Reviewed by Dr Jessica Gunawan and Physician Kwek Le Yin

Colours of Phlegm in Throat: What They Mean in TCM

Published January 13, 2023| 7 min read

You're probably aware that the colour of your phlegm is a tell-tale sign of your health and type of condition you might be experiencing. Here's what the different colours of phlegm indicate.

Woman with visible discomfort holding her throat with her left hand.

Contrary to general belief, it’s normal for the human body to produce mucus. The respiratory system is lined with gelatinous material to protect against allergens and harmful bacteria. As the mucus traps bacteria, viruses and other foreign substances that attempt to enter the body, it thickens and forms phlegm in your throat.

Certain types of infections will change the appearance of your phlegm. Find out what different colours of phlegm mean and the steps to get rid of phlegm naturally.

White Phlegm

The colour is a by-product of the increased production of white blood cells. Thick, white phlegm is a sign of congestion and infection onset. It may also indicate airway inflammation in people with asthma.

Traditional Chinese Medicine (TCM) associates white phlegm with a pathogenic Cold Impairing Yang (active energy) or a Spleen Yang Deficiency. Subsequently, it can lead to the accumulation of Dampness in the body and the development of this phlegm type.

Yellow or Green Phlegm

Sick woman in bed holding a cooling patch to her forehead with her left hand while looking at an ear thermometer. — A cough, fever, and dark yellow or green phlegm are signs of a severe infection.

Light yellow or green-coloured phlegm comes from the enzymes in white blood cells. It shows that your body is fighting off an infection.

Dark yellow or green-coloured phlegm, if accompanied by a cough, fever, or sneezing, is a sign of a worsening infection.

From a TCM perspective, pathogenic Heat depletes bodily fluids and causes your phlegm to become thick and yellow.

Scanty Phlegm

A dry cough with no phlegm is a clinical symptom of atypical pneumonia – an infection of the lower respiratory tract.

Tuberculosis onset relates to Dryness in the Lungs, which stems from a Lung Yin (passive energy) Deficiency. Consequently, your body may produce minimal phlegm that’s difficult to expectorate.

Brown Phlegm

Thick, gooey, and dark brown phlegm is a symptom of chronic lung diseases, such as cystic fibrosis or bronchiectasis. The former is a genetic condition that can lead to severe organ and digestive system damage. The latter widens lung airways which results in a build-up of excess mucus in the lungs, and you’d be more vulnerable to frequent infections.

The colour brown in phlegm can be attributed to dried blood and chronic inflammation. In addition, lung bacteria may induce gradual changes in the appearance and consistency of phlegm.

TCM states that phlegm turns brown when pathogenic Heat and Fire injure the Lung’s blood vessels.

Blood-streaked Phlegm

Also known as haemoptysis, streaks of blood in phlegm are tell-tale of various clinical conditions. These include:

Bronchiectasis
Pneumonia
Lung cancer

Pulmonary vasculitis: A group of fast-progressing diseases characterised by vascular inflammation and destruction, and necrosis of the pulmonary tissue
Pulmonary aspiration: an accidental inhalation of a foreign object or fluid into the windpipe or lungs
Pulmonary embolism: A blockage in one of the lung’s arteries
Lower respiratory tract infection

Blood-streaked phlegm is due to a Yin Deficiency where deficient yin fails to regulate yang energy.

Purulent and Foul-smelling Phlegm with Blood

Purulent phlegm is a thick, green, yellow, off-white, or opaque substance. It predominantly consists of large amounts of neutrophilic granulocytes – a type of white blood cell.

Anaerobic infections that develop from aspiration, lung abscess, and necrotising pneumonia may produce foul-smelling purulent phlegm. This phlegm type can also mix with blood and appear with a uniform or streaky red colouration.

TCM describes it as toxic-Heat phlegm. You’ll develop this type of phlegm when pathogenic Heat is not cleared from the lungs and it progresses to Heat Toxins (re du, 热毒) that result in the formation of phlegm with pus and which is foul-smelling.

Holistic Tips to Get Rid of Phlegm in Throat

A chronic battle with phlegm can be addressed with clinical and alternative treatments, thus preventing the substance from becoming a post-nasal drip.

Drink more water

A good rule of thumb is to drink water until your urine turns pale.

Similarly, it’s recommended to re-look at your use of medication. You should also limit your intake of dehydrating alcoholic and caffeinated beverages.

Use a humidifier

Woman holding a coffee mug in her right hand while looking at a laptop and sitting at a desk with a humidifier. — Humidifiers provide a continuous supply of moisture to the throat and nasal passages.

Cool-mist humidifiers are reliable devices for moisturising the throat and nasal passages while suppressing phlegm production. To loosen chest mucus, eucalyptus balm or essential oil can be added to a humidifier.

Use herbal formulas or ingredients

Before prescribing herbal remedies, a licensed TCM practitioner will identify the pathogenic factors behind your phlegm type.

“Formulas or ingredients with properties that contradict the cause of a phlegm type are the most suitable treatment options. For example, Cold-phlegm can be medicated with warm-natured bitter almonds (ku xing ren, 苦杏仁), while cool-natured loquat leaves (pi pa ye, 枇杷叶) and Tendrilleaf Fritillary bulbs (chuan bei mu, 川贝母) treat Heat-related phlegm. Be mindful that bitter almonds are slightly toxic and must be avoided by children,” explains Eu Yan Sang TCM physician Kwek Le Yin.

Likewise, herbal formulas may help tonify the Spleen and Lungs – the organ systems responsible for phlegm production and storage. These include Liu Jun Zi Tang (六君子汤）for phlegm produced due to Spleen and Lung Deficiency, Ding Chuan Tang (定喘汤), used for external pathogenic cold with internal phlegm heat, and Qi Guan Yan Wan (气管炎丸), both used for phlegm due to pathogenic cold. A formula called Cold Cough Hou Zao Chen Pi Mo also reduces phlegm production due to pathogenic cold.

It is advised to consult a TCM physician before taking these herbal formulas.

Undergo acupuncture treatment

Acupuncture helps eliminate phlegm by activating specific acupoints in an adult or child’s body.

Boosting qi (vital life force) circulation with acupuncture supports the dispelling of phlegm and strengthens the Lungs. For adults, the points that an acupuncturist may choose to work on are:

Fei shu is located 1.5 finger-breadths lateral to the lower border of the spinous process of the 3rd thoracic vertebra.

An illustration of a left hand, showing he gu (LI4) acupressure point — He gu is located on the back of the hand, between the 1st and 2nd metacarpal bones. It helps dispel pathogens and restores and enhances qi and blood circulation within the meridians.

In the first intercostal space, about 1 finger-breadth inferior to the depression below the clavicle and medial to the coracoid process.

Lie que is located on the radial margin of the forearm, superior to the styloid process of the radius, 1.5 finger widths above the transverse crease of the wrist.

Located on the outer end of the transverse crease of the wrist, where the radial artery pulsates. It dispels phlegm and Fire and revitalises Lung qi.

Feng long — Located on the shin, eight fingers-breadth below the depression of the knee joint, two fingers-breadth from the anterior crest of the shin. It dispels pathogens to improve qi and fluid circulation within the meridians and strengthens the stomach’s function.

Fei shu (Bl13, 肺俞)

He gu (LI4, 合谷)
Zhong fu (LU1, 中府)
Lie que (LU7, 列缺)
Tai yuan (LU9, 太渊)
Feng long (ST40, 丰隆)

Paediatric acupuncture can also be applied to the fei shu point. Other acupoints that may be targeted are dan zhong (膻中), nei ba gua (内八卦), and qing fei jing (清肺经).

Located 4 fingers above the belly button.

Located on the palm, around the Nei Lao Gong acupoint

Located on the palmar surface of the ring finger, from the palmar digital crease to the tip of the finger.

Take over-the-counter medications

Decongestants are available as orally ingested pills or nasal sprays and may help relieve swelling and congestion. Expectorants – a type of cough medicine – like guaifenesin can also thin mucus.

In some cases, you must refrain from trying to get rid of phlegm. Instead, you should consult a clinical healthcare provider promptly if you:

Cough up more than a few teaspoons of blood
Experience chest pain, dizziness, fever, light-headedness, or shortness of breath
Suffer unexplained appetite or weight loss
Have blood in your urine or stools

Knowing the different colours and types of phlegm in throat enables you to seek treatment promptly. It’s also good to discuss alternative remedies with a TCM practitioner. Doing so helps prevent contraindications if you also use clinical medications.