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Asthma/Constantly coughing up phlegm, not sure if this is asthma


QUESTION: I'm not sure if I have asthma or not, and don't worry, I'm in college now but once I get home, I'm going to a doctor to get this checked, but I kind of wanted an answer now, just so I understand what's going on.
The problem is that, for as long as I can remember, I've been coughing up phlegm. Not in an obnoxious, I have TB and I need to go to the doctor sort of way, I just feel something in my throat and I need to either swallow it or spit it out but swallowing it feels weird so I spit it out and its phlegm! usually clear, if I'm sick it might be a different color, but even when I'm perfectly healthy, no colds, no medications, no nothing, I have to spit up at least 5-6 times a day, it's getting kind of ridiculous.
I don't smoke at all, I've done hookah three times in my entire life so, there's none of that, I don't do drugs, and I don't really sleep that well, I've got a very stressful educational career so it keeps me busy. I eat as healthy as any college student can, and most of my exercise is comprised of running around campus to get from class to class, but my campus is in Pittsburgh so its full of hills, its definitely a work out to get from point a to point b. I'm originally from India but I've been living in central NJ for almost 12 years now, and the spitting up phlegm used to be an issue there too, this isn't something that's come up recently. I don't have any pets anymore, I used to have a guinea pig and sometimes I had a little difficulty breathing around him but I never said anything because it usually went away and he seemed to be the only animal that did that to me, I've been exposed to dogs, cats, gerbils, hamsters, guinea pigs, cows, pigs, etc etc etc all my life but just that particular guinea pig, sometimes when I was cuddling with him, it would get hard to breathe. I take no medicine, except for vitamin D pills and I've had absolutely no medical conditions, no allergies, or anything. But to be fair, I think difficulty breathing may be something that runs in my family, my mom says that even as an infant, I struggled with breathing, even opting to breathe out of my mouth instead, something I remember doing as a child as well. My father has similar issues, both of our noses get congested to the point where breathing is difficult to impossible, even though there's nothing else wrong with us, no colds, no sickness, in the absolute prime of health but for some reason, our noses are clogged and I keep spitting up phlegm. Someone suggested that this may be asthma and I wanted an experts opinion, does this sound like asthma? I'm getting tired of not being able to breathe as well and constantly coughing up mucus for no apparent reason so even if this isn't asthma, if you could guide me in the right direction, that would be greatly appreciated. Thank you

ANSWER: Hello Sheena,

    It sounds as if you have allergic rhinitis. Your response to your guinea pig gives a clue that yes you do have some allergy issues. With allergic rhinitis, you have increased secretions, dripping down the back of your throat, which will lead to increased mucus buildup in your lungs. You may want to enter your email and ZIP code address on a site called You could then watch for a correlation between elevated pollen & pollution levels, and if there's a change in your breathing.
    In the meantime, I'd suggest trying in over-the-counter antihistamine like Allegra or Zyrtec to see if they have any impact on your problem. If you see improvement, but it doesn't fully clear, the preferred treatment is a nasal steroid spray such as fluticasone. These are prescription products.
    With asthma, you could have tightness in the chest with coughing, and potentially waking up in the middle of the night with difficulty breathing. You typically would also wake up feeling fatigued since you would not have a good exchange of oxygen while you're sleeping at night. The only way to really verify asthma is by having lung testing done with a special tool called a spirometer. While increased mucus is prevalence in asthma, the other symptoms seem to be missing in your description. This is not to say that it couldn't further develop into asthma at a later point in time. Most asthma is due to allergies, and some people do develop it is an adult.

   Hope this helps you. Try the antihistamine, and if you have further problems or questions please feel free to get back to me.



---------- FOLLOW-UP ----------

QUESTION: Thank you, I'll definitely get some tests done to confirm. I had one other issue that I forgot to put in the previous email, I've noticed that the phlegm I've been coughing up for the past year or so has little black strands in it. I don't know what they are, and it's not like it happens all the time, but I'm a little confused because whenever I try to google what it could be, all I get back are results for chronic smokers and marijuana users, however I do neither of those things, and I live in the very clean part of pittsburgh, very little construction, and not a lot of smog or anything. And the area I live in NJ is suburbs, there are no busses, no factories, all just houses and vallies, so why do I have black in my phlegm??
Thanks again

Hi Sheena,
   My concern of what the black streaking is,  if you are coughing a lot, some small blood vessels may break, and the streaking may be due to the released blood. I spoke with a friend who is an infectious disease specialist, and said that this is not something of fungal or mold nature, and really without full information whether it's an infection, that would be something only determined by testing.

  Please, keep me posted.




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Marc Rubin, RPh Asthma Educator


I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.


Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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