the web: what works and what won’t work – and why it won’t work.
Vital Fluids eg Mucus
Your organic bodily fluids are vital for your health, in Chinese as much as in Western medicine. These fluids are the oil that keeps your body moving smoothly. They moisturise it, inside and out, they cool it, they carry nutrients to it and waste away from it.
So, to be pedantic, mucusis healthy, though we often use the word to mean phlegm, which is thicker and more chronic, appearing in your sinuses, throat, lungs and stomach.
Where are these fluids made? According to Chinese medicine, they start from your Stomach and Spleen energies – in effect, your digestion – working on what you eat and drink (not really so different to Western medicine!).
How they are filtered, purified and separated comes under other energy organs (zang-fu is the correct term), but they start with your Stomach and Spleen.
Your First Medicine! So … What went down your throat?
So what you put down your throat is your first step, for better or worse. As they say, ‘food is your first medicine’.
In Chinese medicine, you can sometimes alter the colour of your phlegm by eating different foods, if you go on for long enough. I don’t mean in the short-term, such as after eating something purple, like beetroot, you clear your throat and see your phlegm is purple: wait a few minutes or have something else to eat and your phlegm colour will revert to normal.
I mean that foods have energetic effects – which means some foods have a cold energy and some have a hot energy. Because these foods have different energies they’ll tend to produce different kinds – and colours – in your phlegm.
Equally, if you go on for long enough, you can often improve your phlegm colour with the right nutrition.
Often, but not always!
The colour of your phlegm depends on other things too, like what syndromes or factors are affecting your health in Chinese medicine. Two big factors are Heat and Cold.
How do Heat and Cold first affect you?
Heat and Cold affect your health by ‘invading’ you! Specifically, they enter by overcoming your body’s defences. In reaction, your body produces symptoms, which are its way of dealing with the problem.
They demonstrate where your body has put the problem: in particular, how far away from your vital ‘core’ it is maintaining the ‘dis-ease’.
Those symptoms are described in Chinese medicine according to a well-developed theory which goes back at least 3000 years, described in detail about 2500 years ago.
Chronic reactions take longer to develop and, being chronic, don’t easily go. That you have phlegm means – nearly always – that your condition is chronic. Why? To find out, you should read our page on phlegm. (Just some examples … it could be due to poor eating habits and nutrition, digestive problems or stress.)
Ongoing disease can do it too
Your body has a whole set of genetic or inherited templates to use when confronted by different diseases. They give it a huge range of options. Your symptoms show how your body is using its resources the best way it knows how.
Modern medicine has ways to ease the pain of these genetically inherited solutions, but if you read my page on Suppression, you’ll understand perhaps why sometimes you are better off allowing your body to deal with the problem its own way.
For example, if your body can clear the disease its own way, you don’t usually get stuck with what is called a ‘remaining pathogenic factor‘ which often follows the use of modern medicines like antibiotics.
Anyway, diseases (ie, your body’s best responses) can change your phlegm colour.
These diseases can be acute or chronic. Chronic means that your body has given up trying to expel the disease (an acute reaction being its first line of defence), and has been forced to allow the disease to penetrate inwards to a deeper level where, with luck, it can ‘hold’ it and prevent it going deeper.
But … this means it (ie you!) has to learn to live with it.
Acute diseases last a few days or, at most, weeks. Chronic diseases can last as long as you do, in theory, unless you get help and/or make a huge change in your life.
Where your phlegm appears from makes a difference.
It is normal and healthy to have saliva in your mouth – that’s a normal kind of mucus and isn’t ‘phlegm’: this is sometimes wrongly called ‘clear phlegm’, but there’s more on ‘clear phlegm’ proper below
your internal organs, muscles and joints are separated from one another by soft flexible sheets of connective tissue (‘fasciae’) that slide smoothly past one another via the presence of oily fluids: again, not phlegm – but body fluids. When these dry out, as in pleurisy, for example, you can’t breathe without inflammation and pain. Inflamed, arthritic joints often lack enough body fluids.
pus emerging from a spot or boil on your skin indicates a longer process during which your body has kept its problems on the outside – usually a healthy reaction, even if painful and unsightly. But this is not phlegm as meant on this page.
healthy vaginal fluids naturally change in colour and consistency through the menstrual cycle: not ‘phlegm’.
overnight, during sleep, the mucus in your throat and lungs may ‘cook’ slightly, thickening it and producing slightly coloured mucus which you spit out in the morning. That’s phlegm: ideally you shouldn’t have it. Its presence makes you potentially susceptible to more serious conditions because, for a start, its presence impedes the free movement of Qi in your Lungs. That reduces your energy – very slightly – making your immune system less effective.
thick, coloured phlegm which you cough up suggests to your doctor an infection and to your acupuncturist a syndrome such as Lung Phlegm Heat. For more about this see Cough.
NBThis page is mostly about phlegm from your lungs or throat or nose, although the theory applies to other body areas too.
The more energy your body puts into defending itself, the more ‘vital’ will be your symptoms, including your phlegm colour.
‘Vital’ means full of life, which in the case of phlegm colour means vibrant, not perhaps an adjective you’d use normally but
brightly coloured, either green or yellow or red, which usually mean your body is applying Heat.
The less energy it has to put into defending itself, or the more chronic its condition, the less coloured will be the phlegm:
white or clear phlegm colour usually means either an absence of Heat or the presence of Cold. It could also mean the lack of enough energy to do anything about it!
The longer it has been cooking, the darker will be the phlegm colour. So brown, even black, suggests a more chronic condition.
That brown or black phlegm might have been any colour before it cooked. However, just as when you leave a stew cooking on the hob for too long and find charcoal when your return to it, so has your body been cooking your mucus!
Brown or black is not a healthy phlegm colour. Long-term smokers often have dark phlegm, coloured by the soot in their lungs.
Do remember that what you have recently eaten may colour your phlegm: this discolouration soon disappears, however. It is harmless.
Darker phlegm colours mean that your body has had phlegm for some time. It is trying to clear it with heat, but, just as charcoal in your saucepan stuck to the bottom of the pan can’t be shifted by applying extra heat, so also with your body. Your body can only clear this black stuff by hawking it up and out. It’s hard to shift. Probably some remains.
Phlegm Colour is one thing. What its consistency looks like is another!
The denser the phlegm, either the greater the Heat applied to it, or the longer it has cooked.
Just like on your stove, if you turn up the heat on a soup you are making, it will become thicker. Or you could put it on low, forget about it, and then be reminded only too late by the smell of burning, at which point the fluids have boiled away, leaving just solids, which quickly carbonise.
So, thick lumpy or stringy phlegm has been cooking for longer.
The more coloured it is, the more Heat there has been in forming it
The less coloured it is, the longer it has been cooking or has been cooking without much Heat
If watery, it suggests what is called a deficient condition, possibly with the presence of Damp-Cold
If thick, it suggests either more heat, such as Damp-Heat, or a longer period of ‘cooking’. This is a more excess condition
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‘Rotten’ suggests Lungs-Heat, ie Heat in the Lungs, probably Lungs Phlegm-Heat, perhaps with Toxic Heat’ (Sorry – no page on this yet).
If it has no smell, then probably Cold predominates
If phlegm/catarrh is clear and watery: ‘clear phlegm’
This is a sign of Cold. What does this mean? One or more of the following might apply:
Your body’s Yang energy is low, specifically the yang of your Stomach and/Spleen, but, if you always have lots of clear watery mucus or phlegm, probably other Yang energies are low too, such as that of your Kidney Yang
Cold-Damp weakening your Spleen
Syndromes called such as Lung Phlegm-Fluids or Lung Damp-Cold, both of which in early stages produce clear phlegm, though later it becomes thicker and whiter
You have just eaten/drunk a lot of food/fluid that is cold to the touch, or has a cold energy
Why might you have clear, watery phlegm/mucus?
You are cold or have entered a cold environment
Recently you caught a disease to which your body responded not with heat but with cold: this is called an ‘invasion of Cold’, such as occurs with Wind-Cold
you have recently eaten or drunk more cold or iced food/fluid than your stomach can handle – see Cold Foods
In Western medicine, assuming other symptoms that help in diagnosis, you could have allergic rhinitis, or early stage bronchitis or early stage pneumonia. With the last two you’d also have a cough with the phlegm
Are you wearing enough for your environment?
You don’t take enough exercise to warm you up and burn away the cold
If you always have mucus that is clear and watery, ie chronic:
While growing up, you were often cold or wore too little
you have recently had an acute, exhausting, illness, exhausting both your yin and yang resources. This clear phlegm may continue until you recover. You should avoid cold foods.
as an adult, you regularly wear too little and are often cold
you are growing old and your energy is running down
perhaps you are vegetarian and never eat warm food, let alone meat and other foods classified in Chinese medicine as Warming
you are vegetarian and always eat food that is raw or classified as ‘cold‘
it is late in the day and you are tired
you don’t wear enough for your metabolism and circulation
What if phlegm colour is white?
White phlegm and sputum (especially if sticky) suggests not that you have great Yang deficiency, but that your Spleen and Stomach Qi are deficient. This produces, together with Kidney Yang deficiency, a condition called Cold-Phlegm’
Possibly you are eating too much sweet or dairy food (= from cows)
You may be eating too many very rich or fatty foods (although heating, these may hamper your Spleen energy from digesting food properly, so might not yet cause signs of Heat)
Probably your digestion is not receiving the respect it deserves …
… You may be eating too fast. Read Nutrition and reflect on how to eat in a relaxed, unhurried way, chewing well.
The white colour also occurs after taking antibiotics for an infection. Here the colour (which, from the infection, was probably yellow or green, being produced by your body’s Heat reaction to the disease) has been reduced or removed, but an underlying problem remains. (Thank heavens for antibiotics, they’ve save many lives, but we have been overusing them, so read Suppression.)
All these help to increase your body’s warmth, compensating for the coldness of the food. As your metabolism warms up it will produce less runny white phlegm.
White catarrh, like uncooked egg-white, is a step towards other forms of phlegm. It easily obstructs normal bodily processes and can become heated, leading to more highly coloured forms of phlegm (for example, yellow or green) with the additional problems they bring.
Try to clear white mucus before it changes to something worse!
What if phlegm colour is yellow or dark-yellow? eg yellow mucus or dark-yellow mucus
The phlegm colour yellow indicates Heat. It might be a lot of heat, or only a little. The thicker, more sticky, more colourful, stronger-tasting or more smelly it is, the more heat.
Where has this heat come from?
If from an acute infection – probably a form of Wind-Heat
in the lower part of your body, inferior to your belly-button, such as occurs in Damp-Heat in your Lower ‘Burner’
you also get yellow phlegm with bronchitis as your body reacts with inflammation, similarly with pneumonia and less seriously with sinusitis
Note: eating the sweet, sticky custard cake in the picture won’t help, not because it is yellow, but because it is heating. (And yes, I enjoyed it, with a coffee. But I was on holiday. Even so, my body reacted to it with some phlegm!)
What if the phlegm colour is purulent?
‘Purulent’ phlegm colour means containing pus. This may be yellow or yellow-green. The pus might contain blood, making it red.
Purulent phlegm colour is a step further down the scale from cold to hot, and indicates – if from the lungs – ‘Lungs Toxic Heat’.
What if you have green phlegm? – Green sputum – ‘green mucus’ and ‘dark green mucus’, ‘dark green phlegm’ and ‘thick green mucus’
Coughing up green ‘mucus’? Green phlegm colour is usually a warmer version of yellow phlegm.
But not always: it could just be older. It depends on the vibrancy of the colour. The more vibrant the colour the more it suggests Heat and an active Phlegm-Heat or Damp-Heat syndrome. By ‘active’ I mean developing, growing, like the ivy in the picture above. For example:
Western-medicine-diagnosed conditions include bronchitis, pneumonia, sinusitis and also cystic fibrosis.
Brown phlegm, sometimes called brown mucus: can be brown-green
As phlegm ages it goes darker. That your phlegm is not yellow, green or red means it is less acute, more chronic. With this brown or brown and green ‘mucus’ (ie phlegm) you have to accept that your body’s reactive powers are diminished. This stuff is older. So, besides whatever syndrome is diagnosed there is almost certainly some yang deficiency, probably being Kidney Yang deficiency and Spleen yang deficiency.
Possible Western-medicine defined diseases for brown phlegm include bronchitis, lung abscess, pneumonia and cystic fibrosis.
Red phlegm colour ie Rust-coloured sputum
A red phlegm colour contains blood. Escaped blood means either that there is excess Heat or, occasionally, that there is Yin deficiency.
Or both, as may occur, for example, in end-stage tuberculosis.
In Chinese medicine, it can occur with Heart Blood stasis or Lung Heat for various kinds of Western diagnosed conditions including pneumonia, TB as mentioned, and pulmonary embolism.
Black phlegm looks alarming!
I once helped my sister move house. I cleared the attic.
When building the house, the builders had put soot 10cm deep between the joists as insulation to prevent heat loss from the rooms underneath into the roof void.
In the dark, moving stored paraphernalia, I disturbed the soot particles.
I emerged looking like a coal-miner newly up from a deep mine. Some hours later I started coughing and spat out huge quantities of black sputum.
But several days later it had all cleared and my excitement diminished!
What did I learn from this?
Air pollutants can cause black phlegm
Smoking eg cigarettes
Dirt from industrial and chemical processes
Exposure to Fire and the smoke and soot it produces
Exposure to infection and your body’s reaction over time
One diagnoses infections because they come with other symptoms, for example of fever, malaise, tiredness and symptoms of the disease in question. Most such reactions are with Heat.
Tuberculosis produces symptoms of heat, darkening phlegm colour, and in time can cause bleeding – red phlegm. This red blood gradually darkens to black as it ages and thickens
Fungal infections in the Lungs produce symptoms of Damp, often combined with Heat. Eventually the phlegm darkens from the Heat, becoming blacker.
Cancer of the lungs or stomach leads to bleeding from Blood stagnation. As the blood ages it darkens so you find yourself coughing up black stuff.
Other infections, such as pneumonia, can lead to Blood stagnation, darkening Blood towards Black.
During Heart Blood stagnation, the heart valves may, in effect, be unable to push blood forwards into circulation. Some blood may find its way back to the lungs, causing Lung Blood stagnation. Here it may escape and need to be spat out, by when it will be black.
What about hard phlegm chunks, coughing up hard mucus, or dark pellets of catarrh?
If there is redness in or round them, probably your lungs are bleeding: see red phlegm, above
Otherwise, the fact they’ve gone hard means they’ve been there for some time, slowly losing moisture and hardening the original phlegm.
Fortunately, your body now has enough strength to cough them up. So they may be from a former illness, almost forgotten, now expelled by your stronger body.
To make sense of them read what is said above about Black phlegm.