Too much phlegm!

Triathlon Forum
1

Doctors, armchair doctors, people who think they know too much, give me some guidance.

I’ve got a phlegm problem! Exercise makes it worse.
Often, I’ve got a little bit of phlegm stuck/built up in the back of my throat. Nothing too annoying. But when I raise my HR, it get worse and worse. After about 5 minutes, I’m hacking and spitting every 5 - 10 seconds. 5-10 ml a time, white sometime with a twinge of green. Pace doesn’t make any difference either - I can bike 12 MPH or 20, same issue, run 9 min/mile or 6:00, no difference.

Under no load, a pulmonary test shows I’m just fine. My doctor has tried a couple EIB meds (Albuterol then chromolyn), but they made no difference at all. I’ve tried cutting out dairy, again no change.

Anyone have an idea what to look at next?

2

Just cut back to a half a pack a day and you will be fine.

3

Just curious, what are the temperature and humidity like where you are?

No answer, but my throat fills up when it’s below about 8.C and slightly wet. Not anywhere as badly as yours does though, but it does reduce my breathing a bit and slow me down.

4

Temperature and humidity don’t seem to matter either.
It was 17F (-8 C) this morning, and it was constant. Pretty dry, no frost this morning
Over Xmas, I was in Virginia and ran when it was in the upper 70s (25 C +/-) and about 98% humidity - it rained 9 of the 10 days I was there, and same symptoms.

5

I’ve had a very similar thing, sometimes to the point of gagging. For me, it only ever occurs during morning sessions. Lunch time/evening are non-issues.

I’ve had moderate success with an antihistamine before a workout. A friend also recommended a big dose of vitamin-c. She does pineapple juice of a morning and claims it’s really helped her.

6

Are you sure the phlegm is from your lower respiratory tract (lungs, bronchi, trachea)? In this case you need to cough it out. If it is from the nose, sinuses or throat, you just need to “hack” it out…

7

Have you gotten an allergy test? I’ve worked with some in the past who have indoor allergies during the winter. Once the furnaces go full blast trying to heat things up the dust/particles that are floating around causes some people’s allergies to go nuts. You could be allergic to something wherever you work out and not even realize it. Maybe some really strong anti-histamines requiring a Rx are in order. Or not…you could give it a try.

Otherwise, may try a sinus cleanse on a regular basis…aka neti pot with the saline mix power. Sounds annoying but my sinuses most of the time produce quite a bit of mucus running or biking outside (or even inside at times). Outside I have gotten pretty good at the snot rockets…inside I try to keep tissues close by.

8

Doctors, armchair doctors, people who think they know too much, give me some guidance.

I’ve got a phlegm problem! Exercise makes it worse.
Often, I’ve got a little bit of phlegm stuck/built up in the back of my throat. Nothing too annoying. But when I raise my HR, it get worse and worse. After about 5 minutes, I’m hacking and spitting every 5 - 10 seconds. 5-10 ml a time, white sometime with a twinge of green. Pace doesn’t make any difference either - I can bike 12 MPH or 20, same issue, run 9 min/mile or 6:00, no difference.

Under no load, a pulmonary test shows I’m just fine. My doctor has tried a couple EIB meds (Albuterol then chromolyn), but they made no difference at all. I’ve tried cutting out dairy, again no change.

Anyone have an idea what to look at next?

If you’re able to rule out allergies, sinus, or respiratory issues, it could be acid reflux, or more precisely Asymptomatic GERD.

I have been dealing with this problem for the last six months, and it’s slowly getting better, but takes patience. Basically, even if you don’t necessarily feel the telltale “burn” in your throat from acid reflux, it COULD still be happening, and if your esophagus is damaged, it will secrete mucus to protect it from the encroaching acid. Exercise will worsen reflux, hence the response. You can try proton pump inhibitor such as Nexium, but most docs recommend a very restrictive diet - no red sauce, nothing spicy, no coffee ( or caffeine for that matter), no alcohol, no carbonated beverages, no fat, no dairy, no chocolate, etc. Diet change would probably result in quicker results, but I love beer, coffee, and spicy food, so I’ve been popping the purple pills.

Bottom line, talk to your doctor, or an ENT specialist, about it first.

https://en.wikipedia.org/wiki/Gastroesophageal_reflux_disease
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3661960/

9

I’ve dealt with chronic allergies, asthma and the like for my whole life. I basically ate antihistamines year round, and even supplemented with NSAIDS when those didn’t work. The phlegm symptoms you describe were so common for me I never even noticed them, as I assumed everyone has them. A few years ago I read Maffetone’s book and started watching what kind of stuff I ate more closely, and the less inflammatory stuff I ate (chips, candy but even more regular hi carb foods like rice, pasta etc) and the more vegetables, fish, olive oil etc that I ingested, the less of these symptoms I had. i’ve now been off all antihistamines, asthma puffers and the like for over a year without any problems. It’s really had a profound effect on my life.

10

Which Maffetone book specifically? I have been struggling for years with symptoms similer to yours. It started as just having difficulty in the colder months with breathing. Now I have mucus and trouble breathing year round. It messed with me pretty bad at IMLP this past year.

11

Phil Maffetone - The Big Book of Endurance Training and Racing. I actually bought it out of interest towards his coaching of Mark Allen and the 180 formula, but ended up being completely captivated by his stuff about nutrition. I suggest you take a look at the symptoms of what he refers to as “Carbohydrste Intolerance”. The insights I got from his book were 100x more valuable than all of the advice, aka medicine pushing, I’ve received from doctors over the years.

12

Thanks!